Sexual health services ‘rolled back’ decades after STI treatment delays and cancelled cervical screenings

Sexual health services have been “rolled back” by decades amid coronavirus upheaval as women face delays to treatment for sexually transmitted infections and have cervical screenings cancelled, experts warned.

Large numbers of GPs are off sick with coronavirus or self-isolating and sexual health clinics have been shut or are running a skeleton service due to staff being deployed to other parts of hospitals to help with the Covid-19 emergency.

Tracey Forsyth, lead contraceptive nurse at British Pregnancy Advisory Service, told The Independent women are routinely telling her they are struggling to access sexual health services.

She said: “Closures mean they are having to travel further to get treatment for sexually transmitted infections (STIs) or get checked out if they think they have got an infection. Some women are having to wait two to three weeks to get treatment. Normally if you get chlamydia, you go back to the place where you had the test taken and they give you the results, but people are finding the place they had the test taken is closed.

“People don’t know where to go and may be waiting a long time for someone to call them back. If you are sat at home, and you haven’t got anything to think about other than your chlamydia, you are going to look at health complications online and you are going to worry. Especially when you are locked in and you don’t know how long the lockdown will last. It is an absolute nightmare.

“Chlamydia’s longer-term risk of pelvic inflammatory disease, which can cause infertility, is of course in the back of someone’s mind. Places are worrying we will have a massive STI problem at the end of Covid-19.

“Some women who have been getting treatment for genital warts have been told ‘sorry we are not doing that at the moment’. The other thing women are worried about is not being able to get smear tests. It is very difficult to access contraception, sexual health and have smears at the moment. There were lots of cuts to services before this. We have rolled the clock back with sexual health by decades due to coronavirus and cuts.”

Ms Forsyth, whose contraceptive team speaks to around 400 women a week via the phone, said disruption to STI treatment is a problem for both men and women and was a “timely public health issue”. People who have chlamydia and gonorrhoea, and the people they have had sex with, need to be treated, she added.

The nurse said many women are finding it easier to buy antibiotics to treat STIs online but noted this choice is not open to those who cannot afford it.

Ms Forsyth, who has been running the UK-wide contraceptive and sexual health phone service for 11 years, said some health services are able to send out STI tests and antibiotics in the post, but this varies massively across the country.

She said coronavirus chaos will hit vulnerable women the hardest due to them being more likely to give up if there are long waits on the phone or potentially not being able to afford to pay for transport to make longer trips to clinics or get phone credit to call services.

“In the pre-coronavirus days, people could just walk into clinics,” she added. ”The reason walk-in sexual health clinics were set up was to make it easier for people to access this vital service. They didn’t have to make a phone call and it helped with big waiting lists for appointments. There is always a stigma with sexual health. People are embarrassed. People don’t want to admit they have an STI. Also, sexual health clinics are completely confidential, and safer than GPs, because there won’t be notes.”

Sexual health charities called for the government to tackle the surging number of STIs in the UK ahead of the coronavirus crisis. A report by the Terrence Higgins Trust and British Association for Sexual Health & HIV (BASHH) released in February drew attention to the “unacceptably high” STI rates with a diagnosis every 70 seconds on average. In 2018, there were 447,694 new diagnoses of STIs, which is an increase of 5 per cent from the year before.

Peter Greenhouse, the spokesperson for BASHH, said: “If you have got urgent symptoms, such as severe pain ulceration or painful discharge, we will see you. But we have massively reduced the number of face-to-face consultations to protect ourselves and our clinics.

“People who have got minimal symptoms or hidden symptoms are in a worse situation because it is more difficult to get it sorted. If you are worried about sexual health call your local sexual health clinic.”

The sexual health consultant added: “Whatever we do to prevent coronavirus with social distancing will also prevent STIs. You have to get up very close and dirty to get STIs. But at the end of the lockdown, people are going to party like its 1999 and it is important to maintain the sexual health services so they are ready for the flood of activity.”

Kate Sanger, the spokesperson for charity Jo’s Cervical Cancer Trust, said the guidance from NHS England is to try to continue providing cervical screenings.

“But we know in some parts of the country, they have stopped sending out invitations for screenings or postponed them for the foreseeable future,” she added. “Provision is patchy. While there are some women who will want to go, some won’t be able to go because they are self-isolating.”

Cervical screening, commonly referred to as a smear test, helps to pick up early signs of cell changes in the cervix that can turn into cancer.