Genital warts (human papilloma virus - HPV)

You don't have to have sex to get an STI. Skin-to-skin contact is enough to spread human papilloma virus (HPV), the virus family that causes genital warts. Some strains of the virus cause warts and are usually harmless, but other strains may lead to cervical, anal or oral cancers. Vaccines can protect against some of the most dangerous types of HPV.

Signs: Pink or flesh-coloured warts that are raised, flat or shaped like cauliflower. Often there are no symptoms.

Crabs (pubic lice)

"Crabs" is the common term for lice that set up home in pubic hair. The term comes from the shape of the tiny parasites, which look very different to head or body lice. The creatures crawl from one person to another during close contact. Pubic lice can be killed with over-the-counter lotions.

Symptoms: Intense itching, tiny eggs attached to pubic hair, or crawling lice.

Scabies

Scabies is an itchy infestation caused by a tiny mite that burrows into human skin to lay eggs. It is not always an STI, as it can spread through any skin-to-skin contact. However, among young adults, the mites are often acquired during sex. Scabies is treated with cream or lotion.

Symptoms: Intense itching especially at night and a pimple-like rash. It may take two to six weeks for symptoms to appear.

Gonorrhoea

Gonorrhoea spreads easily and can lead to infertility in both men and women, if untreated. Antibiotics treat the infection.

Symptoms: Common symptoms are burning during urination and discharge, but often there are no early symptoms. Later, the infection may cause skin rashes or spread to the joints and blood.

In Men: Discharge from the penis, swollen testicles.

In Women: Vaginal discharge, pelvic pain, spotting. Symptoms may be mild and are easily confused with a urinary tract or vaginal infection.

Syphilis

Most people don't notice the early symptoms of syphilis. Without treatment, it can lead to paralysis, blindness and death. Syphilis can be cured with antibiotics.

Signs and symptoms: The first sign is usually a firm, round, painless sore on the genitals or anus. The disease spreads through direct contact with this sore. Later there may be a rash on the soles, palms, or other parts of the body (seen here), as well as swollen glands, fever, hair loss or fatigue. In the late stage, symptoms come from damage to organs such as the heart, brain, liver, nerves and eyes.

Chlamydia

Chlamydia is a common STI that can lead to infertility if left untreated. It clears up quickly with antibiotics, but it often goes unnoticed because symptoms are vague or absent. Chlamydia can also infect the rectum and throat.

Symptoms in men: Burning at the tip of the penis, discharge, painful urination.

Symptoms in women: Vaginal discharge that may have an odour, pain during sex, painful urination.

Cold sores

That painful cold sore you get on your lip every now and then? It’s probably caused by a herpes simplex virus, most often type 1 (HSV-1), but sometimes type 2 (HSV-2). It spreads easily among household members or through kissing. It can also be passed through oral sex with a person who has genital herpes. Although there is no cure, medication may help shorten or prevent outbreaks.

Signs and symptoms: Occasional cold sores on the lips.

Genital herpes

Most cases of genital herpes are caused by a virus called herpes simplex virus type 1 (HSV-1) but it can also be caused by herpes simplex virus type 2 (HSV-2). It's highly contagious and can spread through intercourse or direct contact with a herpes sore. As with HSV-1, there is no cure, but antiviral drugs can help make outbreaks less frequent and may help clear up symptoms more quickly.

Symptoms: Fluid-filled blisters that form painful, crusted sores on the genitals, anus, thighs or buttocks. Can spread to the lips through oral contact.

Hepatitis B

Hepatitis B is a virus that can cause severe liver damage. It spreads through contact with blood and other body fluids. People can be infected through sex, needle sharing and at birth, as well as by sharing razors and toothbrushes. Most people recover without the need for treatment. Those who develop chronic hepatitis can be treated with drugs. There's also an effective vaccine to prevent hepatitis B.

Symptoms: People may develop nausea, stomach pain, weight loss, fatigue, and a yellowing of the skin or eyes (jaundice) with acute infection. Many people have no symptoms at all. Chronic infection can lead to liver cirrhosis and liver cancer.

HIV

The HIV virus weakens the body's defence against infections. HIV spreads through unprotected sex, contaminated needle sharing or being born to an infected mother. It may cause no symptoms for years, so a blood test is the best way to learn your status. Timely treatment is important to help lessen the risk of serious illnesses.

Early symptoms of HIV Infection: Many have no symptoms, but some people get temporary flu-like symptoms one to two weeks after infection: swollen glands, a fever, headaches and fatigue.

HIV Tests

Reliable HIV tests can be done at a clinic or GP's surgery. GP and clinic HIV test results are confidential, but will go on your medical records. One limitation of an HIV test is the "window period" of usually three months, but in certain circumstances up to six months, after exposure to HIV when these antibody tests sometimes do not find the virus. You can pass HIV to others during that time. HIV home test kits are now available, which can be 99.7% accurate, but all positive results would need to be confirmed in a laboratory.

HIV/AIDS treatment options

While there is no cure for HIV, there are medications that can suppress the amount of virus multiplying inside the body. People take a combination of antiviral drugs in the hope of preventing the infection advancing to AIDS. Additional treatments can help prevent or fight off serious infections if the immune system has weakened.

Trichomoniasis

Trichomoniasis is caused by a parasite that spreads during sexual contact. It can be cured with prescription medication.

Signs and symptoms in men: Most men have no obvious symptoms. Some develop a mild discharge or slight burning during urination.

Signs and symptoms in women: Women may develop a yellow-green discharge with a strong odour, vaginal itching or pain during sex or urination. Symptoms usually begin five to 28 days after acquiring the parasite.

Chancroid

Chancroid is a bacterial STI that is common in Africa and Asia but rare in the UK. It causes genital sores that can spread the bacteria from one person to another. Antibiotics can cure the infection.

Symptoms in men: Painful bumps on the penis that may develop into pus-filled open sores, pain in the genitals and groin; swollen lymph nodes in the groin.
Symptoms in women: Painful bumps in the genital area that can develop into open sores; swollen lymph nodes in the groin.

LGV (lymphogranuloma venereum)

LGV is caused by specific strains of chlamydia and is uncommon in the UK. However, it's becoming more common in men who have sex with men. Like other forms of chlamydia, it can be cured with antibiotics.

Symptoms: Open sores on the genitals or anus, headache, fever, fatigue and swollen lymph glands in the groin (seen here). If acquired through anal sex, LGV may cause rectal bleeding or discharge.

Pelvic inflammatory disease (PID)

Not an STI itself, pelvic inflammatory disease (PID) is a serious complication of untreated STIs, especially chlamydia and gonorrhoea. It happens when bacteria spread to infect the uterus and other female reproductive organs. Prompt treatment is essential to prevent damage to a woman's fertility.

Signs and symptoms: Lower abdominal pain, fever, unusual discharge, painful intercourse, painful urination and spotting. There are often no warning signs.

Who’s at Risk of STIs?

Anyone who is sexually active is at risk of an STI, regardless of age, gender, race, social class or sexual orientation. That said, teenagers and young adults acquire STIs more often than older people. By 25, half of sexually active adults have had an STI. Having multiple sex partners also increases your risk. Some STIs are on the increase in men who have sex with men, including syphilis and LGV.

Can virgins get STIs?

Yes, they can. Many STIs spread through any type of sexual activity, including skin-to-skin contact and oral sex. This is especially true of STIs that produce genital lesions or sores.

Preventing STIs

The best ways to avoid getting an STI are to abstain from any sexual contact or to be in a monogamous, long-term relationship with an uninfected partner. To reduce your odds of getting STIs:

• Ask your partner if he or she has an STI.
• Ask partner to be tested before having sexual activity for the first time.
• Use condoms.
• Avoid sexual activity if your partner has signs of an STI.
• Be aware of symptoms and get regular checkups.

The limits of condoms

While condoms are effective in preventing the spread of some STIs, they are not perfect. Condoms are better at protecting against gonorrhoea, chlamydia, HIV and trichomoniasis. However, they offer less protection against herpes, syphilis and genital warts. These infections can spread through contact with skin lesions that are not always covered by a condom. Finally, condoms offer virtually no protection against crabs and scabies.

How to tell your partner

If you think you have an STI, tell your partner(s) as soon as possible. You may be able to spread the infection even if you have already begun treatment or are using condoms. With some STIs, doctors recommend treating both partners at the same time. This may be a difficult conversation. Some people find it helpful to write a script beforehand. Make sure you let your partner ask questions and express his or her feelings.

STIs and pregnancy

It is important for pregnant women to consider being checked for STIs. They can cause women to go into labour too early and may complicate delivery. Many STIs can be passed from mother to baby during pregnancy, childbirth or after the baby is born. The effect of an STI on a baby can include stillbirth, low birth weight, neurological problems, blindness, liver disease and serious infection. There are treatments to minimise these risks. Treatment during pregnancy can cure some STIs and reduce the risk of passing the infection to your baby.

Can STIs come back?

Most STI treatments do not protect you from getting the same infection again. A course of treatment may cure gonorrhoea, syphilis, chlamydia or trichomoniasis, but a new exposure can start a new infection. If your partner is not treated, you can continue to pass infections back and forth. If you're not taking the right precautions to protect yourself, you can be re-infected quickly or even pick up a second STI.

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