13 Sep 2011
Counterculture 44: Sexual health
By Alan Nathan
Bea and Cate, young medicines sales assistants at the OTC Pharmacy, are in the staff room one lunchtime.
"Can I talk to you about something I'm worried about?" Bea asks nervously.
"Of course," Cate replies. "What is it?"
"It's a bit embarrassing and sensitive, so you will keep it to yourself, won't you?"
"Of course, go on."
"You know I've had a new boyfriend for a couple of months now? Well, he told me last night that he's just been diagnosed with chlamydia. I'm worried stiff and don't know what to do about it."
"You've had unprotected sex with him then?"
"What do you think? Why do you think I'm so worried? He says I've got to go to the genito-urinary [GUM] clinic that he went to and get tested, but I don't want to go through all that. I may not be infected, I haven't got any symptoms or anything."
"I don't think that means much," Cate says. "And it's really important that you make sure you're not infected. I really think that you ought to get it checked out. If you don't want to go to the GUM clinic you can get a test without being examined and get treatment if you're positive."
"What, you mean our chlamydia scheme here? But that's going to cost quite a lot of money," says Bea.
"You can get a free test," Cate replies. "But for your own sake you really must do something about it."
Questions
1 Why did Cate say that not having symptoms of chlamydia doesn't mean much and that it's really important to get it checked out?
2 How does a chlamydia scheme in pharmacies work?
3 Can Bea get a free test?
(Answers at bottom of page)
When should you involve the pharmacist?
The pharmacist should always be involved when discussing the possibility of a sexually transmitted infection (STI).
Tracey, a customer at OTC Pharmacy, recently spoke to pharmacist Dee about a possible STI. In private, Tracey explained that on her holiday in Ibiza a few weeks ago she had a ‘bit of a fling' with a waiter in her hotel and had unprotected sex. She didn't feel ill or have any symptoms, but she was worried and didn't know what to do.
Dee's first concern was that Tracey could be pregnant, but Tracey told her she is taking the contraceptive pill. Dee told Tracey the most common STI is chlamydia, followed by gonorrhoea and genital herpes; however, more serious infections such as HIV couldn't be ruled out.
As Tracey had no symptoms the most likely infection, if she had any, was chlamydia; symptoms are more common with gonorrhoea, although up to half of infected women do not get any. The consequences are as for chlamydia (see answers, above).
With genital herpes, warts appear on the vulva, in the vagina and in and around the anus. They may be invisible to the naked eye, but they usually itch or burn.
Dee strongly advised Tracey to go the local GUM clinic for a full, completely confidential, investigation.
For more on sexual health, including chlamydia, download the Counterpart plus feature on sexual health (module 145)
Answers
1 Chlamydia is the most common sexually transmitted infection in the UK. Most people who are infected do not have any noticeable symptoms – around 50 per cent of men and 70-80 per cent of women. It is important to get it diagnosed and treated because it can cause serious problems. In women chlamydia can create inflammation in the reproductive system, which can lead to pelvic inflammatory disease (PID) causing pelvic pain. It can also result in ectopic pregnancy and damage to the fallopian tubes, causing infertility. In men it can cause inflammation of the testicles and infertility. In both sexes it can lead to inflammatory conditions throughout the body, including the urethra and eyes, and a form of arthritis.
2 The customer buys a urine testing kit from an accredited pharmacy, at least two weeks after suspected infection has occurred, and sends the sample to a laboratory participating in the scheme. The result comes back within seven days. If it is positive, the customer can buy a single dose antibiotic treatment from the pharmacy that should treat the infection.
3 Yes. Under 25s, male or female, can get a free, confidential test under the National Chlamydia Screening Programme. Phone 0800 567 123 (free) or go to www.chlamydiascreening.nhs.uk for more information.
