An increase in sexually transmitted infections in the Lakes District Health Board (DHB) region has led to the introduction of a fulltime sexual health service with one health professional calling for a condom campaign.
Figures from Environmental Science and Research (ESR) show the Lakes DHB area was the second-highest ranked region in the country for rates of chlamydia with 916 cases (per 100,000) in the past 12 months.
Lakes DHB also ranked fifth for gonorrhoea with 102 cases in 12 months and sixth-equal for syphilis with 19 cases (per 100,000 people).
But Rotorua GP Tania Pinfold believes the figures need to be looked at with regard to testing capabilities.
"Any figures released as a result of testing are going to depend on how much testing was done and how it was done.
"How many people per region have actually been tested and how did the person doing the testing know which box to tick when testing."
Pinfold said the Lakes DHB region was second-to-none for health services for young people.
"That's not just for sexual health – that's for services across the board."
A Lakes DHB spokeswoman said it had partnered with Bay of Plenty DHB to combat syphilis and shared a specialist consultant.
"The action plan drawn up for this work guides a co-ordinated, systematic response to disrupt the transmission of syphilis and reduce the associated complications.
She said there was an emphasis on increased case finding, case treatment, and contact tracing.
She said the need now was for a consultant-led service rather than GP-led.
"The increased volumes and complexity require a time commitment from a consistent senior medical leader to ensure that we can respond appropriately to the increasing infections within our community.
"The increased workload for sexual health service has meant that capacity has to increase from a part-time service to a fulltime service.
"Other service changes include making the sexual health service available every weekday, as opposed to certain times on different days of the week. Booked GP and consultant clinics are available as required. The staffing for the service has seen an increase in both nurse and administration staff."
Bay of Plenty DHB sexual health service clinical lead Massimo Giola believes the country is in need of a condom campaign.
Giola said both the Lakes and Bay of Plenty regions had high rates for gonorrhoea and chlamydia but, put into context, New Zealand as a whole had high rates internationally.
"New Zealand has a similar health care system to those in the United Kingdom and Canada and we rate higher than both in cases per population."
Giola said reasons for this were numerous and diverse.
"The decline in use of condoms from the early 2000s, particularly since it became known that HIV was not a lethal disease and possibly caused relaxation in people, is one.
"Also things like Tinder [for heterosexuals] and Grindr [for gay, bi, trans and queer people] make it easy to find partners or see who is around looking for sex."
However, finger-pointing was easy, according to Giola, who also said there were more often structural and deep-rooted causes.
"In regions New Zealand where there is not abundant access to free sexual health services, we see higher STI numbers. There also remains a stigma around STIs which makes disclosure hard for some people."
Giola said he was "reasonably happy" with some of the initiatives introduced by the new Government after what he believed to have been 10 years of sexual health being out on the back burner.
"We are in desperate need of a national campaign promoting condom use and we also need to make sure people feel okay to talk to their GPs or a nurse or clinic staff. And every person who is sexually active needs to take part in regular screenings."
In New Zealand, chlamydia is not classified as a notifiable disease but is the most commonly reported STI, although the rates have remained stable since 2013.
Unlike syphilis and gonorrhoea, it was more widely reported by females although that was probably due to lower rates of testing in men, ESR public health physician Jill Sherwood said.
It was most common in women aged 15 to 29 with the highest rates among Māori and Pacific Islanders.
• The first sign of syphilis is a sore or ulcer at the site of infection, usually the genitals, anus or mouth. Untreated, it can lead to rashes, swollen glands, fever, hair loss, aches and warty growths.
• Late-stage syphilis can cause damage to the heart, brain, nerves, eye, blood vessels, liver, bones and joints.
• The disease is spread through sexual contact and is infectious if not treated with antibiotics.
• In women, symptoms include unusual discharge, tummy pain, bleeding between periods and pain when urinating. In men, they include unusual discharge, irritation of the inside of the penis, sore testicles and pain when urinating.
• Without treatment if can lead to pelvic inflammatory disease, ectopic pregnancy, infertility and sterility.
• It is spread by skin contact during sexual intercourse and can be treated with antibiotics.
• Most people with chlamydia have no symptoms but left untreated it can damage a woman's reproductive system.
• However, in women, symptoms could include discoloured discharge, pelvic pain, bleeding between periods, pain during sex and rectal pain and bleeding. In men, symptoms could include discharge, sore testicles, pain urinating, pain during sex and rectal pain and bleeding.
• Chlamydia is spread by sexual contact and can be treated with antibiotics.