Your guide to STIs
People...let’s be unsexy for a moment. Let’s sit down and have an adult conversation about your genitals and their health. Whether you have a vagina, a penis, an asshole, a mouth, all of the above, some of the above, or somewhere in between. Your bits and bobs are not immune to the nastiness of sexually transmitted infections (STIs). Also, if you’re still calling them sexually transmitted diseases (STDs), you’re sooo behind the times. It’s all about the STIs now. A fact which no doubt has made every wedding planners job immensely easier when sending out Save The Date cards.
The more informed you are about your sexual health, the better prepared you’ll be to take action if something undesirable happens.
STIs: Ranked (from Awkward to Deadly)
Gonorrhea A.K.A The Clap
How will I know if I have it
Gonorrhea is a bacterial infection, and like many STIs can be asymptomatic. This means you might have it and have absolutely no idea that it’s in your system, because it doesn’t give you any symptoms.
When symptoms do occur, vagina owners may experience bleeding when it’s not time for their period. Penis owners may experience swollen testicles or arthritis (inflammation of the joints), genital discharge of various colours and a burning or painful sensation when peeing.
In cases of oral infection, there are rarely any symptoms. This is why some experts are blaming it for the rise of antibiotic resistant strains of the infection.
How did I catch it
Sexual fluid exchange.
Fluid exchange means any sharing of sexual fluids with a person carrying the infection. This can include all sexual acts, but also for instance, touching your eye while you have trace amounts of infected fluids on your hands.
Oral gonorrhea is contracted through oral sex (vaginal, penile or anal) with someone carrying the infection.
What do I do once I have it
If you suspect you have it, go to your nearest Sexual Health clinic and they will perform a swab test or a urine sample (don’t put off being tested for fear of the urethra swab, you’ll be able to pee in a cup).
Once you’ve been diagnosed you’ll be given a course of antibiotics. I shouldn’t need to tell you that you MUST take all of your antibiotics.
You won’t be able to have sex for a while during and after treatment, it’s worth discussing with your doctor when you’ll be able to recommence the fuckery.
Once you’ve finished your antibiotics you will be re-tested to make sure you’re all clear. Your doctor may offer you treatment for your partner, and access to an anonymous notification service for any previous sexual partners who might be at risk.
Keep in mind you can be reinfected, so whatever you did to catch it in the first place...try not to do it again you silly sausage!
What happens if I don’t treat it
If you don’t treat it, it can lead to pelvic inflammatory disease (PID) for vagina owners, which in turn can lead to infertility.
Penis owners could find themselves infertile, but will also experience a large amount of discomfort in the meantime.
And regardless of what junk you have, leaving it untreated can increase the possibility of contracting other STIs.
How can I prevent it
You’re going to get sick of hearing this by the end, but use protection (condoms, dental dams, femidoms, etc).
If you’re sexually active with more than one partner, or your partners have more than one partner, you should all be having regular STI screenings. This means once every three months.
There’s nothing wrong with having regular sexual health check ups, because remember with great genitals comes great responsibility. And let’s be honest, prevention is a lot less inconvenient than finding treatment or a cure.
Chlamydia A.K.A The Koala-Killer
How will I know if I have it
Despite it being literally the most common STI Chlamydia, is a bit of a ninja infection. A lot of people who have it may not realise they do, because they’re asymptomatic.
The people who are symptomatic will find the symptoms similar to those of Gonorrhea in all the ways that matter.
Penis owners may experience an itchy urethra, sore ballsacks and pain when they ejaculate.
Vagina owners can experience abnormal bleeding and discharge as well as burning when peeing, pelvic and lower abdominal discomfort, pain during sexy times and vaginal itching.
Oral chlamydia affects the cells in your throat and is usually asymptomatic. When there are symptoms, they tend to be a sore throat, cold sore like lesions around the mouth, and small, painless sores inside the mouth. However, oral chlamydia is relatively uncommon.
How did I catch it
Sexual fluid exchange.
The infection can be oral, anal or genital. This means that any form of unprotected oral sex (including rimming) is a risk. You can also contract it from sharing sex toys without using condoms or dams.
What do I do once I have it
If you have any of the symptoms, or even if you’ve been having unprotected sex recently, you should go to your friendly neighbourhood sexual health clinic. As with Gonorrhea, they’ll do a swab or urine test to check.
If you do have it you’ll be given a course of antibiotics.
What happens if I don’t treat it
If you leave it untreated, it can lead to pelvic inflammatory disease (PID) for vagina owners.PID is when the infection spreads from the vagina to the cervix, the endometrium (lining of the uterus) and the fallopian tubes. From there you can look forward to abdominal pain, pain during sex, fever and funky discharge.
How can I prevent it
Use barrier protection.
Herpes Simplex Virus (HSV) A.K.A Herpes, Coldsores
How will I know if I have it
There’s two types of HSV and both virus types can cause genital herpes but with different outcomes.
With both types, if you’re symptomatic you might experience tingling, itching, redness and nerve pain before an outbreak. During an outbreak you might experience a rash, sores, chafing and cracked skin.
HSV-1 - 85% of the population has it. This guy causes oral cold sores. It can cause genital infection when someone with the cold sore virus (whether symptomatic or not) performs oral sex on someone (who hasn’t had any exposure to HSV-1). Initial genital HSV-1 infection may be quite painful, but recurrences and infection when someone is asymptomatic occur much less frequently than with genital HSV-2.
HSV-2 - 20% of the population has it. It’s associated with frequent symptomatic outbreaks as well as atypical and asymptomatic infection and a risk of transmission to sexual partners. Most people with genital HSV-2 will, at some time, require treatment with antiviral medications for control of recurrences or relief from symptoms. It’s really, really rare for you to contract this type orally and cold sores are pretty much exclusively caused by by HSV-1.
How did I catch it
There are no fluids required for this bad boy, and condoms don’t provide enough protection to keep you safe.
You don’t need to have had sex to catch this. All you need to have had is ‘sexual contact.’ What does that mean? Well, because this is spread through the skin, it means that if at any point your skin touched the skin of someone with the virus, that’s enough for transmission. Obviously this doesn’t mean holding hands, but it can mean giving someone a hand job and then touching your genitals. It could be sharing sex toys. It could be from dry humping without underwear on.
What do I do once I have it
If you think you have herpes, make an appointment with your GP or local sexual health clinic. They’ll take a swab from the ulcer, skin split or itchy spot and send it to a lab for virus detection. This is the most accurate way of diagnosing herpes and will also tell you whether it’s HSV-1 or HSV-2.
Many clinics will use blood tests to screen, but if you can, try and request the swab since herpes blood tests are notorious for returning both false negatives and false positives.
If it’s confirmed that you’ve got herpes, your doctor will talk to you about ways to manage the virus and prevent infecting others. Despite the fact that there’s no cure for herpes, contracting it isn’t the end of the world. In fact it’s not even the end of your sex life! It just requires a bit of extra safety and awareness.
What happens if I don’t treat it
Since there’s no cure for herpes, you’re mainly in for pain and discomfort if you leave it untreated. Most treatments are focused on minimising the duration and severity of the symptoms.
How can I prevent it
Avoid sexual contact with anyone who is symptomatic. Many people who carry HSV are asymptomatic, so always ask your partner’s history (and offer your own) before sexual contact.
Human Papilloma Virus (HPV) A.K.A Genital Warts
How will I know if I have it
Chances are you’ve already had it, since 90% of us will be infected with at least one genital type of HPV at some time in their lives. There are tons of different kinds of HPV and they can do varying amounts of damage - from nothing at all to cancer.
There are about 40 types of HPV that target the genital and anal area. Despite it being one of the most common STIs, most infections are asymptomatic. This is great in the sense that you might not be suffering, but is also how it spreads so prolifically.
For people who experience symptoms, they’ll usually present as genital warts either on the genitals or on the anal area. For vagina owners, the warts may only appear internally - these would be picked up during your cervical screen/pap smear. Which you have regularly. Because you’re a responsible adult. For those who don’t get tested, sometimes the first symptoms they’ll experience will be from the cancer that has already developed.
How did I catch it
The same as Herpes, this one is a skin-to-skin transmission. So any sexual contact with someone carrying the virus is enough to do the trick. Even if you didn’t have sex. Even if a condom was used.
What do I do once I have it
There’s no cure for HPV.
If you have one of the asymptomatic strains, your body will fight it off and, most likely, you’ll never know you had it.
If you have genital warts, you can have the warts removed to help minimise any discomfort or pain you’re experiencing. But if you’ve ever had a wart removed from a hand or foot, you’re already imagining how much worse that might feel on your fun bits.
If you’re concerned that you may have a cancerous strain, you need to talk to your doctor. They can perform a swab of your throat, anus or vagina to check for abnormal cells. And if you want to know what happens if they find abnormal cells, you’re in luck, because I’ve gone through that experience for you!
What happens if I don’t treat it
Best case scenario - If you’ve contracted one of the many strains of HPV that are asymptomatic and aren’t cancerous, then you probably won’t know you have it and you can wait for your body to clear it naturally.
Moderate case scenario - If you notice that you have genital warts and choose not to have them removed, they may cause discomfort, but they won’t escalate into anything worse.
Worst case scenario - The biggest threat that HPV poses is cancer. The strains that cause cancer don’t have any symptoms themselves, and will only be picked up through a cell screening. For vagina owners, this is done through a ‘cervical screen’ (previously known as a pap smear). However, the risk isn’t limited to cervixes. HPV is the cause of nearly all cervical, anal, penile, vaginal, vulvar, and oropharangyal cancers. So be aware of any changes in the risk areas and if you’re concerned, go straight to your doctor to have a cell swab.
How can I prevent it
Using barrier protection will minimise the chances of contracting genital warts.
You can get the HPV vaccination, which now protects against 9 of the cancer causing strains of HPV.
If you have a vagina, make sure you stay up to date with your cervical screening tests. And if you notice any of the preliminary symptoms of cancer in the at risk areas, go to your doctor immediately.
Syphilis
How will I know if I have it
Syphilis is a complex beast. It has 4 stages.
Stage One - Within around 3 weeks of contamination you’ll develop a sore at the site of the infection. This is usually pretty visible for penis owners, but can be trickier for vagina owners if infection occurred inside the vagina. The sores (often called chancres) aren’t usually painful. You may also get sores at other sites on your body, and you may notice inflamed lymph nodes near the area of the sore.
Here’s the tricky part - the sores will heal on their own within 3-6 weeks. But the infection is still inside your body, which means you’re still passing it on to others.
Stage Two - Between 2 and 12 weeks after the sore develops, you’ll notice a rash developing over your whole body, including your palms and soles. It’s usually reddish-brown, with small sores. The sores might contain pus, or they might be moist sores that look like warts.
The rash usually heals within 2 months without scarring. But as with stage one, even though the obvious symptoms have gone, you are still infected and contagious.
Once syphilis has spread through your body you might experience fevers, sore throat, weakness, weight loss, hair loss, swollen lymph nodes, headaches and irregular pupils.
Stage Three - This is known as the “Latent Stage” because for all intents and purposes it looks like you’re fine. It occurs a year after infection, and can last anywhere from 1 to 20 years. The only way to know for sure if you’re infected at this point, is through a blood test. However you can still have symptomatic relapses periodically through the latent stage. Oh, and if you get pregnant you can pass it on to your baby, have a miscarriage or a stillbirth.
How did I catch it
Fluid exchange.
What do I do once I have it
The good news is, it’s pretty easy to treat; a course of antibiotics and you’re normally fine. But the antibiotics won’t reverse any damage that the infection has already done, so you know, don’t drag your feet about getting it treated.
What happens if I don’t treat it
Stage Four - Also known as the “Tertiary” or “Late” stage. This is where shit starts to go really downhill. It can start as early as one year after infection, but realistically can happen at any time once infected. You can look forward to blood vessel and heart problems, blindness, nerve system problems, some serious mental disorders, oh and death.
Oh, and in the mean time you can have these fun complications called “gummas” which can cause symptoms similar to leprosy (you know, like having your nose fall off).
How can I prevent it
Use barrier protection.
Hepatitis A.K.A Hep A, Hep B, Hep C
How will I know if I have it
Hepatitis is literally an inflammation of the liver but it also refers to the viral infections causing this inflammation. The three most common strains are A, B and C. During the ‘acute’ phase of hepatitis (first few weeks after infection), you may not have any symptoms at all.
Once symptoms start you might notice a drop in appetite, a low fever, stomach pains and nausea, fatigue and a super sexy Simpson’s-esque skin colouring called jaundice.
How did I catch it
Hepatitis A - Very fucking easily. Basically if someone with Hep A didn’t wash their hands in the bathroom and then handled food, they’ve probably passed it on to everyone who consumed that food. It also spreads through day-care centres where staff aren’t fastidious enough about washing their hands after changing diapers. The sexual act to be most aware of with Hep A is rimming, because it’s transmitted faecally.
Hepatitis B and C- Fluid exchange (including sharing needles, razors, toothbrushes, etc)
What do I do once I have it
Hepatitis A - It will go away on its own.
Hepatitis B -There is no known cure. Once you’ve been diagnosed with it, your doctor will talk to you about steps you need to take to manage your liver function, depending on how much damage has been done.
Hepatitis C - Your doctor will prescribe you a course of drugs known as Direct Acting Anti-Virals (DAAs), DAAs are now able to cure 90% of people with Hep C. Even better, if you’re living in Australia it’s covered under Medicare.
What happens if I don’t treat it
Hepatitis A - This is the chillest version of hepatitis and a lot of people can contract it and not even realise that they have it. It pretty much heals itself without causing any real liver damage.
Hepatitis B - There’s two types; acute and chronic.
If you’ve got acute Hep B you can expect jaundice within 12 weeks, along with all the flu like symptoms mentioned above. However, lots of people who get acute Hep B don’t actually notice that they’re sick and never have any symptoms. But if you’re one of the unlucky ones you can get really sick, really quick and end up with massive liver damage.
Chronic Hep B patients get the same symptoms as the acute patients, and similarly might go for years without realising they’re infected. But they have the fun bonus of being super susceptible to liver cancer.
Hepatitis C - About 25% of people beat the virus after a short term infection. However chronic Hep C can cause liver failure and liver cancer.
How can I prevent it
Hepatitis A - Wash your damn hands! And if you’re planning on rimming, use a dental dam.
Hepatitis B - Get vaccinated. Use protection. Keep any and all open cuts, wounds, sores, etc covered up, especially if you work in a place where you’re exposed to other people’s fluids.
Hepatitis C - Use protection. Keep any and all open cuts, wounds, sores, etc covered up, especially if you work in a place where you’re exposed to other people’s fluids.
Because hepatitis can go for so long undetected it is seriously fucking important to get regular blood tests to ensure that you haven’t been infected. If you don’t get tested, you could be asymptomatic for years while it ravages your liver beyond repair. Get tested. For more information, check out the Australian Government website on hepatitis. It’s pretty informative.
Human Immunodeficiency Virus (HIV)
How will I know if I have it
Soon after infection, some people experience flu-like symptoms such as a fever, headache, tiredness and a rash. Sometimes people start developing symptoms, like tiredness and night sweats, two to seven years after infection. As with so many STIs, many people who are infected are asymptomatic and may not realise they’ve contracted it.
How did I catch it
Fluid exchange.
What do I do once I have it
If you think you might have it, it’s crucial that you get to your doctor or local sexual health clinic to be tested. A simple blood test will tell you whether or not you have it. There’s currently no vaccine or cure for HIV, but people who are HIV-positive can take daily medications to help to manage it and prevent it from progressing to anything more damaging.
An exciting development to prevent HIV is PEP (post-exposure prophylaxis) which allows people who believe they have recently been in contact with HIV to be treated immediately, and lower the chances of contracting the virus.
With proper management HIV is no longer a death sentence and people who have contracted it can live long, happy, healthy lives.
What happens if I don’t treat it
If left untreated, HIV can cause AIDS (Acquired Immune Deficiency Syndrome), a syndrome which occurs when the body's immune system is damaged and cannot fight off infections and cancer.
How can I prevent it
Use protection. Get tested regularly. If you’re in an at risk community for HIV, consider taking PrEP (pre-exposure prophylaxais). It’s available in Australia now and is medication you take before sex to help prevent HIV.
No one is immune to contracting STIs, and with so many of them being sneaky mother-fuckers that don’t present symptoms it’s super important to get screened regularly, so you know your status.
STI Testing
Regular screening doesn’t check for all of the different STIs.
The standard asymptomatic STI screening practice in Australia only recommends testing for HIV, chlamydia, syphilis, hep B and gonorrhoea (and gonorrhoea is only recommended for at risk populations).
Penis owners still aren’t tested for HPV, even though they can be carriers, or contract oral strains. This is despite the fact that recent studies have shown nearly half of all men have genital HPV.
This means that even if your STI test comes back negative, you can still be carrying some risky sexual baggage.
With sexually active genitals comes great responsibility, but the more informed you are, the better prepared you will be.
It's also important to remember that if you contract an STI, or if you know someone who does, it's NOT a reflection on them as a person. For a start, you now know that not all STIs are contracted through sex. But also, they’re called STIs because they are, ultimately, just an infection. Same as you can get from anything else. Just these ones happen to affect your genitals.
Like any kind of illness, disease, injury, etc our health should not be a moral judgment on us as individuals. Blaming a person for contracting a virus, disease, or infection is no better than asking a rape victim what they were wearing at the time of their assault. We're better than that.
Stay safe. Get tested. Get treated.
That is all.
You may go now.