Sexually transmitted infections have been around for as long as mankind but experts say patterns of human behaviour are changing now that sex is instantly available through dating apps
Yet record numbers of chlamydia and gonorrhoea cases are not a problem confined to any one area of the State. STI cases, also referred to as STDs, have been increasing year-on-year across Ireland for decades, apart from a brief dip during the Covid-19 pandemic. Aside from concerned doctors, though, there is relatively little discussion about this trend.
“And then add in public clinics dealing with infections that are over-subscribed, underfunded and understaffed. Often they operate on an appointment basis, as if the treatment of sexual infections can wait weeks.”Dr Freedman maintains some patients are being inappropriately tested and treated, for example, through the use of the wrong antibiotics or ineffective tests.
Prof Sam McConkey, infectious diseases consultant at Beaumont Hospital in Dublin, attributes some of the increase to a pent-up demand for services following the pandemic. “We had to close clinics during the pandemic as staff were redeployed, so we weren’t diagnosing cases. And because people weren’t being treated promptly, there was an increase in the amount of disease going around.
The HPSC estimates that up to 40 per cent of chlamydia cases and one-quarter of gonorrhoea cases are being picked up via home testing. One in 10 tests is returning a positive result. The site next to the offices of The Irish Times in Dublin, which is now a sports centre, was once a hospital for treating venereal disease, I found out while researching this article.
While most STIs are easily treatable if detected, Prof McConkey says the presence of such infections in young women presents a key challenge. “They can be vulnerable to chlamydia, where scarring of their tubes can lead to ectopic pregnancies and infertility. That’s not something anyone wants.”Chlamydia may be responsible for up to 15 per cent of female infertility but years may pass before a woman discovers, in a later stage in life, that she cannot have children, according to Dr Freedman.
Meanwhile, the number of HIV cases this year is up 10 per cent on 2022, which was already a record year for new notifications. The challenge for doctors is that many STIs are “silent”, making them more difficult to detect and treat. “If a man has gonorrhoea in his throat, there is no sign of it. Anal gonorrhoea, too, is completely silent,” says Dr Freedman.
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