Your guide to STIs (English)

Your guide to Sexually Transmitted Infections (STIs)

Your notes

This resource has been designed with Black, Asian and minoritised ethnic communities to provide information on sexually transmitted infections.

What is a Sexually Transmitted Infection?

able to get pregnant), chronic (long-term) abdominal pain, joint problems, or in some cases can be fatal.

A sexually transmitted infection (STI) is an infection passed from one person to another Some STIs don’t have symptoms which is why person through sexual contact. Most STIs can be cured. Some cannot be cured but, but can be it is important to use prevention methods and get tested regularly. managed effectively with the right medications.

How do I know if I have an STI?

How can an STI be passed on?

You can catch an STI by having sex with someone who has an infection. These infections are usually passed from person to person through unprotected (condomless) vaginal, anal, and oral sex; or by sharing sex toys. Some STIs, such as HPV/Warts and Herpes, can also be passed through skin-to-skin contact.

The only way to know for definite if you have an STI is to get a full screen test from a sexual health service provider.

Many STIs don’t show any signs or symptoms, however, if you experience one or more of these symptoms then you should speak to a doctor or nurse.

Who can get an STI?

Anyone who is sexually active can get an STI, no matter their age, gender, sexuality or ethnicity. If you're having unprotected sex, touching your partner's genitals, or your partner is touching your genitals, then there is a risk of transmitting an STI.

Can STIs be cured?

Most STIs can be completely cured. Other STIs and blood-borne viruses, such as herpes and HIV, can't be cured. However, they can be treated effectively with the right medications to a point where they are well managed, and people are able to live full healthy lives. Some STIs, like gonorrhoea, are becoming harder to treat due to antibiotic resistance.

Can STIs impact my health?

There are many different STIs that range in severity. If left untreated, some STIs can cause serious health problem such as infertility (not

Pain when urinating

Unusual bleeding - between periods or after sex

Abdominal pain

Pain during sex

Green/yellow discharge from vagina, penis or anus

Rash on hands or feet

Suddenly needing to pee

Fever

Bad smelling discharge

Blisters, warts, ulcers or spots

Swollen lymph nodes

Stinging, itching in genital or anal area

Exploring STIs

Cause

Symptoms

Chlamydia

Most people don’t experience any symptoms, but for some, symptoms will develop 1-3 weeks after infection.

Gonorrhoea

Symptoms usually develop within 2 weeks of infection, although some people will have no symptoms at all

Trichomoniasis

Most people have no symptoms, but for some, symptoms develop within 4 weeks of infection Most people experience a short, flu-like illness 2-6 weeks after contracting HIV. After this HIV may not show any symptoms for some time.

HIV

Genital Herpes (HSV)

Genital warts (HPV)

Public Lice (Crabs)

Syphilis

Pain during sex

Condomless. Anal, oral or vaginal sex

Sharing sex toys

Touching the genitals

Breast feeding or pregnancy

Sharing needles

Diagnosis

Treatment

Complications Untreated, Chlamydia can lead to infertility, long-term abdominal pain, or joint problems

* Gonorrhoea is becoming harder to treat due to antibiotic resistance

Can lead to infertility, long-term abdominal pain, or joint problems

No significant long-term complications

There is no cure for HIV, but you can stop the progression of the virus with the right medication

If HIV is left untreated, your immune system will weaken and will be unable to fight off certain infections. This is known as ‘late stage’ HIV and can be fatal

There is no cure for HSV, but antiviral medication may shorten the duration of ‘outbreaks’ by 1-2 days

Complications are incredibly rare and usually only affect people who have weakened immune systems (e.g. by HIV or immunosuppresive medications)

Warts can be treated with cream or lotion, or can be frozen off. Abnormal cells found in the cervix during cervical screening can be removed before they progress into cancer

High-risk types may lead to cancer of the cervix, throat or anus. There are no long-term complications of genital warts

Treated with insecticide cream, lotion or shampoo

No significant long-term complications, but can cause irritation or minor infections of the skin

If untreated it causes damage to the heart and the nervous system (including the brain), which can be life-threatening

Urine sample

Swab of vagina, anus or throat

Blood test

Inspection by medical professional

Injection or course of injections

Antibiotics

Prevention

There are a variety of methods that can lower your chances of getting an STI, protecting yourself and your partner, so you can enjoy sex and intimacy.

Condoms

Using condoms correctly every time you have sex will offer protection from STIs and unplanned pregnancy.

Condoms are effective at preventing the transmission of some STIs including chlamydia and gonorrhoea. Some infections can be passed on through skin-to-skin contact during sex including syphilis and the viruses that can cause genital herpes and genital warts.

How to put on a condom:

1

Check the expiration date printed on the wrapper or box, and the kitemark

4

Unroll the condom down the shaft of your penis all the way to the base and add water based lube to prevent tearing

2

Make sure the condom’s ready to roll on the right way: the rim should be on the outside so it looks like a little hat, and will unroll easily

5

After you ejaculate (cum), hold onto the rim of the condom and pull your penis out of your partner’s body. Do this BEFORE your penis goes soft!

3

Pinch the tip of the condom and place it on the head of your penis. Leave a little bit of space at the top to collect the semen (cum)

6

Throw the condom away in the bin – don’t flush it down the toilet (it can clog pipes)

PrEP

HIV-negative people can use PrEP (Pre-exposure prophylaxis) to protect themselves from HIV. PrEP is medication that is taken on an ongoing basis, often daily. If taken as recommended, PrEP is highly effective at preventing HIV infection. Condoms can still be used for protection from other STIs. PrEP is free and can be obtained from sexual health services.

PEP

PEP (Post-Exposure Prophylaxis) is a month-long course of drugs to help prevent HIV infection that is taken after a possible exposure to HIV. PEP can be obtained from most sexual health services and emergency departments. PEP must be started within 72 hours after you have had sex, preferably as soon as possible.

Cleaning sex toys

STIs can be passed on by sharing sex toys, so it is important that they are kept clean before, during and after use. It’s best to use condoms on sex toys, and to change condoms before using them on different parts of the body, such as the mouth, vagina and anus, or between one person and another.

Vaginal herbs and fogging

Putting herbs or tablets into the vagina, douching with water, as well as steaming, fogging or smoking the vagina to tighten and dry it for sex can be very risky. This can cause cuts and sores inside the vagina, making the cells more susceptible to infection, and increase the chances of a condom splitting.

The safest way to clean the genitals is to wash the vulva with water. Do not insert water inside of the vagina or use any soaps on the vulva, as this can disrupt the natural PH balance.

*

Vaccines

There are vaccinations against human papillomavirus (HPV), hepatitis A and hepatitis B, that will protect against disease caused by these viruses and prevent the spread of these infections.

These vaccines are free on the NHS, but eligibility criteria apply. Speak to your GP to find out more.

What should I do if I think I’ve been exposed to an STI?

If you have had unprotected sex with a new or casual partner and are concerned about the risk of picking up an STI, arrange to get a sexual health screen from a sexual health clinic or online service.

If you think you could have been exposed to HIV, then you can access PEP (Post Exposure Prophylaxis), a treatment that can stop you becoming infected with HIV, at a sexual health clinic or at A&E. PEP must be taken within 72 hours of exposure but ideally should be started as soon as possible after exposure.

Regular testing

Regularly getting tested for STIs can prevent you from unknowingly passing on an STI to someone else. If you’re having regular unprotected sex, it’s recommended to get tested every three months.

Women aged 24 and under who are sexually active should have a chlamydia test annually and on change of sexual partner.

Undetectable = Untransmissible

Although HIV can’t be cured, treatments available now mean that people living with HIV can reduce their viral load (the amount of HIV in their blood) to undetectable levels, meaning they can safely have sex without transmitting the virus.

Testing

Some STIs have no symptoms so it is possible to have an STI and not know it.

The only way to know if you have an STI is to have a full screen STI test.

Everyone should have an STI screen, including an HIV test, on at least an annual basis, especially if having condomless sex with new or casual partners.

HIV/STI testing and treatment is free for everyone and regardless of immigration status. Getting tested for HIV or being HIV positive will not affect your immigration status.

Where can I get an STI test?

Sexual health clinics can screen for the full range of infections and will see people with or without symptoms.

STI self-sampling kits are also available to order online and are a good option for people with no symptoms. Kits are free for people in most areas and are also available to buy. You get a kit, collect your own samples, and post them to a lab to be tested.

Some charities, like BHA for Equality, offer free HIV/STI testing clinics in community venues.

To find your nearest clinic, visit the website link section at the back of this booklet.

How long do STIs take to show up in tests

Clinicians often refer to ‘window periods’ when testing for STIs. This means the length of time it takes from catching an infection to it showing up on a test.

2 weeks Chlamydia Gonorrhoea HIV Syphilis Hepatitis B Hepatitis C

45 days

12 weeks

What happens if I test positive?

book the appointment. For example, you can request an interpreter if English is not your first language, and you can request to be seen by a male or female doctor.

You will also need to notify past sexual partners of your diagnosis, as they will also need to get tested.

The appointment

If you test positive for an STI, then you will be asked to go back to the clinic to talk about what treatment you need.

How often should I get tested?

If you’re sexually active, you should have an STI & HIV test every year, or every time you change sexual partners. However, it is advised that some communities test more frequently: → Men who are gay, bisexual, or have sex with other men, should have an annual test for HIV and STIs or every three-months if having condomless sex with new or casual partners → Black ethnic groups are also advised to get tested more regularly than others if having condomless sex with new or casual partners

Confidentiality

You don't have to give your real name if you don't want to. If you do, it will be kept confidential. Your GP won't be told about your visit without your permission. The Home Office will not be informed.

If you have tests and the results aren't available during your visit, the clinic will need to contact you later, so give them the correct contact details.

The clinic will ask how you want to receive your results. They can usually be given to you over the phone, by text, or in an unmarked letter.

Pre-appointment requests

If you have any special requirements for your appointment, you can request them when you

At the start of the appointment the doctor or nurse will ask you about your sexual history, which will help them to decide which tests and treatments are appropriate to offer you. Sexual history includes: → The last time you had sex → If this was with a regular or casual partner → If this was with a man or woman (including transmen and transwomen) → And if it was with a man, whether he has sex with other men → If you had vaginal/anal/oral sex → Whether a condom was used → If you have ever injected drugs → If you have been paid or have paid for sex → If you have had sex with someone from another country – This is used to assess risk for HIV → The number of sexual partners you have had in the last few months

Samples

You might be asked to provide a sample to test for any infections. This could involve: → Swab of either the throat, rectum, penis or vagina. The doctor or nurse may ask you to take the swab yourself if you feel comfortable doing so → Blood test → Urine sample – make sure you haven’t passed urine for 1hr before your appointment as this can make results invalid

FAQS

Can you tell if someone has an STI?

Some STIs don’t show any symptoms, so it is impossible to tell if someone has an STI by looking at them. The only way to know is to take an STI test.

Can you get STIs from oral sex?

Yes. Some STIs live in the throat or on the skin, so you can get an STI from oral sex. Minimize your risk by using a dental dam or condom during oral sex.

Do all forms of contraception prevent STIs?

No, only condoms can prevent STIs. Contraception such as the pill, coil, implant etc. will only prevent pregnancy, not STIs.

Do condoms prevent against all STIs?

No. Condoms are most effective against STIs which are transmitted through body fluids, e.g. chlamydia, gonorrhoea, syphilis and HIV. Some STIs can be passed on through skin-to-skin contact. These include the HSV and HPV viruses (the viruses that can cause genital herpes and genital warts).

Do only gay men get HIV?

No. Human immunodeficiency virus (HIV) can be transmitted in various ways, including through sex. It doesn’t matter what sexual orientation or gender you are—anyone who is sexually active can be at risk of HIV.

I’m a lesbian. Can I still get an STI?

Yes. If you have sex with anyone, no matter their gender or genitals, there’s a chance of passing on an STI. If you’re touching your partner’s genitals, or they are touching yours, then there is a risk of transmitting some STIs.

Do I need to test for STIs if I’m married or in a monogamous relationship?

A monogamous relationship won’t automatically protect you from STIs (or pregnancy). It’s recommended for you and your partner to get tested yearly as a part of a regular health check.

Can I prevent pregnancy and STIs if I wash my genitals immediately after sex?

No. Many people believe that douching (flushing the vagina with water, soap, or antiseptic) is good hygiene, and prevents infection or pregnancy. However, douching does not prevent pregnancy and can create a higher risk of STI infection. Douching alters the vaginal flora and increases the likelihood of developing bacterial vaginosis (BV).

Can I catch the same STI more than once?

STIs that are caused by bacteria or parasites (such as gonorrhoea, chlamydia, syphilis, and trichomoniasis) can be caught repeatedly; your body does not become immune to them after they are treated. Therefore, it is important to get tested regularly and to use condoms to reduce your risk of catching these STIs again in the future.

Many STIs don’t show any signs or symptoms, so the only way to know if you have one is to have a number of tests done at the same time (a full screen).

BHA offers free & confidential sexual health information and advice for Black, Asian and ethnic minority communities. This booklet offers general information on sexually transmitted infections. If you would like further information & advice, contact us at pash@thebha.org.uk

Further information Find you nearest sexual health service → www.nhs.uk/service-search/sexual-health Information on Sexually Transmitted Infections www.sexwise.org.uk www.nhs.uk/conditions/sexually-transmitted-infections-stis

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Information on sexual health www.gmpash.org.uk

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Advice, support, and information for BAME communities www.thebha.org.uk

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Advice, support, and information for people living with HIV www.ght.org.uk

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Advice, support, and information for LGBTQI www.lgbt.foundation

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Illustrations by Shilvan Da Costa Content co-produced by BHA for Equality and the Northern Contraception, Sexual Health and HIV Service.

Design by Jennifer Corcoran 27eleven.co.uk Published November 2022