Deep Dive
Why are STIs on the rise in Ireland, and what challenges does this pose for public health?
STIs are on the rise in Ireland due to factors like casual sex, lack of awareness, and insufficient healthcare facilities. The country is not on track to eliminate sexual diseases by 2030, as infections like gonorrhea and syphilis have seen significant increases over the past 5-8 years. These infections, while treatable, can have severe long-term consequences if undiagnosed, including damage to the brain, heart, liver, and other organs.
What role does community awareness play in combating STIs?
Community awareness is crucial in combating STIs, as many infections go unnoticed and unreported. Public discussions, like those on radio programs, help educate people about the importance of regular testing and safe sex practices. Dr. Derek Freedman emphasizes that infections are often silent, with no symptoms, making testing essential for early detection and treatment.
Who should get tested for STIs, and under what circumstances?
Anyone who engages in risky sexual behavior, such as having multiple partners, unprotected sex, or sex under the influence of alcohol or drugs, should get tested. Dr. Freedman highlights that infections like gonorrhea and syphilis are increasingly common, particularly among young girls, and stresses the importance of knowing one's sexual partners and using protection like condoms.
What are the long-term consequences of untreated syphilis?
Untreated syphilis can lead to severe long-term consequences, including damage to the brain, heart, liver, lungs, skin, and bones. Historically, syphilis was a major cause of death, but antibiotics have made it treatable. However, without testing and treatment, the infection can progress silently, causing irreversible harm.
Why is gonorrhea particularly concerning in Ireland today?
Gonorrhea is concerning due to a significant rise in cases, with Dr. Freedman noting that he now sees in a month what he used to see in a year. The infection is increasingly found in the throat and back passage, and it is particularly worrying among young girls. While gonorrhea in the penis is usually symptomatic, infections in other areas can go unnoticed without testing.
What misconceptions exist about STI testing in Ireland?
A common misconception is that Catholic guilt discourages Irish people from getting tested. Dr. Freedman disagrees, stating that this notion was dispelled decades ago. Instead, he observes that individuals from other religious backgrounds, such as Muslims, may feel guilt due to cultural or religious stigmas around certain types of sexual activity.
- Increase in STIs in Ireland
- Ireland is not on track to eliminate sexual diseases by 2030
- Statistics only represent reported cases from clinics and SH24
Shownotes Transcript
Now, our next item is a conversation about sexually transmitted illnesses and diseases and may not be suitable for little ears if you want to take them away from the radio. Now, it looks as if sexually transmitted infections or STIs are on the rise.
showing worrying signs, statistics for 2024. It follows a huge uptick the year before, with Ireland not set to reach our target of eliminating sexual diseases by 2030. Joining me now to discuss the increase is Dr Derek Friedman, a specialist consultant in sexual health and sexually transmitted diseases based in Rennela. Derek, welcome to the programme and happy new year to you. Happy new year to you and to the audience and thank you for
giving us the opportunity to talk about this ever-present problem. Okay, and an ever-present problem it is because some of the statistics that have been released show a very worrying trend. What
What's interesting about the statistics, though, is you say that they only tell a bit of the story because this is only from clinics. Basically, the statistics would come from the clinics and from the SH24 free testing service.
But there's a lot of infection seen in the community which is not notified and people aren't aware of. Although most of the important infections are notified by the laboratories and they are accurate. Okay. So I mentioned in my introduction that Ireland is not on target to eliminate sexual diseases by 2030. Is that ever likely to happen?
Well, I think sex is enjoyed and very popular and I think it's highly unlikely to happen and Ireland is not an outlier in this. This is seen throughout the world and particularly where there's a lack of heterosexuality
health care and health facilities to deal with infections and there's a lack of awareness about the potential for infections and where people don't talk about it. That's why, you know, coming onto the air like this is so valuable to make people aware, to make people cognizant and of the necessity to get checked up because these infections are completely silent. You've no signs, no symptoms, no way of knowing you have it.
until somebody comes back and tells you. So getting checked is terribly important.
So who should get checked? Anybody who's having sex or anybody who's having risky sex or who? Well, I mean, basically, you know, there are hundreds of thousands of people having sex in Ireland every night. A minute proportion would actually have to worry about infection. It's basically when you have sex with somebody you don't know, somebody who's casual, having sex under the influence of drink or drugs, same as driving.
and not using protection like a condom. But the essential is get the name of the person you're with, get the telephone number and I always say give breakfast so you know where you've been. Condom, condoms, condoms. Okay. It seems like a message that is so old yet you have to keep repeating that message. Absolutely. I mean, sex is a very powerful driving force. It's probably the next most powerful force after hunger.
We were talking about getting tested and, you know, people should be tested. But I was interested in the comments by Dr. Aisling Loy, who's a consultant in sexual health in St. James's Hospital, where she believes that one of the reasons people don't go to get tested is because there is what she called a hangover of Catholic guilt that makes Irish people uncomfortable with the idea of regular testing. Is she right? Yeah.
I wouldn't agree with that, frankly. I mean, I think Gay Byrne dispelled Catholic guilt 40 years ago. I don't see that. I see probably more people from other religions, Muslims in particular, who feel very guilty that they're having sex, and particularly if they're having a type of sex that may not be approved by their ethos, and some of the kind of other sects as well. They're the people I see.
In terms of the statistics, and as we said, the statistics only tell a certain part of the story, you believe that there are some very worrying statistics for conditions like gonorrhea and syphilis? We're certainly seeing a huge increase in gonorrhea and in syphilis over the last decade.
five to eight years. And this is very worrying because these are readily treatable and readily curable infections that have long-term consequences, particularly syphilis. I mean, syphilis was the big killer in Ireland and throughout the world at the beginning of the 20th century.
Antibiotics have dealt with that, but if you don't get tested and if you don't know that you've got the infection, you don't get treated and it can go on and completely destroy you, affect your brain, your heart, your liver, your lungs, your skin, your bones, everything.
That was the old story. I mean, when I was a medical student, I used to see a lady who used to walk up and down Grafton Street with this high-stepping gait that was typical of syphilis. You don't see that anymore because of antibiotic treatment, but if you don't get diagnosed, you don't get treated. And are there any symptoms of syphilis that...
would make me want to go and get tested? Syphilis is difficult because you may get a sore, a painless sore, but because it's painless, maybe it's on an area of the body that you can't inspect, you don't see it. Frequently you get a rash, but again, the golden rule is symptoms are not reliable. You're lucky if you get symptoms, but if you've been at risk, you won't detect it unless you're tested.
And then gonorrhea as well. You were telling me before we went on the air that the amount of gonorrhea that you see today is huge compared to what you used to see. I see in a month what I used to see in a year and a lot of gonorrhea again. Well, if somebody has gonorrhea in the penis, it's usually symptomatic. Usually they have a discharge, but
But a lot of it is in the throat and in the back passage. And in particular, what's quite worrying is we're seeing a lot of gonorrhea among young girls. On young girls? Young girls. And usually it's carried in their throat. OK, so again, back to getting tested, because this is vitally important that people hear the message. What people listening to us right now should be tested for STIs?
People who've had multiple partners, people who've had unprotected sex, people who don't know where they've been because they were too drunk and just people who also, particularly people who should be afraid of bringing something home. Dr. Derek Friedman, thank you very much indeed for joining us on the programme and Dr. Friedman is a specialist consultant in sexual health and sexually transmitted diseases.
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