Sick sex: the alarm is there, but it is not said

The testimony of an HIV-positive tested patient in Reggio. That of doctors who deal with pathologies caused by unprotected relationships in the area. As cases increase, information and sexual education campaigns disappear. Ignorance, fears and prejudices remain to triumph. In 2017, during the 56th National Congress of the Association of Hospital Dermatologists, concerns were raised about the rise in sexually transmitted infections (STDs). These infections included HIV and syphilis tests, gonorrhoea, warts, fungal diseases, and others. Since 2000, Italy has seen a 400% increase in syphilis cases. According to the Istituto Superiore di Sanità (ISS) newsletter, which updated new diagnoses as of 31 December 2021, there has been a consistent decline in infections since 2012.

However, even if on a national basis, some data gives food for thought:

Since 2015, the number of people diagnosed with HIV infection has seen a late increase. In 2021, over one-third of affected individuals discovered their infection due to symptoms or related pathologies. This trend is accompanied by an increase in the proportion of AIDS patients who learn about their condition in the few months before its development. Calabria stands out for being among the last in Italy for infections and cases but is one of the regions that exports the most in healthcare, with 25% of cases.

Talking about STDs today is more complicated. After two years of a pandemic, screening and health attention were all aimed at COVID-19. Both the ISS and the doctors interviewed confirm this. As far as HIV is concerned, infections have fallen so much. After the twenty years of the 80s and 90s and the fight against the AIDS epidemic, social communication funds shifted towards other issues, such as obesity. However, both at a national and local level, research indicates a lack of attention to sexually transmitted diseases (STDs); very little discussion surrounds this topic. There are no prevention campaigns; there is no communication. This has meant that diagnoses are usually late, and undergoing tests is anything but a habit.

the case of the City of the Strait

Reggio Calabria is an exemplary case. The Infectious Diseases Department of the Grand Metropolitan Hospital says that in the two years between 2018 and 2019, they recorded a surge in HIV and syphilis infections, especially in young people aged 25 and over. Although these are often homosexual and bisexual patients, the incidence of hetero patients has increased.

A recent Microbiology publication from the same unit examines the trend of syphilis infections in both the pre-pandemic and COVID-19 pandemic periods. The research confirms a consistent increase in infections, a trend already observed in the previous two years. Additionally, most cases underwent testing in private facilities, with treatment administered at outpatient hospital levels.  Those knowledgeable about the subject are aware of the connections revealed in tests between syphilis and HIV. Syphilis, often referred to as the “HIV highway,” weakens the immune system, making HIV transmission more likely.

Doctor Alfredo Kunkar gives an insight into the situation:

«In the face of greater freedom of sexual mores, the emergence of greater promiscuity experienced too lightly represents the primary cause of this situation. Combining this with the absence of a culture of prevention, the picture is clear. Until a few years ago, syphilis appeared to be under control. However, its resurgence is notable. It’s occurring even among sections of the population not typically considered vulnerable, such as drug addicts or prostitutes. Instead, it’s affecting the so-called “unsuspected.”

Along with this resurgence, there’s a rising incidence of disease. This situation warrants reflection on the issue, particularly among younger individuals. The lack of discussion and preventive measures is concerning. Coupled with this, comprehensive sexual education is absent in schools. Consequently, there’s a misconception about the nature of dealing with STDs and the appropriate treatments.

CIRCUMCISION: MASSIMO GALLI WARNS ABOUT EASY PREVENTION

«It’s an old catchphrase. Massimo Galli, director of the Institute of Infectious and Tropical Diseases at the University of Milan, suggests that circumcised individuals likely have a lower risk for STDs.  This is because, with the operation, a biological microenvironment favourable to infection is missing. «However, there is no general agreement on this. In short, circumcision does not give total security of being protected from risk; the possibility of becoming infected remains. All the more reason, therefore, is that its application for epidemiological purposes is not feasible.”

Taken and reformulated from www.panorama.it Below is the article on Panorama.

It would eliminate a part of the skin, the foreskin, rich in some cells called Langerhans cells. These cells are highly susceptible to infection, the AIDS virus. Without these cells, the risk of contracting the disease was estimated to be 6.7 times lower than in an uncircumcised man. But many doctors are sceptical.

Circumcision equals seronegativity? This is the controversial equation that a growing number of researchers support to draw attention to the results of 34 international studies conducted on AIDS. According to what appears to emerge from this research, circumcision would significantly reduce the risk of contracting HIV for men. Balanced newspapers such as the Financial Times have reported on the new hypothesis.

In 2002, Dr. Helene Gayle, director of the Gates Foundation’s HIV/AIDS and TB program, concluded that “circumcision halves the risk of infection” after reviewing around thirty international studies. For some circumcised men, particularly those at high risk, such as those with STDs, this percentage could increase up to 70 per cent.

SKEPTICISM

However, there also remains a lot of scepticism about these hypotheses. For example, it has been emphasized that circumcision does not provide immunity against other infectious agents such as syphilis and herpes. Additionally, the Cochrane Collaboration, an international non-profit organization focusing on public health issues, noted that medical studies supporting the preventive benefits of circumcision overlook cultural and religious factors.

AVAILABILITY IN BOTSWANA

The debate on preventive circumcision thus sees the medical-scientific community divided. The STD costs and, above all, the cultural brakes on widespread circumcision among populations at risk are decisive factors. But in at least one African country, Botswana, which has frightening percentages of AIDS and HIV-positive patients (official estimates are 20%, perhaps double in reality), according to a group of Harvard researchers. The majority of parents are now ready to subject newborns to “preventive” circumcision.