We are hours away from entering into the second national lockdown of 2020 and, understandably, people are feeling both jaded and worried. Businesses and homes are being lost, lots of families are down to a tiny income and basically it’s hard to see any positives about this upcoming four week lockdown. With all of this doom and gloom it’s easy to get mired in what we’re losing, which is why it’s nice to see a spark of positivity twinkling in amongst the rubble of our daily lives, even if this positive is borne directly out of a negative.
Sexually transmitted infections (STIs) have always been a fact of sexual life, with some sufferers more well known than others. King Henry VIII, for example, who is widely believed to have had syphilis. These infections have continued well into the modern day, which is why barrier methods of contraception, i.e. condoms, are still number one on the list for protection. But in lockdown people were just not able to hook up for casual sex any more, and even on the run-up to the first lockdown the number of one night stands were on a sharp decline as people feared being exposed to Covid 19. And of course masks during sex are usually only appreciated by those with certain sexual preferences.
So, why are the experts claiming that now is a ‘one in a lifetime chance’ to drive down sexual infection rates permanently?
When lockdown rules are followed to the letter, people aren’t having sex with new partners and therefore they aren’t passing on infections. The other real game-changer here is being able to test yourself for STIs at home. With these home tests people can usually be treated quickly and without exposing anyone else to the infection. And then when lockdown ended they were infection free. Dr John McSorley, the President of the British Association for Sexual Health and HIV, wants people to get tested now – even if they have no symptoms to reduce the transmission rate as much as possible when ‘normal’ life resumes.
The argument for testing now.
The C 19 outbreak has meant the closure of 54% of UK sexual health services, with 38% of staff being re-deployed elsewhere in the NHS. There’s been an uptake in virtual consultations because patient feel more comfortable with doing this rather than visiting a clinic. You can get advice, diagnoses and sometimes treatment over the phone. If this opportunity is harnessed, and the testing keeps going, it could have an unprecedented effect. The only time when history shows us a similar situation is at the beginning of the HIV epidemic when fear reigned, but even then there wasn’t this clear-cut period of time when whole swathes of the population changed their sexual behaviour. It’s very much as if someone has pressed ‘pause’ on casual sexual relationships and so we all have a chance to recalibrate, take advantage of the home testing opportunity and emerge healthier than before.
Showing HIV the highway.
People carrying HIV are at their most infectious just after they’ve caught it because that’s when the virus is at its highest levels in the body. If diagnosis is made during lockdown it naturally follows that the transmission rate will fall (and fairly dramatically) because people are much less likely to be having sex with others during the key infectious period. And not only this, but if treatment is started immediately then it can lower virus levels to an undetectable level and therefore it cannot be passed on. Do you see how this is all shaping up?
Dr Gary Whitlock, who works at the Dean Street Clinic in London which diagnoses around ½ of all HIV cases of gay men in the UK, has said “We think there may be less and less people around who are infectious.” This statement is based partly upon the fact that uptake of a drug called PEP, which prevents HIV infection if taken immediately after exposure, has fallen sharply from around 50 people per week requesting it to less than 30.
Dr McSorley is also hopeful that syphilis could soon be confined to history, and what a great coup that would be for modern medicine! Earlier this year cases had risen to WWII levels but with the advent of online solutions he is anticipating that it will encourage more and more people to come forward who haven’t before because they live too far away from a suitable clinic, or they just lack time for an appointment.
Online testing and treatment is certainly not a magical solution though, because there will be missed opportunities to carry out further testing if necessary. Gonorrhoea is a particular problem with its resistance to certain antibiotics. No face to face appointments also rule out risks being spotted – domestic abuse and child protection issues, etc.
There will undoubtedly be a period of increased sexual activity in the population after what will have been such a dry spell for some people, but perhaps surprisingly sexual health experts are all for encouraging this because it seems a natural response. It’s not normal for people to be confined to their homes for weeks on end, whereas it is normal for them to be sexually intimate with others. But there’s one caveat here and that’s to get tested NOW so we have a prevention rather than cure situation when lockdown is eventually over. How good would it be to take advantage of this rather trying time and secure a bit more protection from STIs?
What to do if you think you have an STI during lockdown?
The simple advice is to look online for testing and treatment options if that’s what you want to do. But if you want a face to face appointment there are lots of sexual health clinics still operating across the UK and you’re not breaking any lockdown rules to go to one because we are allowed to travel for medical treatment during this draconian period of restrictions. It’s important to remember that there are different avenues for healthcare available out there.
