A big rise in sex diseases in England threatens to cause a public health crisis, warns the architect of the government's sexual health strategy.
Many people fail to have safe sex
Professor Michael Adler is the latest expert to warn that growing levels of complacency about safe sex could have serious consequences.
His comments come as a separate study shows that lesbian and bisexual woman often fail to take adequate precautions to protect themselves from sexually transmitted disease.
Although the rate of STI transmission among lesbian and bisexual women is relatively low, the report suggests that women who think they face no risk are wrong.
Writing in the medical journal, Sexually Transmitted Infections, Professor Adler, of the Royal Free and University College Medical School, London, paints a dismal picture of the nation's declining sexual health over the past decade.
He points to the government's failure to deliver on all the sexual health targets set out in its publication, The Health of the Nation, in 1992.
There has been an upsurge in chlamydial and gonococcal bacterial infections of well over 70% since 1997.
Cases of HIV and Aids are set to rise almost 10% a year, and to double between 1997 and 2005.
It is no exaggeration that we now face a public health crisis in relation to sexual health
Syphilis has risen 374% since 1997, with an increase of 112% alone between 2000 and 2001.
In addition, the teenage pregnancy rate of 8.3 per 1,000 in 2000, is well below the Health of the Nation target of 4.8 per 1,000.
Professor Adler said the £47.5m the government has allocated for its sexual health strategy, announced in 2000, won't even cover one aspect of the strategy - the chlamydial screening programme.
He warned sexual health clinics are struggling to cope with demand - with some people in large urban centres forced to wait over a month for an appointment.
And he said consultant expansion in genitourinary medicine was currently 90% below target.
He said: "It is no exaggeration that we now face a public health crisis in relation to sexual health.
"Sexual health is not an NHS or political priority. Until it becomes so, we will witness further failure upon further failure."
A Department of Health spokesman said a 10-year action plan had been put in place, but it was unrealistic to expect quick fixes.
He said: "We must both improve and modernise services, and also seek to change individual behaviour."
The same issue of the journal carries a survey of the sexual experiences of over 1,200 lesbian and bisexual women.
Among the 328 women asked about safer sex practices, a third who had had penetrative sex with men had never used a condom.
And over 85% of lesbians engaging in oral sex with other women did not use dental dams.
A dental dam is basically a small sheet of latex which acts as a barrier between the vagina or anus and the mouth.
In addition, one in five of those sharing sex toys said they did not wash them before sharing.
Although uncommon, women can pass on sexually transmitted infections to other women, including herpes, trichomoniasis, papilloma virus, syphilis, HIV and bacterial vaginosis.
The survey also found that the first sexual experience for many lesbians is with a man.
One in four lesbians and almost a third (29%) of bisexual women had been pregnant.
The average number of sexual partners in the preceding year was one, the survey showed.