Malta needs a good clinic for sexually transmitted diseases

Malta will continue to see an increase in the number of sexually transmitted infections unless it has a proper genito-urinary clinic, Irish expert Derek Freedman believes.

The local clinic, housed at Sir Paul Boffa Hospital, offers very little privacy to those waiting to be seen by a doctor, something that can inhibit people from seeking help.

"Unless the country has a good clinic, diseases will continue to double because once they become prevalent in the community, they continue spreading," he told The Times, pointing out that sexually transmitted infections could also damage Malta's reputation as a tourist destination.

The local genitourinary report published in June showed that the number of people infected with gonorrhoea through casual, unprotected sex has more than doubled in a year.

Dr Freedman, who was in Malta for the annual academic meeting of the Maltese Association of Dermatology and Venereology, said the increase could boil down to a lack of inhibition among young people.

"In some Western countries we are seeing sexual activity starting earlier and sex has almost become a consumer item for adolescents, something else they want apart from their Wii and Xbox. They feel entitled to it," he said.

He said sometimes sex becomes so shorn of romance that people do not even know the name of the person they have slept with, especially when there is alcohol involved.

This could be dangerous since, if one person gets diagnosed with an STI, he would not be able to contact the other person to get tested.

"Men tend to show symptoms of a lot of infections while women don't. If a couple swaps phone numbers, if someone is diagnosed with an infection, he can inform the other person," he said.

Dr Freedman stressed that anyone at risk of infection needs to be offered a proper range of tests and told clearly whether they have caught an infection, again underlining the importance of a well-equipped clinic which does not put off patients.

"It is not enough to get a cursory physical examination and maybe just a urine test," he said, adding that anyone who was at risk of infection should get tested for syphilis, Hepatitis B, HIV, gonorrhoea, Chlamydia, warts and herpes.

Dr Freedman said all STIs - including HIV - are treatable and most are minor if diagnosed and treated early.

"It is the responsibility of the health authorities to ensure that there are the necessary resources to do this. Otherwise the population will suffer and patients can have long-term problems like sterility, infertility and ectopic pregnancies."

He said people tend to focus much of their worry on HIV which, although it was originally fatal, has now become a chronic infection that can be easily treated and looked after. But the damage can only be restricted through early testing and diagnosis.

He highlighted the importance of HIV-positive patients being open about their status with their partners. "Without openness there is no relationship, just someone taking advantage," he said, adding that, although HIV is not spread with every sexual contact, risks are always present. Once the primary stage of infection has passed, the transmission rate is around one in every 1,000 episodes of intercourse from women to men and one in 100 episodes from men to women.

Speaking about sex education, Dr Freedman said this needs to come from the parents first and foremost and reinforced in schools. "It is the parents' responsibility to educate their children and pass on their values. Children can get damaged when they see that their parents are unable to talk to them about sex, which should be seen as a natural thing that can be talked about."

While abstinence is the preferred method of protection, condoms need to be readily available, especially in vending machines in bathrooms of pubs, cinemas and hotels. Both the government and the Church should not stand in the way of this, Dr Freedman said.

He questioned the inadequacy of having one doctor to serve all the country's genitor-urinary needs.

"Having one doctor for a population of nearly half a million is grossly inadequate."

The doctor in question, GU Clinic chairman Philip Carabot, has long been known as an advocate of STD awareness but earlier this year was informed by the health authorities to seek permission from his superiors before communicating with the media. This was also questioned by Dr Freedman, who said that for the 30 years he has been working in Ireland he has found the media as "the most efficient and economic" way of transmitting information about good relationships and safe sex practices.

"I cannot see the advantage of silencing such a cheap and effective means of communication," he said.