Hands up if you think these disease only really affect the young, the promiscuous or the gay population? WRONG. In 2015, although the under 25s still have more diagnoses of STDs, there were 28,113 cases diagnosed in people aged 45 to 64 years and this incidence is RISING! The under 25s have benefited from a variety of campaigns, often using social media. The National Chlamydia Screening Programme came in in 2003 for the under 25s. The incidence of STDs in the young is falling, in the middle aged is rising . Why should this be? Has our sexual behaviour all been swayed by Fifty Shades ? It seems the likeliest explanations are that those over 45 are much less likely to use condoms, the fear of pregnancy having passed, and are much less likely to tune in to the social media promotional material about STDs, believing these disease only affect the young. So take home message number one : STDs are no respecter of age or status. Your protection is up to you.
If you were asked to name to commonest viral STD what would you say ? Perhaps you would not know which are viral and which not ? The most important difference to understand is that viral infections, like the common cold, have no medical cure. Medications can control and suppress but ultimately cure is elusive. So whilst bacterial or bacteria like infections ( chlamydia, gonorrhoea) can cause devastating effects, viral infections like HIV, herpes and HPV hand around indefinitely. Genital warts, caused by HPV virus are much the commonest viral STD, responsible for one sixth of all diagnoses.
Vaccination against HPV started in England in 2003 and was offered to girls aged 12 and 13. All the publicity around the launch related to prevention of cervical cancer which is caused by HPV virus. We should be proud that we live in the first country in the world to bring in this vaccine. But we should be ashamed I believe that we are one of the last western countries to offer that same protection to boys and young men. Half of the cases of genital warts are in young men aged 20-24; they are unvaccinated. Many of the young women in this age group are protected from genital warts by the vaccine they had in their early teens. Until the Department of Health remedies this inequity; Take home message number 2 : Gardasil 9 vaccine is available for boys from aged 9 upwards in private medical setting. Please feel free to talk to one of our GPs about this if you have sons.
The number of cases of gonorrhoea and syphilis are rising although these 2 diseases are much more common in men who have sex with men, rather than the heterosexual population. For all of us it is important to understand why this is important . HIV is now understood to be a manageable problem and not a death sentence : consequently the fear which encouraged safe sexual practices has diminished and basically less condoms are being used in all the sexually active population. Both gonorrhoea and syphilis can have catastrophic effects. Strains of gonorrhoea have begun to emerge which are resistant to almost every antibiotic and this could soon become an untreatable disease. Once this happens, it won’t matter whether you are gay, straight, male or female. It will be life changing. Take home message number 3: changes in the sexual practices of other groupscan have a direct effect upon everyone. Once again, your protection is up to you.
So you may be thinking, well perhaps I have taken some risks but I don’t really want to head down to the STD clinic or my GP . Surely I would know if I had caught something?Absolutely WRONG .
Chlamydia causes 46% of all STDs yet 70% of infected women and 50% of infected men have no symptoms at all.
If you feel you have taken risks yourself with unprotected sexual encounters, or indeed that your partner may have done so, please seek advice, testing and treatment. Private GP Services offer a completely confidential service, as does the local STD clinic and your NHS GP.
Dr Jo Josson McConnell
Private GP
