Safer sex

STIs aren't just affecting younger people - they can be a problem at any age. And there are many more than the three we've discussed in the show - chlamydia, HPV and HIV. Chris Smith and Katie Haylor got some closing thoughts from sexual health doctors Caroline Cooper and Graham McKinnon...

Caroline - Well certainly a lot of the sexual health promotion and prevention is aimed at the under 25s but obviously STIs affect people of all ages. And we certainly have seen an increase in people over the age of 50 being at risk of STIs. And if you think that's the time when often people are coming out of marriages, or long term relationships, and may not have experienced the education around STIs and may not realize that they need to have regular testing and treatment when they have new partners.

Chris - For those also the stigma and the concern, the embarrassment factor, might be greater than it is for younger people who by and large seem to be more comfortable with engaging with screening services like those that you offer. So is there anything that someone who is a bit embarrassed, or is in that older group and might not want to go off to the clinic, is there anything they can do to get screened?

Caroline - Yeah absolutely. I think that the younger people are very chilled and they'll be in the clinic chatting to each other. And I had a teacher last week who was mortified that she might bump into one of her students. And certainly for anyone who doesn't want to come to a clinic, either because they're embarrassed or really just for convenience of having to make the time to get an appointment, there's been a rise in online testing over the last few years, and it really couldn't be easier. You can order a testing kit online. For men and women you do a finger prick blood test which will test for HIV and for syphilis. And women can do a vaginal swab to test for chlamydia and gonorrhea and men can do a urine test.

Chris - How do you get do you get the result?

Caroline - The results will come by text, so you send that kit back in the post but you'll get a text and that'll usually be within a couple of weeks. With any positive results you would want to contact someone by phone. So negative results would come by text and it would usually be a phone call with someone who's qualified to have that discussion. Certainly in Cambridgeshire when you're ordering the tests online we have a bit of a screening that people will go through around their risks to make sure that we're having the right test for the right person.

Katie - Caroline, these online tests. Is this a national service in the UK?

Caroline - Yes. I mean they're available all over the UK, generally run out of the local sexual health clinics with different availabilities in different areas. But certainly if you Google sexual health and the name of your town or city you'll get the information.

Chris - And obviously one has to be aware of the fact that a lot of these tests are designed to be excruciatingly sensitive so that we don't miss any cases. But that does mean you have to prepare yourself for the fact that - as Katie heard in her clinic visit - you're going to get a number of false positives.

Caroline - Absolutely. And I think that that's one of the things that we would want to discuss with someone you know in a telephone call if we had any positives.

Katie - Graham, can we bring you in here? What are your closing thoughts on this? We've talked about three particular STIs in this program but there are far more than three.

Graham - One of the things I say to people in clinic when we test them - because we don’t just test for chlamydia - gonorrhea, HIV, syphilis, sometimes trichomonas, sometimes hepatitis. If they’re a bit reluctant about having a blood test I'll say “STIs are a bit like like hyenas, they hunt in packs”. So you know if you've got one you might have another. So it is always good to test for multiple infections where appropriate, and that's what we do.

Katie - I heard on the grapevine that you've been doing some work on an STI I had never even heard of actually. Is this mycoplasma genitalium?

Graham - So mycoplasma genitalium is something that increasingly over the last four years we’ve become more aware of in the UK, and now a number of sexual health clinics are testing for. It's a small tiny bacteria. It's a bit like chlamydia but it doesn't get transmitted as easy as chlamydia, but it causes similar kind of problems.

Katie - Is the treatment similar?

Graham -  The treatment is not similar, it's not straightforward to treat. It has got resistant to some of the first line antibiotics that we use, so often we have to go and do resistance testing as we get a positive result. And then treat with appropriate antibiotics. But we are able to treat it at the moment.

Katie - And all this talk about STIs, can we just get advice from you on safer sex and preventing these cases in the first place?

Graham - When I see someone in clinic I say “if you use condoms that reduces the risk of you yourself getting a sexually transmitted infection”. I also say “when you get together with a new partner, use condoms, both get checked out and then you know what each other has got and you’ve removed the mystery. Have that conversation, say  “let's get a sexual health checkup”. Care about each other's health”, and I think that's an important thing to do as well.