2023-11-07 02:00:00
Sexually transmitted infections are increasing. An expert is calling for more education, starting at schools. Many of these diseases lead to tumors and infertility.
Professor Brockmeyer, you are President of the German Society for Sexual Health. Many may think that diseases like syphilis are long gone, but the number is increasing. Are sexually transmitted infections, or STIs for short, generally increasing in Germany?
Professor Dr. Norbert Brockmeyer: Sexually transmitted infections are increasing in Germany, and continuously: In 2000 we had around 800 syphilis infections, today there are around 8,300. But also chlamydia, gonorrhea – colloquially known as gonorrhea -, hepatitis B and C as well Herpes and HPV viruses are sexually transmitted.
Professor Dr. Norbert Brockmeyer is a specialist in skin and venereal diseases and president of the German STI (Sexually Transmitted Infections) Society for Sexual Health.
Photo: Bernd Thissen
Where does the increase come from?
Brockmeyer: There are many reasons for that. On the one hand, many people still believe today that they only have to test for HIV viruses and only protect themselves against HIV; the other STIs lead a shadowy existence. The AIDS awareness work was and is very successful. One of the reasons why STIs are increasing is that it is now much easier and quicker to find sex partners via chat rooms and other digital channels. As rapid sexual contacts increase, STIs also increase.
So there is a lack of information?
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Brockmeyer: There is a huge lack of education about STIs: We urgently need a lot more education about sexual health in schools. However, this should not be done by teachers, but by external experts. Unfortunately, many conservative parents reject education because they believe it would sexualize their children. The opposite is the case: We know from studies in the USA, for example, that students who are well informed have sexual contacts much later and have fewer STIs. I am convinced that if we had better education about sexuality, we would strengthen children and young people and would also have fewer sexual attacks because the children could protect themselves.
HIV is now considered to be easily treatable. How dangerous are the other STIs you mentioned, such as chlamydia?
Brockmeyer: Many young girls and women suffer from chlamydia, which can lead to infertility and tumors. Gonococci can also spread throughout the body and cause, for example, sepsis or lead to infertility.
What about herpes?
Brockmeyer: Herpes infections are very painful and can lead to psychological trauma, especially in women. I have many patients who regularly experience a herpes infection in the genital area, often at the beginning of their period, because herpes viruses always remain in the body. These women are then afraid to have sex because it causes pain, which can be very distressing. However, great efforts are currently being made to develop a vaccination against herpes viruses.
There is already a vaccination against human papilloma viruses.
Brockmeyer: But it is used far too rarely, even though we have long known that these pathogens cause cervical cancer. HP viruses can also cause carcinomas in the anal area or on the penis. And 50 to 60 percent of throat cancers diagnosed are due to HPV, because they are also transmitted through oral sex. This makes vaccination all the more important. There is now a vaccine that protects against nine types of HPV. This means that 98 to 99 percent of tumor diseases can be prevented. In Australia, vaccination rates are many times higher than here. It is assumed there that cervical cancer will soon no longer occur.
How high is the HPV vaccination rate in this country?
Brockmeyer: It is far too low: for girls it is around 60 percent, for boys it is around 25 percent – so we are far from a goal to protect a broad population, for that the rate would have to be over 80 percent.
Is there a lack of clarification here too?
Brockmeyer: The problem is that we no longer have school vaccinations in Germany. That doesn’t mean that everyone has to get vaccinated, but by doing so we would give many more young people the opportunity to receive this important vaccination and we could really avoid thousands of deaths every year.
There is at least an information campaign running at bus and tram stops with clear images and, for example, the sentence “I’m still itching for my date.”
Brockmeyer: I generally think the campaign is good because it draws attention to the issue. However, she assumes that STIs itch or burn. The problem, however, is that many STIs initially have no symptoms.
Does that mean you don’t even notice when you’re infected?
Brockmeyer: Well, when patients know that they have an STI, many admit when asked that they have noticed something, for example pain or blisters. But they thought it wasn’t so bad. In syphilis, for example, an ulcer forms at the entry point of the pathogen, often on the penis, in the vagina, but also in the mouth or anus. After about two weeks it heals again, but the infection remains. This is usually followed by a skin rash. But it also heals again. For example, it is only in the long term that severe nerve and vascular damage occurs, which can even lead to dementia.
How can you protect yourself?
Brockmeyer: I mentioned the important vaccination against HPV. For example, you can also protect yourself against HIV with pre- and post-exposure prophylaxis, and, like other STIs, with condoms, femidomes or lick wipes. What’s crucial is that I pay close attention to my body when I’ve had sex with multiple people, take symptoms seriously, and go to a doctor for a checkup. Unfortunately, sexuality is an absolutely taboo topic. When it comes to your own underwear, no one talks about sex anymore. In my observation, we have broken down the taboo somewhat when it comes to HIV infections; people are more likely to talk about that, but not at all about syphilis, for example. Therefore, I can only encourage you to take sexual health just as seriously as other health areas and not to ignore it.
About the person: Prof. Dr. Norbert Brockmeyer, 71, is a specialist in skin and sexually transmitted diseases. The dermatologist has been dedicated to HIV/AIDS research for 40 years and is now President of the German STI Society, Society for Sexual Health.
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