Sexually Transmitted Infections (STIs)

Sexually transmitted infections (STIs), also known as sexually transmitted diseases (STDs) or venereal diseases (VD) are diseases that are passed on from one person to another through sexual contact – the infection can be passed on through vaginal intercourse, oral sex, and anal sex. Some sexually transmitted infections can spread through the use of unsterilized drug needles, from mother to baby during childbirth, or breastfeeding, and blood transfusions.

Sexually transmitted infections have been around for thousands of years. The genital areas are generally moist and warm environments – ideal for the growth of yeasts, viruses, and bacteria. Microorganisms that exists on the skin or mucus membranes of the male or female genital area can be transmitted, as can organisms in semen, vaginal secretions, or blood during sexual intercourse.

Examples of sexually transmitted diseases include:

• Chlamydia
• Crabs (pubic lice)
• Genital herpes
• Hepatitis B
• Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS)
• Human papillomavirus (HPV)
• Syphilis
• Gonorrhoea
  
  

Sexually transmitted infections are more easily passed on during unprotected sex – without using safer sex options (i.e. condoms, sanitizing sex toys).

Some infections can be passed on via sexual contact but are not classed as sexually transmitted infections; for instance, meningitis can be passed on via sexual contact, but usually, people become infected for other reasons, so it is not classed as an STD.

The WHO (World Health Organization) estimates that, worldwide, there are more than 1 million new STDs acquired each day. People aged 15-24 acquire half of all new STDs, and 1 in 4 sexually active adolescent females has an STD, such as human papillomavirus or chlamydia. Compared with older adults, individuals aged 15-24 have a higher risk of getting STDs. However, STI rates among seniors are increasing.

Common STIs

1. Chlamydia

Also known as chlamydial infection, chlamydia is an STI caused by Chlamydia trachomatis (C. trachomatis), a bacterium that infects humans exclusively. Chlamydia is the most common infectious cause of genital and eye diseases globally – it is also the leading bacterial STI.

Women with chlamydia do not usually have signs or symptoms.

If there are any, they are usually non-specific and may include:

• cystitis (inflammation of the bladder)
• a change in vaginal discharge
• mild lower abdominal pain
  
  

If chlamydia is left untreated, it may lead to the following signs and symptoms:

• pelvic pain
• painful sexual intercourse, either intermittently or all the time
• bleeding between menstrual periods
  
  

2. Crabs (pubic lice)

Pthiriasis (pubic lice manifestations) are primarily spread through sexual contact. Pets do not play any part in the transmission of human lice. The lice attach to the pubic hair, and may also be sometimes found in the armpits, moustache, beard, eyelashes, and eyebrows. They feed on human blood.

The common term “crabs” comes from the appearance of the lice, with their crab-like claws and body shape.

3. Genital herpes

This STI is caused by the herpes simplex virus (HSV). The virus affects the skin, cervix, genitals, and some other parts of the body.

There are two types:

• HSV-1, also known as herpes type 1
• HSV-2, also known as herpes type 2

Herpes is a long-term (chronic) condition. A significant number of infected individuals never show any symptoms and do not know about their herpes status.

HSV is easily transmissible from human-to-human by direct contact. Most commonly, transmission of type 2 HSV occurs through vaginal, oral, or anal sex. Type 1 is more commonly transmitted from shared straws, utensils, public bathrooms etc. In most cases, the virus remains dormant after entering a human being, in other words, there are no symptoms.

The signs and symptoms associated with genital herpes, if they do appear, may include:

• blisters and ulceration on the cervix
• vaginal discharge
• pain on urinating
• fever
• generally feeling unwell (malaise)
• cold sores around the mouth – for type 1 HSV
  
  

Also, there may be red blisters – these can be painful, especially after they burst and leave ulcers on the external genital area, rectum, thighs, and buttocks.

4. Hepatitis B

This STD is caused by the hepatitis B virus (HBV). It is transmitted through contact with infected semen, blood, and some other body fluids. A person can become infected by having unprotected sex, using an unsterilized syringe, being accidentally pricked by a sharp object, drinking infected breast milk, or being bitten by an infected person.

The patient’s liver swells, and they can suffer serious liver damage as a result of the infection, which can eventually lead to cancer. In some cases, the disease can become chronic. Blood donation centres always check to make sure the donor’s blood is free of the hepatitis B virus.

5. HIV and AIDS

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). Put simply, HIV is the virus while AIDS is the illness/disease. When a person has AIDS, their immune system is altered, and they become much more vulnerable to infections and diseases. As the disease progresses, this susceptibility worsens.

HIV exists in the body fluids of a person who has HIV, such as semen, blood, breast milk, and vaginal fluids. HIV can be transmitted through blood-to-blood contact, which may occur during sexual contact (vaginal, oral, or anal sex), blood transfusions, breast-feeding, childbirth, and the sharing of infected needles.

6. Human Papillomavirus (HPV)

Most people with an HPV infection have no symptoms. Human Papillomavirus is a name for a group of viruses that affect the skin, as well as the moist membranes that line the body, such as the throat, cervix, anus, and mouth.

HPV is most commonly transmitted through vaginal or anal sex. However, oral sex and genital-to-genital contact (without penetration) are also avenues for transmission. Infected people with no signs and symptoms can infect others. The best protection from HPV infection is to be vaccinated.

7. Syphilis

Syphilis is the result of infection by Treponema pallidum, a bacterium. It is transmitted by sexual contact when the infected person has a syphilis lesion. An infected mother can pass this STI on to her baby during pregnancy, which can result in stillbirth or serious birth defects. An infected person, when exposed to HIV, has a higher risk of becoming HIV-positive.

The incubation period can range from 10 to 90 days after initial infection, with the average time being 21 days, before the initial signs and symptoms of the disease emerge. Each syphilis stage has characteristic signs and symptoms. Some infected people have no signs, while for others they may be mild. In some cases, even if the signs and symptoms go away, the bacterium is still there and can cause serious health problems later on.

8. Gonorrhea

Also known as the clap or the drip, this sexually transmitted bacterial infection usually attacks the mucous membranes.  Gonorrhea is the second most common STD, after chlamydia.  The bacterium, which is highly contagious, resides in the warm and moist cavities of the body.

Most infected women show no signs or symptoms. If left untreated, females may develop pelvic inflammatory disease; males may develop inflammation of the prostate gland, urethra, or epididymis.

The disease is caused by Neisseria gonorrhoeae. The bacteria can survive in the vagina, penis, mouth, rectum, or eye; it can be transmitted during a variety of sexual contacts.

As soon as a person is infected, they risk spreading the bacteria to other parts of their body – somebody may inadvertently rub their eye and spread the infection; this prolongs the treatment period. A mother can pass the infection on to her baby during childbirth.

Signs and symptoms of gonorrhea may appear between 2 and 10 days after initial infection, in some cases, it may take 30 days. Some patients have such mild symptoms that their infection is mistaken for something else, such as a yeast infection.

Males may have the following signs and symptoms:

• burning during urination
• testicular pain and/or swelling
• a green, white, or yellow discharge from the penis
  
  

Women are less likely to show symptoms, but if they do, they may include:

• spotting after sexual intercourse
• swelling of the vulva (vulvitis)
• irregular bleeding (between periods)
• pink eye (conjunctivitis)
• pain in the pelvic area
• burning or pain during urination
  
  

If the rectum becomes infected, there may be anal itching, painful bowel movements, and sometimes discharge. When transmission occurred from oral sex, there may be burning sensation in the throat and swollen glands.

Prevention

• Practice safe sex – for each sexual act, use a new latex condom, whether it be oral, vaginal, or anal sex. Avoid using an oil-based lubricant, such as petroleum jelly when using a latex condom. Non-barrier forms of contraception, such as oral contraceptives or intrauterine devices, do nothing to protect people from sexually transmitted infections.
• Abstain – abstaining from any sexual act is the most effective way to avoid becoming infected with an STD.
• Be faithful to one uninfected partner – be in a long-term relationship with a person who is not infected and remain faithful.
• Vaccinations – there are vaccinations that can protect from eventually developing some types of cancer caused by two STIs – the HPV (human papillomavirus) and Hepatitis B vaccines.
• Check for infections – before sexual intercourse with a new partner, check that the partner and yourself have no STIs.
• Drink alcohol in moderation – people who are drunk are more likely to engage in risky behaviour. Avoid using recreational drugs, which may also affect judgment.
• Explain you want safe sex – before engaging in any sexual act with a new partner, make it clear that you would only consider safe sex.
  
  

Education is one of the most important measures. Parents, schools, and society in general need to teach children about the importance of safe sex and explain how to prevent becoming infected with an STI. Education should also include information relevant to the LGBTQ (lesbian, gay, bisexual, transgender, queer/questioning) population.