The number of people being diagnosed with sexually transmitted infections (STIs) is now at record levels.
STIs have jumped sharply in recent years. Syphilis has risen by 486% since 1996. Chlamydia is up by 108% over the same period and rates of gonorrhoea are 87% higher than they were seven years ago. More people are also being diagnosed with HIV. In 2001, a total of 4,419 people were told they had the virus, up 17% on the previous year. The number of new infections is predicted to double between 1997 and 2005.
An estimated 40,000 people living in Britain are now HIV-positive. As many as one in three of these do not realise they have the disease.
There is no clear explanation for the sharp rise of recent years. For instance, there is little evidence to suggest it can be attributed to more people engaging in casual sex.
Changes in sexual behaviour are not sufficient to explain the increase in sexually transmitted infections. It may be the case that more people are engaging in casual sex. However, the rise in STIs is so high that it cannot be explained by this.
The most obvious explanation is that people are simply failing to practise safe sex. However, even this isn’t clear cut. Teenage pregnancy rates are falling suggesting that more couples are using contraception.Recent studies have also found that more people are using condoms when they first have sex. Problems appear to be linked to the choice of contraception. While more teenage girls may be taking the Pill or emergency contraception, the statistics suggest they are not using condoms. Condoms are the most effective way of preventing the spread of STIs.
In addition, there is evidence to suggest that couples put themselves at risk by deciding to stop using condoms when their relationship becomes more stable.
Research shows young and older people are finding it difficult to maintain condom use once they are in a trusting relationship. Obviously, if there is a STI it can then be transmitted. The sharp increase in STIs suggests that couples are becoming more complacent and are not listening to calls to practice safe sex.
In the late 1980s and early 1990s, we had campaigns warning people about HIV. They also helped to prevent STIs. While there have been some new campaigns, overall there hasn’t been the same level of promotion. Increasingly, generations are coming forward who have not heard about HIV and who do not know much about using condoms. They are missing out on the key messages.
This is compounded by the fact that many people have major misconceptions about STIs and HIV. A study published last year suggested one in three 18 to 24 year olds wrongly believed there is a cure for HIV. Cultural issues also play a part. Many people are simply too embarrassed to talk about sex, let alone STIs, with their friends or family.
A lot of people have feelings of embarrassment, shame and guilt around sex. People also do not access sexual health services or get the support they need.
We need to raise awareness and to tell people that STIs are still around and that HIV is still here.