The Better2Know Blog

Regular readers of this blog will know that we have reported on the increased resistance of gonorrhoea to antibiotics regularly over the last few years.  Well, finally there is some good news that gonorrhoea is now less resistant than it used to be according to research by the European Centre for Disease Prevention and Control (ECDC).

Better2Know will soon be launching its service in Botswana.  We have sponsored a small group of young people from the UK to visit Botswana to see the impact that HIV has had on this country. Here is what Shaun, one of the group, has written about their visit in July 2014.

New figures from Public Health England for 2013 show that the trend of more people over the age of 45 are diagnosed with an STI. This has led to claims from some experts that the baby boom generation have rarely (and some have never) used a condom. The FPA’s Harry Walker, who is the Policy and Parliamentary Manager said that “while increases in STI diagnoses can in part be attributed to greater awareness and better testing programmes, there has been an undeniable growth of STIs among older age groups…. some of these people will be from the ‘baby boom’ generation who grew up in the 1960s when the contraceptive pill was introduced and may have never or rarely used condoms.”

PrEP or Pre-Exposure Prophylaxis is a prescribed drug to help HIV negative people maintain their status, even if they have unprotected intercourse with someone who is HIV positive.

The HPV vaccines, Gardasil (which is used at Better2Know clinics) and Cervarix, have had the number of recommended doses changed from three to two. Following research from the Joint Committee on Vaccination and Immunisation (JCVI), their recommendation has been adopted.

We have discussed Gonorrhoea treatment before on our blog. It is an important topic because every day the bacteria causing Gonorrhoea become a little bit harder to treat.

What sex?  You may well ask.  Chemsex is having sex whilst high on drugs, the most common of which is crystal meth.  It is particularly common in MSM in large cities.  The loss of common sense, as well as your inhibitions whilst high, has meant that there is an increase risk of transmitting STIs including HIV during chemsex, as participants are less likely to play safely.  1 in 3 of men questioned said that they had unprotected sex whilst high on drugs.

A research team at the Huck Institute at Penn State University in the United States of America have started the process of developing a Herpes vaccine.  The library where different types of the virus (the viral genomes) is not as comprehensive as the stores of HIV and the common cold.  This means that the researchers have to start from the beginning.

The Labour Party leader Ed Milliband has said that he sees prevention of HIV needing greater emphasis than we currently have in the UK.  He said “Preventing HIV is a far better solution because it’s not necessary for people to become infected.  I think it’s crucial making sure that there is that investment in HIV prevention”.  Public Health England released a report in November 2013 show that new HIV infections in MSM was the highest yet.

Following the death of 19 year old Sophie Jones from Cervical Cancer last week,  Better2Know has designed a short survey to ask women about what they know about cervical cancer, and the different testing options.  There are just nine questions.  If you have got the time, please can you complete the survey and share the link:

https://www.surveymonkey.com/s/KHWS3PK

We will publish the results of the survey on our blog at the end of April.

Thank you.

A report by the Terrence Higgins Trust  called 2020 Vision: Making England’s HIV Prevention Response The Best in the World. was published last month.

The report says that increasing testing by 125% would decrease new infection rates by a third.  This is because people who are HIV positive usually become more responsible about their behaviour with regards to their sexual practices, and also, by starting a medical regime, they can reduce their viral load, and make it far less likely that they will infect new people.  Without this medication, viral loads and the likelihood of passing on the virus remain high.
The report highlights the NHS’s excellent record in HIV treatment and helping those who are HIV positive keep their viral load low to make them unlikely to pass the virus on, but says that more can be done to prevent new infections from those who are HIV positive, but do not know it.  Therefore increasing the number of people having an HIV test should find more people who are undiagnosed so that they can access the same life saving care.

There has been a lot of recent media coverage about the complacency of some medical professionals in putting people forward for HIV testing, as well as some people’s attitude towards the virus.

Following the recent launch of our Better2Know STI testing services in South Africa, Finance Director Anthea Morris has been interviewed by Behiye Hassan of the popular DIRECTOR magazine.

The interview, published in the March 2014 edition of the magazine, explains how South Africa can be the ideal first step towards international expansion.

You can read the full interview here.

A question our friendly booking team often get asked is: what is the most popular STI test? We wondered why people are asking this question. It seems a strange one to ask, as we think a better question would be: what do most people test positive for?

The number of people, in particular gay men, who have tested positive for STIs including HIV has reached record highs.  It is thought that the rise in unprotected sex and drug use in clubs is to blame for the increase in HIV, Chlamydia, Gonorrhoea and Syphilis where there are record high infection rates.  The number of gay men who tested positive for the first time for HIV in 2012 was 3,250, which is the highest year on record.  There were also 8.500 new cases of Chlamydia, 10,800 new cases of  Gonorrhoea,  2,100 new cases of Syphilis and 11,350 other STIs.

More people are having affairs, romances, relationships and sex with their work colleagues than ever before.  Increasingly, this aspect of work is not as frowned upon as once it was, and many organisations have relaxed their Workplace Relationship Policies, and in some places, they are seen as good for business and can improve performance, and can cement relationships between different teams.

London remains the city with the highest number of HIV positive people in the UK. Although with over 12% of the UK’s population living there, this fact is hardly surprising. However, it is still the city where the number of HIV positive people is growing fastest. Some of this will be down to the high number of single people in London, enjoying all that being single in the capital has to offer, and with increased availability of HIV testing, more people will be getting tested.

Men and their doctors must be encouraged to talk openly about sexual matters, says Professor Geoff Hackett, Chairman of the British Society for Sexual Medicine, who says that Society pressurises men to behave and perform like James Bond, and this makes men feel uncomfortable when talking about sexual health issues including infections and performance.  Women have more opportunity to talk about these issues as they are more likely to access medical help for smear tests, contraception and before and during pregnancy.

Cervical Cancer Around The World

The week of 19 to 25 January 2014 marked Cervical Cancer Prevention Week. A European wide initiative lead by the European Cervical Cancer Association (ECCA) to raise awareness of the causes, treatments and prevention of this illness.

Within Europe 60,000 women are diagnosed with Cervical Cancer every year, and there are 30,000 deaths in Europe each year from this disease (source: http://www.ecca.info). There are 175,000 women in Europe now who are living with Cervical Cancer today. Raising awareness of this disease is seen as being vital in reducing the number of deaths, as many cases could be prevented or treated more effectively through cervical cancer screening and regular testing for HPV. Early diagnosis is important in successful treatment.

It is not only Europe which is affected. The Centre for Disease Control (CDC) in the USA, have estimated that as many as 79 million Americans could be currently infected with at least one type of HPV (source: http://www.cdc.gov/std/HPV/STDFact-HPV.htm#a5). That is a quarter of the population of the country.

Deputy Prime Minister Nick Clegg said this week that the UK’s political leaders should regroup and rethink the issues around HIV, especially among gay and bisexual men. Clegg paid tribute to HIV campaigners but said that there were still too many people living with HIV who continued to face stigma and discrimination.

Health Protection Scotland (HPS) has reported that the number of cases of Syphilis in the last half of 2013 has increased significantly, especially in young hetrosexual people aged between 15 and 25, where five times the number of expected people have tested positive.

Young people may not come forward for syphilis testing, and failure to treat itcan lead to serious complications, including heart problems and worse if left untreated.  There have been various measures  taken to try to prevent and control the growing number of cases, including enhanced contact tracing offered to help people come forward about their previous partners so that they can be encouraged to come forward for testing by a trained healthcare professional, as well as making sure that treatment is completed when someone does test positive.

Semen is a great indicator that a man has enjoyed sex. Here are some other things about Semen.

Every ten years the UK completes a study on the nations Sexual Health.  The survey conducted by Lancet has found the following:

• 82.1% of men and 77.7% of women (aged 16 to 74) had had at least one sexual partner of the opposite sex in the past year.
• Women are reporting more sex, with the number reporting having had a male or female sexual partner in the last year having increased.
• Women are having more oral and anal sex than ten years ago
• 5.5% of women and 4.2% of men in all age groups have never had sex
• 8% of men reported some sexual contact with another man during their lifetime
• 11.5% of women reported some sexual contact with another woman during their lifetime
• 3.6% of men, and 0.1% of women had paid for sex in the last year – increasing their risk of HIV and other STIs
• 7.6% of men and 4.9% of women had had at least two sexual partners with whom they had not used a condom in the last year

The study has been valuable for both healthcare providers and commentators on changing society and its attitude towards sex and relationships. More people are having more sex to an older age than before, which also increases their exposure to HIV and STIs being transmitted later in life.  This shows that healthcare providers have to do more to ensure that everyone, no matter what their age is able to access sexual health.

Today is the most popular day of the year for the Office Christmas Party. We have all seen our colleagues coming in sheepish the morning after the night before (or Monday after), and most people can expect a little banter tinged with jealousy. However if you are worried about you or your colleague and whether they remembered to use a condom, then why not send them this blog?

World AIDS Day 2013 saw organisations and supporters across the world coming together to remember the millions of people who have tragically lost their lives and to raise awareness and support for the fight against AIDS moving forward. 22 years after a group of New York artists came up with the iconic symbol, the red ribbon once again brought awareness and support for people living with HIV across the globe.

In the UK we saw a huge variety of exciting events, awareness raising initiatives and people coming together in the fight against AIDS. Some of the highlights included Northern Rail’s ‘Awareness Train’, the world’s largest awareness ribbon (45 metres long!), Kieran Alger’s thirty one days of half marathons and the World AIDS Day concert: We All Live Together. During this time STOPAIDS met with MPs to hear about their commitment to global treatment, with encouraging news, so it really was a progressive weekend for HIV and AIDS awareness. We caught up with some of the great organisations involved to find out how World AIDS Day went and to find out how you can still get involved moving forward.

So, you have done the right thing and decided to have an STI test, and have chosen to use Better2Know’s services. You have visited one of our clinics across the UK and have enjoyed a discreet and confidential service at a time to suit you, or ordered one of our home testing kits and tested yourself in the comfort of your own home.

Better2Know has the fastest results times in the UK: one to five days depending on the test, however the anxiety waiting for results to come back is never fun, and the big worry is what if the results come back positive.

Do not worry; Better2Know is here to help you. Our patient care does not stop with testing, and we will contact you whether your results are positive or negative. If you test positive not only will we help you to get the appropriate treatment, but also where you can receive any support. If you test positive for HIV, we will arrange a repeat test, and our partnership with the UK’s leading HIV and sexual health charity the Terrence Higgins Trust will help sign post you to counselling and advice that you may need.

A chlamydia testing programme run by Public Health England (PHE) has increased testing by 76% in GP surgeries and other NHS clinics, and found 40% more people with chlamydia than were previously being treated according to new research published today in ‘Sexually Transmitted Infections’.

The testing programme was designed by PHE to make it easier for young adults to get tested and to make it more normal to get tested.  The project was trialled in the South West of England in 76 GP practices.  Staff were trained to develop skills and confidence to increase awareness of the risks of an untreated chlamydia infections.  Publicity (posters and patient cards) were also given to the practices.

Dr Cliodna McNulty, head of PHE primary care unit, said: “General practice is a natural venue to engage young adults in chlamydia testing, and our intervention shows that providing the right skills and resources can significantly improve screening rates in this setting. In doing so, we can also create opportunities for young adults to discuss good sexual health in an easily accessible and familiar place.”

More than 2,200 women every year are having cosmetic surgery to give them the “perfect vagina” in a procedure known as labiaplasty. Many women (including 250 girls under the age of 14) are having this operation on the NHS.  This is a 500% increase on ten years ago.  These figures do not include private surgery where a large number of cosmetic procedures happen.

An article published in the journal Sexually Transmitted Infections has said that condom distribution in prisons increases safer sex, but with no evidence of sex itself increasing.

Research focused on prisons in two states of Australia: New South Wales (NSW) where about 30,000 condoms are freely distributed a month; and Queensland where no condoms are distributed. Of the 2,018 male inmates who participated, both states have similar low levels of anal sex (3.3% and 3.6% in NSW and Queensland respectively) and unsurprisingly a far higher proportion used a condom in NSW than Queensland (the former with 56.8% usage and the latter 3.1%).

The paper concluded on the note that no evidence suggested condom provision increase consensual or non-consensual sex, but did encourage safer sex; “[c]ondoms should be made freely available to all prisoners as a basic human right.”

It has long been observed that Gonorrhoea is becoming resistant to some types of antibiotics. Particularly in the Far East and America. In the UK, Gonorrhoea is usually treated with two different types of antibiotic (including an injection as well as a pill) to make sure that the bacteria is cured by one or both. However, Public Health England (PHE) says that the rate of Gonorrhoea becoming drug-resistant has slowed down.

A bacteria can become resistant to drugs both by Darwin’s theory of evolution and adapting to its environment, and if people do not finish their course of antibiotics. IF you do not finish the course, and not all the bacteria have been killed, then those that remain become stronger and more likely to be able to survive the antibiotics next time. As Gonorrhoea is so infectious, you can see how different antibiotics not quite killing the bacteria can lead to a multi-drug resistant strain quickly, and it becoming wide spread.