文章概括：這篇文章報(bào)告了倫敦成為英國(guó)性病之都的情況。封鎖期間，性病診斷數(shù)量下降，但隨著限制放松，病例數(shù)量激增。2022年，倫敦確診的淋病和梅毒病例創(chuàng)下歷史最高紀(jì)錄。倫敦的感染率是其他地區(qū)的兩倍以上。年輕人口增長(zhǎng)快、大型社交網(wǎng)絡(luò)以及同性行為導(dǎo)致的感染是倫敦成為性病高發(fā)地的原因之一。此外，艾滋病不再是致命疾病，但性行為與毒品濫用帶來(lái)的風(fēng)險(xiǎn)仍需關(guān)注。

Britain?|?Sexual health

英國(guó)|性健康

Clap for the NHS

為英國(guó)國(guó)家醫(yī)療服務(wù)體系鼓掌

London is the STI capital of Britain

倫敦是英國(guó)的性病之都

Jun 8th 2023

As the country?locked down for covid-19, Britons had fewer chances for casual unprotected sex. They also had fewer tests for sexually transmitted infections (STIs). Not surprisingly, diagnoses plummeted. Not any more. On June 6th the?UK?Health Security Agency reported that nearly 83,000 cases of gonorrhoea were diagnosed in England in 2022—the most since records began in 1918. Cases of syphilis were at their highest since 1948. London’s rate is more than twice that of any other region, making?STIs a particularly metropolitan problem (see chart).

隨著新冠肺炎病毒在英國(guó)的蔓延，英國(guó)人進(jìn)行隨意的無(wú)保護(hù)性行為的機(jī)會(huì)越來(lái)越少。他們也較少進(jìn)行STI(STI)檢測(cè)。毫不奇怪，診斷數(shù)據(jù)直線(xiàn)下降。然而如今情況有所反轉(zhuǎn)。6月6日，英國(guó)健康安全機(jī)構(gòu)報(bào)告稱(chēng)，2022年英格蘭確診了近83000例淋病，這是自1918年有記錄以來(lái)最多的一年。梅毒病例處于1948年以來(lái)的最高水平。倫敦的感染率是其他任何地區(qū)的兩倍多，這使得STI成為一個(gè)大都市特有的問(wèn)題(見(jiàn)圖表)。

London’s special status is nothing new. In the 1500s Henrys VII and VIII shut down Southwark’s brothels, or “stew houses”, to try to stop the spread of syphilitic sores. A study in 2020 estimated that in the 1770s a staggering one in five Londoners was likely to have had “the pox” by the age of 35, against 8% of people in the provincial city of Chester and less than 1% in rural areas. Given that gonorrhoea is around four times as infectious, a majority of Londoners may have had an?STI, marvels Simon Szreter of the University of Cambridge, the paper’s lead author.

倫敦的特殊地位并不新鮮。16世紀(jì)，亨利七世和八世關(guān)閉了薩瑟克區(qū)的妓院，別名“燉菜館”，以試圖阻止梅毒的傳播。2020年的一項(xiàng)研究估計(jì)，在18世紀(jì)70年代，令人震驚的是，五分之一的倫敦人在35歲之前可能已經(jīng)患有“梅毒”，而在省會(huì)城市切斯特，這一比例為8%，在農(nóng)村地區(qū)不到1%。該論文的第一作者，劍橋大學(xué)的Simon Szreter驚嘆道，考慮到淋病的傳染性是其他疾病的四倍，大多數(shù)倫敦人可能患有STI。

Thanks to antibiotics, among other things,?STI?rates today are a fraction of what the Georgians endured. But London is still a relative hotbed. As in the 18th century it has a young, fast-growing population with large social networks to spread?STIs. Rates are no longer highest among squaddies and scullery maids but in other marginalised groups (eg, in the Afro-Caribbean community). A more modern metric is that London is England’s gayest region. Though under 4% of its people identify as gay, lesbian or bisexual, where sexual orientation is known, men who have sex with other men account for half of its new?STIs.

多虧了抗生素和其他東西，如今的STI率只是十七世紀(jì)格魯吉亞人忍受的一小部分。但相對(duì)而言，倫敦仍是一張STI的溫床。和18世紀(jì)一樣，它擁有年輕、快速增長(zhǎng)的人口，以及傳播STI的大型社交網(wǎng)絡(luò)。這一比例不再是在清潔工和洗碗工中最高，而是在其他邊緣化群體中(如加勒比黑人社區(qū))。一個(gè)更現(xiàn)代的衡量標(biāo)準(zhǔn)得出倫敦是英格蘭同性戀最多的地區(qū)。盡管不到4%的人認(rèn)為自己是同性戀或雙性戀，性取向是已知的，但與其他男男性行為導(dǎo)致的傳播占了新增STI的一半。

Such figures are in part a sign of liberation.?HIV?is no longer the death sentence it was for many in the 1980s. Pre-exposure prophylaxis (PrEP), a pill taken daily, can almost completely ward it off. According to Preventx, a testing firm, rates of gonorrhoea and chlamydia among men who take?prep?are nearly double those among men who do not, perhaps in part because they feel it is safe not to use condoms. Dating apps (notably Grindr) have made both sex and drugs easier to find. Surveys suggest that around one in five gay or bisexual men in London have sex while on drugs like crystal meth, which can reduce inhibitions and increase sex drive. “You can have a ridiculous amount of sexual partners, upwards of 20 in a weekend,” says Ian, who spent many years having “chemsex”.

這些數(shù)字在某種程度上是解放的標(biāo)志。艾滋病毒不再像20世紀(jì)80年代那樣是許多人的死刑。暴露前預(yù)防(PrEP)，每天服用一粒藥丸，幾乎可以完全避免艾滋病。根據(jù)Preventx檢測(cè)公司的調(diào)查，接受PrEP的男性中淋病和衣原體感染率是不接受PrEP的男性的近兩倍，部分原因可能是他們認(rèn)為不使用避孕套是安全的。約會(huì)應(yīng)用程序(尤其是Grindr)讓性和毒品都變得更容易接觸到。調(diào)查顯示，倫敦大約五分之一的同性戀或雙性戀男子在服用像冰毒這樣的毒品時(shí)發(fā)生性行為，這種藥物可以減少抑制力，以提高性欲?！澳憧梢杂卸嗟秒x譜的性伴侶，一個(gè)周末可以有20多個(gè)，”伊恩說(shuō)，他多年來(lái)一直從事“化學(xué)性愛(ài)”。

The fun is not without risk. Gonorrhoea is becoming increasingly resistant to antibiotics. As well as?STIs, “chemsex” carries a greater risk of sexual assault, drug addiction and death. “We probably have more young men dying of chemsex than we do dying of?AIDS,” says Dr Anatole Menon-Johansson of Brook, a sexual-health charity.

樂(lè)趣并非沒(méi)有風(fēng)險(xiǎn)。淋病對(duì)抗生素的耐藥性越來(lái)越強(qiáng)。除了STI，“化學(xué)性”還帶來(lái)了更大的性侵犯、吸毒和死亡風(fēng)險(xiǎn)。性健康慈善機(jī)構(gòu)Brook的Anatole Menon-Johansson博士說(shuō):“死于化學(xué)性行為的年輕人可能比死于艾滋病的還要多?！?。

Georgian Londoners were loth to admit that sex outside wedlock spread?STIs. Today it is fear of stigmatisation that can hold up the aiming of health messages at gay men—as in a monkeypox outbreak in 2022. When men who have sex with men get 84% of new syphilis cases and 72% of gonorrhoea cases, such reluctance is counter-productive. The figures should be “a wake-up call to improve sexual-health education targeted at gay and bisexual men,” says Peter Tatchell, a gay-rights activist. “Blame won’t solve the problem; education will.”

格魯吉亞時(shí)期的倫敦人不愿意承認(rèn)婚外性行為會(huì)傳播性病。如今，正是對(duì)污名化的恐懼阻礙了針對(duì)男同性戀的健康信息傳播——正如2022年爆發(fā)的猴痘。當(dāng)男男性行為者導(dǎo)致的感染占84%的新梅毒病例和72%的淋病病例時(shí)，這種不情愿是適得其反的。同性戀權(quán)利活動(dòng)家Peter Tatchell說(shuō)，這些數(shù)字應(yīng)該是“提高針對(duì)同性戀和雙性戀男性的性健康教育警鐘”?！柏?zé)備解決不了問(wèn)題；教育可以?！?/p>