STIs & Teenage pregnancy

Comments1. As noted in the draft guidance, Sexually transmitted infections in the UKare out of control with an epidemic of Chlamydia, Gonorrhoea, Syphilis,HIV and other STIs.There has been a massive increase of sexually transmitted diseases (STIs) inthe UK over the past years. Diagnoses of gonorrhoea and chlamydia have allmore than doubled between 1995 and 2004. Syphilis cases rose by astaggering 1500%. Cases of HIV and AIDS are set to rise almost 10 per cent ayear and have more than doubled between 1993 and 2002. There has been arecord numbers of HIV infections in 2001, with 5393 newly diagnosed cases.This was the highest number of new diagnoses recorded in a single year sincethe beginning of the AIDS epidemic. (Draft NICE guidance; MW Adler, Sexualhealth – health of the nation. Sexually Transmitted Infections 2003; 79: 85-87;Written answer; Sexual Health; Miss Melanie Johnson: Sexually TransmittedDisease data for England; as at 28 November 2003)2. There has been a massive increase in sexual promiscuity as measured bythe number of lifetime sexual partners, a significant increase in riskysexual behaviour and a trend to earlier sexual intercourse. The key toreducing STIs will be addressing the underlying cause for the epidemic ofSTIs, which is mainly the steep increase in promiscuity.The number of lifetime sexual partners had increased from 8.6 to 12.7 for menand from 3.7 to 6.5 for women over the past 10 years. Britons also have sex atan earlier age now. For over 55s the average age of losing their virginity was19, within the 25-34 age group it was 16 and among the 16-24 year olds it isonly 15. Over the past 10 years, there has been a “considerably higher rate ofnew partner acquisition among those younger than 25 years and those notcohabiting or married. These strong age effects are reflected in the substantiallyhigher incidence of STIs in those younger than 25 years, compared with olderpeople.” (The Observer, “Sex uncovered, result of a poll of 1027 adults aged 16or over”, 27 October 2002; Johnson AM et al. ‘Sexual behaviour in Britain:partnerships, practices, and HIV risk behaviours’, National Survey of SexualAttitudes and Lifestyles; Natsal 2000; Lancet 2001: 358; 1835-42.)3. There has been a doubling in GU clinic attendances over the past 10years. A record attendance at GU clinics has failed to stop the dramaticincrease in STIs. To increase access to GU services even further isunlikely to stop the epidemic of STIs.Between 1991 and 2001, attendances at GU (genito-urinary medicine) clinics inEngland, Wales & Northern Ireland rose from 669,291 to 1,332,910. In 2004,there were 1.5 million appointments at GUM clinics. At the same time, therehas been a dramatic increase in all STIs. The government’s drive to furtherincrease access to GU clinics will therefore not stop the epidemic of STIs.(Draft NICE guidance; Sexually Transmitted infections in the UK: new episodesseen at Genitourinary Medicine Clinics, 1991 – 2001; Public Health Laboratory)3