A PROMINENT Scottish GP has come under fire from sexual health experts for claiming the "tyranny" of safe-sex advice is ruining relationships.
Glasgow-based GP Dr Des Spence argues that strong messages warning about the risks of sexually transmitted infections (STIs) such as HIV and chlamydia have also had the effect of generating a "huge amount of disproportionate anxiety".
He called for more to be done to "normalise" testing positive for STIs, such as encouraging routine testing at home.
Spence said there was a hyped-up climate of fear around most STIs and pointed out that chlamydia, contrary to common belief, could clear up without the need for medication, and that HIV was no longer a guaranteed killer thanks to modern treatments.
However, sexual health consultant Peter Greenhouse, of the British Association for Sexual Health & HIV (BASHH), accused Spence of "misrepresenting" current practices in sexual health.
Writing online for the British Medical Journal, Spence said changes in modern sexual health medicine were welcome – such as "clap clinics" moving from a "portable building behind the hospital bins" to shiny new buildings.
But he added: "What is concerning about sexual health is its tyranny of terror messages: these are weapons of mass destruction of relationships."
Spence highlighted the adverts used to raise awareness of HIV, writing that "in the 1980s we lived in constant fear of being crushed to death by colossal falling tombstones", referring to the hard-hitting Don't Die of Ignorance ad campaign.
He said there was a "very low risk" of contracting the virus for the heterosexual population and HIV is now treatable and "no death sentence".
He also cited publicity about chlamydia, saying the message around the infection has been one of "increasing prevalence and increasing risk of infertility".
But he added: "Chlamydia clears itself, and the rise in prevalence is an artefact of new testing.
"Chlamydia is treatable, complications rare ... and infection does not increase risk of infertility."
Spence told the Sunday Herald he wanted the article to generate debate on whether sexual health advice should be more proportionate.
"My experience is that, for example if someone has been told they have got chlamydia, that can cast enormous mistrust within a relationship – yet the timescale of when people might have been exposed (to the infection) is very poorly understood.
"We need to be more honest about the prevalence of these infections and we might help to normalise and destigmatise positive tests."
Greenhouse said: "We're not saying scaring everyone is the way to go, but for something as serious as HIV, the impact of [the Don't Die of Ignorance campaign] is the generation who were born between 1970 and 1978 have the lowest rates of STI of any generation before or since.
"He (Spence) is misrepresenting the old-fashioned messages as if they are still being put out and they aren't, not from the sexual health clinics."
David Bingham, senior health promotion specialist at the Terrence Higgins Trust Scotland, which will this week launch a one-hour "drop-in" test for HIV at its Glasgow clinic, pointed out that being diagnosed with the virus still had a major impact on people's lives.
"Although there is some hope in terms of living a full life, having a positive result is still devastating for most people I know that have been diagnosed with HIV," he said.
"They do quite often have depression, get very stressed out and it leads to life changes."
He added that while the virus was not a "major factor" for the heterosexual population, it is estimated that one in 25 gay men in Scotland has HIV, around one-quarter of whom are undiagnosed.