Given the devastating long-term effects of the HIV virus if undiagnosed, and the challenge it has put forward to science, it is not surprising that news regarding a potential cure for HIV has hit the headlines. Here we take a look at the recent case of an infant who is claimed to have been cured of HIV in an effort to tease out potential implications for adults with HIV.

Essentially, the infant was the offspring of a woman who not too long ago had found out that she was HIV positive. As a result of not knowing about the virus, the mother had not received prenatal treatment for HIV, which increased the risk of the infant being infected with HIV. Once the baby was born it was tested for HIV, and before the lab results had returned, the medical team had already put the baby on a cocktail of common treatments for HIV. What happened next was remarkable. The infant’s immune system responded astoundingly well to the medications, and within 29 days of starting treatment the baby was considered functionally cured of HIV. After having received further treatment for ten months, the baby was followed up with two blood tests and several tests for HIV-specific antibodies. All of these indicated that there were no detectable levels of HIV.

This is only the second time a person has been cured from HIV. The first case was the infamous “Berlin Patient”, who was an adult that had been cured as a result of his cancer treatment in which he received blood stem cell transplants that contained delta 32 (a known genetic mutation found to increase resistance towards HIV).

Although this is only the second time that a person has been cured from HIV, the implications are in stark contrast to each other. Obviously, an infant’s immune system is very different from an adult’s immune system. Furthermore, most adults do not find out about their HIV infection until months or even years after they have been infected. It is not speculative to assume that the virus may have expanded more after a few months than after a few days, and that the treatment options are likely to be more complex in adult cases especially if previous co-morbidities exist.

It also appears that the implications of the baby case do not fit into the two lines of research that are looking into the cure for HIV for adults. The first line of research is based on considering whether cancer drugs may have an effect on the virus. The second line of research is based on the Berlin Patient case and exploring the genetic mutation that he received. Both of these require extensive, time-consuming studies and results could be years off.

While these studies and the news from the USA may be exciting, there is currently no cure. Safer sex is the only way that you can minimise the risk of HIV transmission and at risk groups are advised to get tested regularly as the sooner a person is diagnosed and put on treatment, the greater the chance of a normal life expectancy. The STI Clinic advocates condom use as this is the only way to minimise the risk of sexually transmitted infections.

Although sexual health is important, the topic still remains a sensitive area that most patients do not wish to discuss. Recently we were made aware of potential confidentiality changes that may happen at NHS sexual health or GUM clinics, which both surprised and shocked us. Here we provide our view on the matter.

Up until now, individuals who have sought treatment at sexual health clinics in the UK have been made aware that their tests and diagnoses are kept under a separate identification numbers and not accessible to other clinicians who may treat them in other circumstances - such as their GP. This is valuable as it is a way of circumventing the embarrassment and stigma that may deter individuals from getting tested for STIs and from accessing treatment. However, a recent oversight in the latest version of the Health and Social Care Act appears to have made it possible to merge sexual health information with other clinical information for the same individual.

We feel that while on the one hand the accessibility of such information could be valuable, overall it is likely to do more harm than good if patients are made aware of the proposed change. For instance, researching sexual health is notoriously difficult as few individuals wish to take part in such studies and it is challenging to estimate how many individuals may have an STI but be unaware of it due to lack of symptoms. If this information were to be provided to general medical records, then researchers would have greater access to valuable data. However, given the nature of the data, we believe a standard procedure of consenting a patient to provide the information would be far more ethical. If this method is used, then we see no need to merge the records.

It has been argued that individuals who have HIV may benefit from all of their clinicians knowing about this and we have to agree that this is unarguable. But what if the merging of records puts people off getting tested in the first place? Early detection is crucial with HIV as patients can be monitored and put on medication that will give them a close to normal life expectancy and makes them less infectious. So maybe a system that encourages testing is better than one that is totally joined-uu?

Since we opened in 2008, we have spoken to many patients who are worried that somebody will find out about them contacting us. We understand how sensitive issues regarding sexual health are, and have done our utmost to keep our services 100% discreet. This is what patients expect and demand. The proposed change will be good for us and other private providers but will it be good for the nation’s sexual health strategy? We think not.

As a means of allaying the general beliefs of what is conventional and what is unacceptable, Age UK has made public the part that sex and sexual health play in the lives of older people. Speaking candidly about their attitudes to sex and aging in an Age UK online survey, many of the 2000+ participants aged over 65 years told of their wish to stay sexually active yet did not know where to go for advice on such matters.

The survey brings to light that sex is considered important to older people, with about one quarter of participants reporting that age had not affected their sex lives and two thirds (62%) revealing that they currently enjoyed a fulfilling sex life. Indeed, age has no boundaries to sexual relationships, with 18% of over 65-year-olds wanting to be more sexually active, 12% indicating that they would like to try new things with their partners, and 8% eager to start a new sexual relationship.

Regardless of wanting an active sex life, communication with partners and healthcare workers about such matters is an issue for older people. Over a quarter (28%) of the survey’s participants reported that they did not talk to their partner about sex, and women in particular found it difficult to reveal their emotions. This was partly due to embarrassment, and a sense of awkwardness around approaching the subject.

The survey also indicated that over 65-year-olds found difficultly in opening up to healthcare workers, with over two thirds (69%) never pursuing advice on sexual health. Moreover, three quarters (76%) of older people do not currently look for sexual health advice and only 14% have looked for such advice in the last 20 years. This is a concern when faced with the increasing number of sexually transmitted infections among people aged over 45 years. Such lack of communication may indeed impact on sexual wellbeing, considering that about half (46%) of over 65-year-olds (increasing to 54% of women in this age group) believe that they don’t require advice on sexual health. Despite this, when advice was needed, 17% of participants approached a nurse or doctor for information.

Age UK provides older people, along with their family, friends and carers, information and advice about talking about sex and safely remaining sexually active. Calls to Age UK Advice are free on 0800 169 65 65.

A little while ago it was reported that 20 million new STD cases were diagnosed each year in the US. This alarming report comes at a time when the transformations of proactive and reactive measures to STDs are causing controversy across countries. Here we consider the implications of current trends abroad and in the UK.

Although the importance of sexual health cannot be stated enough, the nature of the issue often means that partners do not discuss this information with each other, or are simply unaware that they have an STD due to lack of symptoms. This of course, is not news. As we have reported in the past, contracting an STD is common among many age groups including the not so young. According to most recent publication from the UK Department of Health, the incidence of STDs increased by two per cent to 426 867 cases reported in 2011. The increase appeared to be largest for individuals aged 15-24, with gonorrhoea and syphilis diagnoses having the largest increase - but not the largest amount of cases. HPV was deemed the second biggest STI while somewhat surprisingly; the cases of Chlamydia appeared to have decreased by two per cent.

This is similar to the findings in the US, where the report stated that their main diagnoses included chlamydia and HPV. When it comes to the decline in chlamydia in the UK, the most likely explanation appears to be that the National Chlamydia Screening Programme in the UK has contributed to increased sexual health screens detecting and treating STDs early on and therefore preventing the spread among individuals.

Despite HPV being of interest to both countries, it is reasonable to assume that we will not know the outcome of HPV vaccinations for a few years to come. However, we dare to predict that epidemiological studies will reflect cross-national differences worthy of our attention and hopefully serve as useful guidance for future strategies.

One country that may or may not be of particular interest is Australia, where both boys and girls are due to receive HPV vaccinations. This strategy has surfaced after a publication in Science recommended that both boys and girls should receive HPV vaccinations. Although these recommendations have been noted elsewhere, we are not aware of any strategies that have been officially implemented in other countries.

While it is clear that some strategies are working (such as Chlamydia reduction in the UK) other STIs are being ignored and are on the increase. We are sure that the HPV vaccination programme will be effective but there needs to be a proper strategy for HIV containment and the increase in gonorrhoea infections that are becoming harder to treat.

Although clinical trials with the aim to develop a safe and efficient herpes vaccination can be dated back to 1920, there is no available cure or immunisation for genital herpes at the current time. However, an early online publication of a study in Nature suggests that researchers’ are one step closer to developing a vaccination model which differs from previous attempts.

Previous studies have primarily focused on the so-called T-cells, which are known as the immune system’s anti bodies. Generally, when a virus or uncommon bacteria is circulating in the body, the T-cells respond to it and also learn to recognise it in case a future encounter will occur. Therefore, if a virus or some bacteria reappear, then the T-cells are prepared to respond. However, this is not effective in all organs as T-cells have restricted entry to the central nervous system, intestines, vagina and lung airways.

In an attempt to circumvent this issue, the researchers’ have utilised an alternative vaccination approach which entails “priming” and “pulling”. The former consists of a conventional vaccination which aims to provoke a system-wide T-cell response whereas the latter aims to recruit T-cells directly into the vaginal tissue via an application of chemokine’s, which are known to help mobilize immune cells. By using this methodology on female mice, the researchers’ key findings indicated that it was possible for the T-cells to create a long-term niche and reduce the spread of the virus into the sensory neurons.

Although this study was conducted by highly established researchers at Yale Medical School, it is likely that a considerable amount of research is required before these findings are translated to human treatment.

Have you ever joked about in the playground when you were a child, touching someone and getting a disease like a game of tag but not really sure what the diseases were or looked like? We have found something that could give you that education. There is an interesting little cake shop that can perhaps enlighten you by putting you face to face with all sorts of diseases but without the danger of catching them! “Eat Your Heart Out” is back for Halloween from the Evil Little Cake Shop and Miss Cakehead at The Pathology Museum part of St Bartholomew’s Hospital in London. They will be open from 26^th-28^th October 1100-1900, educating people on what an STD is and looks like alongside other conditions such as kidney disease and skin cancer. What have really caught our attention are the herpes chocolate slabs, STD cupcakes and chlamydia cookies to mention just a few items on the menu. However if you are interested in something for that special occasion, they have a tiered wedding cake called “riddled” featuring the cell structures of STD’s….what more is there to say than who wants to go? We do, so we may see you there!

Alarmingly, according to the Terrence Higgins Trust, we in London are more at risk of contracting a sexually transmitted infection (STI) than anyone else in Europe but we cannot verify this statement as the figures pertaining to individual cities all over Europe just don’t exist. However, it is certain, according to the HPA (Health Protection Agency), that we are at least far more at risk in London than we are anywhere else in the UK.

The European Centre for Disease Prevention and Control ECDC has reported that the UK is situated very near the top regarding the rates of Gonorrhoea, Chlamydia and Syphilis in relation to other European countries but we don’t know for sure. With sexual health awareness week falling on the 17^th of this month it is important to be aware of just how at risk we are. If you are experiencing symptoms in the genital area, get tested right away. A short course of antibiotics will cure most STIs.

Everyone is back to school and with that parents are being encouraged to have their daughters vaccinated against HPV (human papilloma virus), which is a sexually transmitted virus that can cause both genital warts and cervical cancer. Gardasil protects against all the strains of HPV that cause genital warts and cervical cancer.

The vaccine is given to girls in year 8 but is also available on the NHS for girls under the age of 17. The vaccine is administered on three separate occasions and if the full 3 doses are not administered the vaccination will be ineffective so people are urged to come back for their second and third dose. Many in the past have not come back, leaving them unprotected against this potentially serious virus.

The UK has recently upgraded its vaccination from Cervarix, which only protected against 2 strains of HPV.

It is without a doubt that men and women do not understand the danger of leaving chlamydia untreated otherwise how can we explain the climbing rates of infection in the UK? Chlamydia can render women infertile so it is vital to get tested for this extremely common infection especially before trying to conceive. People are also not aware of the fact that 70% of women who are infected and 50% of men who are infected do not have symptoms, making Chlamydia a very dangerous infection. If left untreated, chlamydia can cause serious consequences.

Without treatment, Chlamydia remains in the body before infecting the fallopian tubes which can then cause Pelvic Inflammatory Disease (PID). It is this disease that causes infertility by blocking the fallopian tubes. All fertility clinics will test a couple for chlamydia before they try to conceive however, it may be too late at this stage. Since the infection is symptomless in many cases, women and men are strongly advised to get tested each time they change partner.

Another infection which is often linked to reproductive problems is Ureaplasma. There is very little hard evidence proving how the infection affects our ability to conceive or how it affects the pregnancy itself however, in theory, if the infection is present in the male’s semen when the baby is conceived, it is thought that there is a greater risk of miscarriage later on in the pregnancy. Most private fertility clinics will test the male’s semen sample for this bacterium. If it is present, it can be cleared up with a short course of antibiotics.

It is possible that deliveries will be affected over the Olympic period, 23rd of July until 9th September. Items sent via Royal Mail Special Delivery and posted from or to London could potentially be affected.

Patients are asked to place orders early in the day if they wish to receive their item the next day. Furthermore, First Class items that are posted from or to London could arrive early in the morning or much later in the day than usual.

To be absolutely clear, we will still be dispatching all orders received by 5.00 pm Monday to Friday on the day the order is received.

Thank you for your patience at this time. If you have any further queries, please contact us.