The rates of STIs have been increasing steadily since 2002, writes Hélène Hofman, pointing out that people are more likely to have unplanned sex and take sexual risks when they're away from home.
Over the coming weeks people will take their annual holiday, go to a music festival, sporting event or even take a short weekend away. Experts warn that it's during these times that alcohol is consumed, inhibitions are lost and you're most likely to have unprotected sex and pick up a sexually transmitted infection (STI).
"Our research has shown there are particular times of the year when people are more likely to take risks. That is when people are out of the home setting, at festivals, sporting events or on holiday," says Enda Saul, programmes and communications manager for the Crisis Pregnancy Agency.
"We've found that it's in these situations that unplanned sex takes place and sexual risks are taken."
The HSE Health Protection Surveillance Centre (HSPC) says, for the first half of last year, provisional figures show there were 1,387 cases of STIs notified for that period from STI clinics and some GPs. The highest number of reported cases of STIs, which include chlamydia, genital warts, gonorrhoea, HIV and syphilis, were among the 20-29 age group.
Since 2005, the Crisis Pregnancy Agency has been running the "Think Contraception" campaign to highlight the risks of unprotected sex to 18-25 year olds. This year it will distribute 150,000 tins, containing a condom and a leaflet with information on using condoms, unplanned pregnancy and STI clinics, at music and sporting events around the country.
These events include last weekend's Oxegen festival, the upcoming Electric Picnic, the Galway Races and big matches at Croke Park in Dublin.
"If people plan for sex then they will more than likely use protection. We know people use contraception so we need to keep encouraging that," says Saul.
The rates of STIs have been increasingly steadily since 2002. However, that increase can be attributed almost entirely to the growth in population, the increase in availability and quality of screenings and the fact that more people are coming forward for tests. The Dublin Well Woman Centre released its annual report for 2006 last week and revealed that from 2002 to 2006 the number of requests for full STI screening has increased three-fold from just 600 in 2002 to 1,800 in 2006.
"In most cases the people presenting are symptom-free and just want to check things out because they know that with STIs there aren't always clear signs," says Shirley McQuade, medical director of the Well Woman Clinic. "We have also seen an increase in the number of couples coming in together. They may just be starting a relationship and want to make sure they don't have any infections. That's a good sign from a public health perspective, that people are coming in before they have symptoms," says McQuade.
According to genito urinary physician Dr Derek Freedman, one of the common misconceptions about STIs is that there are symptoms or signs.
"The most important thing to know about symptoms is that there are none. That's why we have to do the tests," says Freedman. "The golden rule to remember is that if you're at risk from one infection you are at risk of them all. When you are screened, you should be screened for them all."
According to the HSPC report, chlamydia and ano-genital warts accounted for 81 per cent of the cases reported in the first half of 2006. However, Freedman says that other STIs are making a comeback.
"We're seeing an extraordinary resurgence in infections such as syphilis and gonorrhoea. In the 1990s, I might have seen two or three cases of gonorrhoea a year, recently I've seen two or three cases in the one week . . .
"That's because people are travelling more to countries in southeast Asia like Thailand and are less inhibited," says Freedman.
People are also being given antibiotics all the time by doctors. All the gonorrhoea we're seeing now is resistant to first-line anti-biotics and we have to use special anti-biotics, he says. "Antibiotics are also a problem if they are taken before the diagnostic tests [for STIs] are carried out because it means that our diagnostic tests are impaired and we cannot give a precise diagnosis to them or the partner, which has serious consequences," Freedman says.
While many people may return from holidays having contracted a STI, Freedman points out that this is usually because of excessive alcohol consumption.
The Irish Study of Sexual Health and Relationships published by the Crisis Pregnancy Agency and the Department of Health and Children in October last year, found that when people in the 18-24 age group have failed to use a condom they cited drinking alcohol (20 per cent) and "not being prepared" (16 per cent) as the main reasons.
"We're hugely aware of the influence of alcohol," says Freedman. "People come to me after holidays, or even after a weekend. Some of them don't even remember if they had sex because they've had so much to drink," he says. "Drink is responsible in 60 per cent of cases."
In cases where a risk may have been taken he recommends contacting a doctor for advice and going to a reputed STI clinic for a full screening within five to 10 days.
"These days we get this phenomenon called 'cyberchondria' where people look things up on the internet," says Freedman. "If you take genital herpes, for example, there are over 666,000 sites if you do a search - and about two of those are useful," he says. "It's better to go to a clinic, you can't diagnose yourself. Watch out for expert knowledge and make sure a full set of tests are taken, including a pelvic examination . . . There is also this misconception that you don't need a cervical smear until you're over 25.
"People should have cervical smears within one or two years of commencing sexual activity. I have seen significantly abnormal smears in girls under 20," he says.
"The same stigma doesn't apply to STIs that applied in the past. These are simple, easy-to-treat infections. There are very few of these infections that really affect your quality of life. Even with HIV there is good treatment available and we have people with HIV alive for over 30 years and healthy and leading a good life," he says.
"My advice is very simple. First get a name of the person you're with, get a mobile number, give breakfast, get to know the person. Use protection for the first three months of a relationship, and if either of you have any anxiety don't be afraid to come and get a full check-up. Finally, don't be frightened if either of you find a problem. These are accidents, not tragedies," he says.