- Sexually transmitted diseases are rampaging through the
UK unchecked as a new generation of young people, who missed the Aids scare
of the 1980s, fail to protect themselves by practising safe sex.
- According to a report published yesterday by the British
Medical Association, sexually transmitted infections, which include HIV/Aids,
gonorrhoea and syphilis, have soared by almost 300,000 cases between 1995
and 2000. The consequences can be devastating. Those who become HIV positive
may not die but are condemned to a lifetime on toxic drugs, while thousands
of women who unknowingly contract chlamydia, which often has no symptoms,
- In the 80s and early 90s sexually transmitted infections
dropped dramatically as young people reacted to the government's "Don't
die of ignorance" campaign, featuring the now notorious iceberg and
tombstone images. But, says the BMA, the group most at risk now - aged
18-24 - are too young to have seen the adverts or been impressed by the
dire message. Many no longer fear HIV/Aids because of the arrival of the
antiretroviral drugs that keep people alive - even though there is still
- Vivienne Nathanson, the head of science and ethics at
the BMA, said there was a need to alert people to the dangers of their
sexual behaviour. "I don't think we need a return to things that are
overtly designed simply to scare, but we do need to have systematic education
of the public," she said. "We need to look at whether we need
a national coordinated education campaign. We need to break the complacency
that seems to have arisen."
- But although the BMA concedes the government has made
a start, by drafting a national strategy for sexual health which will include
an element of campaigning, James Bingham, a consultant in genito-urinary
medicine at Guy's and St Thomas's hospital in London said the £47.5m
over two years pledged to implement the strategy was nowhere near enough.
He and colleagues had calculated that it would cost £250m just to
modernise GU clinics around the country.
- "Very considerable resources are going to be needed,"
he said. Some clinics were under such pressure that they were having to
make people wait more than a week to be seen, which was unacceptable, he
said. He was in favour of people whose sexual behaviour might put them
at risk going for regular check-ups at the clinics.
- Paul Martin, sexual health programme manager in Brighton,
where gay men have been encouraged to go for six monthly sexual health
"MOTs" because of an outbreak of syphilis, said their clinics
were now "bursting at the seams".
- Dr Bingham said he was surprised that the government
strategy had not come jointly from the health and education departments,
because it was vital that children should be taught about safe sex in school.
"We have a Danish medical student in the clinic at the moment,"
he said. "She says she is stunned at the lack of knowledge and the
embarrassment of young people here over sex. At the school she went to
they were throwing condoms around the classroom at the age of five. It
wasn't seen as anything special."
- Dr Nathanson said she thought sex education could begin
in schools as young as seven, if it was done carefully. "We need to
start before people have sex. The education needs to be terribly sensitive.
Not all 12-year-olds are sexually active, but some are."
- The public health minister, Yvette Cooper, said: "The
rising rate of sexually transmitted infections is an undoubted public health
concern." The sexual health strategy would include a campaign to begin
in the autumn aimed at young people which would build on the successful
work - in schools and out - of the teenage pregnancy strategy.
- During 1999 teenage conception rates in England fell
7% amongst the under 16 age group and 4% amongst the under 18s. "Although
these are complex problems the work of the teenage pregnancy strategy shows
it is possible to make a difference," said Ms Cooper.
- Infections on the rise
- Gonorrhoea has always been with us - it was described
by the ancient Egyptians and mentioned in the Old Testament. Antibiotics
and fear of Aids brought it under control at the end of the last century,
but according to the public health laboratory service, between 1999 and
2000 cases rose from 15,984 to 20,663 in the UK.
- It is caused by the bacterium Neisseria gonorrhoea. It
has an incubation period of two to seven days and can be transmitted to
partners before the symptoms appear. Antibiotics usually lead to a complete
cure. In women there may be no symptoms. The bacteria affects the cervix
and infection may spread to the fallopian tubes, causing pelvic inflammatory
disease. If it is untreated scarring on the tubes can lead to infertility.
- Caused by the bacterium Treponema pallidum. The first
manifestation is the appearance of a chancre - a hard, painless ulcer -
at the site of the infection between 10 days and three months after it
has occurred. This may go unnoticed, healing without treatment several
weeks later to leave a scar. But the infection will have spread. Two to
four months after infection a non-irritating but widespread rash appears
on the body.
- The infection may then appear to disappear, but the infected
person can still transmit syphilis for about four years. About a third
of those who are untreated develop serious disease which can involve the
brain and spinal cord or the heart and blood vessels, leading to disability
and even death. The babies of pregnant women with syphilis may miscarry
or be stillborn.
- The most common bacterial sexually transmitted infection
in the UK, yet few know they have it. There are often no symptoms, particularly
in women. The infection causes inflammation of the cervix and can lead
to pelvic inflammation. Left untreated it can cause scarring on the tubes
- Human immunodeficiency virus attacks the immune system.
The infected person may have no symptoms for 10 years or more, but they
will infect sexual partners and anyone with whom they share a needle. Women
can also pass the virus to their babies. Sufferers may have an initial
mild illness and may then appear well until the immune system is so undermined
that they cannot resist other infections and tumours develop. Without expensive
drugs they will die. New infections were up from 2,761 in 1998 to 2,942
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