STIs

A sexually transmissible infection (STI) is an infection that you get from someone else through any form of sexual activity, including vaginal, anal and oral sex, and sharing sex toys.

They’re super common and the number of cases is on the rise in Australia, particularly among young people.

The good news is that with the right protection, correct information and regular health checks, most STIs can be avoided or treated. If left untreated they can cause some serious health problems.

STIs

Chlamydia

Chlamydia is the most commonly reported STI among young people in Australia. It’s caused by a type of bacteria and usually has no symptoms and is easily treated with antibiotics. If left untreated, it can sometimes lead to more serious health problems like infertility.

Causes & preventions

Chlamydia is spread by sexual contact with someone who has the infection. 

Condoms, along with water-based lubricant, are the best way to protect yourself against chlamydia when having vaginal or anal sex. If you’re having oral sex, condoms or dental dams can also help prevent infection.

The symptoms

Most people who have chlamydia don’t show any symptoms. If symptoms do occur, they usually develop about 2 to 14 days after having unprotected sex with someone who has chlamydia.

Women with a chlamydia infection may experience:

  • a change in vaginal discharge
  • crampy pain in the lower abdomen 
  • menstrual changes including longer, heavier periods
  • pain when peeing
  • bleeding / spotting between periods or after sex
  • pain during or after sex.

Men with a chlamydia infection may experience:

  • a discharge from the penis
  • discomfort or irritation at the tip of the penis
  • pain when peeing
  • swollen and sore testes.

In men and women, chlamydia can be spread through oral sex, causing an infection in the throat. Chlamydia can also be spread through anal sex, causing an infection in the rectum. This can cause rectal pain and discharge from the anus or have no symptoms.

Risks if not treated

If chlamydia is not treated it could lead to pelvic inflammatory disease (PID) - an infection of the uterus and fallopian tubes. This can cause chronic pelvic pain and even infertility in some cases. Chlamydia can also cause complications with pregnancy, and newborn babies can develop eye and lung infections. In men, chlamydia can lead to longer-term infection of the testicles.

Testing & treatment

Testing for chlamydia is easy and can be done through your GP or by visiting a sexual health clinic. Testing can be done by providing: 

  • a urine sample (best test for men)
  • a vaginal swab (best test for women)
  • an anal swab, for anyone who has had unprotected anal sex, and/or
  • a throat/oral swab, for people who’ve had unprotected oral sex.

If meeting with a healthcare professional is an issue, Queensland residents aged 16 years or older can order a free chlamydia and gonorrhoea urine test online through 13 HEALTH webtest. There are 2 options to provide urine for a webtest:

  • at a pathology collection centre after getting a form online (this is the quickest way to get your results)
  • by ordering a home mailing kit online and sending it back to be tested.

13 HEALTH also provides support and reminders to get treatment if your webtest is positive. If someone is at risk of having chlamydia or gonorrhoea in the throat or rectum this test will not detect infections in those sites. To find out more go to 13 HEALTH webtest. 

Chlamydia can be easily treated with a single dose of antibiotics. It’s important to complete the treatment and follow up with your GP or healthcare professional to make sure the infection has been cured.

You should also refrain from having sex for seven days after treatment is completed, as you can still pass the infection to a partner. Likewise, you should inform your partners so they can also get tested and treated. This will help to prevent re-infection.

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Your responsibilities

If you’ve been tested and find out you’ve got chlamydia it’s important to let anyone you’ve had sex with in the past six months know, so they can also be tested and treated.

Telling sexual partners about their exposure to an STI is important for their health and the health of anyone they may have had sex with. 

You can do this yourself, or if you want to remain anonymous your GP or healthcare professional can do it on your behalf. You can also use an online contact tracing tool like letthemknow.org

Syphilis

Caused by a type of bacteria, syphilis is an STI that’s on the rise in Queensland.
It’s easily curable, but can leave permanent damage if you don’t get it treated.

Causes & preventions

Syphilis is spread through unprotected vaginal, anal and oral sex. It can be highly infectious if someone has sores or a rash and can be spread just by engaging in intimate skin-to-skin contact. The safest ways to protect against syphilis include:

  • using condoms 

  • using water-based lubricant to prevent condom breakage
  • avoiding sex with someone who has a visible ulcer or sore on their genitals or mouth
  • having regular STI check-ups, especially if you change partners
  • completing a full course of treatment if you’ve been diagnosed with an STI.

Unfortunately, there is no vaccine for syphilis. And while it can be cured, previous infection and previous treatment do not protect a person from getting syphilis again.

The symptoms

Primary syphilis

Syphilis can initially cause sores or ulcers around the genital area, mouth, or throat 10 - 90 days after infection. These sores, called chancres, can be any size or shape.
They are often painless, don’t bleed, and feel like a hard button on the skin.
They can sometimes be internal and go unnoticed. 

If they are not treated, they usually heal and disappear after a few weeks but the syphilis infection will remain in the body.

Secondary syphilis

Two to six months after getting infected, the secondary stage of syphilis occurs. Symptoms may include a flu-like illness, a rash on the torso, palms, and soles of the feet, swollen glands, wart-like lumps around the moist areas of the body, and hair loss. Some people also get headaches, tiredness and pains in the bones, muscles and joints. If these symptoms disappear the person is still infectious.

Early latent syphilis

This means that the person does not have any signs or symptoms but is still infectious.
The only way they would know they have syphilis is to get a blood test.

Late latent syphilis

This means the person is not infectious. The only way the person would know they have syphilis is by having a blood test.

Risks if not treated

If the infection is not treated, the signs and symptoms will go away, although some may come and go for up to a year. Regardless, the syphilis infection remains in the body and can still be passed to sexual partners.

If late latent syphilis is not treated, the infection can lead to serious, permanent problems like damage to the nerves, brain and large vessels near the heart. 

A pregnant woman with syphilis can pass it on to her unborn baby. This is called congenital syphilis which can be a severe, disabling or life- threatening infection for babies.  The earlier syphilis is treated during the pregnancy, the lower the risk of the baby becoming infected or being damaged by syphilis. All pregnant women should therefore have a syphilis test in the first 12 weeks of pregnancy (or at the first antenatal visit) and again at 28 weeks for women who may be at high-risk. 

Additional testing for syphilis in pregnancy may be needed in areas affected by a syphilis outbreak and for certain at-risk populations.

Testing & treatment

A simple blood test is usually used to diagnose syphilis. If a person has an ulcer or sore this can also be tested with a swab. There is a short period after exposure to syphilis when tests may not pick up the early stages of infection so repeat tests may be required.
If a person has contracted syphilis they will test positive to blood tests three months after infection, and usually much earlier.

Syphilis is usually treated with penicillin injections. A person with syphilis should not take part in any sexual activity until seven days after completing their course of treatment and all signs and symptoms of syphilis have cleared.

It is important to have a repeat blood test three to six months after treatment to make sure the infection has been cured.

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Your responsibilities

Get regular STI check-ups at your GP or sexual health clinic, and always use a condom during oral, vaginal or anal sex. If someone has syphilis or syphilis-like symptoms, don’t have sex with them until seven days after they’re finished their antibiotic treatment.

If you’ve tested positive to syphilis it’s important to let anyone you’ve had sex with in the past 12 months know (depending on what stage of syphilis infection you have), so they can also be tested and treated. Telling sexual partners about their exposure is important for their health and the health of anyone they may have had sex with.

You can do this yourself, or if you would prefer your doctor or health worker can do it anonymously, on your behalf. You can also use an online contact tracing tool like letthemknow.org.

Gonorrhoea

Gonorrhoea is a common STI that can be cured with antibiotics.
It can often occur without symptoms which makes regular testing very important.

Causes & preventions

Gonorrhoea is spread by having unprotected vaginal, anal or oral sex with someone who is infected. The best way to avoid getting gonorrhoea is to use a condom when having vaginal or anal sex, and to use a condom or dental dam for oral sex.

The symptoms

Sometimes people are unaware they have a gonorrhoea infection because there aren’t any visible symptoms. But when symptoms do occur, they usually develop a few days to a week after infection first occurs.

For women, some of the symptoms of gonorrhoea include:

  • crampy pain in the lower abdomen
  • a change in vaginal secretions
  • pain / burning sensation when peeing
  • bleeding / spotting between periods or after sex
  • pain during or after sex
  • enlarged and painful infected glands near the vaginal opening.

For men, symptoms may include:

  • a yellow discharge from the penis
  • pain and burning sensation when peeing
  • swollen and sore testes, if the infection travels up the urethra.

For rectal infections, both men and women can feel rectal pain, discharge or bloody mucus from the anus, and a feeling of fullness in the lower bowel.

For throat infections, symptoms include a sore, red throat and pus on the tonsils.

Risks if not treated

If gonorrhoea isn’t treated properly it can lead to pelvic inflammatory diseases (PID) in women, which can cause chronic pelvic pain, infertility and ectopic pregnancy.

For men, gonorrhoea can progress to the testes and lead to infertility.

If the proper treatment isn’t given, gonorrhoea can also increase the risk of HIV transmission in both men and women.

Testing & treatment

Testing for gonorrhoea can be done by providing:

  • a urine sample (best test for men)
  • a vaginal swab (best test for women)
  • a penis (urethral) swab  
  • an anal swab, for anyone who has had unprotected anal sex
  • or a throat/oral swab, for people who’ve had unprotected oral sex.

If meeting with a healthcare professional is an issue, Queensland residents aged 16 years or older can order a free gonorrhoea and chlamydia urine test online through 13 HEALTH webtest. There are two options to provide urine for a webtest:

  • at a pathology collection centre after getting a form online (this is the quickest way to get your results)
  • by ordering a home mailing kit online and sending it back to be tested.

13 HEALTH also provides support and reminders to get treatment if your webtest is positive. If someone is at risk of having gonorrhoea or chlamydia in the throat or rectum this test will not detect infections in those sites. To find out more go to 13 HEALTH webtest. 

Gonorrhoea can usually be treated with a single dose of two different antibiotics. It’s important to complete the treatment and follow up with your GP or healthcare professional for another test to make sure the infection has been cured, as gonorrhoea can be resistant to some antibiotics. 

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Your responsibilities

If you test positive for gonorrhoea, it’s important to let anyone you’ve had sex with in the past few months know, so they can be tested and treated. Telling sexual partners about their exposure to an STI is important for their health and the health of anyone they may have had sex with. 

You can do this yourself, or if you would prefer, a GP or healthcare professional can do it anonymously, on your behalf. You can also use an online contact tracing tool like letthemknow.org

Genital Herpes

Genital herpes is a common STI caused by the herpes simplex virus (HSV). 

Causes & preventions

Herpes is caused by two different but similar viruses: herpes simplex virus type 1 (HSV1) which is typically referred to as a cold sore, and herpes simplex virus type 2 (HSV1) which commonly infects genital and anal areas. Both HSV1 and HSV2 can occur on the lips, mouth, genital or anal areas. It is possible for a person to be infected with both HSV1 and HSV2. 

Around three-quarters of Australian adults are infected with HSV1, while one in ten adults are infected with HSV2.

HSV enters the body through skin around the mouth, genitals and anus, or through small cuts on the body. The virus lives in the nerves beneath the skin and may remain inactive and unnoticed for years. 

It’s not completely understood what causes the virus to break out and develop blisters, but menstruation, emotional upset, sexual activity and sunburn have been known to trigger an episode.

To prevent the transmission of genital herpes always wear a condom, and if you feel an episode of herpes coming on or you’re already showing symptoms, avoid skin-to-skin contact. To minimise the risk of infection it’s best to hold off from sex until one week after all sores and ulcerations have completely healed.

The symptoms

An episode of herpes usually occurs in several stages over seven to ten days. Symptoms can include:

  • a mild tingling or itching, which lasts 12 to 24 hours

  • small blisters accompanied by irritation, pain and swelling of the affected area 
  • formation of shallow ulcers, usually a couple of days after the blisters break 
  • potential swelling and tenderness in the glands around the groin.

Blisters and ulcers can form in the vaginal opening, anus, penis or scrotum and may be accompanied by pain during bowel motions or when peeing.

Some people do not experience any symptoms during the first herpes episode or any episodes thereafter. Other people may experience a small outbreak of blisters and related symptoms with the first episode and then be relatively symptom-free from then on. If you do get symptoms, try and see a doctor or nurse straight away as they can test the blisters. 

It’s common for people in these scenarios to not even know they’re infected. They can still infect sexual partners with the herpes virus even though they show no ongoing signs of infection.

Sometimes people experience more severe symptoms during episodes. These may include flu-like symptoms, fevers, joint pain, groin discomfort, tingling or itching, as well as painful blisters and ulcers. In these severe cases it can take up to three weeks for sores to heal and for symptoms to disappear.

Risks if not treated

Although there is no cure for herpes, treatment plays an important role in minimising pain, reducing recovery time, and limiting the recurrence of episodes. If you do not receive treatment, you are at greater risk of passing the virus on to sexual partners. 

Treatment

Antiviral drugs won’t cure herpes, but they will help manage it. If taken at the beginning of an episode they can reduce the duration and severity of symptoms. Herpes episodes can also be managed by:

  • keeping the affected areas as dry as possible
  • wearing loose non-restrictive clothing 
  • using anaesthetic gels to help reduce pain
  • avoiding the use of soap on affected areas
  • bathing affected areas with salt water when lesions are present.

See your local GP or healthcare professional for more advice on what treatments you require.

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Your responsibilities

If you have herpes it is your responsibility to take extra precautions to protect your sexual partners from infection, and let them know you have it.

Avoid sex if you feel an episode coming on, and avoid kissing, oral sex and sexual intercourse if you have lesions present on the mouth, lips, genital or anal areas. Wait until a week after the sores have healed before you have sex again. 

HPV – Human Papilloma Virus

HPV is a very common sexually transmissible infection that can increase the risk of cervical cancer and cause genital warts to form.

Causes & preventions

HPV lives in the vagina, vulva, cervix, anus or penis and sometimes the mouth or throat.
You can catch it by skin-to-skin contact, through unprotected oral, vaginal, and anal sex with someone who is already infected. It’s possible to catch it even when there are no warts visible which is why genital HPV infection spreads so easily.

Although condoms don’t cover all the bodily areas where genital warts can be found they still help reduce the transmission of HPV.

There are many strains of the HPV virus, which can be classified as either low-grade or high-grade. There are also some types of HPV infection that can be prevented through vaccination. 

If you are a Queensland high school student or aged 11-13 you’re eligible for a vaccine that prevents infections caused by the nine most common types of HPV. Click on the School Immunisation Program to find out more. 

Women should also discuss cervical screening with their doctor, as regular cervical screening can accurately detect HPV infection early.  You should still have Cervical Screening Tests even if you have had the HPV vaccine. 

The symptoms

HPV infection causes genital warts. Many people who carry the virus however do not develop visible warts, as their immune system keeps the infection under control. Some warts may be difficult to see as they occur inside the vagina, cervix, or anus.

Risks if not treated

HPV normally goes away by itself without treatment but for some people, warts can become unsightly or cause discomfort.

For more about the links between HPV and cervical cancer check out the National Cervical Screening Program page.

Testing & treatment

Although there is no cure for HPV infection, genital warts often go away on their own.

If genital warts are causing you discomfort you can see a GP or sexual health clinic for a check-up. In most cases, the presence of warts can be confirmed by checking the genital area. 

If warts are unsightly or causing pain, various treatments are available such as application of special cream, or cryotherapy (freezing). Changes in the cells of the cervix caused by HPV infection can also be assessed and treated if necessary. To find out more about treatments speak with your GP or healthcare professional. 

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Your responsibilities

The introduction of the National HPV Vaccination Program in 2007 has greatly reduced HPV infection in young Australians as it offers protection against many HPV strains. Aside from vaccination, condoms can also help reduce the risk of genital HPV but they won’t cover all the areas where genital warts can be found so cannot provide 100% protection.

Your best protection, for yourself and any sexual partners, is to be vaccinated before you become sexually active, use condoms and have regular Cervical Screening Tests. 

HIV

HIV is a  blood-borne virus  that can develop into Acquired Immune Deficiency Syndrome (AIDS) if left untreated.

Causes & preventions

HIV stands for Human Immunodeficiency Virus. It is passed on when infected pre-cum, semen, blood or vaginal fluid enters the body of an uninfected person. This can happen by:

  • not using a condom during anal or vaginal sex

  • sharing needles and other injecting equipment
  • blood to blood contact.

HIV cannot be transmitted through saliva, sweat, tears, mucous, vomit, urine or faeces and you cannot catch HIV from kissing, hugging, sharing eating utensils, shaking hands or any other everyday social contact.There is no need to be scared of a person living with HIV.

Currently, there is no vaccine for HIV. The best way to prevent the infection is to use condoms when you engage in anal or vaginal sex. You should also use water-based lubricant to reduce the risk of a broken condom.

There is also Pre-Exposure Prophylaxis (PrEP). It’s a daily pill that is effective in preventing the HIV virus from becoming established in the body.
You can talk to your GP or local sexual health clinic to find out more about PrEP.

If you are injecting drugs, do not share needles or injecting equipment as HIV can be transmitted via blood-contaminated equipment. Free, sterile injecting equipment is available via the Queensland Needle and Syringe Program.

Also, do not have sex if you or your sexual partner has a genital sore, ulcer or STI until it has been treated. Untreated STIs allow HIV to spread more easily.

If you believe you may have been exposed to HIV, you may still be able to prevent the infection by using post exposure prophylaxis (PEP) treatment. It is vital to take PEP immediately after being exposed to HIV, preferably within two hours, but it may still be effective within 72 hours. Once the PEP treatment is started it must be taken at specific times over a four-week period. Find out where to get PEP here.

The symptoms

People who have been recently exposed to HIV may experience flu-like symptoms, while others will have no symptoms at all. After initial symptoms disappear, HIV may not cause any symptoms for many years. During this time, the virus can be passed on without people knowing. While you may look and feel healthy, the untreated virus could be doing harm to your body.

Risks if not treated

If HIV is left undiagnosed or untreated, it may develop into AIDS. This can damage the immune system, making it hard for the body to protect itself from disease. When damage is severe a person can get sick from related infections or cancers and develop other life-threatening illnesses. 

Testing & treatment

Testing for HIV requires a blood test.

If you’ve recently had unprotected anal or vaginal sex, or you think you may have been exposed to HIV through sharing needles or other injecting equipment, you should get tested as soon as possible.

You will need to wait until 6 to 12 weeks after exposure before a blood test can provide a reliable result. During this time, always use condoms and under no circumstances should you donate blood.

To find out where you can get a rapid HIV test use this clinic search tool.

HIV is currently not curable but medication like HIV antiretroviral treatment (ART) helps people with HIV lead long, healthy lives and lowers the chance of spreading the virus to other people. 

ARTs keep the virus from multiplying and provide the immune system with relief from HIV infection, allowing it to strengthen.

People living with HIV should consult an HIV specialist to ensure they can access the latest treatment, support and clinical advice. 

Starting treatment for HIV as early as possible will improve long-term health prospects. Starting it later can increase the time the virus has to damage the immune system.

HIV ARTs are subsidised through the Pharmaceutical Benefits Scheme (PBS) for anybody with a Medicare card.

You can find out more about treatment and support on the Queensland Positive People website.

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Your responsibilities

If you find out that you do have HIV, anyone you’ve had unprotected anal or vaginal sex with should be advised to have a test. If you feel unable to tell your current or ex-partners, your GP or a member of your healthcare team can assist by contacting them. This will be done discreetly and confidentially in order to protect your privacy. It is extremely important for your partner’s health and the health of other people they may have sex with that partner notification occurs.