PostHeaderIcon Sexual Health Testing Options

Background

The traditional approach to sexual health in the UK has been that patients should be encouraged to attend a GUM clinic in their locality if they feel they need to be tested. This is all well and good but people generally only feel the need to be tested for a sexually transmitted infection in the event that they have done something they wish they had not, or if they develop genito-urinary symptoms that they find troubling. Given that STIs do not always have symptoms and people generally do not wish to be subjected to tests that they believe are unnecessary, you can see how problematic this can be for maintaining a low level transmission.

Chlamydia Public Awareness Campaign

An alternative approach has been to raise public awareness of the fact the some STIs do not always have symptoms. We had an extremely effective campaign in the UK a few years ago surrounding Chlamydia, which focussed on the fact that you could be infected and not know it. The campaign was advertised on television and there was a plethora of street ads. This effort to raise public awareness led to a large number of people availing themselves of free tests that could be sent to your home for you to complete at your leisure under the auspices of the National Chlamydia Screening Programme. While this was to be welcomed, one adverse impact of the success of the campaign was that it focussed attention on only one STI and people only got tested for that one infection.

Gonorrhoea

The success of the Chlamydia campaign has led to fewer people getting tested for gonorrhoea. While most men (around 95%) will develop symptoms with a gonorrhoea infection, almost half of infected women will be asymptomatic. Gonorrhoea is the second most common bacterial STI in the UK and it is back on the rise after being in retreat for a number of years. Anyone getting tested for Chlamydia really should be tested for Gonorrhoea at the same time and this is a major limitation of the National Chlamydia Screening Programme.

HIV

HIV services are being split from sexual health services in some hospitals and health trusts and this has the potential to cause problems down the line if it precludes HIV testing being offered as part of a general sexual health screen. HIV continues to be on the rise in the UK but it is not completely out of control. Also, contrary to popular myth, HIV infection rates are rising fastest in the heterosexual population. Although men who have sex with men (MSM) are still disproportionately affected by HIV infections, they no longer constitute a majority of new diagnoses. It is important to communicate this message so nobody is labouring under the misapprehension that HIV does not have the potential to affect him or her because they are not gay or an intravenous drug user.

Getting Tested

It is recommended by Public Health England that people aged 16 – 24 get tested once a year for STIs. It is further recommended that people get tested every time they change sexual partners. The problem with this advice is that there are no really good NHS services available that make it easy for people to get tested for a broad range of infections. The NHS has made it fairly easy for people to get tested for something like Chlamydia but this is only one STI. There are a number of private services that offer testing by post but they also have limitations in that many of them are not staffed by healthcare professionals and they also have a rather limited range of tests as most can only test using urine samples or vaginal swabs. This limitation rules out testing for blood-borne viruses and bacteria such as Hepatitis, Syphilis and HIV.

An Alternative Approach

There is one clinic in Harley Street in London that has a comprehensive EU-wide internet testing service using an accredited pathology lab but some of its screens are quite expensive and may be out of the financial reach of some people. TheSTIclinic.com does have very accessibly priced basic tests like Chlamydia and Gonorrhoea and their individual blood tests are also quite accessible too but their wider screens are quite pricey. We are not saying that the prices are unreasonable, simply that they are out of the budgetary reach of most people. While this clinic is providing a valuable service and we are not going to denigrate them for making a profit out of healthcare, there is a yawning gap in the UK between what is available in the private sector and what the NHS is offering. The Sexual Health part of the NHS really needs to emulate these private sector providers to ensure that good sexual health services are conveniently available to all and not just the few who can afford them.