Sexually Transmitted Infections

What are sexually transmitted infections?

Sexually transmitted infections (STIs) are infections caused by some bacteria, viruses and other organisms.
They can be passed from person to person through any form of sexual activity, including vaginal, anal and oral sex. Some STIs can be passed through skin-to-skin contact alone.

Chlamydia*

• Often has no symptoms.
• May cause pain when urinating, a discharge from the penis or vagina, or pain in the lower abdomen.
• Infection of the rectum can occur but usually has no symptoms.
• Infection of the eye can occur and causes a red, painful eye.
• May cause bleeding between periods and after sex.
• Can be serious as it may cause pelvic inflammatory disease (PID), inflammation of the testes and infertility if not treated.
• Diagnosed with a urine or swab test.
• Treated with antibiotics.

Gonorrhoea*

• Often has no symptoms.
• May cause pain when urinating, a discharge from the penis or vagina, or pain in the lower abdomen.
• Infection of the throat may follow oral sex. There are usually no symptoms, but the infection can still be transmitted.
• Infection of the rectum may cause irritation, pain or discharge.
• Infection of the eye can occur and causes a red, painful eye.
• May cause bleeding between periods and after sex.
• Can be serious as it may cause pelvic inflammatory disease (PID), inflammation of the testes and infertility if not treated.
• Diagnosed with a urine or swab test.
• Treated with antibiotics.

HPV (Human Papilloma Virus)

• HPV is common, anyone who has ever had any form of sexual contact can have HPV.
• May appear as lumps (genital warts) around the vulva or in the vagina, on the penis, around or inside the anus. These may be painless or cause some irritation/itch.
• HPV can be present without any visible warts.
• Some types of HPV infect the cervix and over time can cause cervical cancer. These are not the same types of HPV that cause visible genital warts.
• Vaccination can prevent some types of HPV.
• Visible warts can be removed by freezing them or applying a wart cream.

Genital Herpes

• Can be transmitted through vaginal, anal and oral sex, as well as skin-to-skin contact.
• Usually appears as small painful blisters at first, which become shallow ulcers and scab over and heal up.
• First episode is usually the worst. Some people never have another episode.
• Repeat episodes are usually milder and may come on with stress or ill health.
• Anti-viral tablets can be taken to prevent repeat episodes and reduce the risk of passing the infection to others.

Mycoplasma Genitalium

• May cause discharge from the penis, discomfort on urination, abnormal vaginal discharge, and bleeding between periods and after sex.
• Diagnosed with a urine or swab test.
• Treated with antibiotics.

Trichomonas

• May cause a thin, yellow-green vaginal discharge which may feel irritating and have a strong smell, but there may also be no symptoms at all. Symptoms are uncommon in infections of the penis.
• Diagnosed with a urine or swab test.
• Treated with antibiotics.

HIV (Human Immunodeficiency Virus)*

• Spread by blood-to-blood contact (e.g. sharing injecting equipment) or by exchange of fluids (semen, vaginal discharge, anal mucus) during sex.
• It can be passed to a baby during pregnancy, childbirth or breastfeeding (medications can significantly reduce this likelihood).
• People who come into contact with the virus may experience a flu-like illness for a short period.
• HIV will damage the immune system if untreated. Although there is not currently a cure, there are medications (called antiretrovirals) to prevent this damage from happening.
  With early and continued treatment, people living with HIV can reach a normal life expectancy.
• Post Exposure Prophylaxis (PEP) is a course of anti-HIV drugs that may stop HIV infection if it is started soon after exposure to HIV. It needs to be started within 72 hours and the sooner it is started the more effective it is. The PEP Hotline is open 24/7, call 1800 022 226.
• Diagnosed with a blood test.
• Pre Exposure Prophylaxis (PrEP) is a tablet that can be taken every day by people who are HIV negative to reduce their risk of getting HIV.

Syphilis*

• Primarily transmitted through direct contact with the sores or rash of an infected person. It may also be spread through direct contact between the mucous membranes of the mouth, genitals or anus.
• Initially, this infection may produce a painless sore in the mouth or genitals.
• Skin rash, patchy loss of hair, feeling generally unwell or moist lumps around the genitals and anus may develop later.
• If not treated, these symptoms may disappear and can recur within the next 2 years.
• It can be passed to a baby during pregnancy.
• Diagnosed by symptoms and with a blood test.
• Treated with an antibiotic injection.

Hepatitis B*

• Spread by exchange of body fluids (blood, semen, vaginal discharge, anal mucus) during unprotected vaginal, anal or oral sex, and sharing injecting equipment, unsterilized tattooing/piercing equipment, and sharing personal items such as toothbrushes, razor blades and nail clippers.
• Someone with Hepatitis B may not develop symptoms for many years but can still pass the infection to others.
• It can be passed to a baby during pregnancy.
• If untreated it can lead to liver failure or liver cancer.
• There is a vaccination to protect against Hepatitis B and treatment is available.
• Household contacts should be vaccinated.
• Some people may clear the virus with time but all people with Hepatitis B should have regular monitoring of their liver function.
• Diagnosed with a blood test.
• Treated with antiretroviral medication.

Hepatitis A

• Spread by small amounts of infected faeces entering the mouth (e.g. licking around the anal area or another part of the body which has had contact with the anal area, such as fingers), but can also spread by contaminated food and water.
• Can affect the liver and cause symptoms such as tiredness, fever, nausea, joint or stomach pain, dark urine, jaundice (yellow skin and eyes) or loss of appetite.
• There is a vaccination to protect against Hepatitis A.
• Diagnosed by symptoms and with a blood test.
• It is recommended that people who have anal/oral sex be vaccinated to prevent them from being infected with Hepatitis A.

Hepatitis C

• Affects the liver and may cause serious damage.
• Sexual transmission is rare, although the risk of infection increases when HIV or other STIs are present. It is spread by blood-to-blood contact, so sharing needles, tattooing or body piercing with used needles/equipment, and people with blood transfusions prior to 1990 may be at risk.
• There is no vaccination for Hepatitis C
• Diagnosed with a blood test.
• Treated with medication known as direct-acting antivirals.

* Notifiable STIs

Chlamydia, Gonorrhoea, Syphilis, HIV and Hepatitis B are notifiable. This means that the Communicable Disease Control Branch (SA Health) will be notified by the doctor or nurse ordering the test if the result is positive. Anyone diagnosed with these infections will be asked to provide their sexual contacts over the last 3–6 months (the time period depends on the infection and its incubation period). These individuals can be contacted (notified) anonymously to explain the risk of infection and the need for testing and treatment as appropriate.

Prevention of STIs

• Use condoms.
• Make sure semen, blood, vaginal or anal fluid are not passed between you and your partner/s.
• Talk about any past infections with your sexual partner/s.
• Get tested regularly.
• Don’t share injecting equipment or anything that comes into contact with blood (e.g. tattoo equipment).
• When there are sores, lumps or ulcers around the mouth or genital area, or unusual discharge, avoid vaginal, anal and oral sex or any activity involving skin contact with the affected area.

Non STIs

Some non-sexually transmitted infections can also cause a discharge. These include Bacterial Vaginosis and Candida (Thrush). Although these conditions do not always require treatment you should see a health professional if you are concerned about any changes in your discharge.

When to consult a doctor

You should see a doctor when symptoms of an STI are first noticed or if a sexual partner is diagnosed with an STI or has symptoms of an STI. Even if you have no symptoms, you can get an STI check at the doctor or sexual health clinic. Routine STI screening is recommended for any new sexual contact, or if your partner has had a new sexual contact.