Don’t second guess safer sex

Overall diagnoses of sexually transmitted infections were down last year, according to latest figures released by Public Health England, which show that there were 434,465 diagnoses in 2015, compared to 449,642 in 2014. However, this 3% reduction was in large part due to less chlamydia testing taking place among young people – 135,000 fewer tests than in 2014.

It’s really important that we don’t become complacent about preventing STIs. As well as differences in the number of people testing, STI statistics could start to reflect ongoing upheaval in the commissioning of sexual health services. We have heard about some clinics closing, opening for fewer hours in the day, or restricting appointments to just young people. It’s hard to know the true impact of this and how many people struggle to access testing services.

Looking more closely at the figures, it is also clear that some STIs are on the rise. Worryingly, the number of people diagnosed with syphilis at primary, secondary and early latent stages, increased by twenty per cent in one year. According to the PHE figures, 5,288 people were diagnosed with syphilis in 2015 in England, compared to 4,412 in 2014. Many people believe that this infection, which is fatal in its late stages, was wiped out in the UK in the Victorian era. In fact, it has gradually been reasserting itself, particularly among men who have sex with men.

Gonorrhoea, (commonly known as ‘the clap’) which has never gone away, also saw an 11% rise in new diagnoses. Men who have sex with men were statistically the most likely to be diagnosed with this infection, which is easily passed between people through unprotected vaginal, oral or anal sex.

The tests we now use for these infections are more sensitive and more likely to pick up infection, so we would expect to see more diagnoses because of better detection rates, but it is still a worrying trend. Now, more than ever, people need to be able to access clinics and specialist services.

It is also important that we continue to get the public health message out there that consistent and correct use of condoms can significantly reduce STI transmission. Anecdotally, there does seem to be a concern that some men who have sex with men are choosing not to use condoms for a variety of reasons including ‘message fatigue’ and a belief that condoms reduce sensation and are unreliable anyway. In fact, condoms are less likely to split or break if used correctly and if the man has chosen the correct size. Many new condoms are designed to give maximum sensation and can add extra pleasure to the experience.

Men who think they can guess the STI status of their partners (known as serosorting) by asking them about their sexual history and HIV status are taking a massive risk based on assumptions that may be false, yet we do hear that men are attempting to vet their partners in this way. It is not enough to check if someone else has symptoms since many people don’t have obvious signs of infection. Better to be safe than second guess when it comes to safer sex.