Sexually Transmitted Infections (STIs)

Sexually transmitted infections (STIs), previously known as sexually transmitted diseases (STDs), are infections that are caught and spread through sexual contact. Anyone who is sexually active can get infected with an STI, it is not just those who have a lot of sexual partners. However, the chances of getting an STI increase as the number of sexual partners increases.

Despite all the warnings about STIs and the need to practice safe sex, the number of STIs in the UK is still on the increase, with over 500,000 new cases diagnosed every year. In the UK in 2010:

• Chlamydia was still the highest growing infection, increasing from 60,000 cases in 2000 to over 160,000 cases
• Genital warts cases grew from around 70,000 reported cases in 2000 to over 100,000 cases
• Gonorrhoea was the second most common bacterial STI. Although the number of reported cases was quite low, it is a huge problem in the UK as an estimated 40,000 cases or more go undiagnosed each year
• Genital herpes infections increased by about 20,000 cases between 2000 and 2010
• Bacterial vaginosis or gardnerella vaginalis, most often associated with a Chlamydia infection, reached nearly 40,000, representing an increase of 20,000 cases since 2000
• Other STIs such as Mycoplasma genitalium, Ureaplasma urealyticum, Trichomonas vaginalis and non-specific urethritis increased from around 50,000 in 2000 to 80,000 reported cases
• 86,500 people were living with HIV (human immunodeficiency virus) in the UK at the end of 2009, of whom over a quarter (28%) were unaware of their infection. In 2010, there were 6,136 new diagnoses of HIV, contributing to a cumulative total of 114,766 cases reported by the end of December 2010
• As of December 2010, there were 26,791 diagnoses of AIDS in the UK, and 19,912 people diagnosed with HIV had died

Causes

There are numerous types of infections that are classed as STIs.

STIs caused by bacteria include Chlamydia, syphilis, gonorrhoea, Mycoplasma, Ureaplasma and non-specific urethritis.

STIs caused by viruses include genital warts, genital herpes and HIV.

STIs caused by parasites include Trichomonas, pubic lice (crabs) and scabies.

A person infected with any of the above can pass the infection on to their partner through unprotected vaginal, oral or anal intercourse, or even through close contact of their genitals.

Symptoms

Symptoms vary depending on the infection. Common signs of a sexually transmitted infection include an unusual discharge of liquid from the vagina or penis; pain or burning when passing urine; the appearance of pain, itching, rashes, lumps or blisters around the genital area; pain or bleeding during or after sex.

Some infections lead to pelvic inflammatory disease in women with symptoms that include fever and pain or tenderness in the lower abdominal region. This needs to be treated as soon as possible to avoid the risk of infertility.

Some sexually transmitted infections show no symptoms at all. People unaware that they have a sexually transmitted infection may, without knowing it, pass the infection on to any sexual partner.

Treatment

Treatments for STIs depend on the type of infection.

The bacterial infections Chlamydia, gonorrhoea, syphilis, Mycoplasma, Ureaplasma and non-specific urethritis are treated with a course of antibiotics such as a penicillin, tetracycline, doxycycline, azithromycin, cefixime or metronidazole. The type of antibiotic chosen depends on the particular type of bacterial infection and any other conditions such as allergies that may prevent the person from taking the medicine.

Genital herpes cannot be cured. The virus that causes genital herpes, known as the HSV-2 (herpes simplex virus), may remain dormant within the nerves for months after a person first becomes infected, but will suddenly break out from time to time to form sores and blisters around the genital area, only to disappear again some days later. Some people may experience several outbreaks every year. The antiviral agents aciclovir, famciclovir or valaciclovir can be used to reduce the time and severity of each appearance of genital herpes and to reduce the number of recurrent outbreaks but the HSV-2 virus can never be eliminated.

Genital warts can be removed by a minor surgical procedure or through the application of a solution containing podophyllotoxin, or a cream called imiquimod.

There is no cure for HIV but antiviral therapy can suppress the virus and delay the infection from developing into AIDS (Acquired Immune Deficiency Syndrome).

The parasitic infection Trichomonas vaginalis may be treated with metronidazole. Other parasitic infections, such as lice and scabies, caused by small insects may be treated with locally applied solutions containing insecticides.

When to see your Pharmacist

Talk to your pharmacist if you want general advice about sexual health. Your pharmacist will be able to advise you where your nearest clinics are located should you think that you have an STI.

Other than providing preparations for the treatment of scabies or pubic lice, your pharmacist cannot supply medicines without a prescription to treat other STIs, but will be able to advise you on the correct way to use medicines prescribed by the clinic or by your doctor.

Male and female condoms are widely available from your local pharmacy and can be discretely carried in a wallet or handbag.

Some pharmacies have a Chlamydia screening service.

When to see your doctor

STIs are common so do not feel embarrassed about getting help. Most STIs can be treated if caught early. However, if left untreated they can be painful and uncomfortable and can lead to permanent damage to your reproductive system and your fertility. By not treating the infection, you also risk passing it to current and future sexual partners.

If you think you have an STI and you would prefer not to see your usual doctor, visit a genito-urinary medicine (GUM) clinic for free and confidential advice and treatment. Clinics are usually situated in hospitals, your records will stay within the clinic and will not form part of the hospital records. Your doctor need not know you have attended a clinic unless you give your permission for him or her to be informed. You can find the number of your nearest clinic in the phone directory under GUM, STI, special clinic or sexual health clinic, or you can phone the Family Planning Association.

How to protect yourself and your partner from STIs

The most effective protection against STIs is to use a male or female condom. Other forms of contraception may reduce the risk of an unwanted pregnancy but they do not reduce the risk of catching STIs.

Condoms help prevent the transfer of the bacteria, viruses or parasites that are responsible for causing STIs by reducing the transfer of body secretions between partners. However, although the use of condoms is the best form of protection, the risk of catching an STI cannot be totally eliminated. Close skin to skin contact during sexual activity may allow an STI to be transferred from one partner to another. The risk is particularly high when lesions or blisters are present in the genital area and so sexual activity is best avoided during these times.

If you suspect that you or your partner has an STI, do not ignore it in the hope that it will go away by itself. Get a test. This will not only put your mind at rest, but will also ensure that you receive the correct treatment as soon as possible, thereby reducing the risk of infertility and other problems that the STI may cause, and reducing the risk of the STI being spread to other partners.

Tests for STIs will be made if you visit your local GUM clinic or you can order tests online. Some pharmacies operate a Chlamydia testing service. Most tests simply involve providing a urine sample. Anyone that is sexually active, anyone that changes partners or has more than one partner should have an STI test at regular intervals.

If you suspect that you have an STI, or if the test confirms that you have an STI, tell your partner or recent partners. It is only fair and responsible that you do so. This will allow your partner(s) to be tested and, if necessary, treated. You can make decisions about your sexual practices and the use of condoms and it will reduce the risk of your partner(s) unknowingly passing the STI on to others.

Useful Tips

• Always use a condom
• Try to limit your number of sexual partners
• Have regular tests for STIs
• Carefully follow the instructions for any medicines
• Take the full course of any antibiotics or antiviral medication prescribed

Further information

Family Planning Association
The Family Planning Association or FPA is a registered charity that makes sexual health a priority public health issue in the UK. The FPA is not just about contraception and pregnancy. It educates and informs people about sexual health and campaigns to improve sexual health services. The FPA’s publications and website give information, help and advice about STIs.

FPA
50 Featherstone Street
London
EC1Y 8QU
Helplines:
England: 0845 122 8690
Northern Ireland: 0845 122 8687
www.fpa.org.uk

STIClinic

STIClinic.co.uk is private company offering an online sexual health clinic as alternative to a GUM clinic. Based in London, it offers a range of accurate STI home test kits for the most common sexually transmitted infections in the UK, including Chlamydia, gonorrhoea and genital herpes, delivered discreetly to the door within a day or two. If the test is positive for an STI, it will recommend, but not supply, the best course of treatment.

STIClinic’s website provides information on each of the different STIs, their causes, symptoms, treatments and tests.

STIClinic
Hexpress Ltd.
Office 404, 4th Floor
Albany House
324/326 Regent Street
London
W1B 3HH
Tel: 020 7084 7290
www.sticlinic.co.uk