Separated by a Common Language

Is a Manchester sexual health clinic trying to tell me something?

I just feel that I should say this up front: there is nothing autobiographical about this post. There. Got that out of the way. The topic only came up because I was in a conversation that involved an allusion to leaflets in doctors' (AmE) offices/(BrE) surgeries. 

Those leaflets are sometimes about (AmE, old-fashioned) social diseases. In either country it's possible to find references to  Sexually Transmitted Diseases or STDs or  Sexually Transmitted Infections or STIs. Is there a difference? Not really. To quote one (US) site on the matter:

STI stands for sexually transmitted infection, and many people, mostly the medical community, have begun transitioning from “STD” to “STI” in an effort to clarify that not all sexually transmitted infections turn into a disease. For instance, the vast majority of women who contract HPV (human papilloma virus) will not develop the resulting disease cervical cancer. In fact, most cases of infection will clear up within two years. Additionally, people who use this term believe that it also eliminates some of the shame that’s been associated with the acronym “STD.”

The UK seems to be far ahead of the US in adopting the "new" term.

The GloWBE corpus has about 5 times as many STD(s) in AmE as STI(s), but about 1.2 times as many STIs in BrE as STDs. The numbers for the non-abbreviated forms were not as strongly separated by country, but there were still more sexually transmitted diseases in the US and infections in the UK.

GloWBE is useful because relatively current and country-coded, but  it's counting up phrases from the web and there's no guarantee of the Britishness of someone writing a comment on a British news site (etc.). I wanted to check further because the UK numbers weren't as stark as I had expected. The friend in the aforementioned conversation has a nurse for his partner, a (UK) nurse, and his experience/impression was that in the medical profession it is almost always STI in the UK. That's been my impression too.

So, I searched for the terms on the National Health Service (UK) website and found about 4 times as many sexually transmitted infection(s) as sexually transmitted diseases but similar numbers of STI and STD. This seemed to be because almost whenever the NHS site uses the abbreviation, they use both abbreviations, as in "Sexual health testing for people with symptoms or who have had sex with someone who has a confirmed STI/STD" on a list of clinic services. In some cases, when I clicked through on a hit for STD there was no visible STD on the page, just STI. Which is why, boys and girls, it is generally better to use a corpus rather than Google for getting word-frequency counts. Some SEO magic seems to be going on on there.

On the National Institutes of Health (US) website there are twice as many sexually transmitted diseases as sexually transmitted infections.

Was STI coined in the UK? Not necessarily, but it's hard to tell. Only sexually transmitted disease (first citation, 1962) is in the OED. Searching Google Books, I find instances of sexually transmitted infection going back at least as far, but there's no clear separation between US (red) and UK(blue) books at the start of the term's history.



Why has STI caught on more in the UK? Some possibilities:

• A more enlightened approach to sexual health? 
• Better management of terminology due to the dominance of the National Health Service in delivering patient information and treatment?
• It fits better with other names for illnesses in the dialect?

In terms of the last point, a first thing to wonder is whether STD is more popular in the US because Americans are more used to calling such things diseases, as in venereal disease. The answer seems to be "no". Venereal disease is and was just as well used in BrE, as far as I can tell.

What about the word infection, is that more common in BrE more generally? The answer is complicated, so I've decided to make that a separate post. It's half-written, so it might even be the next one!

And I leave you with what may be my favo(u)rite disease joke, from Cyanide and Happiness: