HIV treatment has come a long way but there’s still work to do

As a sexual health doctor I realize a lack of funding threatens the treatment of physically transmitted infections

G onorrhoea. Syphilis. Words my patients listen to and tend to shudder at. Yet sexually transmitted infections, or STIs, have been around for centuries, unfussy about in whose genitalia they infect and ready to inflict whole-body havoc on those who do not access testing and treatment.

Luckily UNITED KINGDOM sexual health clinics, like the 1 I work in, have been providing STI care for years 100 years in fact since 2017 marks the centenary from the 1917 Venereal Condition Act . The act forbade the unsafe treatment of STIs with the unqualified and complemented the public wellness (venereal diseases) regulations of the prior year, which demanded free, private services to diagnose and deal with STIs, and paved the way for the development of the NHS 30 years later. Each pieces of legislation followed the 1913 royal commission upon venereal diseases , which documented during the first world war whenever STI rates among troops had been sky-high and Master Kitcheners advice to soldiers was having little impact. In this new experience you may find lure both in wine and women. You should entirely resist both.

This reputation of the need for education, prevention plus access to sexual health care marked the beginning of an incredible journey towards healthy intercourse and relationships for all. The 1920s saw the production of the first latex condom a happy alternative to sheaths made of lamb intestine or pet horn. In 1928, Alexander Fleming discovered penicillin, an antibiotic afterwards found to cure syphilis plus which remains a first-line therapy for the infection today. In 1960, the oral contraceptive pill had been introduced, followed by continuous advancements within family planning that would empower a lot of women worldwide. And in 2008, your papilloma virus (HPV) national immunisation programme was introduced for teen girls, a vaccination that defends 300, 000 young women a year towards deadly cervical cancers and extremely transmittable genital warts.

In a time of austerity, when sexual and reproductive wellness budget cuts of more than 20% imply clinic closures and the loss of sources, never has this hard work plus progress felt so precious. Reports display sexual health services have been the particular hardest hit by reduced financing and I see first-hand the effects of this particular disinvestment. Staff cutbacks, reduced starting hours and fading morale are grim realities facing my specialized, putting patients at risk, leaving one of the most vulnerable voiceless and paving the way in which for more STIs, antibiotic resistance, unexpected pregnancy, sexual abuse and woman genital mutilation (FGM).

To commemorate the achievements made over the past one hundred year and to illustrate the work left to undertake, the British Organization of Sexual Health (Bashh) has made a short film to help remind us of how far weve arrive and how essential it is to protect the particular rights we have. The film harmonizes with a podcast Bashh has co-produced using the National Archives , aptly named A Bit of a Scratch.

Undoubtedly, one of the greatest achievements in sexual health continues to be the advances in HIV treatment. The year 1981 heralded the start of one of the biggest public health challenges in history: the virus with no cure and apparently no rhyme or reason concerning whether those infected would endure to their next birthday. The introduction of extremely active antiretroviral therapy (Haart) within 1996 transformed a terminal condition into a chronic, manageable condition the bona fide result of teamwork between sufferers and professionals who shared the most popular goal of survival.

The focus is currently on rolling treatment out to people who need it and preventing HIV transmitting. The recent Happy trial showed the particular preventative powers of pre-exposure prophylaxis (PrEP), when antiretroviral therapy is delivered to prevent acquisition of HIV. A lack of expenditure means PrEP is still not available in the NHS, despite its use adding to a 32% decrease in new HIV diagnoses in Londons sexual health clinics . Within the absence of funding many clinics, which includes my own, have set up PrEP centers that provide support and monitoring for those who obtain PrEP over the internet the cheapest method of getting the drug and avoiding the life-changing HIV diagnosis.

Of further problem are the high rates of undiscovered infection, with 13% of those coping with HIV unaware they have got it [pdf]. Thirty-nine per cent of those diagnosed with HIV in 2015 were diagnosed in a late stage, increasing their danger of death tenfold. Where I actually work in south London, two-thirds associated with patients are from black plus minority ethnic communities, which stay isolated and at high risk of HIV acquisition and late diagnosis. Just a considered, well-funded approach will be able to change these statistics around.

The need for investment within sexual and reproductive health providers is crystal clear. I, alongside the particular sexual health community, call on the federal government to be inspired by and to carry on the incredible progress of the previous 100 years. Too many lives have been dropped to preventable situations there are simply no excuses to lose any more.

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