Midland Regional Hospital Portlaoise STI clinics could very busy.
The doctor who oversees the sexually transmitted infections (STIs) clinic at Portlaoise hospital has urged anyone who believes they have an infection to present to the clinic to get checked.
Dr Dominic Rowley did so in the knowledge that the clinic is at capacity with the number of people presenting increased significantly in recent years.
The consultant in infectious disease is attached to St James Hospital in Dublin but runs a weekly clinic in the Midland Regional Hospital Portlaoise.
The Portlaoise clinic has been operating for a number of years but a link established with St James through the Dublin Midland Hospital Group has seen the service expand.
He said the hospital's location is ideal for setting up a clinic outside Dublin that reduced the number of patients that have to travel to the capital for checks or treatment.
Dr Rowley said the clinic, which he runs in conjunction with lead nurse Deirdre Gordon and public health doctor, Barbara Hynes, is very busy.
“The demand is out the door. We could probably be open at least three nights a week. As it stands we are only open one night a week. We have a waiting list. An STI clinic should never have a waiting list. We have reduced it,” he said.
He said patients are presenting mainly from Kildare and Laois. He said most self refer but some come from GPs who cannot provide the treatment.
As for the STI incidence, he said the numbers match the demand for the service.
“It is huge. Every STI has jumped this year alongside HIV,” he said.
Dr Rowley said there are many reasons why infections rates are on the increase.
“There is a complacency there about safe sex. There hasn't been a public health campaign about safe sex. Sexual health education is lacking.
“We also have online dating which is a contributory factor. After a night out you can go home and under the influence of recreational drugs and alcohol you can have an encounter,” he said.
He said STI incidence is observed mostly among people aged 30 and under but there is a change.
“We are seeing a lot of people now who are getting STIs in the 50s and 60s. They are now starting new relationships whereas previously they would have been widowed or divorced and their sex life would have been over. Now people are having what we call sexual debuts at a much later age,” he said.
He said the NHS in the UK is to start giving out free condoms for the over 65s.
At the other end of the scale, Dr Rowley said infections are presenting in the underage group.
As to gender, he said women tend to be better than men about having their sexual health checks through their GPs.
As to the difference between Dublin and a more rural county like Laois, Dr Rowley said there was very little difference in what is presenting.
“That is very positive in that we are looking after everything that we should be looking after. People are definitely having sex in the Midlands as they are in Dublin,” he said.
He said foreign holidays also contribute to the incidence but another factor is the Electric Picnic.
“There is always a big spike after the picnic,” he said.
There is also no regional disparity in the types of STIs.
“Chlamydia is the number one in the Midlands the same as in Dublin. Gonnorea, syphilis, HIV genital warts is the exact same as in Dublin,” he said.
He said people are presenting to the Portlaoise clinic when their STI is at an advanced stage.
“Undiagnosed STIs in women can cause infertility, not uncommonly. Even something as innocuous as chlamydia if left for up to 10 years can cause a lot of problems in the pelvic area and can cause infertility.
“Syphilis, HIV or hepatitis can be life-threatening. Undiagnosed STIs can be fatal and can cause serious consequences,” he said.
He said people with fertility issues can often present to the wrong service.
Another big demand for service is from the LGBT community.
“We have had a big 'men having sex with men' population in our clinic,” he said.
He said HIV is present in this population who attend the Laois hospital but their treatment is delivered in Dublin.
Part of the expansion of the Portlaoise service is the provision of PrEP (Pre Exposure Prophylaxis). It is taken by people in advance of sex to prevent the contraction of HIV.
He urged anybody with a concern to present to the clinic which runs from 5.30 pm to 8 pm every Tuesday night.
“The message is get checked and come into us. We have heard everything before. You are coming into a non-judgemental environment where there is free condoms, free lube and very friendly open staff.
“The more we engage with people, the more they get checked is the only way we have of educating people and reducing infection rates,” he said.
At present nine staff are attached to the unit. Two doctors and four nurses staff each clinic.
Dr Rowley praised hospital managment for the full support for the service. He hopes the demand for services can help them to support its expansion.
“We could easily open four nights. We want to set up an express clinic. We would like to have a clinic where you can come in with no symptoms,” he said.
Such a clinic would only require nurses to take blood with patients bringing in their own swab samples.
Dr Rowley said there has not been a public health campaign ion the cards and is badly needed.