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Cases of gonorrhoea in England have reached record highs, while syphilis cases are at the highest level since just after the Second World War, according to the UK Health Security Agency (UKHSA). Gonorrhoea diagnoses rose to 82,592 in 2022, an increase of 50.3% compared to 2021, while infectious syphilis cases increased to 8,692 in 2022, the largest annual number since 1948. As well as gonorrhoea and syphilis, it’s important to be aware of the risk around all sexually transmitted infections (STIs) including chlamydia, genital herpes, genital warts and HIV. As Dr Hamish Mohammed, consultant epidemiologist at UKHSA, pointed out: “STIs aren’t just an inconvenience – they can have a major impact on your health and that of any sexual partners.” Here, sexual health experts talk through what you need to know about STI prevention, testing and treatment… 1. Anyone can potentially get an STI “Don’t think that because you haven’t caught one in the past – or because you only sleep with people that you don’t think have STIs – that you are immune, because the truth is that no one is,” Sarah Mulindwa, a specialist sexual health nurse who is working with Lovehoney, told PA Media. Regardless of gender, sexual orientation, whether you have lots of partners or you’re in a monogamous relationship, anyone can potentially get an STI. And they affect all age groups, too. “There’s no upper age limit on getting an STI,” Julie Bowring, consultant gynaecologist in sexual and reproductive health at London Gynaecology, added. The number of common STIs caught among the over 65s in the UK increased by 20% from 2017 to 2019, according to the Local Government Association. This may in part be due to differences in health awareness. “When that generation of patients were at school, they didn’t get quite as good and comprehensive sexual health education as we get now,” Bowring said. “And if you look at all the media campaigns for sexual health infections, it’s usually targeted at a younger demographic.” 2. Not all contraceptives protect against all STIs “It’s a common myth that when you’re on regular contraception, you might have protection against STIs,” said Bowring. “I think that can sometimes be missing in information that’s given to patients when they start contraception.” While birth control methods such as the pill, coil or IUD will protect against unintended pregnancy, they won’t protect against STIs. “Condoms [or dental dams] are the only effective method of protecting against STIs if you are sexually active,” said Mulindwa. “And even then, only when you use them correctly: wearing one to cover the whole length of the penis, and using from start to finish of sex, including during oral, anal, or vaginal penetration.” 3. Symptoms can vary greatly With a wide range of symptoms that vary in severity, STIs can sometimes be difficult to spot. “Certain STIs, such as chlamydia for example, might not even present any symptoms in the person that has it,” Mulindwa explained. “If you are experiencing any form of discomfort in and around your genitals, then it is imperative that you get tested right away.” Other signs may include an unusual discharge from the vagina, penis or anus; pain when peeing; lumps or skin growths around the genitals or anus; a rash; unusual vaginal bleeding; itchy genitals or anus; and blisters, sores or warts around these areas. “It can be quite difficult for women to sometimes know when a symptom might be STI related,” added Bowring. “It could be their periods, it could be something non-STI related. If there is a risk of infection and you have noticed a change in either your discharge or your pain, then it is worth getting checked out.” 4. Routine testing is a good idea Because some infections don’t result in any symptoms, routine testing is important. “If you’ve changed partner then it’s a good idea, if you haven’t had STI screening, to attend your local service to get that done,” Bowring advised. Home testing kits are also available with swabs and finger-prick blood tests. “It’s recommended that you screen at least every six months for the most common infections – chlamydia and gonorrhoea – and yearly for blood tests to screen for HIV, syphilis, and hepatitis C,” Mulindwa added. “Depending on your risk factors, you may need to screen more frequently.” 5. Treatments are available STIs are extremely common and there’s no need to feel embarrassed or ashamed if you do catch one, and treatments are available. “The majority of STIs are curable, and even those that aren’t – for example, herpes – have treatments available to manage outbreaks,” said Mulindwa. “Some STIs like chlamydia are treatable with a course of antibiotics, and others require creams and ointments.” 6. Options for people with HIV have come a long way Thanks to scientific breakthroughs, providing they have access to treatment, most people with HIV will not develop any AIDS-related illnesses and can live full lives. “There are now options available that can stop HIV reproducing in the body and prevent you from passing it on, as well as drugs designed to prevent infection if you have been exposed,” said Mulindwa. “People who are HIV positive and are undetectable (which means the level of the virus is very low) are unable to pass it on even when they have unprotected sex.” A relatively new drug called Pre-Exposure Prophylaxis (PrEP) – designed to reduce the chance of contracting HIV – can be helpful for people who may be at increased risk. Health professionals at NHS sexual health clinics can talk you through the options for preventing and managing HIV. 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Manchester City reached the pinnacle of the European game with victory in the Champions League final on Saturday, which also saw them complete the treble. Here, the PA news agency looks at what could come next for the club. Could this be the first of many European triumphs for City? The club will certainly hope so. While winning the Champions League may have been a long-held ambition and the culmination of everything hitherto done in a now 15-year project under Abu Dhabi ownership, it was not a one-off target. The club have advanced considerably on and off the field and they intend to establish themselves firmly among the continent’s heavyweights. Winning every season is obviously not realistic but they want reaching the latter stages each time to become the norm. Will Pep Guardiola carry on at the helm? The inspirational Catalan has been the central factor in City’s success. The club identified Guardiola as the man to bring them European glory long before they even appointed him and their set-up is tailored to him. Their trust in him has paid off handsomely and they will naturally want him to stay as long as possible. There is uncertainty as Guardiola has never favoured long-term commitments. All his contract renewals at City have been relatively short. After winning the Champions League there is a feeling he could see his business as done when his current deal expires in 2025. On the other hand, he does seem firmly wedded to the City project and spoke on Saturday of not wanting the club to win one Champions League “and disappear”. City fans can expect at least a couple more campaigns from him. Will he need to reshape the team? With the way City have charged through the closing stages of the season to sweep up three trophies, there would seem little reason to make major changes. A specialist left-back would be desirable after Joao Cancelo left on loan in January and seems likely to move on, but that position has been a recurring problem throughout Guardiola’s tenure and has hardly hindered them. Some new signings may be necessary if the influential pair of Ilkay Gundogan and Bernardo Silva leave. Gundogan is out of contract this summer and yet to commit while Silva is apparently open to a new challenge and could go if a suitable offer arrived. City are hopeful both will stay, however. Other than that, there seem no pressing issues. Can they maintain their standards? It would surely be impossible for City to remain at the same level they have been this season. Last year Liverpool produced a very high standard and came within a whisker of winning the quadruple but, after their exertions took their toll, fell away this term. City will be anxious to ensure any downturn is not as dramatic. Five Premier League titles in six years, however, suggests Guardiola has a good idea how to prevent this. There is an elephant in the room though isn’t there? Yes. The Premier League’s Financial Fair Play investigation into City may be out of sight at times but it has not gone away. City are facing more than 100 charges for alleged rule breaches. This could loom over them for some considerable time but, with little clarity over the process or the nature of the charges, it will be business as usual in the meantime. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Zach Mercer and Danny Care included in England World Cup training squad Football rumours: Wilfried Zaha eyes move to Paris St Germain On this day in 2019: Chris Froome ruled out of Tour de France after crash

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