STIs are infections caused by pathogens passed from person to person via unprotected sexual contact.  More than 30 bacteria, viruses, and parasites are transmitted via sexual contact.  Out of the 30 pathogens, 8 are responsible for the most significant incidence of STIs.  Of the 8, 4 are curable, and 4 are incurable viral infections.  The 4 curable STIs are syphilis, gonorrhea, chlamydia, and trichomoniasis.  The 4 incurable STIs are hepatitis B, herpes simplex virus, HIV, and human papillomavirus (HPV).

How are STIs spread?

STIs are predominately spread through sexual contact, whether vaginal, oral, or anal.  Syphilis, HPV, and herpes can also be spread through skin-to-skin contact.  In addition, some STIs can also be transmitted from mother to child during pregnancy, childbirth, or breastfeeding. 

More than 1 million STIs are acquired daily worldwide, most of which are asymptomatic.  Remember that 1 million are for those who have taken an STI test.  As STIs can be asymptomatic, many people do not realise they have an STI, so it is estimated that the number of current STIs is much higher. 

The World Health Organisation states that each year there is an estimated 374 million new infections of chlamydia, gonorrhea, syphilis, and trichomoniasis.

Are STIs really asymptomatic?

We are conditioned to diagnose an infection based on diagnosing our symptoms; however, the frequency of asymptomatic STIs is why STI rates are so high.  STI awareness has predominantly focused on symptoms alone; however, most people with an STI don’t even know they have the infection.  It is very common for someone to have an STI and have no STI symptoms.

What are some common symptoms of STIs for those that are not asymptomatic?

While many STIs can have no signs or symptoms, some common early symptoms of a new STI include:

• Unusual discharge from the penis or vagina
• Scores or warts on the genital area
• Painful or frequent urination
• Itching or redness in the genital area

How harmful are STIs really?

STIs can have long-term consequences beyond the initial infection, mainly if left untreated.

• Herpes, gonorrhea, and syphilis can increase the chances of getting HIV
• Transmission of STIs from mother to child during pregnancy can result in stillbirth, neonatal death, low birth weight, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities
• HPV infection causes cervical cancer, which is the fourth most common cancer among women globally
• Hepatitis B can cause cirrhosis of the liver and liver cancer, accounting for approximately 850,000 deaths yearly
• Gonorrhea and chlamydia are the leading causes of pelvic inflammatory disease and infertility in women

So how can I protect myself against getting an STI?

The simple answer is WEAR A CONDOM.  The condom is the most effective contraceptive to protect against most STIs, including HIV and unintended pregnancy.  Condoms carry a 98% effectiveness rating for most STIs.  Condoms will not cover you for STIs that are spread through skin-to-skin contact, such as herpes, syphilis, and HPV.

You should wear a condom for all vaginal and anal sex encounters.  However, if engaging in oral sex and a condom is not being used, a full STI check and clearance is the best form of protection.

Currently, two vaccines are available for 2 viral STIs: hepatitis B and HPV.  Prevention for these starts through vaccination.

I had unprotected sex recently.  What should I do?

Whether you had unprotected sex or during a recent sexual experience, the condom broke, the first rule of thumb is to try not to panic.  You aren’t the first person to experience a broken condom, and you won’t be the last.  The only thing to remember is that there is an increased risk of getting an STI and address this risk as soon as possible.

First up, head to the bathroom, and take a moment to yourself.  You could experience a wide array of emotions at this point, from fear, disbelief, worry, anger, or stress.  Remember, you don’t have to go through this alone; speak to family or friends, someone you trust so that they can support you.  Suppose there is no one you can talk to.  In that case, various services online, such as your state-specific family planning services, can provide support.

Secondly, remove any sexual fluids from your body, reducing your risk of acquiring a urine tract infection (UTI).  Don’t douche yourself, as this will only cause problems to your natural bacteria and pH, but wash the outer region of your genital area.

Within the next 3 days, visit a health care professional to take a dose of emergency contraception to prevent unwanted pregnancy and a dose of post-exposure prophylaxis (PEP) to reduce your risk of infection.  Starting treatment as close to exposure is vital to lowering your risk of infection.

Gonorrhea and Chlamydia symptoms generally develop up to 2 weeks after unprotected sex.  Common symptoms include unusual discharge and pain when urinating.  You must get an STI test to ensure you have not contracted these STIs.  14 days post-exposure is considered the most ideal time for reliable results.

Syphilis is an STI that is hard to detect.  Common symptoms include:

• Small sores in the genital area or mouth
• Blotchy rash on palms of hands or soles of feet
• Fever
• Headaches
• Joint pain

The incubation period for syphilis is around 6 weeks; therefore, getting tested 6 weeks after exposure is vital for the most reliable results.

A recommendation is to get an additional full STI test done 3 months after exposure.  This provides reassurance that you are negative or that any treatment you have received has worked. Remember, the best form of protection against an STI or unwanted pregnancy is to wear a condom for ALL sexual encounters.