SEX can be a dangerous business, as consultant Dr Ainsley De Silva would agree. As the man in charge of a hospital department dealing with sexually transmitted diseases, very little surprises him.
"I think patients think they can shock us, but we have seen and heard it all," he said. "I have seen people as young as 12 here. We have seen lords and ladies and people from all walks of life, including ministers of religion and doctors."
Last year, 20,458 patients were seen at the Royal Bournemouth Hospital's GUM (genito-urinary medicine) clinic, an increase of 1,757 from the previous year.
Some just attend for a check-up, including two or three couples a day who are in a new relationship and want to find out if it is safe to have unprotected sex.
Now the department is about to launch its first outreach clinic, to take place at Poole Hospital's red outpatients' area between 2pm to 7pm every Monday from February 3.
"For quite a few years we've felt that there are lots of patients who come from that area who have been finding it difficult to reach us," explained Dr De Silva. "We were funded to enhance and expand the service and we have utilised this money to open a clinic at Poole."
While the Bournemouth clinic is open access - meaning patients can just turn up without first going to their GP - the Poole clinic will be appointment-only*.
"We will have one doctor and limited staffing, so we can't handle it any other way, but we hope to provide as comprehensive a service as it is here in Bournemouth," said Dr De Silva.
Sexually transmitted diseases, or STDs, are among the most common infectious diseases in the world. In the west, the number of cases rose steadily between the 1950s and the 1970s, stabilised in the 1980s when fear of Aids encouraged more people to use condoms, then began increasing again.
That picture is reflected locally. "Like elsewhere, we have seen huge increases in sexually transmitted diseases," said Dr De Silva. "Being an open clinic with a walk-in facility, our numbers have perhaps gone up more than other clinics, especially in the south."
In the year ending September 2002, cases of chlamydia increased by 137 to 806, but Dr De Silva hopes the rise may be due to greater awareness. Infected women usually have no symptoms, but if untreated, the disease can lead to pelvic inflammatory disease, ectopic pregnancy and infertility.
Last year the Royal Bournemouth saw a spate of syphilis cases, some acquired from a prostitute working in the area. In the past, syphilis could lead to insanity and death, but these days it is 100 per cent curable with antibiotics.
With the success of modern drugs in keeping Aids at bay, there are signs the safe sex message is being ignored.
"The risk is more, but life expectancy and quality of life with HIV have certainly improved. It seems to lull people into thinking it doesn't matter, but it shouldn't be so," said Dr De Silva.
Safe sex is not just about using condoms, but also about being choosy over sexual partners, he says. "I sometimes feel society has failed when you have 14-year-olds asking for HIV tests," he admitted.
What is important to Dr De Silva and his colleagues is that people do not ignore any unusual symptoms such as inflammation, sores, pain, discharge and difficulties with urination.
"People hope it will go away and don't come to us for a while. In the meantime, they have not only got themselves into a worse situation but also spread it a bit," he said.
Booking for the Poole clinic opens on Monday. For an appointment, ring 01202 704644.
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