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Love Hurts

October 17th, 2005

Dr Petra

Last night’s Panorama (BBC1) provided a worrying insight into the UK’s sexual health crisis. Those working in sexual health within the UK probably wouldn’t have been too shocked about the long waiting lists, overstretched and underfunded services, and increased numbers of patients presenting with STIs. However I’m sure the programme may have come as a surprise to people who don’t work in sexual health.

The programme pointed out people are having more sexual partners at a younger age, taking greater sexual risks (particularly not using condoms), and both gay and straight couples aren’t taking steps to protect themselves from STIs.

To indicate the scale of the problem, the programme conducted its own survey where Panorama staff called up all the sexual health clinics in the UK presenting with either an a symptomatic or symptomatic STI. In most cases they found long waiting lists and problems with access. Whilst the idea of using ‘mystery shoppers’ (where people pose as patients) fits with the UK’s recommended standards for sexual health I couldn’t help but wonder why the Panorama team hadn’t simply contacted each clinic and asked for their current waiting times, or searched the existing published literature for evidence. It would have been quicker, produced the same results, and perhaps freed up the space for a genuine patient to call and get advice.

In another scene a woman called Sian underwent investigations to see why she was having problems conceiving. She had one child but wanted a baby with a new partner. They’d been trying for a while with no luck and Sian suspected a previous chlamydia infection was to blame. She was right. Her infection hadn’t been treated promptly and had damaged her fallopian tubes.

This story within the programme proved to be a situation of television manipulating details for its own ends. Earlier last week to promote the Panorama programme, BBC news ran a short film about Sian. In it she was shown watching a male stripper, then admitting to chlamydia, followed by being given bad news after her exploratory operation. In the BBC news version we saw her surgeon tell her that her tubes were damaged and she wouldn’t be able to have a baby, followed by Sian breaking down in tears in her hospital bed. In the actual Panorama programme the surgeon explained to Sian that whilst her tubes were damaged her ovaries and womb were okay and she’d probably be able to conceive via IVF.

Whilst I appreciate Panorama’s need to attract audiences, they also have to take responsibility for the sexual health messages they give. More people would have seen the small clip during the news that implies total travesty if you get chlamydia. That may have led to people misunderstanding the infection and becoming afraid, yet the short news version offered no advice about what to do.

Guidance on dealing with sexual health specifies we ought to reduce stigma and embarrassment – sadly the Panorama film did not really begin to tackle those issues, nor appear to consider them in the making of their documentary or the publicity around it.

The main focus of Panorama was to blame the government for not funding sexual health services. Many successive governments haven’t funded sexual health. Whilst in the 1980s there was a focus on HIV, other STIs have always been neglected in funding and importance. Whilst Panorama had a point in asking questions about funding, there was little focus on why sex education is also failing, the sexualisation of the wider media, commercialisation of sex, and finally individual responsibility.

The government does need to fund more sexual health services – and run more public awareness campaigns – the latter can’t happen until the former is in place. But ultimately the public can also take more responsibility around their sexual health – using condoms, getting treated promptly if they suspect they have an STI, and avoiding risky activities like ‘barebacking’ (sex without condoms).

I thought the Panorama programme did well to bring the sexual health crisis to the public eye, but it only told part of the story. We desperately need more funding for sexual health, but without improvements in sex education, confidence building, awareness and increasing people’s willingness to use condoms, extra funding of services won’t be enough to solve our problems.

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