Rural Residents Travel Hours for STI Testing Amid Stigma, Expert Claims

In a concerning revelation, Dr. Aisling Loy, a Consultant of Sexual Health and HIV Care at St James’s Hospital in Dublin, has highlighted the ongoing stigma surrounding sexually transmitted infections (STIs) in rural communities of Ireland. In an interview on The Pat Kenny Show on Newstalk, Dr. Loy noted that individuals are often compelled to travel considerable distances—sometimes hours—to seek STI testing and treatment, primarily to avoid being seen in local clinics. This behavior underscores a persistent culture of shame and stigma that continues to affect public health initiatives, even as societal attitudes shift from the more pronounced stigma of the 1980s and 1990s.

According to Dr. Loy, the stigma associated with STIs remains a significant barrier to accessing healthcare services. "I work in Dublin, but I think outside of Dublin, especially, I would have patients who travel for many, many hours to come to a clinic in Dublin, so not to be seen locally," she stated, emphasizing that the fear of social judgment continues to hinder healthcare efforts.

Statistics from the Health Service Executive (HSE) reveal a troubling trend in STI rates in Ireland, which have surged by 31% since 2019, although there was an 11% decrease in the past year. Dr. Loy mentioned that the peak occurred in 2023, yet recent strategies have led to a 15% to 20% decline in cases this year. "Thankfully, over the last two years, the strategy and the interventions that have been in place have started to see a decline," Dr. Loy explained.

The reasons behind the rising STI rates are multifaceted. Dr. Loy posits that increased access to care through free online testing services may have contributed to the rise, alongside behavioral changes such as decreased condom usage and an increase in the number of sexual partners. "We think there’s more access to care with free online testing services that are available. We know that people are now maybe taking more risks; they’re not using condoms as much," she elaborated.

Despite the progress made in managing STIs, Dr. Loy pointed out that there are still significant gaps in service provision. "There’s still 10 counties in Ireland that don’t provide any sexual health services in their counties," she remarked, advocating for the expansion of services to enhance access to sexual health care for all demographics, not just young people.

In addition to STIs, Dr. Loy noted advancements in HIV prevention, particularly among the gay, bisexual, and men who have sex with men (GBMSM) community. Initiatives such as the introduction of pre-exposure prophylaxis (PrEP) in Ireland in 2019 and the adoption of a 'test and treat' approach have significantly improved health outcomes for those diagnosed with HIV. "This means that they can’t pass it on," Dr. Loy stated, highlighting the importance of timely treatment.

The implications of this stigma and the barriers to healthcare access are profound, affecting not only individual health outcomes but also the broader community's public health landscape. As Ireland continues to confront these challenges, experts like Dr. Loy call for increased awareness, education, and service availability to foster a more inclusive and supportive environment for sexual health care. The fight against stigma and the enhancement of access to care remain paramount in addressing the rising incidence of STIs and ensuring that all individuals can receive the health services they need without fear of judgment.