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Press releases Saturday 24 July 2004
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(1) YOUNG PEOPLE
PUT AT SERIOUS RISK BY POOR ADVICE ON HOLIDAY SEX
(2) NICE IS
CREATING INFLATIONARY PRESSURE ON THE NHS
(1) YOUNG PEOPLE PUT AT SERIOUS RISK BY POOR ADVICE ON HOLIDAY SEX
(Sex, sun, sea, and STIs:
sexually transmitted infections acquired on holiday)
http://bmj.com/cgi/content/full/329/7459/214
Holidaymakers, and young people in particular, face death and serious health problems from risky sexual behaviour abroad, while they receive little preventative advice or appropriate screening on return, according to a paper in this week's BMJ.
Sexually transmitted infections (STIs) in the UK continue to rise, making "any sexual encounter potentially hazardous" yet travel brochures carry minimal advice on safe sex (3%) and preventative measures do not go far enough. Even more worrying, says the author, "is tour operators' encouragement of sex with partners by presenting prizes."
The review paper, by Sheffield consultant Dr Karen Rogstad, showed that in one study of holidaymakers attending a genitourinary medicine (GUM) clinic within three months of their return home, a quarter had slept with a new partner while away, and two thirds had not used condoms or had used them haphazardly.
A separate study of holidaymakers in Tenerife showed that 50 per cent of those aged 25 or younger had had sex with someone new while on holiday, compared to 22 per cent of those over 25.
Travellers to developing countries are additionally at risk of "tropical" infections, such as syphilis, which is also now a major problem in countries of the former Soviet bloc. HIV infection rates are also on the increase at home and abroad, and the risk is increased in areas of high prevalence, such as sub-Sarahan Africa, the Far East and, more recently, India, Latin America, and the Caribbean. Between 2000 and 2002, 69 per cent of men in the UK who acquired HIV from heterosexual sex were infected while abroad.
With such high rates of infection more widespread education is vital, says Dr Rogstad. Preventative advice should be offered to all holidaymakers, particularly those going to the developing world. Young people should be encouraged to seek health screening on return from holiday, and secondary prophylaxis (taken soon after exposure to reduce the risk of an infection taking hold) for HIV and Hepatitis B should be considered in certain circumstances.
Contact:
Dr Karen Rogstad, Department of
Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
Email: karen.rogstad@tesco.net
(2) NICE IS CREATING INFLATIONARY PRESSURE ON THE NHS
(National Institute for Clinical
Excellence and its value judgements)
http://bmj.com/cgi/content/full/329/7459/224
(Challenges for the National Institute for Clinical Excellence)
http://bmj.com/cgi/content/full/329/7459/227
The National Institute for Clinical Excellence (NICE) is creating inflationary pressure that the NHS cannot afford, argue researchers in this week's BMJ.
Responding to an article on the rationale behind NICE decisions, Professor Alan Maynard and colleagues say that giving NICE a real budget would encourage it to examine the effect of its decisions on the whole NHS.
NICE exists to give health professionals advice on providing their NHS patients with the highest clinical standards of care. Its approach to economic evaluation is based on affordability, efficiency and equity, yet the authors suggest that this approach has been self serving and inflationary.
They believe that NICE's role is too peripheral to the NHS. Instead, NICE should inform NHS decision making and provide better information on the equity implications of new and existing technologies. It should also focus not only on service enhancement but also on withdrawal of existing ineffective or inefficient therapies.
Give NICE a real budget, they say. This would force it to examine the cost effectiveness of existing treatments as well as new ones and to prioritise and fund the excessive demands they are making on local NHS budgets.
The NHS cannot afford NICE generosity, even with increased NHS funding. Over the next few years the current substantial growth in NHS expenditure is likely to fade, and NICE will have to make hard choices in a much more difficult economic climate, they conclude.
Contacts:
Professor Alan Maynard, Department
of Health Sciences, University of York, UK
Email: akm3@york.ac.uk
or
Dr Karen Bloor, Senior Research
Fellow
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