Sexually transmitted diseases are spreading at an alarming rate, particularly among tenagers.

Women's Editor Christen Pears reports on the epidemic that could leave thousands of women infertile.

THE two women flicking through the pages of glossy magazines are smartly dressed and in their 30s. The comfy chairs and pot plants create a homely atmosphere and, at first glance, they could be friends relaxing together. But they don't acknowledge each other and the basket of condoms and leaflets about chlamydia on the table show this isn't someone's living room but the waiting area of the new genito-urinary medicine unit at James Cook University Hospital in Middlesbrough.

"You can't tell someone has a sexually transmitted disease just by looking at them," says the unit's director Dr Abayomi Opaneye. "It goes right across the spectrum."

The genial consultant is passionate about his work, giving up much of his spare time to educate people about the dangers of STDs, but he and other sexual health experts are fighting what currently seems like a losing battle.

The number of people being diagnosed with STDs in Britain is now at record levels. Syphilis has risen by 486 per cent since 1996, chlamydia is up by 108 per cent over the same period and rates of gonorrhoea are 87 per cent higher. More people are also being diagnosed with HIV and the number of new infections is expected to double by 2005.

The latest figures from the North-East are particularly worrying. From 2001 to 2002, the number of STDs rose by more than 21 per cent in the region, which is one of the worst rates in the country and twice that of London. In Hartlepool, the cases of gonorrhea tripled - the fastest increase in Britain.

Dr Opaneye says: "We are very high in this area for STDS, gonorrhoea, chlamydia and genital warts because people take risks. Why do they take risks? Because of alcohol, probably drugs, ignorance or they just don't care.

'People have let down their guards. They think we can treat everything with a tablet and the fear has gone, but they are playing Russian roulette."

Women, traditionally thought to be less promiscuous than men, are contracting infections in increasingly high numbers and the figures are particularly high among teenagers.

Of 22,697 cases of gonorrhoea in the UK in 2001, 42 per cent were among women under 20. Thirty-six per cent of chlamydia cases were diagnosed in the same age group.

Chlamydia can cause infertility but 70 per cent of sufferers have no way of telling they have the disease. It has been referred to as a "fertility timebomb", with some sexual health experts predicting a boom in the number of childless women.

Between 1995 and 2000, cases in the UK rose from 30,877 to 64,000. The number of cases doubled on Teesside during the 1990s and trebled in County Durham from 1995 to 2001.

Earlier this year, a pilot scheme was launched at two schools in York to test pupils for chlamydia and the Family Planning Association is calling for a national screening programme for women under the age of 25.

Dr Opaneye says: "These sorts of things are good but I am worried about chlamydia. It has become endemic and it will continue to increase until people start practising safe sex."

But the message doesn't seem to be getting through. When HIV and AIDS hit the headlines in the late 1980s and 1990s, the safe sex message was everywhere, but the fear has begun to subside, and the younger generation wasn't aware of it in the first place.

While there have been some new campaigns, public awareness seems to have fallen and there is a whole new generation which seems ignorant of the benefits of using condoms. There is also a raft of misconceptions about STDS and HIV. A study published last year suggested one in three 18 to 24-year-olds wrongly believed there is a cure for AIDS.

Another factor could be easier access to the morning-after pill, which is now available over the counter. One in five 16-year-old girls uses this form of contraception each year but while it may prevent pregnancy, it is no use against STDs. Dr Opaneye says: "People used to be scared about having a STD but now they think they can just come to the clinic and it will be all right. We have powerful drugs for HIV now and people aren't dying like flies any more, but there is no cure. We don't want a stigma with sexual health but we do want people to take it seriously."

He believes education is the key - both at home and at school. There are three health advisers attached the GUM clinic at James Cook and part of their remit is to visit local schools but, says Dr Opaneye, "it's a mammoth task" and there simply aren't enough resources.

"There's nothing wrong with a boy meeting a girl and having a bit of fun but you don't want an STD or a pregnancy. Of course people get carried away but you have to take responsibility and use a condom. The men are getting better but it's got to be a woman's responsibility as well."

Negotiation is also a key factor. Young people are keen to experiment but they often forget that there is more to relationships than sex.

"A girl might have sex because she thinks she will lose the boy if she doesn't and a lot of that is down to ignorance. Young women need to know that relationships are also about having things in common or commitment. Who teaches the girls to negotiate these things?"

But it isn't just teenagers who are failing to take precautions when they have sex. Twenty-seven-old Catherine had unprotected sex with a man she barely knew while on holiday. They continued seeing each other when they got home but six months into the relationship, he told her he had genital herpes.

She says: "I had to get checked out and fortunately, I was okay, but I could easily not have been - and it might not have been just herpes. What if he had HIV?

"I've never been one for casual sex and before that I'd only had two sexual partners but I was on holiday and we fancied each other. Neither of us had a condom but both wanted to carry on and we took a calculated risk. I certainly won't do it again."

The number of patients over 40 is rising, often those who are back on the dating scene after a divorce or separation. Many infections are caught while on holiday abroad and cases are also spreading among the lesbian, gay and bisexual communities.

"It all goes back to what I am saying about education. Perhaps the adults don't know as much as they think they do. Having sex without a condom is always a risk," says Dr Opaneye. "I am all for fun, for sex, but it has to be safe sex - sex with responsibility."