Sexual health clinics which appeal to both men and women could help reverse rise in STIs
If the current rise in sexually transmitted infections (STIs) in the State is to be reversed, then community-based sexual health clinics delivering free or subsidised healthcare and contraception must be set up across the State, according to a new report.
The report from the Women's Health Council, an advisory body to the Minister for Health, says that these clinics must be presented in such a way as to appeal to both men and women in a gender balanced way.
It points to the fact that specialised sexual health services are scarce outside the main urban centres in the Republic, that condoms in Ireland are among the most expensive in Europe and that the cost of a visit to a GP for treatment or screening can deter many people who do not have medical cards. These are all issues that need to be tackled, it says.
Furthermore, it says "the old- fashioned name of family planning clinic has now become unattractive even to young women", and men perceive family planning services to be for women only.
"Therefore, sexual health clinics, covering contraception, STIs, sexual dysfunction and any other relevant health issue, should be established nationwide and presented in such a way as to appear to [ be for] both men and women," it says.
It hopes these can be established in all the new primary care centres proposed by the Health Service Executive.
The report, Women & Sexually Transmitted Infections: A Gendered Analysis, refers to a "staggering" increase of 173.8 per cent in notified STIs in the Republic in the decade from 1994 to 2003.
While it says the rise is partly due to increased awareness and screening as well as more sensitive diagnostic methods and improved notification systems, "it still points to a significant upsurge in risky sexual behaviour". And it says the statistics are a "huge underestimate" of the real incidence of STIs because of the current lack of a comprehensive system of surveillance.
Similar increases have been documented throughout the EU, it says, and as a result many governments have implemented specific sexual health strategies. "It is hoped that this report will support and assist the formulation of an Irish sexual health strategy as a matter of urgency," it says.
Looking at the types of STIs being reported, it says the most common types are ano-genital warts, chlamydia and non-specific urethritis. It expresses concern at the fact that "despite the very serious consequences of chlamydia infection there is no national strategy for its screening at the moment".
This infection has been reported to lead to infertility in both men and women, and there was a 1,044 per cent increase in cases of it reported to the Health Protection Surveillance Centre between 1995 and 2004.
The report adds its voice to calls for a national chlamydia screening programme and says it should be for both men and women.
Meanwhile, the report says women are at greater risk of contracting STIs because of biological, cultural and socio-economic factors. Yet it says young women are often unable to bring up the topic of condom use "for fear of being perceived as too forward or experienced".
And it says it is unsatisfactory that the legal age of consent for sexual intercourse and medical treatment are not the same. The legal age of consent for sexual intercourse is 17 years, but a child becomes an adult for the purposes of consenting to medical or surgical treatment at 16 years.
"The above situation is unsatisfactory and has the potential of limiting young people's access to appropriate sexual health services," the report states.
It calls for revised legal and practical guidelines in relation to age of sexual and medical consent.