Stateside, things couldn’t be more confused regarding prostitution and safe sex. Prostitutes themselves are up in arms over the fact that police can arrest a sex worker once they can find reasonable evidence in the form of condom possession.  Prostitutes have taken to not carrying condoms and are therefore more at risk of contracting and spreading sexually transmitted infections and most worryingly, contributing to the spread of HIV. Is there any reason why arresting a sex worker on the basis of condom possession is a good idea?

Two organisations, the PROS Network and the Sex Workers Project gathered in New York State to highlight before lawmaker’s, the importance of passing a new bill in order to put a stop to this practice. There are apparently known cases of prostitutes who do not carry condoms now because they are afraid of being caught and arrested. This is surely not the way to crack down on street walking when rates of STIs and HIV are on the increase. These sex workers fear they will be arrested if they carry condoms and at risk of infection if they don’t. They are unhappy with either outcome so they feel that they might as well make money, take the health risk and avoid being put behind bars.

This is clearly not a satisfactory situation. Nobody wants prostitutes hanging around their neighbourhood but pretending that they can be coerced into giving up their line of work is foolhardy. Prostitution is not called the oldest profession for nothing – it has been around for ever and will always be there. Pretending that you can stamp out prostitution in this way is ludicrous and a public health hazard. Lawmakers need to use some common sense and pass a law that ensures public health is safeguarded.

One of the most worthy apps created yet has got to be Chec-Mate, an app designed to help you verify that a new partner has been tested and therefore certifiably free of sexually transmitted infections (STIs). It is currently available for the iPhone and will be accessible to Android users shortly. The main idea behind the app is to get new partners talking about their sexual health early on into their relationship or before a relationship even begins in an effort to control increasing levels of STI rates.

It will be used to share the most recent test results with prospective partners and also in order to find local sexual health clinics. The company behind the app stresses that once a person’s results are live, they cannot guarantee that they have not subsequently contracted an infection. They emphasise that the role of the app is an opportunity to get people to take more responsibility for their sexual health but admit that the results displayed should not be taken as gospel since they are subject to change after time. What the creators seek to do is get rid of the taboo surrounding sexual history and get people talking about it freely and openly.

Nice idea but we cannot see this one catching on. Having said that, we do support it so here is where you can get hold of this app.

Over 6,000 cases per year of oral cancer have been reported for the first time ever and the increase is thought to be due to the increasing rates of human papilloma virus (HPV). The majority of cases in the UK were reported among men in 2011. It is thought that the higher rate in men could be related to the fact that men tend to drink alcohol to a greater degree and smoke more heavily than women.

There has been a 90% increase in the amount of cancers originating at the base of the tongue and a 70% increase in the number of cancers discovered on the tonsils. These areas are strongly associated with HPV. The HPV is likely to have been transferred to the mouth during oral sex.

80% of sexually active people in the UK are likely to contract HPV at some stage in their lives and many of them will contract less serious strains of the virus however there are cancer causing strains that could be potentially fatal if not caught in time and treated.

The good news is that those who have a HPV related cancer are more likely to recover than those who have developed cancer due to drinking alcohol and smoking. With such significant increases in these cancers that can be associated with HPV-16, we are likely to see doctors recommending that boys as well as girls get vaccinated with Gardasil, a vaccination that protects against HPV-16.

Recent research has found that the bacterial infection, Mycoplasma genitalium, an infection which can be transmitted sexually, increased the risk of African women becoming infected with HIV.

The Mycoplasma Genitalium bacterium was only discovered in 1980 and research into this relatively new infection is on-going. Previous data from a bigger study of HIV in women from Zimbabwe and Uganda was used in order to assess the effects of M. genitalium on the risk of contracting HIV. At the study’s outset, the women were all HIV free. It was discovered that 190 women from the study group had become infected with HIV after follow-up meetings. These women and the women who were not infected were tested for the bacterial infection M. genitalium and it was found that the infection was present in 15% of the women who went on to develop HIV as opposed to 6.5% among the women who did not go on to contract HIV.

The presence of other STIs, and especially infections such as herpes simplex II, also increased the risk of contracting HIV. M. genitalium was however more commonly detected in this particular study than other STIs such as chlamydia and gonorrhoea.

Much research is being carried out in the area of M. genitalium as there is still little known about this infection. The NHS does not test for it in their GUM clinics at the current time. A short course of antibiotics can eliminate the infection. We always advise patients who are having symptoms to have a full screen but maybe getting tested for Mycoplasma Genitalium as part of a routine STI check-up should be the norm as its prevalence increases.

Correlations have been made for a long time between the effects of the increasingly popular erectile dysfunction medications and the simultaneously increasing number of cases of sexually transmitted infections. Now we have the figures to prove it. With data taken from a recent report by the Health Protection Agency, it seems likely that this hypothesised correlation is a valid one.

The spread of sexually transmitted infections among those between the ages of 50 and 90 years is growing rapidly and is being described as a small epidemic.  The number of new cases of HIV among those over the age of 50 years had doubled over a period of ten years in 2009.

This is indicative of people not taking the necessary precautions when it comes to the use of condoms and sex. It is thought that the responsibility to get tested is as much down to the patient as it is the GP in that GPs are simply not recognising the symptoms of sexually transmitted infection in the older generations these days and are assuming symptoms are associated with something else. The truth of it is that men and women are having sex well into their nineties today with the help of Viagra and other such medications and curbing the rise of infection rates is something we all have to consider including those in the medical community.

The Department of Health in the UK is being put under pressure to review the national HPV immunisation programme following a dramatic rise in oropharyngeal (throat) cancer cases that have been linked to HPV. Over 70% of these cancers are caused by the human papilloma virus (HPV) according to the latest evidence. The figures were collected by the Institute of Head and Neck Studies, which surveyed various countries, including the UK on the topic of cancers and their relationship to HPV. 10 years ago, less than one third of throat cancers were caused by HPV, indicating the need for a decision to vaccinate boys as well as girls.

Research shows that boys are more prone to developing cancer of the throat since there is a higher concentration of the HPV virus found in the female genital tract. Studies show that there is a very strong link between oropharyngeal cancers and oral sex and the average age of patients presenting with it is getting lower.

The same old argument prevails however regarding the cost of this expensive vaccine. We don’t know if administering the vaccine to boys is worth the expense but it seems that the medical evidence is coming down on the side of a widened vaccination programme. We have already seen the recommended HPV vaccination change to a more expensive but wider spectrum vaccine, so we would not be surprised to see a change in the recommendation regarding vaccinating boys on this latest evidence.

There has been a swathe of news reports highlighting the misunderstanding surrounding the HPV vaccine among the girls who have received it. In a recent survey carried out in the US it was found that almost 1 in 4 of those questioned thought that the vaccination would lower their risk of contracting other sexually transmitted infections in addition to HPV and a number of these girls had not used a condom the last time they had engaged in sexual activity. The results of the survey are published in the Archives of Paediatric and Adolescent Medicine.

The HPV vaccine is offered to young girls at a stage in their lives when there is possibly much confusion surrounding the topic of sexual health and so the message needs to be clearer and education must start earlier, at least at the point of administration. The average age of the girls questioned were 17, having completed the three doses of the vaccine.

There is really no excuse for this level of ignorance amongst this population group. Girls of that age should not be vaccinated against anything without the healthcare provider explaining exactly what the vaccine will protect against.

If there wasn’t already enough reason to practice safe sex consistently, we have recently been reminded that there is a natural weakness in female immunity as ovulation occurs, more than at any other time throughout the menstrual cycle. This is thought to occur in order to allow sperm to survive a potential immune response once inside the body of the female and go on to fertilise an egg. According to a recent study, this has the potential to make women more susceptible to a sexually transmitted infection while ovulating.

A study was carried out at the Laboratorio de Inmunobiologia Moleculare at the hospital Gregario Maranon and Complutense University, Madrid, and the team used mice for the purposes of the study. They found that estradiol, a sex hormone, which is mostly made in the ovaries and the placenta (in pregnancy) decreased the immune response in female mice leaving them more exposed to potential infections including yeast infections and sexually transmitted bacteria and viruses.

Since the mice were only tested using candida albicans (the cause of yeast infection), this is not enough proof to suggest that women would be more susceptible to all sexually transmitted infections during ovulation and so further investigations will be carried out in this area although the scientists behind the study are confident that their finding will translate to other infections.

The Alcohol and Sexual Health Working Party is speaking out against the way the NHS is dealing with sexually transmitted infections and young people - they suggest that the NHS is missing an opportunity to tackle the problem of STIs considering the existence of statistics highlighting strong links connecting the abuse of alcohol and sexually transmitted infections in those aged between 15 and 24 years.

Almost half of all sexually transmitted infections are diagnosed among young people in this age bracket and according to a 2009 British probability survey, those who consume a lot of alcohol are more inclined to have unprotected sexual activity and with many partners compared with those who drink moderately.

The Alcohol and Sexual Health Working Party’s reports suggest that over 1.5 million 15 to 24 year olds attend sexual health clinics annually and among this number, a shocking 1 in 5 young people consume what is considered to be a dangerous amount of alcohol.

The working party thus ask that all clinicians dealing with young people be trained to ask about the individual’s drinking behaviour and also that during any visit to the doctor, questions regarding diet, drinking and smoking are asked alongside questions regarding the patient’s initial complaint. A report commissioned by the Health Secretary will be published this month and will set guidelines for future consultations..

According to the Daily Mirror, alcohol is directly associated with unsafe sex. The results of 12 studies were analysed and it was revealed that each time the level of blood alcohol increased by 0.1mg/ml, the likelihood that unprotected sex would occur would increase by approximately 3%.

Participants were divided up and depending on the group they were allocated, had to drink certain amounts of alcohol or a placebo. They were then asked about whether they would have unprotected sex. The study hardly provides with any new platform from which to raise awareness and considering the study was based on intention and not real life situations, the results and conclusions are of little weight.

A spokesperson for the Terrence Higgins Trust states that we already know that alcohol allows us to make bad decisions and take risks and advises that if people suspect that they will get tipsy and make an unwise decision over the Christmas break, that they carry condoms with them in case. This is much better advice than the advice of NHS earlier this month which involved stocking up on the morning after pill before it becomes too difficult to obtain over the festive period!