“The rate of STI's have been increasing steadily since 2002, writes Helene Hoffman, pointing out that people are more likely to have unplanned sex and take sexual risks when they're away from home.”

Irish Times Health Supplement 10/07/2007

Over the coming weeks people will take they're annual holiday, go to a music festival, sporting event or even take a short break away. Experts warn that it's during these times that alcohol is consumed, inhibitions are lost and you're most likely to have unprotected sex and pick up an STI.

“Our research has shown that there are particular times of the year when people are more likely to take risks. That is when people are out of the home setting, at festivals, sporting events or on holiday,” said Enda Saul, programmes and communications manager for the Crisis Pregnancy Agency.

“We've found that it's in these situations that unplanned sex takes place and sexual risks are taken.”

The HSE Health Protection Surveillance Centre says for the first half of last year, provisional figures show there were 1,387 cases of SIT's notified for that period from STI clinics and some GP's. The highest number of reported cases of STI's which included Chlamydia, genital warts, gonorrhea, HIV and Syphilis, were among the 20-29 age group.

Since 2005, The Crisis Pregnancy Agency has been running the “Think Contraception” campaign to highlight the risks of unprotected sex to 18-25 yr olds. This year it will distribute 150,000 tins, containing a condom and a leaflet with information on using condoms, unplanned pregnancy and STI clinics, at music and sporting events around the country.

These events include last weekends Oxegen festival, the upcoming Electric picnic, the Galway Races and big matches in Croke Park in Dublin .

“If people plan for sex then they will more than likely use protection. We know people use contraception so we need to keep encouraging that,” says Saul.

The rates of STI's have been increasing steadily since 2002. However that increase can be attributed almost entirely to the growth in population, the increase I availability and quality of screenings and the fact that more people are coming forward for tests. The Dublin Well Woman Centre released it's annual report for 2006 last week and revealed that from 2002 – 2006 the number of requests for full STI screening has increased three-fold from just 600 in 2002 to 1,800 in 2006.

“In most cases the people presenting are symptom free and just want to check things out because they know that with STI's there aren't always clear signs,” says Shirley McQuade Medical Director of the Well Woman clinic. “We have also seen an increase in the number of couples coming in together. They may be just starting a relationship and want to make sure they don't have any infections. That's a good sign from a public health perspective, that people are coming in before they have symptoms,” says McQuade.

According to genito urinary physician Dr Derek Freedman, one of the common misconceptions about STI's is that there are symptoms or signs.

“The most important thing to know about symptoms is that there are none. That's why we have to do the tests,” says Freedman. “The golden rule to remember is that if you were at risk from one infection you are at risk of them all. When you are screened, you should be screened for them all.”

According to the HSPC report, Chlamydia and ano-genital warts are accounted for 81 per cent of the cases reported in the first half of 2006. However, Freedman says that the other STI's are making a comeback.

“We're seeing an extraordinary resurgence in infections such as syphilis and gonorrhea. In the 1990's, I might have seen two or three cases of gonorrhea a year, recently I've seen two or three cases in one week…

“That's because people are travelling more to countries in South East Asia like Thailand and are less inhibited,” says Freedman.

People are also being given antibiotics all the time by doctors. All the gonorrhea we're seeing now is resistant to first-line antibiotics all the time by doctors. Antibiotics are also a problem if they are taken before the diagnostic tests (for STI's) are carried out because it means that our diagnostic tests are impaired and we cannot give a precise diagnosis to them or the partner, which has serious consequences,” says Freedman.

While many people may return from holidays having contracted an STI, Freedman points out that this is usually because of excessive alcohol consumption.

The Irish Study of Sexual Health and Relationships published by the Crisis Pregnancy Agency and the Dept of Health and Children in October last year, found that when people in the 18-24 age group have failed to use a condom they cited drinking alcohol (20%) and not “being prepared” (16%) as the main reasons.

“We're hugely aware of the influence of alcohol,” says Freedman. “People come to me after holidays, or even after a weekend. Some of them don't even remember if they've had so much to drink,” he says. “Drink is responsible in 60% of cases.”

In cases where a risk may have been taken he recommends contacting a doctor for advice and going to a reputed STI clinic for a full screening within 5 – 10 days.

“These days we get this phenomenon called ‘cyberchondria' where people look things up on the internet”, says Freedman. “If you take genital herpes, for example there are over 666,000 sites if you do a search – and about two of those are useful,” he says. “It's better to go to a clinic, you can't diagnose yourself. Watch out for expert knowledge and make sure a full set of tests are done, including a pelvic examination… There is also this misconception that you don't need a cervical smear until you are over 25.

“People should have cervical smears within one or two years of commencing sexual activity. I have seen significantly abnormal smears in girls under 20,” he says.

“The same stigma doesn't apply to STI's that applied in the past. These are simple, easy-to-treat infections. There are very few of these infections that really affect your quality of life. Even with HIV there is good treatment available and we have people with HIV alive for over 30 years and healthy and leading a good life,” he says.

“My advice is very simple. First get a name of the person you are with, get a mobile no, give breakfast, get to know the person. Use protection for the first 3 months of a relationship and if either of you have any anxiety don't be afraid to come get a full check-up. Finally, don't be frightened if you or your partner find a problem. These are accidents, not tragedies.”