It's the bumper season for 'party' sex - and for the STIs that all too often result from drunken abandon, writes Kate Holmquist
There's one Christmas present nobody wants but lots of people are going to get. And like most unwanted presents, it could be tempting to pass it on to someone else.
We're talking syphilis, gonorrhoea, chlamydia and even HIV. Unprotected sex takes place all year round, but assexually transmitted infection (STI) clinics remind us every year, Christmas is a bumper season for "party" sex enjoyed at speed and regretted at leisure.
While one of the fundamentals of good sex is the warm glow the next day, guilt and fear are too often the consequences. Dr Derek Freedman, specialist in genito-urinary medicine in Ranelagh, Dublin, and consultant with St James's STI clinic, says: "The worst sex is regretted sex." Most people who have casual sex get drunk in order to drown inhibitions. This is part of the experience, he says.
"I had too much to drink and got laid," is the typical explanation he hears when people visit him with worries that they've picked up an STI. "And it is not just boys," he says. Others admit that they remember little. "Some don't even remember if they had sex or not. They say, 'I was there so it could have happened'."
A male patient returned from Cyprus after a frolic in a swimming pool with three English girls. Irresistible as it may have seemed at the time, the man in question felt anxious afterwards because it wasn't possible to use a condom during sex in a swimming pool.
"We are very aware of the high infection load carried by English girls, although we are catching up," says Dr Freedman.
Cases of syphilis - which most people think of as a dark plague of the 19th and early 20th centuries - have doubled again, the Health Service Executive announced this week. There's also been a big increase in chlamydia, which may cause infertility in women and arthritis in men if left untreated.
Some 10,000 STI cases were reported in 2005, but the true figure is probably far higher, because gonorrhoea shows no symptoms in 86 per cent of women and 55 per cent of men, while chlamydia goes undetected in 70 per cent of women and 50 per cent of men.
CHRISTMAS DRUNKENNESS CAN have people who have been eyeing each other up all year finally making a move. "Some people have easy sex because they're shy. It means they don't have to talk," Dr Freedman explains.
Others prefer the non-amorous encounter. One female patient, diagnosed with an infection, described a partner only as "shag buddy". While others, when approached by infected partner to warn them, "just didn't care", Dr Freedman says.
Whether there's any meaningful conversation involved or not, sexual contact with a new partner should always involve a condom, whether or not there is penetrative sex, he warns. This message was reinforced this week by the HSE's Catherine Murphy, assistant director for population health.
Dr Freedman asserts: "The debate over whether condoms are 100 per cent effective is a smokescreen some people use to perpetrate their own ideas to the disadvantage and harm of other people. There's no doubt that I would see very, very few people in the clinics who used condoms. It just doesn't happen."
TEENAGERS TEND TO be terrified of sex, people in their 20s the most savvy, and people in their 30s and 40s the most likely to be uninformed and take risks. "I've had men over 60 being diagnosed with HIV as a result of recent contact," says Dr Freedman.
Alarmingly, there are still sexually active people out there who don't use condoms to protect themselves against infection because the public health messages get lost in the daily barrage of advertising information, he adds.
Having taken a risk, it's sensible to have a full screening - especially before having sex with anyone else, including a spouse or long-term partner.
"Everything can be treated, but you have to have all the tests," says Dr Freedman. One of the most embarrassing aspects of becoming infected is having to tell a spouse or partner, although people are usually incredibly understanding.
"One married man was infected with HIV through gay relationships, and when his wife came in to us her only concern was, 'Will my husband be all right?'"
In Irish society, says Dr Freedman, sex has become a "very available expression of personal identity and is almost beginning to be seen as a commodity", especially among teenagers who read teen magazines and wear clothing that makes them appear sexual well before they are ready. Parents have a responsibility in this, he says. Many parents are so aware of their teenagers' sexual proclivities that the parents bring their children into the STI clinics when there has been risk of infection. "It is great to see so much openness, communication and support between the generations. Of course, for many of the parents, anxiety about a possible infection may still be a fresh memory."
People are more assertive and open about sex now, but they aren't necessarily more sexually active than their grandparents' generation, he says. "People in their 60s, 70s and 80s were quite sexually charged, though less explicit. They allowed themselves to be ashamed."
Not that shame should be endured in the case of STIs. Says Dr Freedman: "Sex is to be enjoyed. You will enjoy it better if you know the person you are with, if you're not loaded with drink, if you're taking precautions and if you give them breakfast the next morning."
Contacts:The GUIDE Clinic, St James's Hospital, Dublin, 01-4162315/6; the HIV Helpline, 1800-459459