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Panorama: Love Hurts

BMJ 2005; 331 doi: (Published 20 October 2005) Cite this as: BMJ 2005;331:971
  1. Christiane Rehwagen, Roger Robinson editorial registrar (crehwagen{at}
  1. BMJ

    BBC 1, 16 October at 10 15 pm

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    In the past 10 years sexually transmitted infections (STIs) almost vanished from public consciousness in the United Kingdom. After fairly successful campaigns in the 1980s the problem of STIs seemed, mistakenly, to have been banished. For at a time when more sexual partners and risks at a much earlier age are common practice, UK genitourinary medicine clinics are struggling to meet demand.

    Panorama began its report about STIs with an early morning visit to a small clinic in Sheffield, where the phones were ringing without interruption and where the receptionist's standard reply to callers was “Earliest in a month” or even “No appointments at all can be made at the moment.” This clinic sees more than 1500 patients a month.

    Cut to a “girls' night” in the local strip club, typical of the uninhibited nightlife in which many youngsters seem to indulge most weekends. Among the group of revellers featured was 24 year old Sian, who had been diagnosed as having chlamydia and has been trying to get pregnant for more than two years.

    Reporter Andy Davies' documentary juxtaposed footage from the overloaded genitourinary medicine clinic, where huge numbers of positive test results were being analysed every day and where the workload had doubled in the past decade, with interviews with young, sexually active adults. “After a boring week of work, being at the same time exposed to sex in the media all the time, the only thing to look forward to on the weekend is to get completely drunk and then having sex with whoever is available,” admitted one young clubber. With attitudes like this, missing condoms provided no obstacle to intercourse.

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    Sexual health clinics are struggling to meet demand

    Credit: BBC1

    The numbers speak for themselves: 1 in 10 under 25s is infected with Chlamydia, but only one in three realise that they are infected. Compared with a decade ago, there are twice as many new cases of gonorrhoea, three times as many new cases of HIV infection and chlamydia, and 16 times as many cases of syphilis being recorded.

    Long waits for appointments are making matters worse. A survey conducted by the Panorama team revealed that only a quarter of the UK's genitourinary medicine clinics were able to offer an appointment within the recommended 48 hours. Each treatment delay could have serious consequences, such as an increased risk of complications and of passing on infections, as well as a higher susceptibility to HIV.

    The thrust of this documentary seemed clear: the government urgently needed to get its message across. This autumn £130m ($227m; €190m) was due to be spent reducing waiting times at clinics, to be followed by a £15m safer sex campaign next spring. A chlamydia screening programme for all 16 to 24 year olds is also expected to start soon.

    But for many, like Sian, it is already too late: at the end of the programme she found out, after laparoscopy, that like about 100 other young women in Sheffield every year she would now never be able to get pregnant naturally and that her only option would be in vitro fertilisation.

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