Incidence of Sexually Transmitted Infections in the United Kingdom - Research Paper Example

Incidence of sexually transmitted infections in the United Kingdom This paper conducted a study of the increase in incidence of sexually transmitted infections in the United Kingdom. All sections of the population were covered and review of literature along with secondary data (methodology) was used to gather evidence regarding this. It is seen that there is a gradual increase in the incidence of STI in UK. It is more common among male homosexuals (MSM) and younger population. Both black-Africans and whites have similar instances of incidence and is comparatively higher when compared to other ethnic groups. Introduction: Physical intimacy is an accepted way for any society whether it is animals or humans for its survival and growth. Among humans, civilized societies have evolved certain accepted norms and behaviours regarding this. But even so, unrestricted and unnatural intimacy has often resulted in negative backlashes in the form of diseases and infections, referred today as sexually transmitted infections (STI) or sexually transmitted diseases (STD). Societies around the world are now seen as more promiscuous and free with regard to physical intimacy. As a result, the incidence of STI should also increase under such circumstances. This paper looks at the incidence of STI in UK and reviews whether it increases, decreases, or remains static over the years. In the process, the paper will review relevant literature on this area. It will also conduct a methodology based on secondary research that will substantiate the aims and objectives of the paper. It will look at the ethical point of view that is a pre-requisite in any form of research in organized societies. Aims: Incidence of STI is an area of concern in any country. It is often said and reported that it is increasing over the years to the practices followed in modern societies. This paper aims to look at the occurrence of STI in UK in order to study whether such infections are on the rise over the years. Objectives: The objective of the study is to inform the reader about the dangers and increase in the incidence of sexually transmitted infections or diseases in the UK. It is hoped that the results will prompt the public regarding the dangers that the society faces under such circumstances. People face health issues that may result in permanent disability and even death. Moreover, the social stigma that is attached to such diseases may cause mental trauma especially if the persons involved are young people. The expenditure and resources needed to control, prevent, and cure infections can be a burden on individuals, families and the state. Hence it is essential that the public and the government be aware of the seriousness of the situation. Hypothesis: The incidence of sexually transmitted infections is on the rise in the United Kingdom over the years. Literature review: Sexually transmitted infections cover a whole range of infections that can be defined as follows – “The first was a broad definition including acute hepatitis B, syphilis, gonorrhea, Chlamydia, or non­specific urethritis, or the first clinical episode of herpes or genital warts. The second was a narrow definition that considered only acute bacterial infections (syphilis, Chlamydia, or gonorrhea); this was seen as a better proxy for unprotected anal intercourse” (Imrie et al 2001, p. 1452). For the purpose of this paper, all these infections are considered to fall under the ambit of STI. The logic behind the stand is that the study looks at the incidence and increase of STIs in its totality and does not focus on a particular one. All figures and statistics will cover the infections mentioned above at random. The paper will focus more on the patterns, behaviours, and incidence of such diseases and provide a review regarding its increase, decrease, or static nature. The fact that many patients use private treatment and hence do not come under the ambit studies in any form is a disadvantage. It is also assumed that STI and STD (sexually transmitted diseased) are used interchangeably in this context. In any case, the basic cause behind the transmission of STI can be summarized as follows. “The epidemiology of the sexually transmitted diseases is largely that of sexual behaviour. In both Western and Third-World countries the incidence of STD is increasing, even in countries with adequate treatment facilities” (Vlok 1996, p. 580). The author adds that this behaviour is an extension of intimate social behaviour. In other words, the consequences of such intimate behaviour will result in such STI or STD infections. Methodology: a. Research design: The need to conduct a particular area of study can arise from many factors. “It might spring from an experience researchers have had in their personal lives or workplaces. It might come from an extensive debate that has appeared in literature for several years. It might develop from policy debates in government or among top executives” (Creswell 2003, p. 74). Any study can use secondary data or primary data apart from what has been learnt from review of literature. “Primary data result from first hand experience and observation. Secondary data come from what others have experienced and observed” (Guffey 2007, p. 273). Primary research data can be obtained through several means and include interview and questionnaires, either through direct contact, mail, the internet or telephone (Baker 2003, p. 177). The advantage of primary data is that the researcher can obtain relevant information that is directly related to the area under study. The disadvantage is that it can be expensive in terms of resources like money and time. It may not always be possible to get willing people to participate in studies. This is especially true for studies as this one which involves moral and social issues. The advantage of secondary data is that it is relatively easier and cheaper to access. Any person who can have access to a good library or any other organization which collects and stores information will get plenty of reference material. The one great disadvantage is that a researcher may not get information that is directly related to the area of study. It is proposed that this study used secondary data in order to arrive at a conclusion. The difficulty in finding willing respondents, the sensitivity of the subject, and the resources at hand (for this study) prevents this writer from conducting primary research through interviews and surveys. Moreover, it is seen that a lot of secondary data is available through various studies by individual, and other governmental and non-governmental organizations. b. Inclusion exclusion criteria: The study will include all relevant data that is associated with incidence of STI in the UK. It will include all age groups irrespective of gender and race. This is because STI can occur in any person who indulges in unnatural or unprotected physical intimacy. c. Ethics: The concept of ethics in research is of primary importance. It is imperative that certain codes of conduct like protecting the identity of participants, safeguarding information and knowledge provided by them etc. In other words, “applied ethics investigating how normative ethical theory can be applied to specific issues, or to particular situations and circumstances. Examples of such fields include environmental, medical, professional and medical ethics (Israel & Hay, 2006 p. 13). This is especially true in studies that are morally and socially sensitive like the present one. But in this instance, only secondary data is used and the question of ethics with regard to participants or respondents does not arise. This paper has taken into consideration relevant ethical issues like attributing the source of information from where it was collected. All attempts have been made to see that the study is free from plagiarism. d. Expected outcomes: It is expected that the study will substantiate the research hypothesis that sexually transmitted infections are on the rise in the United Kingdom. STI incidence in the UK: According to a report published by the Health Protection Agency, the age group that is most vulnerable to STI is between sixteen and twenty four (National Health Service n.d.). This observation indicates that sexual intercourse (both protected and unprotected) is high between boys and girls falling in this age group. The Health Protection Agency, in its 2008 report has published the following key findings regarding STI in this particular age group. “Young people (aged 16-24 years old) are the age group most at risk of being diagnosed with a sexually transmitted infection, accounting for 65% of all Chlamydia, 50% of genital warts and 50% of gonorrhea infections diagnosed in genitourinary medicine clinics across the UK in 2007” (Health Protection Agency 2008, p. 3). These facts become more alarming when the fact that this age group is only twelve percent of the total population in the UK, but accounts for more than fifty percent of all STI cases. Figure 3 (Health Protection Agency 2008, p. 5) A few of the more prevalent or common STIs other than HIV infections are given in the above graph. On the whole, most of these infections show a marginal increase over the years. Chlamydia is the more prominent among those that show a steady increase. Incidence of gonorrhea on the other hand shows a massive increase starting from 2002, but declines significantly by about 2002. It can be concluded that STIs other than HIV infections are showing a growing trend albeit marginally over the years. According to a study by Hawker et al, STI incidence in UK is increasing over the years. “New attendances at GUM clinics in England, Wales and Northern Ireland doubled between 1991 and 2001 (Hawker et al, 2005, p. 41). With regard to AIDS and HIV, the UK is seen as relatively as having low levels which come to only one percent of the population. But even so, the reported cases of infections have doubled between 1999 and 2003, says an article published by AVERT. But since then, the incidence has slightly come down. It is estimated that there are around 83,000 people that have been infected, and that nearly a quarter of them are not aware of it. “Although HIV is often perceived to be a ‘gay’ problem, infections acquired through heterosexual sex account for the largest number of HIV diagnoses in the UK. The majority of people who acquired HIV heterosexually were infected overseas but only became aware of their status after being tested in the UK. In terms of HIV infections actually occurring within the UK, gay men (and other men who have sex with men) accounted for two thirds of new cases” (AVERT 2010). The organization is an international non-profitable charity organization and hence it is assumed that there is no bias involved in its findings and publications. The article goes on to state that even though the UK has relatively low levels of incidence of infection, knowledge about prevention is declining among the population. In 2000, nearly 90 percent of the population knew about the dangers about HIV, AIDS, and unprotected sex. But this has come down to around 80 percent by the year 2007. This lack of knowledge will only result in the increase of incidence of STI in the form of HIV and AIDS in the future. The article goes on to state that voluntary and government organizations engaged in education and prevention remains woefully under-funded and under staffed at present. The government needs to see to it that this situation is changed in order to prevent rising incidence of such infections though unprotected sexual activities. The increasing number of immigrants into the country only adds to the problem. The following figure reveals the HIV infection situation in the country showing details of racial and ethic mix. Figure 1 (AVERT 2009) It should be noted here that these figures related to incidence of the infection not through unprotected unnatural sex alone. The infection can also spread due to sharing or use of contaminated needles and transfusion of infected blood (Medline Plus 2010). So these figures are only indicative of overall incidence. But it illustrates the trend of HIV and AIDS infection in the country. It can be seen that black-African section of the population is more vulnerable. It peaked around the year 2003, but began a significant decline and has even become lower than the white population in the country. It the case of the white population, the incidence peaked during 2007, but is showing signs of coming down. Incidence is low in the case of other races in the country. Whites account for nearly ninety percent of the population. It can be seen that infection is higher among the white population and those belonging to the black-African sections. The above article also states that the maximum incidence is seen in men who have homo-sexual preferences, followed by those who are heterosexuals. But incidence of HIV infection is coming down probably due to educating the population along with clinical care taken by healthcare practitioners and workers. As mentioned in the above section, the incidence of the HIV and other STI is very high among men having sex with men termed as MSM. The following graphs illustrate the observations. Figure 2 (Health Protection Agency 2008, p. 4) Two distinct trends can be seen from the above graphs. In the case of HIV infection, the graph shows a steady rise till the year 2005, then declines briefly for one year, and then rises to an all time high in 2007. This is in contrast with the overall HIV infections due to all causes as seen in figure 1. This indicates that STI induced STI infection among homosexuals is on the rise. This also strengthens the argument that HIV infections in men are much higher when compared to other STI. The right hand side graph in figure two shows that STIs other than HIV is coming down after 2006 in the case of syphilis and gonorrhoea. In the other three infections, the trend remains static to a certain extent. Taking into consideration the above two figures, it can be said that MSM participants are at a higher risk with regard to HIV infections. But a late fall in the incidence of other STIs (in 2006) does not provide conclusive evidence that there is a decline. It could be due to the fact that a concerted effort at educating the public could be partially responsible for the fall. Only further research and studies will provide evidence regarding a rise of fall is STIs among MSM in the country. The only comforting factor is that HIV positive men contacting AIDS have marginally come down during these years. The mortality rates remain constant. But taking into consideration, the increase in the number of HIV infection and the static mortality, it is an indication that treatment and care is getting better over the years. In other words, the mortality rate remains static in spite of the increase in the number of HIV infections among MSM. The fact that these figures are provided by a government agency gives credence to the statistics provided. “Teenage pregnancies are also seen to increase in the country. This could be indicative of changing social and moral standards in the courtly. The number of conceptions per 1,000 girls aged 12 to 15 has risen from 7.8 in 2006 to 8.1 in 2007, todays figures show. Around 8,196 girls under 16 are estimated to have become pregnant in 2007, which represents just under 1% of all conceptions” (O’ Hara 2009). The overriding concern is that it could lead to an increase of STI incidences due to such relaxed and casual attitude towards physical intimacy among teenagers. Conclusion: A study of the increasing incidence of STI in the UK has been attempted in this paper. Due to the sensitive nature of the topic and also taking into consideration the lack of resources for an in-depth study, only secondary research has been made use of in the methodology. The availability of relevant statistical information and other data also prompted this researcher to opt for secondary research. It can be seen that the information supports the hypothesis and the intended outcomes of the study. There has been a gradual increase in the incidence of STI in the UK. The most affected section are what is referred to as MSSM, followed by the younger sections of the population. Increase in the number of teenage pregnancies also indicates that moral values are changing which could result in higher incidence of STI. With regard to ethnicity, both the black-African and white sections of the population have similar rates of incidence. HIV and AIDS is most rampant or common when compared to other types of infections. On the whole, it can be said that there is a gradual increase in the incidence of STI in the country. Unless steps are taken by all stakeholders (parents, organizations, government, school/college authorities etc) this situation is bound to worsen further. Apart from undermining the health of those affected, trauma, and wastage of resources of all stakeholders will only increase in the future. References AVERT 2010, AIDS & HIV in the UK – the current situation, AVERT, viewed 26 April 2010, http://www.avert.org/aids-uk.htm AVERT 2009, United Kingdom – statistics by race age and gender, AVERT, viewed 26 April 2010, Baker, MJ 2003, The marketing book, 5thedn, Butterworth-Heinemann. Creswell, JW 2003, Research design: qualitative, quantitative and mixed method approaches, 2nd edn., SAGE Publications Guffey, ME 2007. Mary Ellen Guffey’s essentials of business communication, Cengage Learning Hawker et al 2005, Communicable diseases control handbook, Wiley Health Protection Agency 2008, Sexually transmitted infections and young people in the United Kingdom: 2008 report, HIV and Sexually Transmitted Infections Department, viewed 26 April 2010, http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1216022461534 Health Protection Agency 2008, Sexually transmitted infections and men who have sex with men in the UK: 2008 report, Health Protection Agency, viewed 26 April 2010, Imrie et al 2001, A cognitive behavioral intervention to reduce sexually transmitted infections among gay men: randomised trial, British Medical Journal, vol 322, pp 1451 – 1456 Israel, M & Hay, I 2006, Research ethics for social scientists, SAGE Publications Medline Plus 2010, HIV infection, National Library of Medicine, viewed 26 April 2010, National Health Service n.d. Open your eyes to STIs, Direct Gov.UK, viewed 26 April 2010, http://www.nhs.uk/Livewell/Sexandyoungpeople/Pages/STIs.aspx O’ Hara, M 2009, Teenage pregnancy rates rise, The Guardian, viewed 26 April 2010, Vlok, ME 1996, Manual of community nursing and communicable diseases, 5th edn. Juta & Company Ltd. Read More