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Sexually Transmitted Diseases on the Rise in the UK

Jun 13, 2008
Sexually transmitted infections (STI's) are rising rapidly in the UK and Sexually Transmitted Infection Clinics (or Genitourinary Medicine GUM Clinics) are finding it difficult to keep up with demand despite recent increases in NHS funding in the UK. Chlamydia and gonorrhoea are amongst the commonest STD's.

Young women are at increased risk of acquiring these. In particular, women between the ages of 15 and 25 are probably most at risk. Chlamydia is especially common. Very sensitive and easy to use self testing is now possible. These use the new NAAT technology allowing young women either to take vaginal swabs themslves or to collect a urine sample. The lack of embarrassment these sampling methods are associated with increases the chances of successful screening. These new methods of STD testing are proving to be exceptionally useful in the fight against Sexually Transmitted Infections as illustrated by this article in the New York Times recently. It describes the use in gay males but the principle is applicable to all. Check it out by looking up the Health Section in the New York Times.

A significant problem with chlamydia is the high rate of asymptomatic infection - ie people who have chlamydial infection and do not know it. Figures as high as 70% in women have been quoted by some authorities. Men also may have asymptomatic infection with up to 50% of males not knowing they have chlamydial infections. A further complication is that chlamydial infection may remain dormant or latent for very long periods of time and so it is appropriate for patients when they do receive a diagnosis of chlamydia to warn all recent partners that they need to be screened. Consequently, it is really very important that people with different partners are regularly screened even if they do not have symptoms. In addition, people who stray outside their regular relationship and "play away from home" should always get checked before they have sex with their regular partner again. Chlamydia may infect the throat, vagina, anus and also penis and all should be screened if they are used as sexual sites. If chlamydia is diagnosed then treatment with doxycycline or azithromycin is the treatment of choice.

Gonorrhoea may also be without symptoms in many men and women and so should be routinely screened for in routine Sexually Transmitted Disease (STD) checks. For both men and women, urine samples using NAAT technology are appropriate tests. For either sex, obtaining a sample of gonorrhoeal discharge if present, is very helpful in terms of identifying which antibiotic might be best to use. Again, gonorrhoea may affect the throat, vagina, anus and penis and all of these sites should have samples taken from them to rule out infection. If gonorrhoea is diagnosed then treatment with cefixime of ceftriaxone is the treatment of choice in the UK. Ciprofloxacin was the treatment of choice but has the resistance is so great worldwide that this is not now a first line therapy.

Both chlamydia and gonorrhoea have the potential to cause infertility in both males and females together with Pelvic Inflamatory Disease (PID) in females and epididymo-orchitis in males.
About the Author
Dr Sean Cummings has a specialist interest in prevention and diagnosis of Sexually Transmitted Infections and HIV. http://www.freedomhealth.co.uk
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