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Close one door in public health and sometimes others open, ones you thought were shut for good.
So it’s been for Canada and sexually transmitted infections (STIs).
Back in 1997, the fear of AIDS and a hugely effective public health campaign on safe sex and condom use had virtually eradicated two long-time scourges — gonorrhea and syphilis.
That year, the rates for both were at their lowest since they first began to be reported in the 1920s.
Indeed, federal public health officials were so elated they set a 2010 deadline for the elimination of gonorrhea, while syphilis, already almost off the map, was to be kept at 0.5 cases per 100,000 people, or below. Everyone took a bow.
That was then. Today, both diseases have returned with a vengeance.
The gonorrhea rate has jumped 94 per cent since 1997 and syphilis is now at nine times the rate it was then, with no abatement in sight. New deadlines haven’t been set and aren’t likely to be met.
What happened? In a nutshell, a false sense of security.
“The introduction of anti-retroviral HIV drugs in the mid-1990s led to a return to high-risk sexual activity,” says Lisa Hansen, an epidemiologist with the Public Health Agency of Canada.
“It’s going to be an ongoing challenge to handle this because people have to change their behaviour.” Change it once again, that is.
It could be difficult in gay communities where safe-sex burnout is rampant and where the younger generation wasn’t around when the horror of the AIDS epidemic hit in the ‘80s. Some men taking HIV drugs think they’re somehow guarded against getting other sexual infections. Conversely, others with the virus feel they’ve got nothing to lose by having unprotected sex.
While health officials believe gay and bisexual men account for much of the recent resurgence, no one ignores the possibility of a crossover into the general population. After all, the rate of chlamydia – the other sex-linked bacterial infection that must be reported to Ottawa – has shot up by 70 per cent since 1997 and it mainly affects females.
Hansen says studies of teenagers are showing they overestimate the risk of AIDS but “dramatically underestimate” the risk of other STIs.
part of the problem