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 STIs.

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.

Campaign failure

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.

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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 1,726.

-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.

Trends

More up-to-date figures from the National Disease Surveillance Centre (NDSC) show that the rise in STIs is a steady trend.

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 conservative.

Two of the books which came under criticism

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 older'.

"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.

Alcohol

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 programmes.

-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


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