Sexual health, myths and facts

Main Category: HIV / AIDS
Article Date: 06 Jun 2004 - 9:00 PDT


It's well documented and it's official: sexually transmitted disease is on the rise in the UK. According to The National Survey of Sexual Attitudes and Lifestyles (NATSAL) 2000, a major study of sexual behaviour in Britain, new diagnoses of acute sexually transmitted infections in genito-urinary clinics rose by 20 per cent among men and 56 per cent among women between 1990 and 1999. The same study highlighted the fact that typical risk factors for an infection, including number of sexual partners and payment for sex, have also risen over the past decade.1

Although sexual transmitted infections (STIs) are now so common that they should concern all of us, there are many different myths surrounding the area. Too many of us still want to believe that we couldn't possibly be the type of person to get an STI, and believe that we don't need to know about how such infections could affect our lives.

Yet STIs are almost completely preventable with the right knowledge and by practising safer sex. Below we uncover the truth about STIs - and how they can be prevented.

MYTH 1:
THE ONLY PEOPLE WHO GET AIDS IN THE UK ARE DRUG USERS AND MEN IN HOMOSEXUAL RELATIONSHIPS

FACT:
According to the AIDS charity Avert, when a test HIV became available in the mid 1980s the main risk groups were identified as: men who have sex with men, injecting drug users, and recipients of blood products (such as haemophiliacs) were identified as the main risk groups for HIV. At that time, many of the people in these risk groups came forward for testing.

Since this time, the picture has changed considerably:

-- Screening processes for blood donations were introduced in 1985 and, since then, there have been no recorded cases of HIV transmission through blood product use.

-- Needle exchange programmes in the UK have limited the risk of infection to injecting drug users.

-- Although homosexual men remain the group most at risk of getting HIV in the UK, heterosexual transmission has risen steadily over the last 15 years. In 1999, the rate of heterosexually transmitted HIV infection overtook the rate of infection among men who have sex with men for the first time. There were 2,225 reports of heterosexually transmitted acquired immune deficiency syndrome (AIDS) during 2001, and heterosexuals were far more likely to have their condition diagnosed at a late stage than homosexual men.2

THE UPSHOT:
Nobody can assume that they are exempt from the risk of AIDS or other sexually transmitted infections (STIs). Safer sex is the best way that you can limit your risk of the disease.

MYTH 2: WITH ADVANCES IN MEDICINE, THERE IS NO NEED TO WORRY ABOUT SEXUALLY TRANSMITTED INFECTIONS (STIS). IT ONLY TAKES A COURSE OF ANTIBIOTICS AND YOU ARE FINE, ANYWAY!

FACT:
It is quite true that most sexually transmitted infections (STIs) can be completely cured if they are caught at an early stage, and that the treatment may be as simple as a course of antibiotics. This is one of the reasons why you should be tested regularly, and why you should immediately approach a healthcare professional if you have any concerns about an STI. However, if left untreated, STIs can pose a long-term risk to your health and fertility.

The infections chlamydia and gonorrhoea can both lead to pelvic inflammatory disease (PID) if they are not treated. This can, in turn lead to long-term pelvic pain, blocked Fallopian tubes, infertility and ectopic pregnancy in women, and pain and inflammation of the testicles and the prostate gland in men. Genital warts and genital herpes are two common viral infections, so antibiotics will not treat them. They can be treated with antiviral medications, but both conditions can recur recur.3

Although antiretroviral drugs have been developed to slow the progression of HIV to AIDS, the number of cases is now staying level after previously declining. And there are now some drug-resistant strains of HIV emerging.2

THE UPSHOT:
Early detection of STIs is important, and there is a lot that medicine can do to help. But medicines cannot cure all STIs, so prevention through safer sex is by far your best tactic.

MYTH 3: CONDOMS PROTECT AGAINST ALL STIS.

FACT:
Using a condom correctly for oral, anal and vaginal sex is a good protection against infections such as chlamydia and gonorrhoea. Condoms are also important in preventing the transmission of HIV. However, according to the Family Planning Association, there is little evidence to suggest that condoms protect against the transmission of genital warts. It is also uncertain whether or not condoms can protect against genital herpes.3

THE UPSHOT:
Using a condom is always important because it helps to prevent the transmission of many sexually transmitted infections (STIs). But because condoms cannot protect against every form of STI, it is also important to limit the number of sexual partners you have, and to be tested for STIs on a regular basis.

MYTH 4: YOU CAN TELL THE SORT OF PERSON WHO IS LIKELY TO HAVE AN STI BY WHAT THEY LOOK LIKE - YOU JUST HAVE TO BE A GOOD JUDGE OF CHARACTER.

FACT:
According to Government figures in The National Strategy for Sexual Health and HIV,4 almost all sexually transmitted infections (STIs) are becoming more common in the UK. The number of visits to genito-urinary medicine clinics has doubled since the early 1990s.5 Cases of genital chlamydia have almost doubled over this period of time, and there has also been an increase in the number of cases of syphilis.6 The number of newly diagnosed HIV infections in 2000 was the highest since reporting began.7

THE UPSHOT:
STIs are common enough to affect anyone who is sexually active. You don't have to have a large number of sexual partners to contract an STI. 'Gut instinct' is not a reliable way of judging the likelihood of infection from a partner. Safer sex and medical tests are the only sensible solution.

MYTH 5: MY IUD/PILL WILL PROTECT ME AGAINST STIS TO SOME DEGREE

FACT:
Non-barrier contraceptives only offer protection against pregnancy. They do not offer any protection whatsoever against sexually transmitted infections (STIs).

THE UPSHOT:
Using a condom to protect yourself against STIs is usually the best option. However, you may chose to combine condoms with the Pill or another contraceptive method for increased protection against unwanted pregnancy.

MYTH 6: YOU ARE NOT AT RISK OF AN STI IF YOU ARE IN A MONOGAMOUS RELATIONSHIP

FACT:
According to NATSAL 20001 an increasing number of us are engaging in risky sexual behaviour likely to result in a sexually transmitted infection. On average, we have more sexual partners than before, are more likely to have a sexual relationship with more than one person at once, and are more likely to pay for sex than before.

Many of us believe that having only one partner exempts us from sexually transmitted infections, but with increasing opportunities for transmission, it is very easy to 'be unlucky'.

THE UPSHOT:
There are only a few scenarios where you can be sure enough of protection against STIs to stop using a condom. These are:

-- When neither you or your partner have had a sexual relationship before

-- OR when you and your partner have been tested for all STIs since the beginning of your monogamous relationship

-- AND when you are certain that your partner is telling the truth, and is not having sex outside of your relationship.

MYTH 7: ANYONE INFECTED WITH AN STI WILL HAVE OBVIOUS SYMPTOMS SUCH AS A RASH OR DISCHARGE

FACT:
There are many potential signs of a sexually transmitted infection (STI). These include:

-- Itching around the genitals or anus

-- Burning or pain when you urinate

-- Bleeding and pain during or after sex

-- Rashes, blisters or bumps around the genitals or anus

-- Unusual discharge from the penis or vagina.

However, according to the Family Planning Association, many STIs have no symptoms at all. Neither is it unusual to have more than one infection at once without knowing.3

THE UPSHOT:
If you have been at risk, or if you want to stop using condoms in a long-term relationship, you should get tested for STIs at your local sexual health clinic.

MYTH 8: PEOPLE WHO USE SEXUAL HEALTH CLINICS ARE ALL DIRTY OR PROMISCUOUS. AND PEOPLE WILL FIND OUT THAT I'VE BEEN THERE!

FACT:
People who use sexual health clinics are people with the sense to get tested. If you have engaged in any sexual behavior that could have put you at risk of a sexually transmitted infection (STI) you'd be wise to join them. Sexual health clinics are completely confidential, and will not even tell your GP about your visit without your permission. People of any age and sexual orientation can visit these clinics. All tests and treatments are free, and you can refer yourself to any clinic in the country: you only need to book for an appointment.

THE UPSHOT:
Sexual health clinics are found in most large hospitals. Both the Family Planning Association helpline 0845 310 1334 and NHS Direct 0845 46 47 (open 24 hours) can give you details of your local clinic.3

FURTHER INFORMATION: WHAT IS SAFER SEX?

The Family Planning Association advises:

-- Always use a condom

-- Before you have sex discuss with your partner what protection you will use, and keep condoms ready

-- Learn about how sexually transmitted infections (STIs) are spread, what the signs of infection are, and where to go for help if you are worried

-- Have a routine check up at a sexual health clinic

-- If you or your partner have symptoms, seek advice before you have sex again

-- Tell your partner if you have an infection so that they can be treated too.3

Contacts:
The Family Planning Association helpline: 0845 310 1334
NHS Direct: 0845 46 47 (open 24 hours)

References:

-- Natsal 2000: Sexual Behaviour in Britain: partnerships, practices and HIV risk behaviours. Lancet 2001; 358: 1835-42.

-- Avert. United Kingdom HIV and AIDS Statistics Summary.

-- Family Planning Association. Factsheet on Sexually Transmitted Infections.

-- The national strategy for sexual health and HIV. Department of Health. Published July 2001

-- Trends in sexually transmitted infections in the United Kingdom, 1990-1999. New episodes seen at genito-urinary clinics: PHLS (England, Wales and Northern Ireland) DHSS & PS (Northern Ireland) and the Scottish ISD(D)5 Collaborative Group (ISD< SCIEH and MSSVD): December 2000, ISBN 09001144 49 5

-- Stokes, T. Screening for Chlamydia in general practice: Literature review and summary of the evidence. Journal of Public Health Medicine 1997; 19(2): 227-232

-- CDSC. 'Increased transmission of syphilis in Brighton and Greater Manchester among men who have sex with men'. Communicable Disease Report Weekly 27 October 2000; 10 (43): 383-6.

http://www.bupa.co.uk/health_information/html/healthy_living/sexual/sex_myths.html

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