Sexually transmitted infections (STIs) may be going undetected during the pandemic, with damning consequences for people’s health in the long-term.
Figures from Public Health England (PHE) reveal fewer people attended screening from March to May 2020. There was a reduction in consultations by sexual health services and specialised HIV services, as well as a reduction in testing for HIV and STIs in such services.
Yet prior to the pandemic, the UK – and England in particular – was seeing an upswing in new diagnoses of two infections: gonorrhoea and syphilis.
PHE data on sexually transmitted infections revealed there were 468,342 diagnoses made in England in 2019, representing a 5% increase since 2018. New diagnoses in gonorrhoea and syphilis had substantially increased by 26% and 10% respectively.
Experts have warned of a “worrying upward trend” in diagnoses of gonorrhoea and syphilis in recent years. Since 2015, gonorrhoea diagnoses have risen by 71% and syphilis rates are at levels not seen since World War Two.
Dr Mark Lawton, a sexual health consultant and spokesperson for the British Association for Sexual Health and HIV, tells HuffPost UK: “We have undoubtedly seen a reduction in the number of people getting tested during lockdown.
“Hopefully this will be, in part, due to people not needing as many tests because of social distancing measures, but it will also be related to reduced capacity within services to meet demand.” Some laboratories have also had capacity issues for STI testing while they focus on Covid testing, he adds.
Unchecked STIs could have severe consequences for health. “There are some possible complications of delayed treatment,” says Dr Lawton.
Gonorrhoea can spread within the body and cause painful joint infections and, in women, along with chlamydia can lead to pelvic inflammatory disease (PID) which may affect fertility. Typical symptoms of gonorrhoea include a thick green or yellow discharge from the vagina or penis, pain when weeing and, in women, bleeding between periods.
Syphilis, if left untreated for years, can lead to heart and brain problems “although this is relatively rare,” says Lawton. Symptoms of syphilis can include: small, painless sores or ulcers around the genitals; a blotchy red rash on he palms of the hands or soles of the feet; small skin growths (similar to genital warts) that may develop on the vulva in women or around the anus in both men and women; white patches in the mouth.
Other symptoms, which are a little more vague, include: tiredness, headaches, joint pains, a high temperature and swollen glands in the neck, groin or armpits.
If people put off going for sexual health screening, it not only has a negative impact on the health of individuals, but can also lead to an increase in infection rates, says Shaeeb Ali, clinical practitioner in general medical practice and independent pharmacist prescriber at MedsOnline247.
And STIs can also lead to mother-to-child transmission, birth defects, and neurological manifestations, Ali warns – so it’s best to get checked for anything you’re worried about.
“Typical symptoms warranting medical review are, but not limited to: sores in the genital area, unexplained rashes/lesions, painful or burning during urination, discharge from the penis or abnormal/change in vaginal discharge, pain during sexual intercourse, and abnormal vaginal bleeding such as intermenstrual bleeding,” Ali says.
Even if you aren’t experiencing any symptoms, experts recommend you should visit a sexual health clinic regularly as some infections may not present with any signs at all.
Some infections, like chlamydia and gonorrhoea, can present with atypical symptoms or symptoms similar to other common infections, such as urine infections and bacterial vaginosis, and therefore can go undetected, adds Ali.
If you’re concerned about attending a clinic, you can order a home-testing kit instead. A typical home-test kit may contain: a urine sample bottle, vaginal swab, oral swab, and a rectal swab.
Home test kits work by providing a sample of urine or a swab, explains Ali. For women, depending on the type of STI being investigated or tested for, the test may come as a swab rather than a urine sample.
Many areas of the country now offer postal testing services which has enabled continued provision throughout the pandemic – in some situations people can receive treatment or contraception by post, too.
Some services are offering telephone or web consultations to minimise face-to-face contact in actual clinics.
“Unfortunately there has always been stigma around STIs and this can be a barrier to people accessing care,” says Dr Lawton. “My advice would be to reassure people that services are still operating, certainly for urgent problems, and to contact their local service for advice. Condoms will of course be people’s best defence against STIs and will reduce the need to attend a clinic.”