The rise in
Sexually Transmitted Infections..
Ireland has seen a big increase in
sexually transmitted infections (STIs) in recent years. The trend is related in
part to the economic boom, but also the fact that we have a young, very active
population. In addition, because Ireland has had a very mixed attitude to sex
education, attempts to provide clear facts to young people have been the
subject of repeated controversy and some resistance.
A few years ago, the Department of Health
launched a national awareness campaign, 'Think Twice Every Time'. Its aims? To
educate and inform 18-35 year-olds about their relationships and their
sexuality. One of the reasons for the campaign was the rise in the incidence of
Speaking at the launch of the campaign,
Health Minister, Micheal Martin, said that the Government was setting out to
achieve a major attitude and behaviour change.
"You can't run a fast campaign, toss
out a bundle of leaflets and hey presto, people suddenly manage their sexuality
differently", he said at the time.
Of course, such a campaign needs to be
carried out in a slow, measured and comprehensive manner. Unfortunately this
did not happen - funding for the project was discontinued after a year in
operation. Many aspects of the campaign, including a website, never saw the
light of day and today, the incidence of STIs here continues to rise. It is a
symptom of the lack of vision and understanding by some health authorities to
serious issues. But it also points to the fact that many people are not be
cautious in their sexual lives.
According to a recent report from the
Department of Health, the number of cases of certain STIs, including chlamydia
and gonorrhoea, have soared. The figures, covering 2000, reveal that of the 14
notifiable STIs in Ireland, ten had shown increases in the number of cases
since 1999. These include:
-Ano-genital warts: up from 3,049 cases in
1999 to 3,735 in 2000.
-Chlamydia: up from 869 to 1,343.
-Gonorrhoea: up from 175 to 290.
-Infectious hepatitis B: up from 2 to 15.
-Non-specific urethritis: up from 1,265 to
-Syphilis: up from 6 to 46.
While the messages about safe sex have
been heeded much more by homosexuals, with the threat of HIV-AIDS,
heterosexuals seem more complacent. The number of new cases of HIV rose by 22%
in 2002, compared with the previous year.
More up-to-date figures from the National
Disease Surveillance Centre (NDSC) show that the rise in STIs is a steady
According to Dr Sheila Martin, medical
director of the Irish Family Planning Association (IFPA), Ireland has a very
young population and a very sexually active one too. However this, she said,
did not mean that the rise in STIs can be blamed only on young people.
"The increase in STIs is right across
the board, so you cannot attribute this rise just to teenagers", she told irishhealth.com.
Hit and miss
However Dr Martin believes that education
is the key to reducing the incidence of STIs and that better information must
be provided in schools. It is an issue that the IFPA has been pursuing for some
time. The organisation believes that Ireland's approach to sex education has so
far been a 'hit and miss' affair, with the result that many young people reach
adulthood without a proper understanding of how their body works.
A recent study of teenagers in Cork found
that the risk of pregnancy is typically regarded as greater than the risk of
contracting an STI. Both STIs and pregnancy were generally referred to as risks
for others, not for the teenagers themselves.
Another study of teenagers in the Tallaght
area of Dublin found that around 50 per cent of those who request emergency
contraception, have had unprotected sex, while a further 45 per cent believe
that their condoms have failed.
Book launch controversy
In an attempt to tackle this issue, the
IFPA, in conjunction with the North Eastern Health Board, planned to launch a
serious of sex education booklets recently. But following complaints from a
number of people, including former Taoiseach, John Bruton, the launch was postponed
by the health board - a move which was heavily criticised by the IFPA. The
association was particularly critical of Mr Bruton's stance viewing it as very
Two of the books which came under
The four books were originally developed
by the British Family Planning Association, but had been modified for an Irish
audience. Mr Bruton said he was particularly concerned that the books did not
adequately deal with the age of consent. However the IFPA's chief executive,
Catherine Heaney, pointed out that one of the books states that it is against
the law for a man to have sexual intercourse with a girl under 17.
The book also advises that 'the average
age when both men and women have sex is now 17. Many wait until they are
"The IFPA firmly believes in
providing as much quality information as possible to assist young people in
making informed decisions about their sexual behaviour. To this end, we are
prepared to work with the NEHB to include a sentence in all of the books which
states the legal age of consent", Ms Heaney added.
The association believes that substantial
investment in a range of programmes is required in order to ensure more
responsible attitudes and behaviour among young people. Such programmes, it
argues, should include:
-School and community-based education
-The establishment of a national free
phone service and web-based sexual health and family planning service centre,
which would be staffed by trained family planning nurses and would operate at
least six days a week.
-Free access to sexual and reproductive
health services, including family planning.
Another area that needs to be tackled in
relation to the rise in STIs is the role of alcohol. According to Dr Martin,
alcohol 'is not totally to blame for the problem, however it does lower
inhibitions and people are more likely to forget to be safe'.
She said that it was important to get the
message out about the role of drink, particularly at certain times of the year
when alcohol consumption increases, such as Christmas, bank holiday weekends
and when people are on holidays. A number of GPs have reported an increase in
people arriving home from holidays abroad seeking STI checks because they can
not remember much about what they did.
But despite the Government's apparent lack
of direction on the issue of STIs, Dr Martin believes that many people
recognise the problem as being very important.
"Health boards and organisations such
as the Crisis Pregnancy Agency are taking it seriously and I believe there will
be a national sexual health strategy eventually", she said.
In the meantime, more facilities are
needed to deal with the rising incidence of STIs.
"Accessing facilities throughout the
country is a problem. For example, currently the waiting list for the STI
clinic at St James's Hospital in the Eastern Regional Health Authority is six
to eight weeks, that is unacceptable. We need more facilities", she added.
If you would like more information on
STIs, including screening, contact the IFPA at 01 - 474 0944