Understanding Sexually Transmitted Infections
STIs and STDs are common conditions transmitted through sex-related activities.
While it’s a topic that can be uncomfortable for some to talk about, it is incredibly important to learn about. There are many ways to reduce your chances of contracting an STI, but as long as you engage in any sexual activity at all, there is still a risk. Therefore aside from practicing safe sex, the key to reducing your chances of spreading an STI, or experiencing complications further down the line, is knowing what symptoms to look out for, how and where to get tested, and the best way to communicate about STIs to protect yourself and your partners.
STD vs STI
STIs (sexually transmitted infections) and STDs (sexually transmitted diseases) are often used interchangeably, by both patients and medical professionals. The key difference between the two however falls on the only different words - disease and infection.
A disease causes health complications, whereas an infection may or may not. An infection is when the body is invaded by a harmful substance, such as bacteria, parasites or viruses.
Therefore the best way to identify the difference between STIs and STDs is that “STI” is the broader term; if you have an STI, you carry a sexually transmitted infection, however this doesn’t specify whether your infection will turn into a disease, or if you will experience any symptoms or health problems because of it.
Because of this, medical professionals are leaning more towards the term of STI; there is hope that it will help reduce the stigma associated with sex related conditions.
Sexually Transmitted Infection (STI) Symptoms
Many STIs carry no symptoms, or ones that aren’t easily noticeable. This is incredibly common in most women with chlamydia. It is also very common to experience symptoms, but not consider them to be STIs, because of other things that could cause the same problem. Therefore, if you are or have been sexually active, it is important to see a doctor for any of the symptoms below to be sure.
STI Symptoms in Women and Men
- Sores, bumps, lumps or spots on or in genitals, oral area or rectal area
- Itching, tingling or burning around genitals
- Burning or painful sensation when urinating
- Pain during sex
- Pain in the lower abdomen
- Rash on hands or feet
- Sore or swollen lymph nodes
- White dots or black powder in underwear
STI Symptoms in Men
- Discharge from the penis
- Urethra irritation
STI Symptoms in Women
- Unusual vaginal discharge
- Vaginal discharge with a strong smell
- Yellow or green discharge
- Unusual bleeding between periods
- Bleeding after sex
There are over 30 types of known sexually transmitted diseases or infections. While there is a long list of sexually transmitted infections, there are a few that are incredibly common and therefore both most easily spread and most commonly tested for. Some of these are included below.
Chlamydia is one of the most common STIs in the UK. It is recommended that if you are sexually active, you get tested for chlamydia every year and/or each time you start having sex with a new partner. Most people with chlamydia experience no symptoms at all and so it is commonly diagnosed through routine screening, or when tested due to a sexual partner testing positive.
Gonorrhoea, otherwise known as the clap, usually presents itself through unusual discharge from the penis or vagina. Like chlamydia, it is easily treatable through antibiotics - usually an injection or tablet. Gonorrhoea (sometimes spelled as gonorrhea) can be passed on from a pregnant woman to her baby, so it is important to get tested and treated before giving birth.
Genital warts is usually transmitted through vaginal and anal sex, but can also be transmitted through oral sex. There is no cure for genital warts, but it is possible for your body to clear out the virus over time. There are however treatments to remove the warts and reduce how often they return.
Genital herpes can go away on its own, however the blisters/sores can return. You won’t be able to be tested for herpes without there being any sores present, so it’s important to see a doctor as soon as you find any.
Pubic lice, otherwise known as crabs, are most commonly found in pubic hair but can also be found on hair around the body - wherever they have been spread to through close body contact. Although they don’t live in the scalp. Pubic lice can be very difficult to see, so the noticeable symptoms are usually what they cause, such as itching, bites, or their waste or eggs being present in your underwear.
Syphilis can usually be treated very easily with a course of antibiotics - usually an injection. In many cases, symptoms of syphilis are not easily noticeable and go away on its own, so it’s important to get tested for it regardless of if you have any symptoms. When left untreated, syphilis can spread to other parts of the body, including the brain, and cause serious long term effects.
HIV is a virus that causes damage to the immune system. HIV can be transmitted in several ways, but in the UK it most commonly happens through unprotected vaginal or anal sex. There is currently no cure for HIV, but there are treatments available that can significantly help reduce the risk of it developing into AIDS, and to allow you to live a healthy life.
Trichomoniasis is caused by a tiny parasite called trichomonas vaginalis that more commonly affects those with vaginas, but can infect penises as well. Leaving this infection untreated rarely causes complications, but it is likely to go away without treatment.
How To Get Tested
If you think you may have an STI, it is recommended that you go to a sexual health clinic (also known as GUM or family planning clinic), as they have the most expertise in both testing and treatments. However, if you can’t find one in your area, or would rather not go to one, there are a few other options available. These include:
- Your GP
- A pharmacy
- A community contraception clinic
- A young people’s sexual health service
If you’re not sure what to do, you can call the National Sexual Health Helpline (0300 123 7123) for free for advice.
Visiting an STI Clinic
At sexual health clinics, you usually have the option to either make an appointment, or attend a drop-in service.
You are able to go to a sexual health clinic regardless of your gender or age, or if you have any symptoms at all. It is a completely confidential service, even for minors - your parents won’t be informed of your visit. If however, they suspect that a young person is at risk of any harm, they may need to inform other healthcare services. This would still not be done without the young person’s knowledge as they will be spoken to first.
It’s important to remember that, while you may feel embarrassed attending a clinic, the staff are very well trained and are used to an array of sexual health conditions, diseases and infections. They will do their best to put you at ease, but let them know if you need extra support or any further explanations, and they will be happy to help you.
When you see a medical professional, they will normally discuss your symptoms and your sexual history with you to assess what tests you may need. In some cases, usually when there are specific symptoms present, you will be tested for a specific STI. In other cases however, if you don’t have any symptoms at all or would like a general check-up, you will most likely be tested for chlamydia, gonorrhoea, HIV and syphilis.
The tests you have might include:
- A urine sample
- A blood sample
- Swabs from the urethra
- Swabs from the vagina
- Examination of genitals
If you have sores on your genitals or anus, it’s likely that you will be tested for herpes. This would be done by a swab taken from the sore.
What Happens If You’re Positive
Receiving Your Results
The length of time it takes to receive your test results depends on several factors including where and how you got tested. However, generally speaking you will need to wait a week or two.
If you had your test results done at a clinic, they would have asked how you would prefer to receive your results - text, call, letter, etc. If your results are positive, you will be asked to return to the clinic to discuss your results and what treatment you need. For some infections whereby there is no cure, the clinic can refer you to a counsellor to help you process and manage the diagnosis.
If you test positive for an STI, it is strongly suggested that you inform any current or previous sexual partners that may have also been infected so that they can get tested and treated. If you are uncomfortable with telling them, or would prefer not to, most sexual health clinics can do so for you without revealing who you are. You just need to let them know and tell them how to get in touch with them.
It is also advised that yourself and any partners refrain from sexual activity until you have been successfully treated. Otherwise you may continue to unknowingly pass the infection back and forth.
The treatment for sexually transmitted infections or diseases depends on the type (bacterial, viral or other), location and stage.
Bacterial STDs: Including chlamydia and gonorrhea
In most cases, antibiotics are able to successfully treat bacterial infections. The most important thing is to take all your antibiotics exactly as they’ve been described. Even if your symptoms go, you should continue to take them. If when you finish your course of medications and your symptoms haven’t gone or they return, let your doctor know immediately.
Viral STDs: Including herpes and HIV
Most viral infections don’t have a cure, but many can clear on their own. There are usually treatment options available to help with symptoms and help reduce the risk of spreading the virus.
Other STDs: Including pubic lice, scabies and trichomoniasis.
For STDs caused by organisms as opposed to viruses or bacteria, the medications are usually topical or oral - depending on the type and location.
Living With an STD
Most STDs are treatable and many can be cured completely with the right treatment. For those that can’t be cured, there will usually be treatment available that will help you manage your symptoms, reduce your risk of complications and help reduce the risk of spreading the infection to sexual partners.
Your doctor will be able to advise you on what the outlook is for your specific STD. It’s important that you follow their treatment plan. Some STDs, such as HIV, may require some lifestyle changes. Such as medication, not being able to donate blood, etc. If you have any questions or concerns about this, communicate with your doctor as it is important to follow the recommendations for the sake of your health and that of your partner(s).
While it's strongly recommended that you disclose any current STIs you may have to your sexual partner, whether you do so and how you do so depends on you.
Preventing STIs and STDs
There is unfortunately no way to completely remove the risk of contracting an STD besides not having any sexual contact - STIs can spread through vaginal, anal and oral sex. Therefore if you engage in any sexual act, it is important to make it as safe as possible.
Condoms are the most effective way to protect yourself against STIs so it is advisable that they are used in all forms of sex. You can also use a dental dam to provide protection during oral sex.
Unfortunately condoms do have limitations. They are incredibly effective at reducing the spread of STIs caused by fluids, but aren’t as effective as those caused by skin to skin contact.
Another important way you can reduce the risk of contracting or spreading STI is through honest communication with your sexual partner(s). Discussing your sexual history and getting screened for STDs before engaging in sexual activity with a new partner is a key way to help stop the spread of infections. If your partner does test positive for an STI, they need to follow the treatment plan exactly as recommended. You can also speak to your doctor regarding this diagnosis about how you can protect yourself.
You can also ask your doctor what vaccinations you are eligible for.
Please note that while this article does cover information relating to all genders and sexual orientations, the NHS have provided LGBTQIA specific advice for safe sex.
Being sexually active carries the risk of being exposed to an STI or STD, but there are some factors that make it more likely. These include:
- Having unprotected sex - oral sex is less risky than penetrative sex but still carries risk
- Having sexual contact with several partners - the risk of exposure to an STI increases with the number of people you have sexual contact with
- Having previously had an STI - having an STI makes it easier to get infected
- Misuse of alcohol or drugs - reduction in judgement has been linked to a higher risk of participating in an activity that may result in an infection
- Sexual assault or abuse - it’s important to see a doctor if you have been assaulted so that you can be provided with emotional support as well as any necessary screening or treatments. Head to the NHS website for help after sexual assault
- Injecting drugs - sharing needles increases the risk of infections including HIV and hepatitis
In many cases, STIs and STDs go undetected for a long period of time, as there are commonly no symptoms in the early stages. Because of this, there are cases that a diagnosis comes later due to complications of the infection. These can include:
- Pregnancy complications
- Pelvic pain
- Pelvic inflammatory disease
- Heart disease
In order to prevent complications, it’s important to attend recommended screenings, such as a cervical screening, and get regularly checked if you are sexually active.
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