Sexual health
Is promiscuity leading to an epidemic of disease?
'It is no exaggeration that we now face a public health crisis in relation to sexual health', concludes Professor Michael Adler in an editorial for the journal
Sexually Transmitted Infections. The article notes that the UK government has completely failed to meet the targets for sexual health set in the
Health of the Nation report in 1992 and that things have only got worse since the Blair administration came into office in 1997. Between 1997 and 2001, rates of diagnosis have gone up for gonorrhoea (78 percent), chlamydia (73 percent), genital warts (six percent), genital herpes (13 percent), and syphilis (374 percent). 2001 also saw the largest single-year reporting of new HIV infection in the UK, with 4,419 cases diagnosed. The rate of pregancy in women under 16 is almost double the target set in 1992.
These figures should be treated with caution. Diagnoses may have gone up in part because of greater awareness of sexually transmitted infections. For example, ten years ago, young people would have been forgiven for thinking chlymidia was a character in a Shakespeare play, but it would be difficult to avoid discussion of it now. Adler also notes that attendance at clinics has doubled. Yet, diagnosis rates have not risen as quickly.
Moreover, some of the percentage rises mask quite small absolute rises. The figure for syphilis seems alarming but there were still only 697 cases in 2001. HIV remains a disease predominantly of homosexual men, and heterosexuals who contracted the disease in Africa. 79 percent of new infections among heterosexuals were acquired abroard. That is not to belittle the problem for those groups, but indicates that there is little in the figures that is new or which suggests a problem for the population as a whole. As for underage pregnancies, the current rate of conceptions is 8.3 per 1000 - exactly the same as it was in 1992.
This is not an indication of a massive threat to public health but rather shows that government moralising dressed up as health concern has been a failure. It is likely that more people are having sex with more different people, and starting younger.
Adler's article gives the impression of special pleading for more resources. 'Sexual health is not an NHS or political priority', he complains. Heaven forbid it should ever be one.
Sexually Transmitted Infections, April 2003
Expert warns of sex disease crisis, BBC News, 15 April 2003