Blog entry by Rcgp Learning
It’s estimated that over 1 million sexually transmitted infections (STIs) are acquired every day worldwide (1). Last year in England alone there were around 420,000 diagnoses of STIs, with chlamydia accounting for 49% of these (2). Despite the prevalence of STIs, many patients still choose not to go for regular sexual health checks. According to Public Health England’s 2017 report on STIs and chlamydia screening, there has been a decline in the number of STI tests carried out over the last 5 years (3).
National STI Day was launched a few years ago to encourage people to take responsibility for their sexual health and attend regular testing. It has been chosen to take place on the 14th January of each year, so that it falls two weeks after New Year’s Eve: a day when traditionally more alcohol than usual is consumed and people are more likely to engage in sexually risky behaviour. Various papers have demonstrated the link between alcohol, risky sexual behaviour and STI diagnoses, with women being more affected than men. (4) (5). This two week period after New Year’s Eve was deliberately chosen as the most common STIs can take two weeks to be detectable (6).
Despite that fact that STIs can lead to serious health problems, it seems that not everyone is as informed as they should be about the importance of safe sex. In 2016, the Family Planning Association (FPA) conducted a survey of more than 2,000 people aged 16 and over across the UK to find out what they knew and thought about safer sex and STI testing (7). Out of the findings of the survey, the following statistics are perhaps the most concerning:
- 68% said that they had never had an STI test
- 52% didn’t know that you can get an STI from oral sex
- 71% said they did not use any form of condom the last time they had sex
- Only 9% learnt at school about how to find and use sexual health services
While genitourinary medicine (GUM) clinics are commissioned to screen for and treat STIs, patients frequently present in general practice to seek advice about STIs and contraception. It's important that GPs are able to have open and honest conversations about sex and sexuality, and know where to signpost patients to sexual health services outside of general practice.
There are a range of sexual health services available in the UK, but as the RCGP highlighted in the 2016 ‘Time to Act’ report, there is evidence of restricted access to contraception and STI testing depending on patients’ location or age (8). The report also expressed concerns about the way sexual and reproductive health services are commissioned and the training available for GPs in sexual and reproductive health (SRH) available to GPs. You can read the full report here.
The RCGP offers various eLearning materials on sexual health and contraception and the following resources are FREE to all healthcare professionals:
Sexual Health in Primary Care – 2 CPD credits
Contraception – 1 CPD credit
HPV - the essentials – 0.5 CPD credits
Women’s Health Framework – Sexual and Reproductive Health Resources – some content is only free to RCGP members
RCGP Members can also benefit from access to the following resources:
EKU4 – Managing of genital chlamydia trachomatis infection
EKU9 – HIV in primary care and ‘HIV in primary care’ podcast
EKU2017.2 – Routine investigation and monitoring of adult HIV-1 positive individuals and increasing uptake of HIV testing
EKU hot topic (December 2014): HIV infection – Treatment and research
(1) World Health Organisation. 2016. ‘Sexually transmitted infections (STIs) factsheet’ [Online]. Available from: http://www.who.int/mediacentre/factsheets/fs110/en/
(2) Public Health England. 2017. ‘Infographic: Sexually transmitted infections and chlamydia screening in England, 2016’ [Online]. Available from: https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables
(3) Public Health England. 2017. ‘Sexually transmitted infections and chlamydia screening in England, 2016’ [Online]. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/617025/Health_Protection_Report_STIs_NCSP_2017.pdf
(4) Hutton et al. 2008. ‘The Relationship between Recent Alcohol Use and Sexual Behaviours’. [Online]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2588489/
(5) Connor et al. 2015. “Alcohol Involvement in Sexual Behaviour and Adverse Sexual Health Outcomes from 26 to 38 Years of Age”. Plos One. Available from: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135660
(6) National STI Day website. http://www.stiq.co.uk/about/
(7) Family Planning Association. 2016. ‘Sexual Health Week 2016’ [Online]. Available from: https://www.fpa.org.uk/sexual-health-week/sexual-health-week-2016
Royal College of General Practitioners. 2016. ‘Sexual and Reproductive Health Time to Act’ [Online]. Available from: http://www.rcgp.org.uk/-/media/Files/Policy/Media/8895-RCGP-Sexual-Health-online.ashx?la=en