Should sexually transmitted
infection (STI) testing be available at the same time as emergency
contraception?
A M C Webb, Abacus Centres for Contraception and Reproductive
Health, Liverpool, UK
The concept of dual
protection against pregnancy and STIs is supported by many international bodies
working in the area of contraception and sexual health but despite attempts to
encourage and educate both humans and condoms fail. Within contraceptive practice promoting the availability of
emergency contraception is well accepted but provision of STI testing and
follow up at the same venues tends to be met with surprise, concern or
sometimes denial. Historically,
different specialties dealing with the unwanted consequences of sex has lead to
a compartmentalisation of the problems rather than a holistic approach to
sexual health. The problem is further
compounded by limited information in many countries about the prevalence of
STIs. As they are so often asymptomatic, unless governments or clinicians have
the political will to commit considerable resources to identifying and reducing
the problem, it may be ignored initially but the health and social consequences
will lead to considerable morbidity and mortality. STIs have been increasing in all European countries where they
have been studied, even in those with considerable commitment to their
identification and treatment. Newer
methods of detecting infections greatly reduce the need for intimate
examinations and one off treatments are successful in many cases. If joined up working and care is not
considered and implemented we may be responsible for reducing one problem
whilst allowing a larger one to grow out of reach.