Flirting with danger

Sexually transmitted diseases (STDs) by their very nature are a hush-hush topic. They may never 'ever' find a place in Bangalore's drawing room chatter, like diabetes or heart disease, but at least the good news is that awareness is a few notches higher than it was a decade ago.

City dermatologists and venereologists say that this new-found awareness has brought many into hospitals looking to get tested and to have their queries answered. This, however, does not reflect a drop in the number of STD cases coming in for treatment.

Although doctors are divided on whether the number of cases is rising or dropping, they're sure on one thing, awareness in increasing.

Dermatologist at Manipal hospital, Dr Krupa Shankar, says, "A decade back we would get 10 to 12 cases related to STDs, per month." Today, he says there are fewer cases, "we get one or two cases a month."

However, Dr Umashankar N, consultant dermatologist and venereologist, Apollo hospital says, "the true incidence of STDs will never be known, not only because of inadequate reporting, but because of the secrecy that surrounds them. Most of them are not even notifiable." He is quick to add that, "all available data, however, indicates a very high prevalence of STDs". While reliable data on worldwide incidence is not available, he says that STDs are "becoming a major public health problem in India".

More people — both men and women, walk into hospitals wanting to know about STDs than they did a decade ago; be it a general check-up, or about doubts they have after reading or hearing about a specific STD.

"The arrival of HIV is another contributory factor, as patients with HIV are highly susceptible to STDs and are highly infectious to others," says Dr Umashankar. The fear among the general population towards HIV, an STI (sexually transmitted infection) and Aids has contributed to more people coming to doctors. While sections of society bemoan the trends of live-in relationships and the youth flaunting a new-found sexual independence, doctors say it is this openness that is raising awareness on sexual health.
Doctors state that an increasing number of men and women are seeking counselling too. "People are marrying later; one can't expect them to remain celibate however. [I] am approached by women who have had two or three partners, and they want to know if they're infected," says Dr Chetana V, consulting gynaecologist at Kaveri Medical center and visiting consultant, Columbia Asia.

This heightened interest in STDs is largely due to the fear of contracting HIV. For most notifiable STDs, the highest rates of incidence is observed in the 20 to 24 age group, followed by the 25 to 29 and 15 to 19 age groups, said Dr Umashankar.

The Internet has proved to be, she feels, a great aid. "Confused after reading up information on the Net leads many seek counselling to understand STDs better," she says. Moreover, women look for answers on hygiene, condom usage, and on questions not just pertaining to pregnancy, but also whether they can get STDs, and the chances of conceiving post treatment.

Anonymity is still sought after and individuals take great pains to choose hospitals that are further away from their residence, says Dr Chetana. There are many who also come to take tests, "just to ensure they are not suffering from any STDs". However, Dr Umashankar and Dr Chetana say that tests are prescribed only in severe cases. In fact, Dr Umashankar said that according to WHO guidelines treatment of STDs should be done with a syndromic approach, meaning, "that the treatment should be done for all STDs".

In fact, doctors emphasis early diagnosis, the only limiting factor they say is, "a patients non-compliance".