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Sexual Health and Family Planning ACT - STI

HPV vaccine reducing rates of genital warts

vaccine sexual health shfpactNew study shows HPV vaccine is working to reduce rates of genital warts.

The human papillomavirus (HPV) vaccine was introduced in Australia in 2007 and New Zealand in 2008 to prevent cervical cancer. It was free for women up to age 26 in Australia and to all women under 20 in New Zealand. This is because 99.7% of cervical cancers are associated with the sexually transmissible infection.

There is mounting evidence the HPV vaccination program is preventing cervical disease. This includes both precancerous lesions and cervical cancer. Although it takes 10 to 20 years from HPV infection until cervical cancer develops, the data are already showing a 17% decline in precancerous lesions in women aged 25 to 29.

Is it normal to get sore or have pain after sex?

sex should never hurtSex should never hurt!

Hi! I only recently have gotten a boyfriend and have started having regular sex. After 2 or more days, it starts to get a bit sore down there. Is that normal? I just assumed it was pain from friction, but I don’t know if that’s right and I’ve never sought help because it’s a bit embarrassing!
Sandra, 17, in Sydney

To start with, sex shouldn’t hurt, and if it does, a good tip is to say “stop”, no matter what! The aftermath of sex also shouldn’t hurt – whether it’s two minutes, two hours or two days later....

New Male Contraceptive

new male contraceptive

A new type of male contraceptive not only prevents babies; It's reversible!

We've been waiting a long time for this. Until now, men have had only two serious options for preventing baby-making: condoms or 'the snip'. A promising new product could be set to change all that, with animal trials indicating that it's not only close to 100 percent effective, but that it can also be fully reversed, making it less drastic than the vasectomy while still offering similar benefits.

Trademarked under the name Vasalgel, the contraceptive is a polymer gel being developed by the non-profit Parsemus Foundation in California, which aims to "find low cost solutions that have been neglected by the pharmaceutical industry".

We reported on Vasagel back in February after it showed itself to be effective in preventing rhesus monkeys from getting pregnant for up to two years.

Sexually Transmissible Infections (STI's)

WHAT ARE STIs? 

  • Sexually Transmissible Infections (STIs) are infections which are passed from one person to another during sexual contact or exchange of body fluids.
  • They are caused by micro-organisms such as bacteria, viruses or parasites.
  • They can affect areas of the body other than the genitals.
  • They do not always cause signs or symptoms.

WHAT ACTIVITIES PUT ME AT RISK OF STIs?

Having vaginal or anal sex without a condom (unprotected sex) can put you at risk of getting an STI. You can also get some STIs from unprotected oral

sex, and from skin-to-skin contact. Some activities put you at higher risk. 

Riskier activities include having unprotected sex:

  • With casual partners (the more partners, the greater the risk).
  • With a partner who has had unprotected sex with casual partners.
  • When travelling outside Australia or with a partner who has had unprotected sex outside Australia.

CHLAMYDIA

  • Chlamydia is the most common bacterial STI in Australia and is especially common in young people. 
  • If left untreated in women, chlamydia can lead to Pelvic Inflammatory Disease (PID), an infection of the uterus and fallopian tubes, which can cause infertility. Chlamydia can also affect fertility in men.
  • Most people who have chlamydia do not have any symptoms. If symptoms are present, in men they can include penile discharge, and pain passing urine or on ejaculation. In women symptoms include lower abdominal pain, pain with sex and/or passing urine, more painful periods, bleeding between periods, and bleeding after sex. 
  • The test for chlamydia is a urine test for men, and a urine test or a simple self-inserted vaginal swab for women. If you are having anal sex a self-inserted anal swab may also be needed. 
  • Chlamydia is treated with oral antibiotics. 

GONORRHOEA

  • Gonorrhoea is a bacteria which infects the penis, vagina, rectum, or throat.
  • It is more common in men who have sex with men but is becoming increasingly common generally in Australia.
  • You can have gonorrhoea without knowing it as not everyone gets symptoms. The most common symptoms in men are discharged from the penis or pain passing urine. In women, it can cause abnormal vaginal discharge, pain with sex, and bleeding between periods or after sex. 
  • The test for gonorrhoea is a urine test for men with no symptoms, and a urine test or a simple self-inserted vaginal swab for women. If you are having anal sex a self-inserted anal swab may also be required.
  • Gonorrhoea is treated with antibiotics which are given orally and by injection.

GENITAL WARTS AND HUMAN PAPILLOMA VIRUS (HPV)

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  • Human Papilloma Virus (HPV) is a group of viruses. There are many types of HPV. Some HPV types can cause genital warts and some types can cause cancers of the cervix or genitals if left undetected and untreated.
  • HPV is transmitted by skin to skin contact during sexual activity and most people will be exposed to HPV in their lifetime. The majority of infections will clear by themselves with no symptoms.
  • If genital warts occur they can be on the penis, vulva, vagina, anus and the skin close to these areas. 
  • Genital warts can be single or multiple lumps, they can sometimes be itchy, painful or may bleed.
  • There is no test for the HPV type that causes visible warts — if you have symptoms see a doctor.
  • Treatment for warts is available and includes freezing, or use of liquid or cream.
  • A vaccine is available which protects against some of the strains of HPV that cause genital warts, cancer of the cervix, and some other cancers — check with your health practitioner.

GENITAL HERPES

  • Genital herpes is a common STI. It is caused by a virus which is transmitted by skin-to-skin contact during genital or oral sex. 
  • The virus may cause painful blisters or sores on the skin but often has no symptoms.
  • Once you have genital herpes it remains in your body for life but is not always active.
  • Treatment is available to reduce outbreaks and help to manage symptoms. 
  • There is no useful screening test available for genital herpes — if you have any symptoms, such as a genital sore which appears from time to time, see a doctor for diagnosis at the time the sore is present.
  • Avoid oral sex when a cold sore is present on or around the mouth.

HEPATITIS B

  • Hepatitis B is a viral infection that results in inflammation of the liver and can cause serious illness. 
  • It can be passed on by unprotected vaginal or anal sex, by sharing drug injecting equipment, during unsterile tattooing or body piercing, or sometimes through dental or other procedures in developing countries.
  • All pregnant women in Australia are usually tested for Hepatitis B when they have their routine ante-natal blood tests.

SYPHILIS

  • Syphilis is transmitted during sexual contact with a person who has the infection. It is uncommon in Australia, however, if left untreated it can cause serious health problems.
  • Syphilis is more common among men who have sex with men.
  • Early symptoms can include a painless ulcer-like sore on genitals or a rash which generally appears on hands and feet. Latent syphilis, which occurs many years after the first infection can have no symptoms.
  • If a pregnant woman is infected with syphilis it can cause serious health problems for her baby. All pregnant women in Australia are tested for syphilis when they have their routine ante-natal blood tests.
  • The test for syphilis is a blood test. It is treated with antibiotics, usually given by injection.

HIV (HUMAN IMMUNODEFICIENCY VIRUS) 

  • HIV is a viral infection that if left untreated, breaks down the body’s natural defences against infections by weakening the immune system and can lead to Acquired Immune Deficiency Syndrome (AIDS).
  • HIV can be present in in the blood, vaginal secretions, or semen of a person infected with the virus. It is passed on by anal or vaginal sex without a condom, by sharing drug injecting equipment, and through unsterile body piercing or tattooing in developing countries. The risk of HIV transmission through oral sex is very low.
  • The test for HIV is a blood test. All pregnant women in Australia are usually tested for HIV when they have their routine ante-natalblood tests.
  • HIV is not curable but can be managed with medication.
  • Medications are available which can reduce the chance of becoming infected in higher-risk groups (PrEP & PEP). See the SHFPACT PrEP & PEP brochure available online or at reception for more information, or ask your health care provider.

TRICHOMONIASIS  

NAME

  • Trichomoniasis is a genital infection caused by an organism called a protozoa 
  • In women, symptoms may include frothy yellow-green vaginal discharge, unpleasant (fishy) vaginal odour, vaginal itching and burning. In men, symptoms may include discharge from the penis and pain on passing urine
  • Trichomoniasis is not usually serious but can be unpleasant.
  • It is treated with an oral antibiotic.

CONDITIONS WHICH ARE NOT STIs BUT WHICH CAN AFFECT THE GENITAL AREA

PUBIC LICE (CRABS)  

  • Pubic lice are small parasites that infect the pubic hair, armpits or chest hair. 
  • They are passed on by direct person-to-person contact with the area that is infected, or by coming into contact with infected bedding or clothes, not necessarily during sexual contact.
  • They can be treated with preparations available over the counter from pharmacies. Clothes and bedding also need to be treated.

SCABIES 

  • Scabies is a skin infestation of a tiny mite, Sarcoptes scabiei. The main symptom is intense itching which is worse at night. Sometimes a small rash is visible. It occurs most commonly in between the fingers, on the wrists, armpits, stomach and genitals.
  • Scabies can be spread sexually as well as through non-sexual skin to skin contact.
  • Scabies is usually treated by applying a topical anti-scabetic cream to the skin of the entire body.

MOLLUSCUM CONTAGIOSUM

  • This is a skin infection caused by a virus which causes small painless firm lumps with a dimple in the centre. It can appear anywhere on the body but in adults, they usually appear on the buttocks, thighs, lower abdomen, and genital area. 
  • It can be spread sexually as well as through non-sexual skin to skin contact.
  • It will resolve on its own within 12 months but can be treated with freezing or cream.

STI's BROCHURE PDF

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References: Melbourne Sexual Health Centre, Australian STI Management Guidelines, ASHM, Family Planning NSW. Last updated Jan 2019.

Syphilis is making a come-back — it's not looking pretty

Syphilis Eye DamageSyphilis, a sexually transmissible infectious disease that has plagued humankind for centuries.

It's currently making a come-back and causing some unusual health problems, including vision loss. Today, syphilis is diagnosed rapidly by a simple blood test, and easily treated with an inexpensive antibiotic...

Trichomoniasis

WHAT IS TRICHOMONIASIS?

Trichomoniasis is a genital infection which is caused by the organism trichomonas vaginalis. While it is common worldwide, it is relatively rare in urban areas in Australia. Trichomoniasis is a vaginal infection, more common in older populations and those living in remote areas. It is a very rare cause of symptoms in the penis.

Trichomoniasis infection during pregnancy can cause premature delivery and low birth weight in the baby.

HOW DO YOU CATCH TRICHOMONIASIS?

Trichomoniasis is a sexually transmitted infection (STI), which is passed on during unprotected intercourse.

WHAT ARE THE SYMPTOMS? 

VAGINAL SYMPTOMS

About 50% of the time trichomoniasis does not cause any vulval or vaginal symptoms. If symptoms do occur they include:

  • An unpleasant smelling yellow or green discharge which is usually frothy and profuse.
  • Vulval and vaginal itch and discomfort.

SYMPTOMS OF THE PENIS/URETHRA

Trichomoniasis very rarely causes any symptoms of the penis/urethra. If symptoms do occur they are:

  • Discomfort with passing urine.
  • Abnormal discharge from the penis.

HOW CAN YOU TEST FOR TRICHOMONIASIS?

Trichomoniasis is not routinely tested for, particularly in areas where it is very uncommon. If someone has symptoms of trichomoniasis, or a partner has been diagnosed, then a swab will be taken to diagnose the infection before treatment.

If your partner has been diagnosed with trichomoniasis you will need testing and treatment even if you have no symptoms.

HOW IS IT TREATED?

Trichomoniasis is treated with the following antibiotics:

Tinidazole (Fasigyn) 500mg x 4 tablets as a single dose
OR
Metronidazole, (Flagyl) 400mg three times a day for one week or 2g as a single dose.

These antibiotics need to be taken with food and can cause nausea, tiredness and a metallic taste.

Alcohol must be avoided while on these medications because they can cause nausea, vomiting and headache if taken with alcohol.

If trichomoniasis is diagnosed during pregnancy treatment options may need to be discussed with a specialist.

It is important to avoid any unprotected sexual intercourse for seven days after treatment has finished to allow the treatment to work completely and to avoid reinfection or infecting others. You may also need re-testing four weeks later if your symptoms continue.

SHOULD SEXUAL PARTNERS BE INFORMED?

Yes, all recent sexual partners will need to be advised, tested, and treated even if they have no symptoms. Your doctor or nurse can assist you with this.

HOW CAN YOU AVOID CATCHING TRICHOMONIASIS?

Using condoms every time you have vaginal or anal sex is the best way to prevent trichomoniasis and other STIs.

REMINDER

If you are diagnosed with a sexually transmitted infection (STI), it is important to be tested for other STIs such as chlamydia. Your partners should also be notified, checked and treated if required. Be sure to have another test after treatment to make sure it has been cleared up.


TRICHOMONIASIS BROCHURE PDF

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Last updated December 2019. References: Melbourne Sexual Health Centre. Australia STI Management Guidelines