Budget Cuts, Stigma, and the Rising Rate of STIs in the UK

24th January 2019

While mandatory sex education is set to become the norm across all British schools for students aged 12 and up in 2020, this progress is lost on everyone else who has had to rely on a largely ineffectual system of sex education. 

Until now, sexuality and relationship education (SRE) has not been compulsory for academies and free schools, who make up the majority of schools across the UK and are not obligated to follow the National Curriculum. On top of that, faith-based schools were also not required to teach SRE. 

As such, for many sexually active people in Britain, their sex education has been non-existant at worst and incredibly heteronormative at best, focusing solely on the prevention of pregnancy and STIs. But with so much focus on STI prevention, how come there is still so much misinformation, stigma and lack of knowledge around STIs? 

Social Stigma and STI transmission

You’d think that because there is so much stigma around sexually transmitted infections, that everyone would be well brushed up on their health status and uptake for STI screenings would be high, since everyone is so terrified about contracting one. 

In reality, uptake for STI screenings is alarmingly low – and according to new data, it is estimated that over half of Brits have never had an STI test. 

Research commissioned by Medicine Direct as part of the Fruit of your Loins campaign promoting STI testing and awareness showed that 58% of respondents have never had an STI screening, while 12% hadn’t had one in over 5 years. 

The campaign, which was launched earlier this year, also showed that 26% of Brits would only get checked if they experienced any symptoms, which is alarming considering that in most cases, some of the most common STIs have no symptoms. 

According to figures from the FPA (Family Planning Association), 25% of all new recorded STIs are found in London alone – however it is important to remember that with a population of over 8 million people, a higher number of STIs is to be expected. And with relatively easy access to health services and the possibility of a more urban, “progressive” attitude towards sexuality and sexual health, people living in London are more likely to even be tested in the first place than their rural counterparts. 

These figures show that stigmatising STIs doesn’t work to decrease the incidence of STIs. In fact, all STI stigma does is continue to silence discussion around STIs, making those who might have them more unlikely to have them checked – which can lead to much worse health problems in the long run. 

This is a worrying trend, since the more common STIs aren’t actually that scary and are also the most treatable, if they’re caught early. 

Most Common STIs are Asymptomatic

While Chlamydia and Gonorrhoea are both on the rise, they are also easily treated with antibiotics. While there have been increasing cases of “Super Gonorrhoea” that is much harder to treat, these cases are still quite rare (even if they do make for sensationalist, attention-grabbing tabloid headlines). 

While both Chlamydia and Gonorrhoea are very treatable, in most cases neither of these infections will show any symptoms, so without regular testing they can go undetected and do further harm. 

If Chlamydia and Gonorrhoea are left untreated, both can lead to pelvic inflammatory disease (PID) which can cause infertility, and an increased chance of ectopic pregnancy in women and people with uteruses. In people of all genders, untreated Chlamydia and Gonorrhoea can increase a person’s chances of contracting HIV. 

As the most stigmatised STI, living with HIV is no longer the “death sentence” it once was in the 1980’s and 1990’s. However, the symptoms around HIV are insidious, and can easily be shrugged off on something else altogether. During the first stage of infection, some people can suffer with flu-like symptoms, such as headaches, fever, a rash and a sore throat. Stage two is asymptomatic, and does not present itself with any symptoms. This stage can last many years (8-10 years on average) during which the person infected may feel completely fine – while the virus continues to weaken their immune system. 

While having a cough doesn’t automatically mean you’ve contracted HIV, it’s important to keep up to date with your own status and the status of your partner – which means having frank, open and honest discussions, and getting regular STI screenings. A good rule of thumb is getting tested every 3 months or so if you have multiple sexual partners, and once a year if you’re in a monogamous relationship.  

If a person is HIV positive, taking regular medication and with an undetectable viral load, they cannot pass on HIV through sex and their sexual partners are perfectly safe. If you are HIV negative, you can also take PrEP to decrease your chances of contracting HIV during a sexual encounter. Unfortunately, PrEP is not available for prescription on the NHS, however it is available through some sexual health clinics.  

How accessible are STI services? 

While getting regular STI tests is the best step towards reducing your chances of contracting an STI, this also has its own hurdles – namely, a lack of comprehensive sex education which destigmatises and demystifies STIs. 

Even taking responsibility for your sexual health and going for an STI screening can be highly stigmatised, given that you’re publicly acknowledging you’ve come into contact with another naked human body – which in itself, is wrapped up in a complex web of stigma and shame. 

In reality, individuals are not solely to blame for not taking complete responsibility for their sexual health. Thanks to budget cuts in the health service, the number of people attending health screenings has dropped considerably, while cases of syphilis, gonorrhoea and chlamydia have risen. 

Earlier this year, former health minister Steve Brine revealed that sexual health checks had fallen by 245,000 in the last 3 years, as local council budgets to promote sexual health had been cut by £55.7m since 2013/2014. 

On top of this, figures from Public Health England show that young Brits, who are among the most at-risk group for contracting STIs, are not learning the communication skills necessary to talk about STIs in their personal relationships. A YouGov survey of over 2,000 young people showed that 43% of women and 56% of men said that its difficult to talk about STIs with friends, while 58% said if they did have an STI, they would find it hard to bring it up with their sexual partner. 

Alarmingly, 47% of respondents also revealed that they have had sex with a new partner without using a condom, with 1 in 10 young people saying they had never used a condom before, despite being sexually active. 

32% of young people also said that they had never seen a condom mentioned in on-screen sex scenes, which just shows the power of representation when it comes to changing societal beliefs. While TV shows like Big Mouth and Sex Education have brought the discussion around sexual health away from your GP’s office into the mainstream, this doesn’t mean everyone suddenly feels comfortable running to their nearest STI clinic. 

How to conduct your very own STI test

If you’re intimidated by accessing public STI services (“what if someone sees me walk in???”), or accessing them through your GP (we get it, they’ve known you since you were a sprog, and the idea of them knowing the sordid details of your sex life can be A Bit Much) don’t fret – there are services for you. 

Through the NHS, you can order a home testing kit, which lets you administer your own complete STI test from the comfort of your own home without the added cringe of a stranger swabbing your genitalia. 

With the NHS self-test kit, you can easily take your own blood and urine tests, and swab your mouth, anus and genitals. Having complete control over your own health screening is also an amazing option for anyone who’s experienced sexual trauma, wherein being touched by a near stranger can be a very upsetting and triggering experience. 

The best part about it, is that it’s completely free – you’ll even get a pre-paid envelope included in your kit to send it off to be tested. On top of that, the packaging is very subtle, so you won’t have to worry about a parcel arriving in the front door with “STI TESTING KIT!!!” emblazoned across the front. So what’s stopping you? Take your healthcare into your own hands (literally) and order a free self-test STI kit from the NHS to stay up-to-date on your STI status.

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