The rise in STIs

In the last few years, Ireland has fallen victim to a silent sexual disease
epidemic. More people than ever are becoming infected with sexually transmitted
infections (STIs) and health boards are rapidly reviewing and expanding their
STI clinics to cope with the ever-increasing demand.
Figures for sexually transmitted infections are gathered by the National Disease
Surveillance Centre, and the statistics for last year reveal just how prevalent
such diseases have become in Ireland today. Over 7,200 people were found to
be infected with some form of STI other than HIV last year, of whom less than
half were in the greater Dublin area.
Genital warts
The most common complaint was anal or genital warts, which was found in over
3,000 people. A further 1,300 people were treated for urethritis, a micro-organism
based infection that causes burning pain when passing urine. Genital warts are
caused by the HPV (human papilloma virus) virus, which has been implicated in
helping to cause cervical cancer. Over 1,000 people were treated for chlamydia,
which can cause infertility if not caught in time.

Alcohol or illicit drugs
are usually involved when people catch an STI - they lower inhibitions and cloud
one's ability to judge safe sexual activity from irresponsible sex.
While the most serious STI infections were relatively uncommon, they still
showed a sharp rise on previous years. More than 200 people were found to be
suffering from gonorrhoea, known colloquially as the 'clap' and 35 people were
treated for syphilis, which was all but eradicated only a few years ago.
In the mid-Western Health Board area, there has been a huge increase in both
the number of people attending an STD clinic and also the number of people diagnosed
with an infection. Last year, over 5,600 people attended for STI treatment in
the region, compared with under 1,400 in 1995. The director of the STD clinic
at the Mid-Western Regional Hospital in Limerick, Dr Catherine O'Connor, reported
that this year has seen an increase in positive diagnoses of 40% on 2000.

Ireland's most common
sexually transmitted disease - genital warts. Over 3,000 were diagnosed last
year alone. They can be treated, but they are always likely to return as there
is no cure.
No symptoms
Dr O'Connor is particularly concerned about the rapid rise in chlamydia among
women in the area. Known as the 'silent infection' because half of infected
men and 80% of infected women experience no symptoms, the bacterial infection
can lead to a raft of serious difficulties. Chlamydia is simply treated with
a course of antibiotics, but can cause prostatitis in men and ectopic pregnancy
in women if left untreated.
"The chance of a patient becoming infertile is increased by 13% following a
first episode of chlamydia, with the percentage rising to 75% for a third and
subsequent episode", Dr O'Connor explained. She is now heading a study to examine
the prevalence of the disease in Limerick, Clare and Tipperary, the first such
study undertaken in Ireland. With the co-operation of GPs from the region, she
hopes to establish the true extent of the disease in the mid-Wes, and use the
information to develop programmes to tackle its spread.
The Mid-Western region has also seen an alarming rise in the incidence of genital
warts. New research also suggests that there may be a link between chlamydia
and cervical cancer too.
Rise in female cases
People in the North West can avail of STI services at Altnagelvin hospital
in Derry as well as a clinic at Sligo General hospital. The region's clinics
saw a 17% increase in the number of people attending, a rise similar to that
seen throughout the country. Of particular concern in the region is the fact
that most attendees at the area's clinics last year were women (55%) and the
majority were young - one in five were teenagers. The NWHB is now undergoing
a review and expansion of its STI service in the hope that the message of safer
sex can be got across better to young women in particular.
The Southern Health Board was the first health board to appoint a sexual health
promotion officer as part of its health promotion strategy, but the safer sex
message continues to fall largely on deaf ears. In the SHB area the rise in
STIs led last summer to a second clinic opening at Tralee General Hospital to
complement the work of the existing clinic at Cork's Victoria hospital.
HIV/AIDS
The SHB clinics report a year on year rise of attendances going back to 1995.
Over 5,000 patients were seen in the region last year, a figure set to be greatly
exceeded this year, the first full year that the Tralee clinic has been in operation.
Special attention in the region is being paid to HIV/AIDS, which is becoming
increasingly prevalent in urban areas. Last year maternity hospitals in the
area introduced an antenatal HIV screening service because of the increasing
numbers of pregnant women who were infected with the virus.

A pubic lice clinging
to a hair.
So what can actually be done to counter this tide of sexually transmitted disease?
Quite rightly, healthcare workers see it as preventable. Sexually transmitted
diseases are the price we pay for being irresponsible when we are sexually active.
Sexually transmitted infections are passed from person to person during sexual
activity, when the bacteria or virus that contains the bears the disease is
transferred from one partner to the other in blood, semen or other body fluids.
STIs are sexually transmittable only - all the misplaced fear in the 1980s
over getting AIDS from toilet seats or swimming pools is equally ridiculous
when applied to any other STI. They are transmitted by any sexual contact, whether
oral, anal or vaginal, that does not involve barrier protection.
Condoms
The pill might help if avoiding pregnancy is your aim, but it is of no use
whatsoever in blocking the transmission of an STI. Only condoms have been demonstrated
to prevent the spread of STIs during sexual contact. It is likely that most
health boards will now invest in more public health information about safer
sex, in the hope that more people will use condoms when they go to bed with
a partner. Currently, given the numbers pouring through STI clinic doors, it
seems that even the fear of catching AIDS (also on the rise) has not stopped
people from having unsafe sex.
HIV/AIDS is undoubtedly the most serious of all STIs, as it remains incurable.
HIV/AIDS can, however, be treated with antiretroviral medications and HIV positive
people can live lengthy and relatively healthy lives today. Other STIs do not
pose the same degree of threat to personal health, but that does not mean that
they cannot cause both pain and embarrassment, not to mention long-term health
problems.
Insanity
Syphilis, for example, can actually lead to both insanity and death if left
untreated for a long period of time, whereas herpes, once caught, never fully
goes away. There is currently an outbreak of this once historical illness in
Ireland, predominantly among gay men, though heterosexuals have also been affected.

Second degree syphilis
causes unsightly lesions on the body.
Other STIs can cause damage to reproductive organs, affecting one's ability
to have children at a later date. Infertility, ectopic pregnancy, chronic pelvic
infections and infections in newborns are only some of the possible complications
that can arise if an STI is left untreated.
Of course, abstaining from sex is the only guaranteed method for avoiding infection
with an STI. However, by practising safer sex, you can cut the risk of becoming
infected. Anyone who is sexually active and not in a monogamous, strictly faithful
relationship, can become infected. Using condoms that prevent the sharing of
body fluids cuts down the likelihood of cross-infection, but occasionally they
do fail during use.
Equally, the more irresponsible one behaves sexually, the greater the chance
of becoming infected. Sleeping with a new partner is like sleeping with everyone
they have ever slept with. Unprotected sex with a variety of partners will not
only inevitably lead to an infection at some stage, but also leaves one at great
risk of contracting HIV. Unfortunately, most STIs are not as immediately evident
as, for example, the measles. In fact, a person can be infected with some STIs
for a matter of weeks without experiencing a single symptom.
Tests
It is not possible to judge whether a person is infected with an STI by sight
- it requires medical testing, which is why it is safest to take precautions
when having sex. Your lover may not even know themselves if they have an infection.
As it can be difficult to detect an STI infection sometimes, it is important
to act whenever an obvious symptom does develop. You should attend your GP or
local STI clinic if you ever notice:
- An unusual discharge from your penis or vagina
- Pain when you urinate
- Sores or blisters in the genital region
- Pain during intercourse
- Blood in your urine or faeces
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