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Sexually shared infections
  1. Ravi Gokhale
  1. Department of Genitourinary Medicine, Arrowe Park Hospital, Upton, Wirral, CH49 5PE, UK

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    editor,—Those who have spent some time in genitourinary medicine will surely agree that the specialty has gone through vast changes over the years. Not only the nomenclature of our clinics from VD clinics or special clinics to psychosexual health departments but also the name of our specialty itself has gone through a metamorphosis.

    I was therefore interested to note the term “sexually shared infections” suggested by Hopwood et al1 and wondered what message it would project to our patients, sorry our “clients.” Hence, I decided to test this new term in my clinic and would like to share the results with the readers of STI.

    Firstly, I saw a young girl who had primary presentation of genital warts. I suggested that she might have “shared” this infection with her partner to which she replied, “Look doctor, I know HE gave it to me because he is the one who was sleeping around.”

    The next one was a young man who presented with acute gonorrhoea. When I said he might have shared this infection with the one night stand he had in Manchester he replied, “Look doctor, I am no fool. I was so drunk that night that I couldn't perform but she went ahead anyway then this happened.”

    The third one was a chlamydia reinfection. The young girl was found to be positive and received a single dose regimen. Her boyfriend was referred to a GUM clinic but by the time he attended they had had protected sex but the condom split and the girl was reinfected. When I mentioned the “shared” element she fumed, “It was him who gave me this in the first place and he wouldn't get treatment himself because he felt OK.”

    English is not my first language but I always thought that you “share” something that is nice. Like sharing the tender moments, sharing your cake, British Airways share offer when it floated on stock market, etc.

    Sharing an STI to me sounds a bit awkward.

    In my opinion people transmit the infections knowingly or unknowingly because of their high risk sexual behaviour. It does not matter if we try to play this down and make it acceptable. There always will be some stigma attached to STIs but we should ensure awareness, patient education, and partner notification. I believe this should be done by professionals in a confidential setting in a genitourinary medicine clinic. Changing the terminology about the mode of transmission will not eliminate the stigma attached to STIs but the more open we are about infections the better it will be for our patients.