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Ann Furedi
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Catching chlamydia
We should treat chlamydia as a fact of modern life. |
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According to US medical experts, all women under 25 should be tested for the sexually transmitted disease chlamydia at least twice a year. UK sexual health experts are thinking along the same lines, and proposals for chlamydia screening are likely to form a part of the government’s soon-to-be issued sexual health strategy.
The concern with chlamydia is motivated more by morals than medicine. But despite this, there are sound arguments for a screening programme.
For the sexual health establishment, chlamydia has become the new AIDS. It has replaced HIV as the medical justification - as opposed to the moral argument - for why it is a ‘bad thing’ to sleep around.
In the past, young women’s magazines warned their readers that sexual experimentation could risk their lives by landing them with HIV/AIDS. Today, the same magazines warn us to play it safe because chlamydia is a risk to future fertility. It may not sound as dramatic as HIV, but the message is more realistic, and therefore is more durable.
Studies show that if you have unprotected sex with an HIV-positive partner you have a 99 percent chance of not contracting the infection. The risk of a young heterosexual woman contracting HIV as a result of a quick shag is extremely small: the risk of contracting chlamydia, by comparison, is very high. And it is true that if the infection is not detected and treated, it can develop into a serious reproductive tract infection.
The infectivity rate with chlamydia is a lot higher than HIV and a lot more people seem to have it. Studies have shown that between 10 and 40 percent of those under 25 are infected. Nobody can determine exactly what the infection rate is, as the infection is usually symptomless and so difficult to detect. You can have it for years without knowing. It tends to be discovered when another problem occurs - such as an unplanned pregnancy.
So it’s true - chlamydia is out there. Fuck around, and you are likely to get it. But - and here’s the good news - it is entirely treatable and, as long as it is caught early, does no lasting harm. Treat it with a simple course of antibiotics soon after contracting the disease and there is no problem at all. (Naturally, this message has not been as widely promoted as the more ‘responsible’ advice to cut down on partners and use a condom.)
The US proposals for a six-monthly check-up could be a brilliant way of managing the genuine risk of sexually transmitted infections without a moral overload. Imagine a campaign to promote screening that ran with a slogan like:
‘Don’t worry. If you pick it up - we’ll pick it up. And then we’ll treat it.’
If the medical and political establishments could bring themselves to promote STD screening as like any other kind of health check it really would be a benefit. If chlamydia tests could be seen as normal and sensible as dental checks and eye tests then people might even go.
But to create that kind of climate would require the health promotion wallahs to cut out entirely the moralising that has become so much a part of their make-up. Because every time they trumpet that the first line of defence against chlamydia is sexual responsibility, they reinforce the notion that those with it have been ‘irresponsible’ and behaved badly - hardly the most effective way to encourage us to get tested.
If chlamydia really is as prevalent as some of the studies suggest then perhaps we should stop throwing up our hands in horror and simply start treating it as a fact of modern life: a stage that most young people are bound to go through, like acne and puppy fat, and manage it accordingly. No moral messages, just medical treatment.
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