Sexually Transmitted Infections

Maggie Smith

(The Gender Centre advise that this article may not be current and as such certain content, including but not limited to persons, contact details and dates may not apply. Where legal authority or medical related matters are cited, responsibility lies with the reader to obtain the most current relevant legal authority and/or medical publication.)

This article will give a brief overview of the main bacterial Sexually Transmitted Infections, (S.T.I.s), occurring in Australia, some of the symptoms of having an S.T.I. and the tests for detecting them. There are many infections it is possible to get from sexual contact. In this article I will only discuss the common bacterial infections. In following issues I will go on to discuss different viruses and parasites. If you have any concerns regarding possible signs or symptoms of an S.T.I. or feel you may have been exposed to an S.T.I. please contact your doctor or your nearest sexual health clinic. This article is to be used as a reference only.

A sexually transmitted infection, (S.T.I.), is any infection that is acquired through sexual contact. It can be caused by bacteria, a virus or a parasite. The sexual contact can be penetrative, (vaginal or anal), oral sex, masturbation, touching someone's genitals or skin to skin contact, depending on the type of S.T.I. involved. The term "signs and symptoms" means physical things a person may notice if they have an S.T.I., such as a discharge from their genitals, pain or discomfort. It is very important to remember most S.T.I.s can be present in a person without any signs or symptoms, therefore a person may not know they have an infection without having a test.

S.T.I.s affect all genders and sexualities. The infections a person could be exposed to depend on what genitals a person has and the type of sex that person has. S.T.I.s do not discriminate. They are bacteria, viruses and parasites that can be passed on during sexual contact.

They affect men and women, gay, straight bisexual or however a person identifies. They affect all races, religions, cultures, socioeconomic groups and education levels. People having any sort of sexual contact can be exposed to and infected by an S.T.I.

If a person has had reassignment surgery he or she is less likely to contract these bacterial infections in their genitals, due to the nature of many S.T.I.s targeting mucous membrane tissue. After reassignment surgery the tissue of the genitals may not be the same mucous membrane type tissue as was originally there, decreasing the risk to that part of the body. However as many S.T.I.s can be transmitted via oral or anal contact the bacteria can infect a person in these sites.

Chlamydia and Gonorrhoea

What are they? Signs and symptoms: These are both bacterial infections. Chlamydia and or gonorrhoea can be transmitted, (passed from one person to another), through penetrative sex, using toys and possibly on fingers. (These infections could be passed on from finger contact in a situation where someone has an infection and touches their own genitals and then someone else's). Gonorrhoea can be transmitted from oral sex, be it fellatio, cunnilingus or rimming.

Possible signs or symptoms of these infections include discharge, (coloured or clear), from a penis or unusual discharge from a vagina, burning, stinging or difficulty urinating.

For a person with a vagina being penetrated there could be pain during sex or bleeding after sex or between periods, if a person still has periods. If a person has anal sex, signs of an infection can be discharge from their bottom, unusual pain during a bowel movement, or pain or discomfort in their rectum at other times.

It is always important to remember these infections can be present without any signs and without a person knowing. These infections are easily passed from one person to another. The presence of one S.T.I. increases the chances of passing on or contracting H.I.V.

What tests are used to identify them?

Both of these infections are easily tested. The tests performed depend on the type of sex a person has. Chlamydia can be tested for with a urine test.

The first part of the urine passed, (not a mid-stream urine), is collected. For chlamydia and gonorrhoea swabs may also be collected from the vagina, cervix and/or rectum depending on what sexual contact a person has had. The swabs used resemble a cotton bud, only slightly larger. Having a swab collected is not painful but can be a little uncomfortable for some people. Some clinicians may allow a person to collect their own swabs while others prefer to do it themselves. For gonorrhoea a throat swab may also be collected.

If a person has symptoms of either of these infections the clinician may collect a few other swabs for testing. If a person presents with a discharge from his or her genitals the clinician may look at a sample of this discharge under a microscope. This will depend on where a person goes for testing.

Treatment

Both of these infections are normally easily treated with a one-off dose of antibiotics. For chlamydia, two tablets of an antibiotic called azithromycin taken at the same time are given. For gonorrhoea the treatment is a one of injection of an antibiotic called ceftriaxone. If there are complications from an infection more antibiotics may be prescribed. The treatment may also differ if a person has an allergy to certain antibiotics.

Syphilis

Syphilis as another bacterial infection. Syphilis can be passed on through vaginal, anal, oral sex and from a mother to her unborn child during pregnancy. The rates of syphilis have been steadily increasing in Australia for a number of years now.

Syphilis is quite a complicated infection to explain. The most common symptoms in an early syphilis infection are an ulcer or ulcers on the genitals, in the anus or in the mouth. The ulcer is not painful. Another sign of syphilis is a rash on a person's chest or back, or the palms of their hands or soles of their feet.

As with most S.T.I.s a person may not know they have syphilis. If the ulcer is in a part of a person's body they cannot see and it is not painful, it is quite easy for them not to know they have it. A person may not develop a rash or be aware of any symptoms. The only way to really know is to have a test. Syphilis in the early stages of an infection is very easily passed on. The infectious stage can last for up to 2 years. After 2 years a person is not usually infectious to others but if not treated the infection can go on to cause serious health problems later in life. This bacterium can affect a person's heart, brain and nervous system. The effects of untreated syphilis on an unborn baby are very serious and can lead to birth abnormalities or death.

How is it diagnosed?

Syphilis is tested for with a blood test. If a person presents to a doctor or clinic with an ulcer a swab may be taken as well.

Treatment.

Syphilis is treated with penicillin injections, usually given in the buttocks. The number of injections needed is determined by how long a person has had the infection for. If a person is allergic to penicillin another antibiotic may be used. If there are already complications from having untreated syphilis for a long time a person may need further tests and different treatment.

If a person is diagnosed with an S.T.I. it is also important to contact current and past sexual contacts to notify them they may have been exposed to an S.T.I. If a person is uncomfortable with doing this the clinician can assist. It is very important that sexual contacts are notified to allow them to be tested and treated and avoid possible problems or complications from the infection. It is also important to know that being treated for these bacterial infections does not give a person immunity to getting it again. Therefore if a person has sex with an untreated partner again, or if they put themselves at risk again, they can be reinfected.The best way to prevent transmission of S.T.I.s is using condoms for penetrative sex, condoms or dental dams for oral sex and gloves for fingering. When using condoms, the condom needs to be on before there is any contact with the other person's genitals. This means not just for the actual penetration but before there is any touching or rubbing of another person's genitals.

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