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CATIE-News: Bite-sized HIV/AIDS news bulletinsHuge increase in STIs among middle-aged CanadiansResearchers have found that among adults sexual activity is linked to health and happiness. As people age, sexual activity continues to be an important aspect of well-being. In Canada, middle-aged adults—between 40 and 59 years of age—represent about a third of the population. Sexual health is an important aspect of middle age. Based on their latest findings, researchers at the Public Health Agency of Canada (PHAC) suggest that when it comes to the topic of sexual health, middle-aged Canadians may require more education. Indeed, some studies of middle-aged adults have found that they may not “consider themselves to be at risk for” sexually transmitted infections (STIs), including HIV. STIs can inflame delicate tissue, cause sores or lesions on or inside the genitals. These changes make it easier for HIV infection to occur. Scientists at PHAC recently reviewed and analysed data on three major STIs—Chlamydia, gonorrhea and syphilis. This data was collected in Canada between 1997 and 2007. The PHAC analysis suggests that there has been a huge increase in these STIs, particularly among middle-aged Canadians. This finding could have implications for HIV transmission. Results—ChlamydiaThe majority of Chlamydia cases occurred in young people (aged 15 to 29 years). However, cases of Chlamydia increased among middle-aged people by 166% during the study period. Although the PHAC researchers pointed out that Chlamydia continues to “disproportionately” affect young women between the ages of 15 and 29, middle-aged men accounted for 60% of cases in 2007. Results—GonorrheaAs in the case of Chlamydia, most cases of gonorrhea occurred among young people. However, between 1997 and 2007, cases of gonorrhea among middle-aged people rose by 210%. Males accounted for 88% of gonorrhea cases. Results—SyphilisIn the case of this STI, researchers focused on what they termed “infectious syphilis”—the relatively early stages, such as primary, secondary and early latent syphilis. Across all age groups rates of syphilis increased eight-fold during the study. However, among middle-aged adults, rates of syphilis increased 11-fold. PHAC scientists found that males were “disproportionately” affected by syphilis. For instance, in 2007, 93% of syphilis cases were in men. Not just CanadaPHAC scientists compared STI rates in two other countries—the United Kingdom and the United States. They found that STIs are also increasing among middle-aged people in the U.K. and U.S. In the U.K., between 1997 and 2007 the syphilis rate in adults aged 45 to 65 increased by 2,839%. In the U.S., the syphilis rate in adults aged 45 to 65 in the same period increased by 46%. As in Canada, middle-aged males bore the brunt of syphilis infections. Why was there a dramatic increase?The trends reported by PHAC are consistent with reports from the provinces of British Columbia, Ontario and Quebec. One reason for the rise in STIs in Canada is that middle-aged people now represent a larger proportion of the population than in 1997. However, this can only account for part of the increase. PHAC researchers put forward the idea that changes in social patterns—such as more divorces among middle-aged people, which has resulted in more single, sexually active people—may also have played a role in the STI increase. The increasing availability of effective oral medication to treat male impotence (erective dysfunction, or ED) has likely also played a role. Increasingly, there are reports of some men using oral ED medicines together with illicit substances, such as cocaine and crystal meth, that temporarily heighten feelings of sexual pleasure. This combination of drugs can result in more sex and more partners and, in cases of unprotected intercourse, a greater chance of getting or transmitting STIs. More than meets the eyeSince PHAC scientists used only laboratory-confirmed cases of STIs for their analysis, it is likely that the true rate of STIs is even greater than what they found. This is because some doctors base their diagnosis of STIs on the symptoms a patient has and prescribe treatment without the use of laboratory testing. STIs can also occur, at least initially, without any symptoms. People who have symptom-free STIs are not likely to seek medical care. GuidelinesWorking with a leading group of physicians, nurses, scientists and other health care workers, PHAC has developed outstanding comprehensive guidelines for the management of STIs—The Canadian Guidelines on Sexually Transmitted Infections. In addition, these state-of-the-art documents include helpful tips for having a discussion with patients about counseling for the prevention of future STIs. The Canadian Guidelines on Sexually Transmitted Infections are regularly updated and available online at. www.phac-aspc.gc.ca/std-mts/sti-its/guide-lignesdir-eng.php. Order your copy of the guidelines by visiting the CATIE ordering centre online at this link: http://orders.catie.ca/index.php —Sean R. Hosein REFERENCES :
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Created on: 01/25/2010 |
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Decisions about particular medical treatments should always be made in consultation with a qualified medical practitioner who is knowledgeable about HIV-related illness and the treatments in question. MORE | |