More sex education, more tests, more awareness, less stigma

Timely treatment of STIs is crucial in preventing chronic conditions and limiting their spread

Tue, Jun 10, 2014, 01:00

Many people overlook the serious direct and indirect impacts of men’s sexual health. Some conditions are specific to men, but many are intrinsically related to sexual and general health in both men and women. Sexually transmitted infections (STIs) are a major cause of morbidity with a direct economic burden. They may also have psychological consequences.

Most STIs are easy to diagnose and have effective and low-cost medical treatments. The critical issues are people’s awareness of their own health, and access to care. Timely treatment is crucial in preventing chronic conditions and limiting their spread. Three factors contribute to the timely treatment of STIs: people seeking medical advice, the practice of caregivers and how sexual health services are given.

The risk of getting and spreading HIV is greatly increased when another STI is present in either partner. Serious illnesses such as syphilis can be life-threatening. Recurring genital conditions such as herpes cause direct physical and emotional strain.

Many men have a low perception of the risks associated with their behaviour. They are often unaware of what and where services are available, and are often reluctant to use them. Sexual health is also affected by factors such as the increasing use of social media to meet partners. Travel, changing relationship patterns and use of pharmacological agents have also affected sexual practices at differing ages.

The Royal College of Physicians (RCPI), with clinicians, community partners, schools and patient support groups, hosts Sexual Health Awareness Weeks (see rcpi.ie/shaw) to promote good communication, which is vital when addressing sexual health and sexuality.

A service well structured to deal with sexual health in men, as for women, can lead to health improvements, economic gain and the removal of stigma; many men say they are too embarrassed to go to their GP for a sexual health examination.

When HIV/Aids emerged in the 1980s, there was a decrease in the reported incidence of acute STIs in Ireland and the EU. However, since the mid-1990s there have been sustained, significant increases in the incidence of STIs, especially gonorrhoea, syphilis, Chlamydia, HPV and urethritis. These increases have been especially evident in young people, ethnic minorities and men who have sex with men.

Urethritis

Urethritis is the most common STI affecting men. It is most frequently due to infection by Chlamydia trachomatis or Neisseria gonorrhoea. It can also be due to other organisms or non-infectious causes. Infection is asymptomatic in most cases of Chlamydia, highlighting the importance of testing and being aware of one’s own health. Gonorrhoea is mainly reported in men and found in high-risk groups such as men who have sex with men.

Complications can occur with both Chlamydia and gonorrhoea. Disseminated infection can occur with certain serotypes of Neisseria gonorrhoea, causing fever, rash, and tenosynovitis. About 30 per cent of men infected with gonorrhoea are co-infected with Chlamydia.

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