Sexually Transmissible Infections (STI's)

WHAT ARE STIS?

Sexually Transmissible Infections (STIs) are passed from one person to another during sexual contact or exchange of body fluids.
They are caused by micro-organisms such as bacteria, viruses, or parasites.
They can affect areas of the body other than the genitals.
They do not always cause signs or symptoms.

WHAT ACTIVITIES PUT ME AT RISK OF STIS?

Having vaginal or anal sex without a condom (unprotected sex) can put you at risk of getting an STI. You can also get some STIs from unprotected oral sex and from skin-to-skin contact. Some activities put you at higher risk. Riskier activities include having unprotected sex:

With casual partners (the more partners, the greater the risk).
With a partner who has had unprotected sex with casual partners.
When travelling outside Australia or with a partner who has had unprotected sex outside Australia.

CHLAMYDIA

Chlamydia is the most common bacterial STI in Australia and is especially common in young people aged 15 to 30.
If left untreated, chlamydia can lead to Pelvic Inflammatory Disease (PID), an infection of the uterus, and fallopian tubes, which can cause infertility.
Chlamydia can also damage the tubes in the testicles and affect fertility.
Most people who have chlamydia do not have any symptoms. If symptoms are present they can include:
- Lower abdominal pain, pain with sex and/or passing urine, more painful periods, bleeding between periods, and bleeding after sex.
- Penile discharge and pain passing urine or on ejaculation.

The test for chlamydia is a urine test or a simple self-inserted vaginal swab. If you are having anal sex, a self-inserted anal swab may also be needed. A throat swab may also be needed.
Chlamydia is treated with oral antibiotics.

GONORRHOEA

Gonorrhoea is a bacteria that infects the penis, vagina, rectum, or throat.
It is becoming increasingly common in Australia.
You can have gonorrhoea without knowing it as not everyone gets symptoms. The most common symptoms are:
- Discharge from the penis or pain passing urine.
- Abnormal vaginal discharge, pain with sex, and bleeding between periods or after sex.
If you have no symptoms, the test for gonorrhoea is a urine test or a simple self-inserted vaginal swab. If you are having anal sex, a self-inserted anal swab may also be required. A throat swab may also be needed.
Gonorrhoea is treated with antibiotics which are given orally and by injection.

GENITAL WARTS AND HUMAN PAPILLOMA VIRUS (HPV)

Papilloma Virus (HPV) is a group of viruses. There are many types of HPV. Some HPV types can cause genital warts. Some types can cause cancers of the cervix or genitals if left undetected and untreated.
HPV is transmitted by skin-to-skin contact during sexual activity. Most people will be exposed to HPV in their lifetime. Most HPV infections will clear by themselves with no symptoms.
If genital warts occur, they can be on the penis, vulva, vagina, anus, and the skin close to these areas. They can be single or multiple lumps. They can sometimes be itchy, painful, or may bleed.
There is no test for the HPV type that causes visible warts — if you have symptoms, see a doctor.
Effective treatment for warts is available and includes freezing or use of a liquid or cream.
A vaccine is available which protects against some of the strains of HPV that cause genital warts, cancer of the cervix, and some other cancers — check with your health practitioner.

HERPES

Herpes is caused by a virus called the herpes simplex virus (HSV), that is transmitted by skin-to-skin contact during genital or oral sex.
There are two types: HSV 1 and HSV 2.
- HSV 1 causes almost all oral herpes (cold sores) and about half of genital herpes infections.
- HSV 2 causes the remainder of genital herpes infections.
The herpes virus may cause painful blisters or sores on the skin but often has no symptoms.
Once you have herpes, it remains in your body for life but is not always active.
Treatment is available to reduce outbreaks and to help manage symptoms.
There is no helpful screening test available for herpes. If you have any symptoms, such as a genital sore which appears from time to time, see a doctor for diagnosis when the sore is present.
Avoid oral sex when a cold sore is present on or around the mouth to avoid transmission from mouth to genitals.

HEPATITIS B

Hepatitis B is a viral infection that causes inflammation of the liver and can cause serious illness.
It can be passed on by unprotected vaginal or anal sex, by sharing drug injecting equipment, during unsterile tattooing or body piercing, or sometimes through dental or other procedures in developing countries.
A very effective vaccine is available to prevent Hepatitis B. Check if you have had this vaccine, and if you haven’t had it discuss this with your health practitioner.
The test for Hepatitis B is a blood test. If you know that you have been vaccinated, you may not need this test.

SYPHILIS

Syphilis is caused by the bacteria Treponema Pallidum. It is very infectious and is transmitted through close skin-to-skin contact during oral, vaginal, or anal sex with a person who has the infection. Syphilis is uncommon in Australia; however, it can cause serious health problems if it is left untreated.
Not everyone has symptoms. Early symptoms can include a painless ulcer-like sore on the genitals or a rash that generally appears on the hands and feet.
The test for syphilis is a simple blood test.
If a pregnant woman is infected with syphilis, it can cause serious health problems for her baby. All pregnant women in Australia are tested for syphilis when they have their routine ante-natal blood tests.
Syphilis is treated with antibiotics given by injection.

HIV (HUMAN IMMUNODEFICIENCY VIRUS)

HIV is a viral infection that, if left untreated, breaks down the body’s natural defences against infections by weakening the immune system and can lead to Acquired Immune Deficiency Syndrome (AIDS).
HIV can be present in the blood, vaginal secretions, or semen of a person infected with the virus. It is passed on by anal or vaginal sex without a condom, by sharing drug injecting equipment, and through unsterile body piercing or tattooing in developing countries. The risk of HIV transmission through oral sex is very low.
The test for HIV is a blood test.
In Australia, an HIV test is done in pregnancy as part of routine ante-natal blood tests.
HIV is not curable but can be managed well with medication.
If you are in a group that is at higher risk of HIV, medications are available which can reduce the chance of becoming infected with HIV (PrEP & PEP). For more information, see the SHFPACT PrEP & PEP brochure (available online or at reception), or talk to your health care provider.

TRICHOMONIASIS

Trichomoniasis is a genital infection caused by an organism called protozoa.
Symptoms:
- Vaginal symptoms may include frothy yellow-green discharge, unpleasant (fishy) vaginal odour, vaginal itching, and burning.
- Penile symptoms may include discharge from the penis and pain passing urine.
Trichomoniasis is not usually serious but can be unpleasant.
It is treated with an oral antibiotic.

CONDITIONS WHICH ARE NOT STIs BUT WHICH CAN AFFECT THE GENITAL AREA

PUBIC LICE (CRABS)

Pubic lice are tiny parasites that infect the pubic hair, armpits, or chest hair.
They are passed on by direct person-to-person contact with the infected area or by coming into contact with infected bedding or clothes, not necessarily during sexual contact.
They can be treated with preparations available over the counter from pharmacies. Clothes and bedding also need to be treated.

SCABIES

Scabies is a skin infestation of a tiny mite, Sarcoptes scabiei. The main symptom is intense itching which is worse at night. Sometimes a small rash is visible. It occurs most commonly between the fingers, on the wrists, armpits, stomach, and genitals.
Scabies can be spread sexually as well as through non-sexual skin-to-skin contact.
Scabies is usually treated by applying a topical anti-scabetic crea to the skin of the entire body.

MOLLUSCUM CONTAGIOSUM

This is a skin infection caused by a virus which causes small painless firm lumps with a dimple in the centre. It can appear anywhere on the body but in adults they usually appear on the buttocks, thighs, lower abdomen, and genital area.
It can be spread sexually as well as through non sexual skin to skin contact.
It will resolve on its own within 12 months but can be treated with freezing or cream.

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Acknowledgements: Melbourne Sexual Health Centre, Australian STI Management Guidelines, ASHM, Family Planning NSW

Tags: STI