Staying Safe in the Bedroom

Christmas and New Year is a time for revelry and fun, with plenty of food and drink... as well as more private activities. The downside to the increased sexual activity at this time of the year is the corresponding rise in the number of sexually transmitted infections, which then have to be treated in the first few months of the New Year. We are already starting to see an uptick in patients presenting with symptoms of an STI. The most common bacterial sexually transmitted infection encountered by us is chlamydia trachomatis.

Chlamydia

Chlamydia is a potentially serious infection that can result in infertility in women, as well as the potentially lethal condition known as ectopic pregnancy, if it is not detected and treated as soon as possible.

Chlamydia will normally take around 14 days to appear in a test result but it can produce a positive result earlier. Any negative result prior to 14 days will need to be repeated at the appropriate juncture.

Testing

Not everyone who contracts the chlamydia infection will experience obvious symptoms, and screening tests can be done from self taken vaginal swabs or urine samples. 

If a woman is experiencing urinary symptoms then it is probably a better idea to test for chlamydia with a urine sample, rather than a vaginal swab. Urine samples need to be collected at least two hours after the last time urine was passed to ensure an accurate result. 

Sexually active people below the age of 25 should be tested once a year for the infection or every time they acquire a new sexual partner, or in the event of experiencing any symptoms such as pain during urination, painful sex, abdominal pain, or abnormal discharges or bleeding from the vagina. The rest of us need to be tested when we change sexual partner or experience symptoms.

Treatment

The good news is that chlamydia can be effectively treated either with a single one gram dose of azithromycin or a twice daily seven day 100 mg course of doxycycline. Both of these treatments come with their own advantages and disadvantages.

Doxycycline should not be used in pregnancy.

Anyone who receives any form of treatment should make sure they are tested again from 6 weeks after treatment commenced, in order to make sure the infection has been cured and to avoid the possibility of false results. 

All recent partners from within the last three months should also be given treatment irrespective of their own chlamydia test results. You and your current partners should be simultaneously treated with antibiotics, while abstaining from sex during treatment, even with a condom. 

Long-term complications from a chlamydia infection are much more likely in people who contract the infection numerous times, so anyone who is infected should take additional precautions in the future, in order to make sure that it does not happen again. The use of condoms is vital, and is the only method to protect against infection – but it is not 100% effective and regular screening is still recommended.

Only recently have we been talking about the possible relationship between gum disease and Alzheimer’s, but two more recent studies have also highlighted a strong association between the herpes simplex virus and this terrible disease of the brain, which causes memory loss. Two studies by Swedish researchers show why these associations have been made.

The first study found that when the HSV1 virus (the strain of herpes virus that often causes the common cold sore) was dormant in a body, and then became reactivated, the HSV1 reacted with certain proteins, forming the same chemicals that cause the Alzheimer’s disease to develop. It is thought that the proteins helped the herpes virus travel via the nerves to the brain. In turn, the proteins were not being transported and distributed as they normally would, the proteins then forming amyloid plaques, a known cause of Alzheimer’s.

We are happy to report that Warticon Cream is finally back in stock and available for immediate dispensing.  Warticon had been out of stock for over a year and fortunately we have had a steady supply of Condyline – the alternative treatment – to take up the slack.

Warticon is prescribed for patients with genital warts and is highly effective in eradicating the warts in around 4 weeks. If you have warts and they are larger than 4 mm in diameter then you need to see a doctor face to face. For smaller warts, we can help. To get a prescription for Warticon or any of the alternative treatments for genital warts, please click on the free consultation button below.

In the past we have written about DVD-players being developed to test for HIV, and how useful it would be if they entered the market. Now it appears that another device is being developed that could help diagnose chlamydia and gonorrhoea in 30 minutes.

The device recently won The Royal Academy of Engineering ERA Foundation Entrepreneurs Award.

According to the inventor, the advice is able to detect anomalies from a blood sample taken from a finger prick and works via a low-cost, disposable microchip that sends ultrasonic waves across the chip.  The waves then agitate the blood sample to perform various functions such as opening cells to release their DNA. Although the chip enables multiple ways of agitating the sample, it appears to only be able to do it for one pathogen at a time. However, it now hoped that the investment received from The Royal Academy of Engineering will help the inventor develop the device for multiple and simultaneous pathogen testing.

Once this is done, and if it is done successfully, then it is expected to be another two years before the device gets out on the market. You can read more about this development at The Engineer website.

We spoke to GSK, the manufacturer of Warticon earlier today and they are still having production problems with Warticon, the popular treatment for genital warts. We have now been advised that they have suspended production until September 2013.

We are fortunate that there is an alternative product that contains the same active ingredient so patients do have a treatment that is available to prescribe. Condyline Solution contains exactly the same active ingredient (podophyllotoxin). The only difference is that Condyline comes as a solution rather than a cream and the solution is at a higher concentration. You can read more information on this product here.

Condyline is available for immediate dispensing and next day delivery. If you have not already registered with The Online Clinic, you can do so by clicking on the free consultation button below.

Warticon treatment for genital warts has been out of stock for several months because of a manufacturing problem. The latest information that we have from the manufacturer is that this item will not be back in stock until May 2013. This is 2 months behind the original date that we were given and that we reported last year.<

Fortunately, there are alternatives to Warticon. Condyline contains the same active ingredient as Warticon and comes in the form of a solution rather than a cream. The other alternative is Aldara, which is a cream that stimulates a localised immune system response to tackle the warts. Both of these alternatives are very effective.

If you are suffering from genital warts then you can register here to get treatment for next day delivery.

New research from the Albert Einstein College of Medicine has identified a key mechanism that plays a part in the proliferation of herpes viruses in human cells. The findings, which were published in The FASEB Journal, could be useful for developing novel approaches in the treatment of herpes.

The study in question was an observational study that examined how laboratory cultures of human cells would react to herpes exposure to herpes simplex virus 2 if they had been pre-treated with medications that contained Akt inhibitors. It is worth mentioning that Akt is a signalling molecule known to play part in many stages of a cell’s course, including apoptosis (cell death).  In the study, the researchers either exposed the sample to one of four different treatments known to inhibit Akt or did not expose the sample to any treatment. This lasted 15 minutes. In the next stage, the cells got exposure to herpes simplex virus 2. This lasted 60 minutes. The key findings indicated that all the cells that had been treated with Akt inhibiting medications had a significantly lower herpes virus infection regardless of the type of cells that had been exposed to the virus. Conversely, cells that had not been treated with Akt inhibitors had been more easily infected by exposure to herpes simplex 2 virus. This led the researchers to conclude that treatments suppressing Akt could be useful for suppressing herpes infections among individuals that have already got the virus.

Although this study presents novel findings, the rationale for it being conducted in the first place is logical when put into context. Specifically, it is worth noting that this study further supports a previous study by the same team, which found that the release of calcium in cells affected the infection by the herpes simplex virus 2. However, we are not aware of similar studies being conducted by other teams that would further corroborate these findings. Similarly, it is too early to see the potential long-term effects this treatment would have. Nevertheless, given the life-long effects a herpes simplex 2 infection brings with it, we are glad to hear that the area is given its due attention from researchers. Further details of this study can be read at The Journal of the Federation of American Societies of Experimental Biology.

One of the charities that we support is the National AIDS Trust and they have lauched an online quiz to raise awareness of HIV and to test your understanding of this virus. HIV can be contracted in a number of ways and diagnoses in the UK are on the increase. Why not take the quiz now and see how much you know about HIV? You might have your preconceptions challenged! Helpfully, the quiz gives you the correct answer after you have registered each of your answers.

Recent research from Princeton University has found some surprising results regarding how herpes can develop into cold sores. The key findings indicate that Herpes Simplex Virus (HSV-1) may only require one or two viral particles in order to infect a skin cell during the first stage formation of cold sores. This is in contrast to many other viruses that spread through the use of millions of particles and has implications’ for research considering the transmission of herpes and evolution of the virus.

The HSV-1 particles may be latent in the cells of the nervous system for a long time but once awakened they invade a skin cell. It appears that a single particle then multiplies to hundreds of copies. These copies then invade nearby cells, which combine to form a cold sore.

Having one or two particles invade a cell implies that the process is like a bottle neck, which on the one hand only enables the fittest particles to pass through and on the other hand renders it vulnerable to treatment as there may be times during this process when the infection is more susceptible to treatments. Moreover, if only two particles are responsible for the initial stage of cold sore formations then that the virus has a limited genetic diversity, which in turn limits the chances for the virus to survive, evolve and spread.

These findings are encouraging and novel and we will be interested to see where this research leads in the future. At the current stage, these findings are more likely to produce further research than a new treatment.

We are pleased to say that Condyline is now back in stock and available for next day delivery. You can order this item by logging into your account if you have already been approved. If you still need to have a consultation with us to get approved, this can be done from here.

The lack of availability of Warticon because of a manufacturing issue has again led to rocketing demand for Condyline (the main competitor product) and this has in turn led to a Condyline stock out in the UK. We had supply issues with Condyline about two months ago for exactly the same reason. We know that the suppliers of Condyline in the UK are on the ball and supplies should resume shortly. We can still take orders for the waiting list and we expect to be in a position to dispense again in the next few days. If the situation changes, we will update the news channel accordingly.

Just when we thought the gonorrhoea situation couldn’t get any worse, the Health Protection Agency (HPA) reports that there has been a significant increase in the number of cases reported over just this last year: a staggering 25% increase to be exact. Fewer than 17,000 cases of the infection were reported in 2010 and last year this figure jumped to 21,000.

According to the HPA, the groups most affected by this STI are men who have sex with men (MSM) and young people between the ages of 15 and 24. It obviously isn’t clear that although the infection is common and treatable, it has the potential to affect fertility and cause complications in pregnancy, as chlamydia does if left untreated.

Although antibiotic resistance has been observed in recent years, the latest figures actually show a reversal of this trend following the introduction of new prescribing guidelines last year. Resistance to Ceftriaxone declined, as did resistance to Cefixime. Resistance to Azithromycin remained stable at the low rate of 0.5%. A higher rate of resistant strains was observed in cases involving MSM.

You can read the full Health Protection Agency statement here.

We are happy to say that Condyline is now back in stock. Warticon remains out of stock until March 2013 owing to a manufacturing issue. The suppliers of Condyline have been quick to take up the slack as we reported in our earlier blog piece a week or so ago and they have plugged the supply/demand gap very quickly. Condyline is highly effective in resolving genital warts and it is becoming a medication requested by patients. We continue to prescribe Aldara as well, so patients still have a choice.

The leading treatments for genital warts are both currently out of stock. Fortunately, Condyline will be back in stock by the end of next week but Warticon will not be available until March 2013! Aldara remains available and we can prescribe this as an alternative. Aldara normally takes longer to work than the other two but it is effective in providing a long term solution. Aldara is available for prescribing through The Online Clinic.

The temporary shortage of Condyline was the result of the manufacturing issue affecting Warticon, where the suppliers saw a surge in demand for Condyline. Fortunately they were quick off the mark to get further stock produced and we should be in a position to start dispensing this again in the next few days.

There is currently a supply issue with Warticon in the UK. Warticon is used to treat genital warts and contains podophyllotoxin. There is another medication called Condyline that contains exactly the same active ingredient but at a higher concentration. We are offering Condyline to all patients with genital warts where it is considered appropriate. If you have any questions about this alternative treatment, please click here or go to the Contact Us page above.

The European Centre for Disease Prevention and Control (ECDC) have continued to highlight the problem regarding gonorrhoea and its increasing resistance to standard treatments and newly introduced antibiotic treatments.

Within only one year, the number of cases reporting resistance rose from 4% to 9% between 2009 and 2010. This is a massive increase and this percentage looks set to rise in this way for the foreseeable future and around much of Europe with more areas on the continent reporting resistant cases every year.

Not only is there the very possible threat of the disease becoming completely untreatable in time, the disease is everywhere and is spreading from country to country at a steady rate. While research is carried out on future treatments the best we can do for now is to make sure the antibiotics prescribed are taken exactly in accordance with instructions and that courses are completed.

Common STIs are not thought to be serious since they have been so easy to treat with a short course of medication. People will have a very different perspective on this infection if it becomes untreatable.

It has been proposed in an NHS report that young girls are offered the contraceptive pill when they are as young as thirteen years of age and without seeing a doctor. It is without a doubt that something needs to be done in order to decrease the number of women requiring emergency contraception and abortions but is this the way? A pilot study carried out with the intention of targeting black women of British, African and Caribbean backgrounds who were between the ages of 20 and 24 and who had never used the contraceptive pill before appeared to have an impact. But does this make the case for making the contraceptive pill readily available to young girls who have barely had an education in sexual health?

The study was far too small to predict with any certainty that the rates of pregnancy and abortion among young people would decrease with the implementation of this sort of action. Furthermore, with the NHS advocating such independence for girls so young, they are also in a way saying it is ok or expected that unprotected sex will occur and as long as we are sending this message to young people, STI rates will continue to climb.mWe believe that condom use should be advocated before putting teenage girls on the pill. However you look at this, it must come back to education. People need to know what they are doing and the potential consequences of unprotected sex.

It was often said that anything , Sofia Vergara, Columbian actress from the hit US comedy drama, Modern Family, would say would sound sexy and so she put this statement to the test during her hosting debut on Saturday Night Live by opening with her since much quoted intro, ‘Gonorrhoea, Rick Santorum, and New Jersey’. We don’t think she quite pulled it off this time but speaking of gonorrhoea and sexiness, it did bring to our minds a recent (and not so sexy effort) to highlight the importance of safe sex among the older generations which was prompted by a 71% increase in STIs among senior citizens in Florida over just the last 5 years.

The most recent campaign produced by the DDB advertising agency, depicts elderly couples performing sexual positions based on the teachings of the karma sutra and is being watched by thousands in its video form across the net. The smiling faces of these senior citizens enjoying intimate and ‘tantricly’ challenging moments are set to raise awareness for safe sex among this age group and also to highlight the fact that men and women among the older generations should be enjoying their sex lives regardless of their age.

Some feel that despite the primary objectives of the campaign, the images in fact negate its very purpose, painting a picture of elderly people and sexual activity in a mocking light.

We think the campaign has at least grabbed the attention of the masses and raised awareness in the area of safe sex and the elderly so long may the videos go viral and hopefully keep the over 50s virus (and bacteria) free!

A new proposal has set tongues wagging and relates to the Centre for Disease Control and Prevention’s (CDCs) suggestion that those who have had more than two sexual partners within the space of one year should not be applicable for organ donation due to the fact that they would be considered more at risk of sexually transmitted infections including HIV and that this is the case for both living and dead donors.

Health professionals are worried that potential donors would be put off by such restrictions and questions regarding their sexual history. Furthermore, they question how a health professional would go about questioning family and friends about the sexual history of a deceased donor?

However, the CDC says that rather than turn away donors who have had more than two sexual partners in a year, they would merely carry out more tests than they usually would.

We are not convinced by this new proposal and it does not take into account how this information is to be gathered and even if someone is categorised as “promiscuous”, they might have been having safe sex, as most responsible people do. If you are responsible enough to sign up as a donor, you are probably responsible enough to have been careful about your own sexual health. As for carrying out additional screening of organs for transplant, rigorous screening already takes place.

The Health Protection Agency has released worrying figures regarding HIV testing in the UK, which reveal that one fifth of British people offered a HIV test will refuse to take it. In 2010, one quarter of those infected with the virus in Britain did not know they had it and people are being treated far too late into their condition, therefore not giving their bodies the best of chances of coping with HIV and also increasing the risk of passing the virus onto others. Furthermore, the number of men who have sex with men testing positive is the highest it has ever been.

In the UK, one in twenty gay men is infected with the virus and that number is even higher in London where one in eleven men are believed to be HIV positive.  Over half of the men and women who tested positive well into their condition last year were past the stage that health professionals would consider the optimum for treatment to commence.

The Health Protection Agency therefore wishes to promote the idea of universal testing in GP practices for new patients and where patients are admitted to hospital in areas around Britain that are deemed at high risk.

Looking at these statistics, this seems like a worthy request and especially when we hear that only 4% of England’s population were tested for the virus in 2010. A spokesperson for the National Aids Trust rightly suggested that people are scared of being tested but instead should be fearful about living with undiagnosed HIV. With only 4% of English people having taken a test in 2010 and one fifth declining the offer, it is high time British people woke up to the problem instead of watching infection rates increase and presuming that they themselves are impervious to the virus.

The Government is warning us that illegal HIV testing kits imported from China are being purchased in Britain and are potentially giving patients the wrong diagnosis. The MHRA (Medicines Products Regulatory Agency) is making plans to close down 6 websites based in the UK that do not comply with European legislation and who operate without accredited laboratories.

The Health Protection Agency (HPA) has written to patients who have availed of such services and warned them of their inauthenticity. Thankfully the organisation regularly investigates websites like these which pose as legitimate health care operations.

It is illegal to sell kits that test for HIV in the UK. Home sampling kits for HIV are legal but we recommend that patients get tested for HIV in a face to face environment. In terms of other STIs, there are legitimate sites online where you can purchase testing kits but you should research and make sure the clinic is genuine. For HIV testing, we recommend Freedom Health in Harley Street. If you are not based in London then we recommend that you contact the Terrence Higgins Trust for further information about services in your area.

Tenofovir, the antiretroviral, when used as a vaginal gel, has been proven to protect women against the herpes simplex virus. A study published in the Cell Host and Microbe journal reveals that due to higher concentrations reaching the vaginal cells in the gel form of the drug as opposed to the oral formulation, the drug’s use can extend to reducing the risk of contracting the herpes virus (HSV). The study was carried out by the Catholic University of Leaven, the University of Rome, the National Institute of Child Health and Human Development and Gilead Sciences.

The gel form of the drug stops the spread of the herpes virus by disabling its DNA enzyme and reduces the risk of contracting herpes simplex infections as well as HIV infections. It has always been known to inhibit the reproduction of the HIV virus but this study highlights its potential regarding HSV. HSV in its shedding phase is contractible even when infected partners present as asymptomatic.

HIV and herpes are closely associated and those who have the herpes virus and who are exposed to the herpes virus are more likely to contract HIV than those who do not carry the herpes virus.

Tenofovir is converted by human tissue into a form that inhibits the activity of the HIV virus and now we know that it does the same for herpes simplex. The study examined HSV infected group cells and individual cells and it was proven that the drug in high concentrations stopped the reproduction of the virus. Furthermore, mice treated with tenofovir and which were infected with herpes experienced no symptoms of herpes and lived longer.

Taking the drug orally will not affect the HSV virus but there is approximately 100 times the amount of the drug present in the gel form when administered directly to the vaginal tissues. Safety and efficacy studies will need to be carried out before the drug is sold in this form and for this use but this could be a breakthrough preventative treatment for a virus that stays with an infected individual for life.

According to a recent survey, it seems that Cambridge University’s acclaimed educational village is lacking one vital resource. 309 students were surveyed about sexual health awareness and the results were frightening to say the least. Half of those surveyed admitted to having had unprotected sex at some stage and half of the group also believed that women were not at risk of pregnancy once they were menstruating.

10% of the group believed that wearing 2 condoms during sex would reduce their risk of catching a sexually transmitted disease. Furthermore, at the survey’s outset, 92% of the group said that they felt confident about their knowledge of sexual health and contraception.

Last year, the Health Protection Agency noted 12,000 more cases of sexually transmitted infections reported compared with the year before and also highlighted that the 15 to 24 year olds represented the most at risk age bracket.

Of course this ignorance is not specific to Cambridge students but to all young people. Really, the main observation is the 92% who felt confident about what they knew. If they are not aware of what they do not know, how can they be expected to learn? The information simply is either not accessible or is not taught in schools.

The Health Protection Agency has warned that a growing resistance to Cefixime may render gonorrhoea untreatable. The most recent statistics show that approximately 1 in 5 cases of gonorrhoea have a reduced susceptibility to Cefixime. The reduced susceptibility has jumped from 10.6% in 2009 to 17.4% in 2010. Some cases of gonorrhoea were completely untreatable with Cefixime.

Instead of Cefixime, doctors are being asked to prescribe a combination of the injection Ceftriaxone and Azithromycin which is taken in capsule form. This is still only a short term solution and we would expect gonorrhoea to develop a resistance to these antibiotics also. Where patients refuse the injection or where they cannot be seen face to face for whatever reason, Cefixime can be prescribed with Azithromycin to be taken orally. The Online Clinic will prescribe this combination for patients who cannot get to a clinic for the injection.

If you are worried about Gonorrhoea or other sexually transmitted infections then you should visit a GUM clinic, your GP or get tested through one of a growing number of online STI clinics. We recommend The STI Clinic as they have a very fast turn around time.

It is already known that certain strains of HPV cause cancer of the cervix, rectum, and most recently the mouth and throat, but a recent study links certain strains of the virus to skin cancer. The study is published in the PLoS Pathogens journal.

The research was carried out using mice at the German Cancer Research Centre where it was revealed that HPV was associated with non-melanoma skin cancers. The mice infected with a strain of HPV and who were then exposed to UV light, were more inclined to develop squamous-cell carcinoma than the mice that were not infected with the strain of HPV. The study also showed that mice who had a weaker immune system were more at risk of developing skin cancer.

It is important to remember that not all types of HPV can cause these serious diseases. The most common forms of HPV will cause genital warts that can quite easily be treated.

A recent study, presented at the International Society for STD Research meeting in Canada, reveals that Trichomonas Vaginalis is much more common than was once thought and the age group most affected are those over the age of 45.

The researchers state that a Trichomonas screen should be routine practice for sexually active women of every age and that that cases should be reported to the public health authorities in the same way as gonorrhoea and chlamydia.

Samples were collected from 7,593 women in the United States and were gathered from women aged between 18 and 89. The results proved alarming with 13% of women in their fifties infected, 11.3% in their forties, 7.9% in their 30s and 8.3% in their twenties.

Everyone is susceptible to this parasite and both men and women can contract it. The vagina becomes infected in women and in men the urine canal is commonly infected. Trichomonas is easily treated with antibiotics such as metronidazole.

Up to 50% of women will not experience any symptoms so it is important to get tested regularly if sexually active. The same is likely to apply for men but there is no data yet to prove this. No large scale study of this kind has been carried out on men in relation to Trichomonas to date. Trichomonas has been associated with premature births and low birth weight babies.

At the Swedish Reference Lab, scientists discovered that a new strain of the gonorrhoea infection is resistant to all current antibiotics available for treatment due to its ability to mutate easily and effectively. They warn that this resistant strain has the potential to pose a serious threat internationally but they do not know how widespread this particular strain is as of yet.

Gonorrhoea has in the past been found to be resistant to treatment and it is feared that it will continue to become resistant as there are signs that the bacteria are growing less sensitive to cephalosporins; the current line of treatment for gonorrhoea. Currently, much research is being carried out in the way of new treatment but scientists worry that it is not happening fast enough.

Preventing the infection is now of utmost importance especially considering the latest HPA (Health Protection Agency) report which suggests that gonorrhoea along with chlamydia are still the most common sexually transmitted infections around.

For now, according to the HPA, the cephalosporin antibiotics that we use for the treating of the infection in the UK are still working however, with signs of less sensitivity, but we will need to investigate just how widespread this new resistant strain is.

This sometimes symptomless infection can cause serious long-term health problems in those who delay diagnosis and treatment.

Seemingly Islington is not the place to be if you want to avoid contracting STIs. The London borough has the highest rate of herpes in the entire country and furthermore the area is one that is quite badly affected by soaring numbers of other sexually transmitted infections.

In 2010, 178 cases of herpes were reported in every 100,000 people. The area also has the third highest rate of gonorrhoea in the country, which has increased by an alarming 26% since 2009. Chlamydia is the most common infection affecting 584 people per 100,000 and it is among the top seven worst areas for syphilis and genital warts. These figures are only the recorded numbers of people presenting at a sexual health clinic – the actual rate of infection will be much higher.

Workers at the sexual health clinic on Holloway Road say that sexually transmitted infection rates are higher in areas that are less well-off and according to them, youth sexual health education programmes in the area have been cut so they were not surprised by these dramatic increases.

The STI rate is 50% higher in London than it is in the rest of England. Despite the small drop in the level of Chlamydia infections detected in the last 12 months, the message is still not getting across and people are still having unprotected sex. Given that some infections are symptomless, many people are walking around with an infection without even knowing it.

According to recently gathered statistics, the weekend of the Royal wedding was one to be remembered for reasons beyond Kate and William’s big day. The requirement for the morning-after pill tripled over the holiday weekend according to one primary care trust in Northamptonshire.

The warm summery days, lively street parties and balcony kisses obviously inspired more than courtly romance. This report has spurred the local trust on to hand out information on their free C Card campaign, which ensures that free condoms are accessible to young people from over 200 different outlets in the county. The number of people seeking the morning-after pill highlights the lack of awareness surrounding STIs, as getting pregnant is not the only complication that can arise from a one night stand.

Those attending summer festivals have been warned by the HPA (Health Protection Agency) to take care of their sexual health this season. But it is not just sexually transmitted infections that get the better of festival goers but also sunburn, sprain, cold and flu, sun stroke and even heart attacks and respiratory illnesses are reported at such events as we throw caution to the wind!

For the first time in ten years there had been a small drop in the number of sexually transmitted infections (STIs) across England according to the HPA (Health Protection Agency), a drop from 424,782 new diagnoses in 2009 to 418,598 in 2010. The decrease is said to be due to the increase in STI testing all around the country.

The numbers of chlamydia diagnoses have remained roughly the same as last year which is believed to be due to the increase of 196,500 tests that were carried out in 2010.

The number of chlamydia diagnoses in women peaked at 20 years and in men they peak at 21 years. In men who have sex with men (MSM), the number of new chlamydia diagnoses increased by 22%. The number of 15-24 year olds getting tested for chlamydia also increased 10% which is very positive considering they are still the most at risk group. The HPA therefore recommend that sexually active under 25s get tested every year for chlamydia and more often if they change partner.

The number of gonorrhoea diagnoses have increased by 3% and, in women, peaked among those aged 19 years. In men, the infection peaked in those aged 22 and 23. The number of new gonorrhoea cases among the 15 to 19 year olds fell by 13% and 14% and the number of cases among MSM has increased by one third.

Genital warts diagnoses have decreased by 3% and in women diagnoses of the infection peaked in women aged 19 years. The infection peaked in men aged 21 years. The number of new cases of genital warts in both women and men aged between 15 and 19 years decreased by 13% and 8%.

Syphilis cases have decreased by 8%.

The number of tests carried out at a GUM clinic increased overall by 1%. The HPA say that the levels of STIs in young people are still unacceptably high. They also state that according to studies, those who become infected are more inclined to have unprotected sex or are lacking in confidence and knowledge and so cannot suggest options for safer sex.

The HPA recommend that consistent use of condoms is vital in MSM especially considering that are at much more risk of contracting HIV and annual tests are advised here. Regular screening for all other STIs is also necessary in this group.

A recent study carried out at the Harvard School of Public Health has shown that young lesbian and bisexual females are at high risk of developing cervical cancer as they are far less likely to go for a smear test than heterosexual females of the same age. The new study’s findings suggest that these women are not paying as much attention to their sexual health and it is also reported that they begin having sex at a younger age and with more people. The study is published in the Journal of Adolescent Health.

The results of surveys carried out in 2005 suggest that out of 4,224 females between the ages of 17 and 25, only 9% had not been sexually active before. 93% of the group surveyed were white. Lesbians made up 1% of the group and they were the least likely to have a pap smear.

Research has shown that approximately three quarters of sexually active lesbian adolescents and 96% of bisexual women have had sex with men at some point. These figures indicate that pap smears are required for the detection of cancer causing sexually transmitted viruses. Even without considering the figures relating to activity with men, women are capable of spreading sexually transmitted diseases between one another. Despite the fact that there is less risk involved, having regular paps and sexual health screenings are still vital.

The author of the study suggested that gay men and women may feel uncomfortable talking to their doctors about their sexual orientation and therefore less informed about their sexual health.

Super injunctions might protect the rich and famous from shame and embarrassment but not their partners. A mysterious star worth over $100 million may be sued a measly one fifth of his vast fortune if it is proved that he knowingly spread herpes to an unsuspecting victim in Vegas. After his one night stand with the unnamed plaintiff, they were left riddled with a lifelong sexually transmitted disease, herpes simplex II, HSV2. Seemingly the defendant gave his word that he had no venereal diseases before they engaged in sexual activity.

The lesson to be learned is that one should get tested every time one changes sexual partner. In many cases an individual will not know if they have herpes as for many, they carry the virus but with no expressed symptoms. The plaintiff may even have had been carrying the virus without knowing it but in the end the risk was not a factor at the time for him/her.

Super injunctions and celebrity gossip aside, STI tests and barrier protection are the only way to avoid contracting such sexually transmitted infections.nIt will be difficult to get to the bottom of this one; we predict an end to the courtroom battle and the handing over of a very large sum of money.

Sexual health researchers in the US are concerned about the increasing resistance of Gonorrhoea to common antibiotics. The CDC (Centres for Disease Control and Prevention) released information last month that was collected on the topic in 2009 and this information listed all of the common treatments that gonorrhoea was now resistant to. Doctors are now prescribing the only remaining treatments known to fight gonorrhoea and information collected in 2010 shows early signs of resistance among these treatments too. The antibiotics fall under a category of antibiotics known as cephalosporins.

According to the CDC, gonorrhoea has the potential to cause very serious health problems if left untreated. The Online Clinic will normally prescribe Cefixime to treat gonorrhoea and we have yet to have case that did not respond to medication but the evidence from wider prescribing and retesting suggests around 10% resistance in the UK. If the infection was contracted in the Far East then there is a higher chance of that strain being resistant; this stems from the overuse of antibiotics in the region.

Many genital herpes carriers (HSV 2 carriers) do not know they have the virus and so spread it to multiple unassuming sexual partners without even realising. Some of their sexual partners will be asymptomatic for life and others will have an outbreak of sores and blisters on a regular basis. The question is who is more infectious?

A recent, large scale study from the University of Washington shows that those with asymptomatic herpes will shed the virus less frequently than individuals who experience symptoms however the amount of virus shed during active episodes of herpes are similar.

498 people collected a genital swab over a period of 30 days and the swabs collected were assessed for viral shedding. In addition, a note was taken of whether there were visible signs of outbreak.

Subclinical shedding is the number of days that the virus is shed without the presence of lesions and subclinical shedding was higher in patients who experienced symptoms. The amount of shedding while the herpes virus was active in either symptomatic or asymptomatic patients was the same.

410 participants experienced symptoms and among them the active virus was detected on approximately 20% of the days they were assessed. The active virus was detected in roughly 10% of the days that the 88 participants who were asymptomatic were tested.

This supports the claim that those who are asymptomatic or have unrecognised HSV2 are as infectious as those who are symptomatic. Most of the viral shedding happens when people have no symptoms.

The researchers also state that approximately 16% of sexually active US adults are seropositive with HSV2, which means that they have the antibodies for the virus but only 10% have recognized herpes of the genitals. 1 in 4 people in the UK are believed to have HSV2 antibodies. You can get tested by post using The STI Clinic's herpes testing service.

The study, published this week in The Journal of the American Medical Association, has highlighted a need for more blood testing in order to uncover those who have HSV2 but who do not know it. The only way to curb the spread of this virus is to be open about a positive diagnosis with new partners, use condoms and get treated when you have an outbreak. The Online Clinic has a large number of patients who take Aciclovir and other antiviral to help suppress herpes outbreaks.

The FDA (Food and Drug Administration) have approved a new instrument developed by BD Diagnostics for the diagnosis of Herpes Simplex Viruses (HSV1 and HSV2) in patients with symptoms.  The tool will aid the diagnosis of both strands of the virus and serve to differentiate between them with the use of external anogenital samples in the hope of decreasing the spread of one of the most common STIs of today.

Being able to find out whether the patient has a type I or type II infection is the first imperative step. Generally speaking, HSV1 is responsible for cold sores (mouth and lips) and HSV2 is responsible for genital herpes (although it is possible to have symptoms in the genital area caused by HSV1). These tests have proved much more accurate than existing culture methods and results are achieved much more rapidly, for example, laboratories will be able to read approximately 96 tests within a two and half hour period.

Such advancements are vital in the area of herpes considering that since its emergence as a serious sexual health risk in the 70’s, the number of cases have steadily increased. There are more than 30,000 new cases each year reported at sexual health clinics around Britain. Some people walk around with the virus and are asymptomatic, meaning that the risk of spreading the virus is high as they do not know that they have it. With more efficient means of testing and higher level of public awareness, the number of cases of infection will hopefully decrease in time.

Researchers from the University of Guelph, Ontario have published a review in Food Research International and reveal that saffron and ginseng come out on top when it comes to aphrodisiacs, with chocolate at the bottom of the pile. They warn against the traditional aphrodisiac Spanish Fly which is made from blister beetles and used in traditional Chinese and African culture.

At the review’s outset, the research team did not believe in the supposed power of the aphrodisiac however, it was revealed that certain substances do work although all of the tests were done on animals so there is no direct evidence that the substances tested would have any beneficial impact on the libido of humans.

The review also strays onto the rise in Viagra and Cialis prescriptions for the treatment of erectile dysfunction (ED), without any indication that the author has any qualifications to opine on matters medical. The review suggests that the side effects of such ED drugs are too dangerous and outweigh the benefits. It is also stated that the drugs are potentially harmful if taken in conjunction with other prescription medications. The review’s author hopes that present ED treatments will be replaced by these natural remedies – what a load of misleading and dangerous nonsense!

Erectile dysfunction does not occur due to a lack of desire or a low libido. ED is a medical condition, which is sometimes the symptom of a more serious cardiovascular illness. There are physiological reasons for the lack of blood flow to the penis which no saffron or ginseng can remedy.

As for comments made about the danger of taking ED treatment with other medication, there is no basis for this concern. PDE5 inhibitors such as Viagra, Cialis and Levitra, can only be purchased with a prescription and after a medical consultation. If patients are taking conflicting medications, they will not be prescribed these ED treatments and other options will be explored. The author should stick to his area of expertise – food and nutrition.

A study published in the Paediatrics journal suggests that more Hispanic and Black girls in the US are being screened for chlamydia than white women of the same age. Minority races are automatically tested for chlamydia when they visit their GP with a complaint whereas it seems the same assumptions are not being made about white girls. Black women are three times more likely to be screened for chlamydia than white girls and Hispanic women are almost 10 times more likely to be screened.

40,000 women participated in this study and were aged between 14 and 25. The study’s author suggests that there is such a discrepancy between numbers due to the perception of race. The author also suggests that insurance providers make assumptions based on race/ethnicity, insurance status and age. Women with private insurance were less likely to be screened for this infection. Considering the symptomless nature of this infection, all sexually active women, especially between the ages of 14 and 25, should be screened.

On a different but related story, Health officials are promoting a very controversial programme in the States that will provide lessons for high school students on abstinence and safer sexual practices and will include an onsite sexual health testing centre. The main aim of this programme is to lower the number of chlamydia and gonorrhoea cases in the high school age group. The number of chlamydia cases has risen hugely from 2005 to 2009 and local health officials believe that providing such confidential and easy access sites inside the school would curb the growing rate of infection.

We may be a long way from sexual health clinics popping up in local schools around England but it does not seem like a bad idea. The longer we ignore the fact that young people are having sex and the longer we think that by avoiding discussion about it, we are in some way protecting them, the longer the spread of STIs will be a problem.

It is two weeks after New Years Eve and one month before Valentine’s Day, S-T-I-Q Day (the UK’s sexual health awareness day) has come around once again. This time of year was chosen since it takes 14 days before most sexually transmitted infections can be detected so getting tested now will ensure all of those romantics have a clean bill of health before the 14^th of February . The goal of S-T-I-Q Day is to promote sexual health screening and this year there is an added extra.

The STI Clinic – the UK’s leading online and postal testing service - launched an Anonymous Notification Service for their clients to inform sexual partners of a positive test result. Anyone who has taken a test through The STI Clinic and had a positive result may avail themselves of this service.

Most men and women do not know they have infections like Chlamydia as it is often symptomless. Yet this is one of the most common sexually transmitted infections and it can have long term consequences such as female infertility and ectopic pregnancies, as we reported yesterday. Between 2008 and 2009 there was a huge increase in the number of STIs reported, 12,000 more in fact, and it is not known how many people are walking around with infections but never get tested.

For more information on S-T-I-Q Day, go to STIQ Day

Not only is infertility a worry for women who have had Chlamydia but now it has been revealed that there is a possibility of having an ectopic pregnancy if there has been a past Chlamydia infection, regardless of having had antibiotics to clear it up. Researchers at the University of Edinburgh found that it was more probable for women who had contracted the infection to produce PROKR2 in their fallopian tubes. The presence of this protein has been linked to ectopic pregnancy, which is the implantation of an embryo outside the womb wall.

This is the first time this link has been highlighted between Chlamydia and ectopic pregnancies. Since Chlamydia, if left untreated, can lead to infertility caused by scarring and blockages in the fallopian tubes, it is understandable that Chlamydia may also cause changes in the fallopian tube without scarring being evident.

Botox may have more to offer than the stymieing of the ageing process. Those who suffer from herpes simplex 1 may in the future be pumped with the siliceous fluid to treat the cold sores which appear as a symptom of the virus.

Currently, Botox is being examined as a treatment for this type of cold sore by the researchers from the Chicago Centre for Facial Plastic Surgery. Participants will be injected with Botox, thus inducing the paralysis of muscles in the lip for a period of duration of 3 months. The researchers are analysing whether or not the virus will be blocked as a result of the paralysis. The paralysis in theory would force the virus to maintain its dormancy as the muscles would not be in use.

Since the virus is impossible to eradicate, it is promising that we may gain some control over these annoying symptoms and maybe look a little younger in the process.

The latest innovation in the determining of sexually transmitted diseases comes in the shape of a tiny microchip. The microchip also serves to detect prostate cancer. The invention was made by Samuel Sia, an assistant professor of biomedical engineering at Columbia University.

All that is needed for the detection of such illnesses by the Mchip is a drop of blood and the results are available between 12 and 15 minutes. The Mchip has been tested in Rwanda for the last 4 years. It is aimed at pregnant women who are located too far away from testing sites. Now earlier detection of such diseases will aid the treatment process.

Smoking, drinking alcohol and chewing betel nuts all increase the risk of developing mouth and throat cancers. The HPV virus also been found to increase the number of cases of oral cancer and is thought to be spread through oral sex and kissing.

The same virus that causes genital warts and cervical cancer is now worryingly associated with cancer of the mouth and throat. The study was published in the Centres for Disease Control and Prevention.HPV has been reported with many cases of oral cancer which itself is on the increase. It is thought that the increase in cases of oral cancers is due to the societal change surrounding sexual behaviours for example, an increase in the practice of oral sex, having multiple sexual partners, and starting to have sexual intercourse from a young age, are all related to these HPV associated oral cancers. The study authors suspect that we are coming into a ‘slow epidemic’ of primarily HPV related oral cancers that have been sexually transmitted. Oropharyngeal cancers that are caused by HPV are the second most common cancers that are linked to the HPV virus.

If the HPV vaccine received by the female population as a means of reducing the incidence of cervical cancer also decreases the number of mouth and throat cancers, the groups receiving the vaccination might also be extend to males.

Will the faces of the JLS singers really help to sell condoms? JLS have launched a new sexual health foundation and are setting out to promote safe sex with a range of JLS condoms. Each band member will have his own face pictured on the condom wrapper.

Looking back at the results of the sexual health figures collected for 2008 to 2009 and issued by the HPA (Health Protection Agency) some months ago, perhaps JLS and celebrities alike would do well to promote the use of condoms. It was reported that those between the ages of 15 and 24 practise the most unsafe sex with one in ten becoming re-infected within a year of being treated.

Despite how positive this type of promotion sounds, there is debate circulating about the mixed messages that musicians in the limelight are sending with their sex, drugs and rock n’ roll lifestyles. I must admit, I imagine JLS as far from the hotel trashing, drug taking ‘cool’ that we have all at one point been romanced by. Rather, I would wonder whether JLS will have a powerful enough influence on the age groups most in need of inspiring. Have they indeed gone passed their obsessional phases with baby faced boy band members?

Or from another perspective, will the innocent, awe inspired, prepubescent individuals among the young loyal British fans feel that sex and sexual promiscuity has now been normalized and Okayed for them by the bonafide goody boy band?

With chlamydia and gonorrhoea on the rise, this type of promotion cannot hurt. High percentages of new cases of these common STIs were contracted by those aged 15 to 24.

The Journal of Consulting and Clinical Psychology has published a study carried out by researchers from the Bradley Hasbro Children’s research centre who explored psychiatric disorders and their relationship with risky sexual behaviour in adolescents. In particular, teenagers who experience dramatic mood swings as characterised by moods that are at one point euphoric changing suddenly to an irritable or remote mood are said to engage in a higher level of sexual activity, a larger number of sexual partners and have an increased risk of acquiring a sexually transmitted infection.

Moreover, teenagers who have disorders such as ADHD or who engage in dysfunctional behaviours such as stealing or behaving in a hostile manner are also more likely to have an active sex life. Anxiety, depression and post-traumatic stress are all contributing factors as well.

Project STYLE was the name of the study carried out and was the first multi-site HIV prevention program for parents and young people with mental health disorders.  More than half of participants were female and African-American and the average age was 15.

The disorders and behaviours mentioned above are associated with impulsive acts and the attitude the teenagers conveyed in their relationship with sex, according to Larry K. Brown of the research centre, displayed this kind of impulsive tendency regarding the number of sexual partners they engaged with and with the absence of contraception.

He suggests that teenagers diagnosed with such psychiatric disorders should have regular sexual health screenings as a part of their regular mental health therapies and treatments. Considering the rise in the number of sexually transmitted infections such as chlamydia and gonorrhoea among young people today, the increased potential of this group to have sexual intercourse without contraception and with multiple partners, would put them at a much greater risk.

More than half of the participants had a history of vaginal or anal intercourse. Of those who were sexually active, 29% had sexual intercourse without the use of a condom. 31% had engaged sexually over the past 90 days with an average of 2 partners each and 15% reported that they had four or more partners. 14% tested positive for an STI. This group was four times more likely to have an STI than other groups.

A study on the effects of an HIV treatment on the herpes virus has been published. Scientists at the Institute for Research in Biomedicine in Barcelona have discovered that Raltegravir (Isentress) the HIV treatment manufactured by Merck, is also successful killing off one of the herpes viruses.

The medication works by inhibiting the action of a protein involved in the replication of the herpes virus. Now scientists are in a promising position regarding the development of a drug that may kill all types of herpes virus considering the fact that all of the herpes viruses contain this protein. Pathogens of the herpes virus include herpes simplex I and II, the virus that causes chickenpox and the Epstein-Barr virus, which is linked to many types of cancer.

Humans do not have the viral protein that is affected by the drug. This means that the drug is unlikely to have any other effects on the body and additionally, the inhibitor is not toxic with the correct dosage and it is already licensed and regulated.

The study set out to develop a drug that could combat the herpes viruses. With the knowledge that all herpes viruses have this protein, there is a great possibility of developing one drug that can cure all types of herpes viruses.