Sexually Transmitted Infections

Recent statistics recording the number of new diagnoses of sexually transmitted infections between 2003 and 2004 in England and Wales show the following:

• An overall rise in the number of new diagnoses seen in GUM clinics of 2 per cent in 2004 compared to 2003 (from 735,302 in 2003 to 751,282 in 2004).

• Chlamydia increased by 8 per cent (from 95,879 in 2003 to 103,932 in 2004).

• Syphilis increased by 37 per cent (from 1641 in 2003 to 2252 in 2004).

• Genital warts increased by 4 per cent (from 76,457 in 2003 to 79,618 in 2004).

• Gonorrhoea decreased by 10 per cent (from 24,915 in 2003 to 22,320 in 2004).

• Genital herpes decreased by 1 per cent (from 19,180 in 2003 to 18,923 in 2004).

(HPA, October 2005)

These figures demonstrate a small but significant increase in reported sexually transmitted infections between 2003 and 2004 (with the exception of syphilis, which had a more significant rise). However, there has been a downturn in the infection rates for gonorrhea and genital herpes.

In order better to understand the current problems it is helpful to examine the figures over a wider time-period.

Table 6 below is an illustration of the same set of sexually transmitted infections studied over a nine-year period. This bigger picture offers a better

ADVANCED CLINICAL SKILLS FOR GU NURSES Table 6 Health Protection Agency October 2005

2004

% change 2003-2004

% change 1995-2004

Chlamydia Genital warts Gonorrhoea Genital herpes Syphilis

103,932 79,618 22,320 18,923 2,252

illustration of the scale of the problem faced in the UK. The most worrying statistics demonstrate the return of syphilis into the sexual ill health of the population of the UK, and, of course, the massive increase in rates of diagnosed Chlamydia.

In examining these statistics, it is important to acknowledge some of the possible anomalies that may exist in the reporting of Sexually Transmitted Infections:

• The figures only represent cases diagnosed and reported by Genito-urinary Medicine Clinics in England and Wales. There are other opportunities for testing and treatment within the healthcare system that do not contribute to the reported figures.

• These are only the cases that are reported. Many infections can be asymptomatic or confused with other conditions, and consequently we can reasonably assume that actual rates may in fact be higher than the reported rates.

• The increase in reported cases of Chlamydia may be down to improved diagnostic technology now picking up infections that have in fact been present for some considerable time.

It is clear, however, that in England and Wales there is currently an epidemic of sexually transmitted infections. The government's response needs to tackle head-on these trends in infection rates through coherent policy strategies and the longer-term modernization of services. Policy-makers and health professionals alike must remain cognisant of the long-term damage caused by sexually transmitted infections, including infertility and a greater risk of contracting HIV. Ignoring the need to tackle STIs may well result in a greater subsequent burden on scarce health resources in the treatment and management of HIV and infertility.

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