By Dr Ted Hiscock
The
Clap (gonorrhoea), the Pox (so-called great pox or syphilis),
non-specific urethritis (NSU), venereal diseases, (VD) & VD clinics
are all historic terms for sexually transmitted diseases (STDs), which
have been replaced with more current ones – Chlamydia, genito-urinary
medicine (GUM), sexual health clinics (SHCs) and GUM clinics. Even STDs
have, in the last decade, been superseded by the term sexually
transmitted infections (STIs). Why all these changes? Is it purely to
confuse Jo/e Public and blind him and her with scientific jargon? Do
they have any relevance to divorce matters? The answer is complex, but
based upon a number of issues.
First:
Venereology was the study and treatment of infections transmitted
between individuals only by sexual intercourse. These included syphilis
and gonorrhoea and were dealt with in special centres where client
confidentiality was protected at all costs – even from the family GP
and spouse. Second; many conditions treated today were not even known
50 years ago, e.g. Chlamydia, bacterial vaginosis and vulvadynia.
Third: Knowledge has improved, and conditions thought not to be
sexually transmitted are now known to be so, e.g. Trichomonas. Fourth:
Different countries in the world place STIs in different specialities.
In the UK they are dealt with by GUM physicians but in many European
countries they are the domain of dermatologists (skin specialists).
Finally;
some conditions such as HIV, AIDS and Hepatitis B & C are modern
conditions whose significance and potential in the world have only been
appreciated in the last 25 years. All very confusing even for those
working in the field!
Unfortunately,
added to this melange of terminology, the occult behaviour and lack of
symptoms of some of these conditions make them very difficult to spot.
Chlamydia, syphilis, HIV early stage disease and hepatitis B & C
tend to go unnoticed for some considerable time and even gonorrhoea may
not produce any symptoms until in an advanced state. Conditions like
genital warts and herpes may not be acquired through sexual intercourse
and may only appear many months after they have passed into the system.
The visual appearance of these innocuous viral infections often send
shivers of horror through the recipient who feels dirty, ugly and
cheapened. The condition Trichomonas used to be considered innocent and
a problem only for women, but it is now known that although most male
partners do not have symptoms of the infection they probably harbour
the organism and pass it on to female partners. Conversely, 30 years
ago, it was always said that NSU was only a male condition and that
women were safe. With modern techniques, it is now known that most of
these cases are caused by Chlamydia!
Human
behaviour is another important vector to confuse this world of STIs. If
only the human population would remain monogamous, or use condoms, the
life cycle of many of these little nasties would falter. Sadly, the
reality of humans needing to propagate the species in the most exciting
and lustful manner often leads to extramarital affairs. So many of
these exploits overshadow safety and regard for the health and safety
of loved ones. Thus when marriage breaks down, with all its heartache
of home and family dehiscence, it is curious that the risk of having
picked up a STI is not high on the list of considerations for many
going through divorce.
Before
moving on in life into new chapters, it is always advisable to confront
the spectre of possibility and have a screening for STIs. And, have a
blood test for HIV; it is better to know than not as early treatment
nowadays saves lives.
• Dr Ted
Hiscock has worked in GU Medicine for more than 35 years and consults
from his surgery in Erdington and also from Whittall Street Clinic,
Birmingham