Introduction

Good sexual health is an integral part of quality of life. However, sexually transmitted infections (STIs) are common and rates are rising (White, 2004). Although diagnoses of STIs declined in the mid-1980s coinciding with awareness of Human Immunodeficiency Virus (HIV), since 1995 there has been a gradual, sustained overall increase of 57% with rates of syphilis increasing by 1058%, chlamydia by 196%, gonorrhoea by 139% and a first attack of herpes simplex by 15%. This can partially be explained by increased numbers presenting for STI screening and an increase in the sensitivity of diagnostic tests over this time. However, it also indicates a fall in safer sexual practices, particularly in young adults and in men who have sex with men (see ‘Sexual risk behaviour’).

STIs are frequently accompanied by painful, burning or itching lesions or discharge in the genital, anal and oral regions. They may also result in serious systemic disease; links have been made between genital warts and cervical carcinoma, syphilis and damage to the cardiovascular and central nervous systems and to congenital disorders, gonorrhoea with sterility and chlamydia with pelvic inflammatory disease (the leading, preventable cause of infertility).

Recognition of the enhancement of the sexual transmission of HIV in those with STIs (Schacker, 2001) and their related adverse health burden (Ebrahim et al., 2005) has resulted in STI prevention becoming a global priority.

Psychological responses to STIs

Diagnosis

Research into the psychological impact of STIs is largely limited to studies of those with genital herpes (see ‘Herpes’).