When I read on the BBC website that ‘England will be the first country in the world to start vaccinating people against the sexually transmitted infection gonorrhoea’, I felt a flare of rare patriotism. We Brits, far from the no-sex-please-we’re-British libel which self-loathing Europhiles like to paste on us, have been known for our sexual generosity (some might say incontinence) since the dawn of cheap foreign travel, so it makes sense for us to take preventive measures. A tiny, immature bit of me even wanted to snigger, as when I was a young girl the idea of ‘the clap’ was a matter of some amusement on the part of my cohort. However, this is a serious business.
It will not be available for everyone. The focus will mainly be on gay and bisexual men with a history of multiple sexual partners or an STI. The vaccine is 30-40 per cent effective, but NHS England hopes it will reverse soaring numbers of infections. There were more than 85,000 cases in 2023 – the highest since records began in 1918. The decision is not just about the record numbers of cases. Gonorrhoea is becoming increasingly difficult to treat. Most cases are treated with a single dose of antibiotics, but there is an 80-year history of the bacterium which causes gonorrhoea repeatedly evolving resistance to our antibiotics. It’s happening to the current treatments too and is why some doctors are concerned that gonorrhoea could one day become untreatable.
This took me back, but not in a juvenile, sniggering manner, to the other sexually transmitted diseases for which there was apparently no cure. I remember the fear and fascination when we were first told at school about syphilis – ‘the Pox’ – which apparently made your nose fall off. Since syphilis was considered a disgraceful affliction, most countries did what any self-respecting nation would do – blame the neighbours. The English, Germans and Italians dubbed it ‘the French disease’, while the French, ever contrary, called it ‘the Neapolitan disease’. The Dutch went with ‘the Spanish disease’, the Turks plumped for ‘the Christian disease’, and in India, Hindus and Muslims blamed each other.
But beyond the immature name-calling, syphilis had a very dark side, which made the individual business of noses falling off look like very small beer indeed. Of all the sexually transmitted diseases, it is the symbol of the cruelty of colonialism and oppression, from Paul Gauguin’s alleged spreading of syphilis in the South Seas to the appalling ‘Tuskegee Study of Untreated Syphilis in the Negro Male’ conducted between 1932 and, unbelievably, 1972 by the US Public Health Service.
Inevitably, women were blamed for the spread of syphilis, as the warnings on the posters produced by government agencies during both world wars testify: You can’t beat the Axis if you get VD. Around 5 per cent of American draftees in 1942 had syphilis; sexually transmitted diseases ‘were the second most common reason for disability and absence from duty, being responsible for nearly 7 million lost person-days and the discharge of more than 10,000 men,’ according to a report in the Journal of Military and Veterans’ Health. Enticing, diseased women were portrayed on many of the posters but it’s always been men who’ve mostly been responsible for spreading sexual diseases; by creating the ‘need’ for prostitution and through homosexuality. I’m not being nasty; as the report says ‘The focus will mainly be on gay and bisexual men with a history of multiple sexual partners’. Gay men do have more sex than lesbians or straight people, and I say that admiringly rather than scoldingly; Martin Amis once claimed that a moderately attractive gay man involved in the New York City bath-house scene in the early Seventies could have more sex in a year than Casanova had in his lifetime.
Medicine has made great advances on the syphilis front; according to a 2020 study, more than 20 per cent of individuals in the age range 15-34 years in late 18th-century London had it; in 2023 fewer than 13,000 new diagnoses of syphilis were made. In 1939, 64,000 Americans died from the disease; during 1968 to 2015, there were 6,498 deaths attributed to it.
Still, there’s always a new venereal disease (how pungent is that phrase compared to the prissy STI? I prefer STD, which has an echo of the original). I was a young, sex-mad woman when herpes raised its head and caught it on purpose from a man I was crazy about; the things we do when we’re in love! Herpes, we were warned sternly, lasted forever, but mine mysteriously cleared up after a few years, without any pharmaceutical intervention. So there is a chance that they could have been fibbing to us all along, like teachers at school tended to in the Olden Dayes vis-à-vis sex, to scare us off doing it.
Gay men do have more sex than lesbians or straight people and I say that admiringly rather than scoldingly
I remember the carefree levity with which my 1970s teenage cohort regarded the idea of VD. But I can’t imagine the fear a tot of an impressionable age would have felt on first seeing the 1986 tombstone/iceberg/volcano ‘Don’t Die of Ignorance’ TV commercial. The televisual public health information campaign in response to the growing Aids pandemic was directed by Nicolas Roeg (picked for his ‘doom and gloom sci-fi aesthetic’) and voiced by John Hurt. There were also newspaper adverts and leaflets were sent to every home in the country. One man who worked at the advertising agency behind the commercial said that ‘scaring people was deliberate’. It was originally planned to sound a civil defence siren at the start, but Mrs Thatcher deemed this ‘over-dramatic’. The phrase ‘Don’t die of ignorance’ became popular in everyday use, not always in the way it was intended: I recall a male friend of mine, cross that he had not been invited to an evening’s entertainment at mine, saying snarkily to a young woman who would be attending ‘Don’t die of ignorance, will you?’ All we did was sit around talking about Madonna and post-modernism, honest!
The medical profession has worked wonders in allowing people with HIV to have long lives generally equal to the general population. Now chem sex is the new hazard for gay men and chlamydia (‘the clam’) for straight women, though men can get it too; globally sexually transmitted chlamydia affects approximately 61 million people and, like syphilis, it can make you blind. I have no idea whether school kids still snigger about sexually transmitted diseases as my generation did, but maybe one of the few good things about the young generation being more humourless is that they take these things seriously. It’s hard to imagine Adele saying of Harry Styles ‘I hate him. I hope he catches Aids and dies,’ as Noel Gallagher did of his Blur bête noires Damon Albarn and Alex James back in 1995.
In the last public statement he made about having Aids, the actor Anthony Perkins said, ‘There are many who believe that this disease is God’s vengeance, but I believe it was sent to teach people how to love and understand and have compassion for each other… I have learned more about love, selflessness and human understanding from the people I have met in this great adventure in the world of Aids than I ever did in the cutthroat, competitive world in which I spent my life.’ It’s certainly a stretch to imagine anyone ever saying the same thing about untreatable gonorrhoea, but we must do our best for surely all are equal in the waiting room at the clap clinic.
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