Patients are having to wait weeks for STI treatments due to growing demand on sexual health clinics driven by the monkeypox outbreak, health leaders have warned.
The rising prevalence of the viral infection is forcing clinics to reduce their usual day-to-day activities by 30 per cent as focus turns to identifying potential monkeypox cases and administering the vaccine to at-risk groups, according to the Terence Higgins Trust.
The British Association for Sexual Health and HIV (BASHH) said that the monkeypox outbreak had also made it harder for people to access PreP — a preventive drug that minimises the chances of contracting HIV in at-risk groups — and long-lasting contraception, such as the coil.
A total of 2,859 infections have been detected in the UK to date, the majority of which are centred in the capital, where the greatest healthcare pressures are being reported.
“So particularly in London, we know that some clinics have lost something like 30 per cent of their day-to-day activities as a result of supporting people with monkeypox,” said Ceri Smith, head of policy at the Terrence Higgins Trust, which has helped co-ordinate the national response to the outbreak.
“We’re hearing from people who are struggling to get appointments for acute STIs, in some cases up to two weeks. People are reaching out for appointments but there’s just nothing available because there’s been so much shifting around of staff and resources to respond to monkeypox.”
Guidance from the National Institute for Health and Care Excellence states that people with acute STIs, such as chlamydia and gonorrhoea, should be offered an appointment within two working days.
Analysis from BASSH shows that £51 million in extra funding is needed to support health services in diagnosing, treating and vaccinating monkeypox patients.
“Sexual health services across England were already facing unprecedented levels of demand, and monkeypox is only placing further strain on the system,” the organisation said.
“Without additional resources to support services to manage these high levels of demand, there will be an ever more severe impact on clinic availability and capacity to provide important STI and HIV services.”
BASSH said many services were “reporting significant reductions in non-MPX activity and some describing 90 per cent reduction in PrEP and LARC [long-lasting reversible contraception] access”.
The Terrence Higgins Trust warned that the long delays in accessing STI treatments were rising patients’ health.
Ms Smith pointed to the example of gonorrhoea, saying it was important to provide “prompt treatment to bring the infection under control and minimise drug resistance”.
For chlamydia, she said it is important women are treated quickly “because it does have risks like pelvic inflammatory disease, which can lead to infertility, it’s left too long”.
“So if we’re talking about a couple of days, that’s maybe not such an issue, but you’re hearing people who worry that it’s taking weeks for them to be able to get an appointment,” Ms Smith said.
As the outbreak starts to spread beyond London and take root in other cities, such as Manchester and Brighton, there is concern that the healthcare pressures reported in the capital will become more prevalent across the country.
The number of cases in the South East nearly tripled between 6 July and 1 August, rising from 91 to 233 — one of the sharpest regional jumps over this period. In the North West, cases more than doubled from 71 to 144.
“We’ve been hearing from our colleagues, clinicians working in sexual health clinics, that there’s been in some areas of the country huge displacement of the day-to-day activity of sexual health services,” Ms Smith said.
Dr Sarah Pitt, a microbiologist at the University of Brighton, said the UK and other western countries had been caught unaware by the ability of the monkeypox virus to spread through sexual contact.
“I think that at least part of the reason why the virus is spreading so easily is because humans were not ready for it to be passed on so readily outside of Africa and through sexual contact,” she said.
Some have speculated that the virus has undergone significant mutations, which have helped to fuel its spread beyond Africa, where it is endemic in parts of the continent.
However, Dr Pitt said that while “some mutations have been noted between the monkeypox strains from a few years ago and the current one”, recent analysis of the virus “does not indicate a drastic change” to its genetic composition.