I I’m looking at someone’s genitals. I can see five or six blisters scattered over the area surrounded by redness. “A lovely, lovely classic rash.” Actually I don’t say it out loud, only in my mind. I have learned from bitter experience that such remarks do not go down well with patients.
In fact, I say, “Yeah. I can see the blisters very clearly. Let’s take some swabs and double check what it is.”
I know exactly what it is. This is clearly genital herpes. New partner, timing, symptoms as well as rash all fit together to clarify the diagnosis – that’s why I’m so excited. The truth is that I don’t usually get to see a lot of classical genital herpes rashes. In normal times patients go straight to sexually transmitted infection (STI) clinics and I rarely see them.
But recently patients have kind of been having fun when it comes to appointments. Where GPs are preoccupied with people suffering (or dying) from late surgery and delayed outpatient appointments, typical GP patients, who are unable to receive, end up in long queues outside A&E . And where STI walk-in clinics have been closed, young people are coming to see their GP.
Anyway, I’ve recently been diagnosed with a lot more genital warts and herpes than usual. I’ve also found a local Genital Urine Medicine (GUM) consultant far more than I ever expected, especially when it comes to guidelines on wart paint.
Because I am seeing more sexual infections than usual, this has puzzled me. Has the lockdown reduced the number of sexual partners people have and the amount of spread of sexually transmitted infections? Or did the opposite happen? Have patients experienced unintentional sexual infections due to the reduction in face-to-face appointments during the past year? It’s hard to know for sure, but some preliminary figures are now being published as each country begins to collate data on sexual infections for 2020.
Seeing someone suffering from STI during lockdown seems a bit strange at first glance. Aren’t we all meant to be ourselves and in our rooms? How did the romancers of these later days meet anyone when all socializing was stopped? How did he negotiate that ever-changing fence of rules and persuade his new acquaintance to break them? They would have literally violated each one, from the no-travel and two-metre rule, to indoor socializing and a final “hug”.
At the start of the lockdown I think there must have been a sort of speculation between the STI specialists and the GP (or maybe it was just me) that it was This. It was this firewall that was supposed to stop chlamydia and all other STIs in their tracks and reduce rates of sexual infection forever.
Preliminary data supported this. in America, The American Journal of Preventive Medicinenoted that the number of chlamydia diagnoses declined by 50 percent in the first surge of March-June 2020 compared to the previous months.
It was working. People would have had fewer companions. Or were they? What passed Were people getting up during the lockdown?
It is often difficult to generalize regarding sexual habits. But one thing is clear: Whether or not pandemic-affected people have sex lives certainly doesn’t impress scientists. research Sexuality during this time.
According to one review, there have been 377 articles written on the subject in English alone and originating from the Western world. Published in January 2021. From this, clear themes come to the surface, notably that co-living couples across the board had less sex. Research in several different European countries, including Poland, Britain and Italy, has reached the same surprising conclusion, that many people reported a lack of desire due to stress. Although some, about 10 percent, had more sex than usual, which immediately shows the difficulty with this kind of research.
Fascinatingly, this yields to the UK fertility rate for 2020. A report from the Office of National Statistics shows that the birth rates in December and January of 2020 have seen a sharp decrease compared to the previous year, indicating that fewer children were conceived. Earlier than usual during the lockdown, which fits with the evidence that cohabiting couples had less sex.
In contrast, stable couples who were not living together in some cases struggled to continue their sex lives. Many people turn to telecommunications for help, as has been the case with every other aspect of our lives until recently, using the Internet, sexting, and webcams to stay connected.
But for single people, the group I’m most interested in, life has been tough. A measurable increase of 11.6 percent was recorded in traffic to porn sites during this time, and the researchers noted a detectable increase in porn use in the morning, when people normally commute to work. According to a study during the initial lockdown in Australia, 7.8 percent of singletons reported sex with casual hook-ups, compared to 31.4 percent in a typical year. A study in the UK raised a uniform rate; 9.9 percent, but when analyzed for age, 17.7 percent of young people aged 18-24 had “intimate physical contact outside the home.”
Another study on men who had sex with men, this time based in Israel, showed that despite the restrictions, 40 percent of the group studied were still on the move and had met a new casual sexual partner during the lockdown period. .
Overall, it appears that both couples and singletons had less sex or fewer partners, but a substantial minority continued to meet new partners despite different lockdown rules in different countries.
But does this modest overall decrease in new partners explain the 50 percent drop in reported chlamydia diagnoses in the US? not a bit.
In fact, this decline may not reflect an actual decline in prevalence, even if sexual behavior changed overnight. We know this because the drop happened very quickly. The US paper reasonably believes that “sexual practices were likely unaffected until after the declaration of a national emergency on March 13, 2020”. We know that chlamydia takes time to replicate – it has an incubation time of two to eight days – and it also takes time to show symptoms like discharge, about three to six weeks. A real decline in cases will not be seen for several weeks after the start of the US lockdown. But the recorded decline started happening within days.
It is likely that the reduction in cases simply reflects a reduction in available medical care. Telephone-only appointments, offering tests only for people with symptoms (missing in high-risk groups without symptoms) and incentives not to leave the house meant a 60 percent reduction in the number of tests performed, versus that 50 percent. Closely associated with is a decline in diagnosis. This means that in the first six months of the pandemic, an estimated 150,000 were undiagnosed in the US.
This position is closely tied to UK statistics, Recently published by Public Health England (PHE) This month, titled “Sexually transmitted infections and screening for chlamydia in England”.
The document said the tests performed were reduced by 25 percent overall and, as a result, there was a 32 percent reduction in STI diagnoses, which was not dissimilar to the American experience. So, although more than 300,000 infections were picked up, there were potentially 150,000 undiagnosed cases in 12 months.
Diagnosis of chlamydia notably declined by 30 percent, but genital herpes, which has to be diagnosed clinically, declined by more than 40 percent. Again, this implies unneeded cases rather than reduction. Public Health England probably hasn’t realized the increasing number of shingles diagnosed in general practice.
Although the document is specific, the BBC thinks it is good news. Its title reads misleadingly, “Sexually Transmitted Infections Fall During Pandemic”, rather than a more cautious but less exciting title, which should probably read, “Diagnosis of Sexually Transmitted Infections Fall During Pandemic, Perhaps Because that people cannot get appointments”.
The PHE report concludes that although community surveys show that fewer people reported…
Credit: www.independent.co.uk /