The STI information that is listed under the sexually transmitted infections section of our website is gathered from reputable medical sources and is updated on a regular basis. If you are worried about any aspect of your sexual health, contact your GP or local sexual health clinic.
The intention of this brief introduction is to inform you about the possible risks associated with unprotected sexual intercourse. It is not intended to dissuade you from having positive sexual relationships.
Getting an STI is nothing to be ashamed of. The risk of STIs is part of the reality of being sexually active. It is important to be able to talk openly about STIs as we would any other infection or illness, free from shame. It is essenital that sexually active people get tested regularly, get treated, use barrier protection during all kinds of sex (condoms or dental dams), communicate with sexual partners, never disclose someone elses’s STI status and reject STI stigma!
Sexually transmitted infections (STIs) are common in Irish society today. All STIs can be treated, and most can be cured. Though most of them are easily treated, there are some that may need more extensive treatment.
The main STIs are divided into two categories – bacterial and viral. Bacterial infections are easily treated with a course of antibiotics if detected at an early stage. Viral infections can be treated with anti-viral medication but in some instances cannot be eradicated from the system.
It is important to note that using a condom during sexual intercourse will not give you 100% protection against STIs/HIV, but it will greatly reduce the risk of contracting an infection.
STI Symptoms
- Itching around the vagina and/or discharge from the vagina for women
- Discharge from the penis for men
- Pain during sex or when urinating
- Pain in the pelvic area
- Sore throats in people who have oral sex
- Pain in or around the anus for people who have anal sex
- Chancre sores (painless red sores) on the genital area, anus, tongue and/or throat
- A scaly rash on the palms of your hands and the soles of your feet
- Dark urine, loose, light-coloured stools, and yellow eyes and skin
- Small blisters that turn into scabs on the genital area
- Swollen glands, fever and body aches
- Unusual infections, unexplained fatigue, night sweats and weight loss
- Soft, flesh-coloured warts around the genital area
BACTERIAL VAGINOSIS
Bacterial Vaginosis (BV) is caused by an imbalance of the normal bacteria in the vagina and symptoms can include a watery discharge sometimes with a fishy smell. It can be more noticable after sex or during the menstrual period. Although it is not a sexually transmitted infection, symptoms can be similar to some STIs. Diagnosis is made by a swab taken from the genital area, and if isolated it is easily treated by antibiotics or a cream inserted into the vagina. Men are generally not affected by BV and there is no evidence to suggest that treating male partners is helpful. A common cause of the condition is washing or douching the vaginal area with perfumed soaps or shower gels which are best avoided.
Candida
Candida or thrush is caused by a yeast fungus which can be found in the vagina, mouth, anus and sometimes the head of the penis. Occasionally the yeast multiplies rapidly and can cause symptoms.
Symptoms:
Itching, soreness and redness around the vaginal area. A thick, white discharge from the vagina, swollen vulval area and discomfort when having sex.
Redness and burning at the tip of the penis, red patches under the foreskin or on the head of the penis.
Treatment
Thrush should be initially diagnosed by a doctor to exclude any sexually transmitted infections. If there are no symptoms it is harmless so does not need to be treated. When treatment is called for it can be bought at a pharmacy and includes pessaries, tablets or creams.
Prevention
Avoid perfumed soaps and vaginal deodorants. Wash and wipe from front to back to avoid spreading yeast from anus to vagina. Wear cotton underwear and avoid wearing restrictive clothing such as tight jeans/trousers, nylon underwear and tights.
CHLAMYDIA
Chlamydia is caused by a bacterium and is one of the most common sexually transmitted infections in Ireland. About half of all men and three-quarters of all women who have chlamydia have no symptoms and do not know that they are infected.
Symptoms
When symptoms do occur in women they include unusual vaginal bleeding or discharge, pain in the abdomen, painful sexual intercourse, fever, painful urination or the urge to urinate more frequently than usual. Men may get yellow, green or white discharge from the end of the penis. They may also have pain while passing urine. Chlamydia in men can sometimes spread into the testicles causing pain and inflammation.
Untreated chlamydia in women can lead to pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes, and/or ovaries. PID can cause scarring inside the reproductive organs and can lead to infertility. Women may also pass on chlamydia to their babies during childbirth, which can result in an eye infection in the baby. The test for chlamydia may be performed on swab specimens collected from the cervix (women) or urethra (men).
Treatment
Chlamydia infection can be easily and effectively treated with antibiotics. Sexual partners need treatment. Sex, even with condoms, should be avoided until all sexual partners are adequately treated.
Prevention
Using a condom correctly during every sexual encounter can lower the risk of contracting chlamydia
GENITAL HERPES
Herpes simplex virus (HSV) is a virus that is spread through direct skin contact during sexual activity. There are two types of the herpes virus, HSV 1 which more commonly affects the mouth and is known as a ‘cold sore’ and HSV2 which usually causes sores around the genital area. When there are no symptoms, HSV lies dormant in the nerve cells, replicating just under the skin during an outbreak.
Transmission:
HSV is generally transmitted by direct contact of lips and /or genitals when the sores are present, or just before they appear. The first outbreak after exposure to HSV is commonly more severe than future outbreaks, as initially, the immune system has not had a chance to produce antibodies. Some people feel generally unwell and have flu-like symptoms with the first attack, they may also complain of swollen glands in the groin area. Outbreaks are generally preceded by sensations of burning, itching or tingling before visible blistering occurs. The virus is most likely to be passed on through skin-to-skin contact when the symptoms of ulcers or blisters are present. However, occasionally the virus can be shed and passed on without there being signs or symptoms. This is called viral shedding.
Pregnancy:
It is very important that pregnant women who have the first attack of HSV during pregnancy inform their doctor or midwife, as it is possible for women to pass on the virus to their baby during childbirth.
Treatment:
There is no known cure or vaccine for HSV. Treatment is available in the form of antiviral medication which reduces the duration of symptoms and accelerates healing. For best results, treatment should begin at the first signs of an outbreak. If treatment begins before the lesion appears, it is possible that the outbreak can be averted.
Another option for people who experience very frequent outbreaks is the use of daily suppressive therapy, in which antiviral tablets are taken every day. Suppressive therapy reduces the frequency of symptoms and recurrence of outbreaks. In addition, suppressive therapy reduces viral shedding, lowering the risk of transmission through sexual contact or kissing.
GENITAL WARTS
Genital warts are Ireland’s most common sexually transmitted infection caused by the human papillomavirus (HPV). The virus is spread through skin-to-skin contact, during genital or anal sex.
Other strains of HPV are associated with 90% of cervical cancer. However, the HPV strains responsible for this differ from the strains that cause genital warts.
Symptoms:
Genital warts are painless growths that may be found around the genital or anal area. The period of time from infection to displaying symptoms can be anywhere from 3 to 12 months. The warts can occur individually or in a cluster. In women, warts can occur either outside or inside of the vagina, on the opening to the womb (cervix) or around the anus. In men, the symptoms are usually seen on the tip or shaft of the penis, on the scrotum, or around the anus.
Treatment:
Depending on the location and size of warts, a doctor will decide on the best method of treatment. A topical cream can be applied to the affected area or in the case of small warts they can be removed under medical supervision by freezing, burning or laser treatment. Surgery is occasionally used to remove large warts that have not responded to other treatment.
Prevention:
The virus that causes genital warts is spread by skin-to-skin contact. Because the warts may be located around the anal or genital area, using a condom cannot guarantee 100% protection, though it greatly reduces the risks if the warts are located on the tip of the penis or inside the vagina.
Pregnancy & Childbirth:
Women who are pregnant may have trouble getting rid of the warts during their pregnancy, but find they often disappear on their own after the baby is born. The warts do not usually cause any harm to the baby.
GONORRHEA “The Clap”
Gonorrhoea is a bacterial infection that is easily transmitted through sexual contact, including oral sex. The incubation period varies from 2 to 14 days, with most symptoms occurring between days 2 and 5 after being infected. A small number of people may have no symptoms.
Symptoms
Between 30-60% of women with gonorrhoea have no symptoms. Women with symptoms may complain of vaginal discharge, difficulty urinating, bleeding between periods, or bleeding after sexual intercourse. More advanced symptoms, which may indicate the development of pelvic inflammatory disease (PID) include abdominal pain, vomiting or fever.
Most men who have the infection in the penis will notice symptoms. These might include pain on urinating like ‘peeing broken glass’ and thick green or yellow discharge. Symptoms may appear two to five days after infection but can take as long as 30 days to appear. Sometimes men with gonorrhoea get painful or swollen testicles. Gonorrhoea can also be found in the throat and rectum but usually without symptoms in these areas.
Diagnosis
Doctors will usually use cervical swabs in women and urethral swabs in men to detect the presence of the bacterium.
Treatment
The infection can be easily treated with a course of antibiotics. It is important to refer all sexual partners to be checked for gonorrhoea to prevent spread of the infection and to prevent re-infection. Sexual contact should be avoided, even with condoms, until all sexual partners are adequately treated.
Prevention
Gonorrhoea is an STI. Proper use of barrier contraceptives such as condoms will significantly reduce the risk of getting gonorrhoea and its complications. However, this does not totally eliminate risk.
HEPATITIS A
Hepatitis A is a viral infection transmitted by the faecal contamination of food and water. It causes an acute form of hepatitis (inflammation of the liver), does not have a chronic stage, and will not cause any permanent damage to the liver. It is not usually sexually transmitted, though outbreaks have been reported in gay and bisexual men. Once recovered it is not possible to pass it on. A vaccine is available that will prevent infection from Hepatitis A and it is recommended when travelling to countries with high levels of the infection, or those who may be at risk from sexual exposure such as gay or bi-sexual men.
Symptoms
These may include jaundice, dark urine, nausea, fever, fatigue, loss of appetite, stomach ache, vomiting.
Diagnosis
The diagnosis of the virus is made through medical examination and blood tests.
Treatment
There is no specific treatment for Hepatitis A. Those infected are advised to rest, avoid fatty foods and alcohol. They are also advised to eat a well-balanced diet and stay hydrated.
Prevention
Hepatitis A can be prevented by vaccination to those at risk as well as following advice regarding food and water consumption when travelling to countries of high risk.
HEPATITIS B
Hepatitis B is a virus that affects the liver and is one hundred times more infectious than HIV.
Transmission
It is largely transmitted through exposure to bodily fluids containing the virus. This includes unprotected sexual contact, blood transfusions, re-use of contaminated needles and syringes as well as transmission from mother-to-child during childbirth.
Symptoms
Hepatitis B may either be acute (short-lived) or chronic (long-lasting). Individuals with acute infection may clear the virus spontaneously within weeks to months. More than 90% of adults who become infected will stage a full recovery and develop protective immunity to the virus.
Acute infection with Hepatitis B virus can begin with general ill-health, loss of appetite, nausea, vomiting, body aches, mild fever, dark urine, and then progresses to the development of jaundice. The illness lasts for a few weeks and then gradually improves in most of the affected people. The infection may also be entirely asymptomatic (without symptoms) and may go unrecognised.
Diagnosis
Diagnosis is made through blood tests.
Treatment
There are currently several treatments for chronic Hepatitis B that can increase a person’s chance of clearing the infection. Treatments are available in the form of anti-virals. In general the medication works by reducing the viral load, thus helping the bodies immune system clear the infection.
Chronic carriers should be strongly encouraged to avoid consuming alcohol as it increases their risk of cirrhosis and liver cancer.
Prevention
A preventative vaccine is available and is recommended to anyone who may be at risk of exposure. The vaccination is highly effective and consists of three injections usually given over a period of six months. Many countries now routinely vaccinate infants against Hepatitis B. In many areas, vaccination against Hepatitis B is also required for all healthcare workers. As higher levels of Hepatitis B are found in gay and bisexual men, vaccination is also recommended for this group. Using condoms during sexual intercourse will also reduce the risk of infection.
HEPATITIS C
Hepatitis C (HCV) is a viral infection of the liver. The infection can cause liver inflammation that is often asymptomatic (without symptoms) but chronic hepatitis can result in cirrhosis and liver cancer. Hepatitis C is spread by blood-to-blood contact with an infected person.
Symptoms of acute Hepatitis C include fatigue, decreased appetite, abdominal pain, jaundice, itching, and flu-like symptoms.
Diagnosis
HCV is diagnosed via a blood test but it can take up to six months for the body to develop antibodies to the virus that can be detcted in the blood, therefore tests should be repeated 6 months after possible exposure to get an accurate result.
Transmission
The virus can be spread by blood to blood contact with an infected person. A common route is through injecting drugs and sharing the equipment used, such as needles, cookers, cotton, spoons, water, etc. Researchers have suggested that the transmission of HCV may be possible through the snorting of illegal drugs such as cocaine and crack when straws (containing even trace elements of mucous and blood) are shared among users. It is to be noted that the virus can survive up to six months outside the body. It can also be spread via inadequately sterilised medical, dental or tattooing equipment. Though no longer a problem in Ireland, blood products in other countries that have not been screened may pose a hazard.
Occupational Exposure to Blood
Medical and dental personnel can be exposed to HCV through accidental exposure to blood, through needlestick injuries or blood splashes to the eyes. Follow Universal precautions to protect against such accidental exposures which significantly reduce the risk of exposure to HCV.
Sexual Transmission
Transmission can occur during unprotected sexual contact if the sexual activity involves blood-to-blood contact.
Shared Personal Items
Though a low risk, for general hygiene reasons it is not advisable to share personal items such as razors, toothbrushes, cuticle scissors.
HCV is not spread through casual contact such as hugging, kissing, or sharing eating/cooking utensils.
Mother to Child Transmission
HCV can be transmitted from an infected mother to her child during the birth process. The risk of transmission in this setting is approximately 6 out of 100.
HIV
Human Immunodeficiency Virus (HIV) is a virus that affects the immune system. AIDS (Acquired Immune Deficiency Syndrome) is a less commonly used term to describe when HIV infection is advanced and has impacted the immune system to a significant level. This leaves the affected person open to certain illnesses known as opportunistic infections. Opportunistic infections are caused by organisms that usually don’t affect people with a healthy immune system. If there has been any risk of exposure to HIV, it is better to be tested sooner rather than later. New treatments, when used at the right time, can prevent or delay AIDS.
How can I get HIV?
The most widely recognised ways of acquiring HIV are:
- Having vaginal, anal or oral sex without a condom with someone who is HIV positive.
- Sharing needles, syringes or other drug-injecting equipment with someone who is infected with HIV.
- An HIV positive mother to her baby during pregnancy, delivery or while breastfeeding.
- Blood transfusions, blood products or organ transplants in countries where screening is not mandatory.
- Tattooing and/or piercing with improperly sterilised equipment.
- A needle stick injury involving blood infected with HIV.
You cannot get HIV through:
- Kissing, touching, hugging or shaking hands.
- Coughing or sneezing.
- Sharing cutlery or cooking utensils.
- Eating food prepared by someone with HIV.
- Swimming pools.
- Insect or animal bites.
- Contact with toilet seats.
Sexual route:
The majority of HIV infections are acquired through unprotected sexual intercourse. An HIV positive person can pass the virus on to someone else if they have vaginal or anal sex without a condom. Though oral sex is a lower risk of transmission, it is still possible to become infected via this route.
Blood or blood product route:
This transmission route can account for infections in intravenous drug users, haemophiliacs and recipients of blood transfusions (though most transfusions are checked for HIV in the developed world) and blood products. It is also of concern for persons receiving medical care in regions where sterilisation of equipment is inadequate. People who give and receive tattoos and piercings can also be at risk of infection where sterilisation procedures are not adhered to.
Mother-to-child transmission (MTCT):
The transmission of the virus from the mother to the child can occur in the womb and during childbirth. In the absence of treatment, the transmission rate between the mother and child is 25%. However, where drug treatment and monitoring are available, this can be reduced to 1%. Breastfeeding also presents a risk of infection for the baby.
HIV Test:
Many people are unaware that they are infected with HIV. HIV testing consists of a simple blood test, although it may take up to three months from catching the infection before the test shows a positive result. This is known as the ‘window period’. If an HIV negative result is given it means the individual does not have HIV. If an HIV positive result is given, it means the individual has been infected with the virus. Every HIV positive result is rechecked to ensure it is accurate.
Treatment
Due to medical advances, treatment for HIV in developed countries has led to an increased lifespan, but there is currently no vaccine or cure for HIV. The only known method of prevention is to avoid exposure to the virus. HIV treatment does not cure HIV, but it stops the virus from reproducing in your body. It can reduce the amount of virus in the blood to undetectable levels, meaning that you cannot pass on HIV. Treatment with anti-HIV drugs is sometimes called combination therapy because people usually take three different drugs at the same time – often combined into one tablet. It’s also known as antiretroviral therapy (ART), or highly active antiretroviral therapy – HAART for short.
Prevention
Using a condom correctly each time you have sexual intercourse will significantly reduce the risk. If there is concern about HIV, it is advisable for both partners to be tested and to ensure that the window period is covered before having unprotected sex. This will only protect against HIV in a monogamous relationship.
Please check out the video on.. HOW COULD I GET HIV? for more information.
PUBLIC LICE 'CRABS'
The pubic louse is a small insect that can live in almost any form of human hair. It can be found in eyebrows, eyelashes, beards, moustaches and even underarm hair, but is found most commonly in pubic hair. Although most commonly passed from direct body-to-body contact, the individual louse can survive for about 24 hours apart from its human host and therefore can be passed on in sleeping bags and bedding. The louse feeds on blood and can leave irritating spots on the skin. Though irritating, it is harmless.
Life cycle
The female louse lays eggs which stick to the body hair, are oval in shape and usually yellow to white, these are called nits. The adult pubic louse resembles a miniature crab when viewed through a strong magnifying glass and this is how the infection got the nickname “crabs.” Pubic lice are tan to greyish-white in colour.
Treatment
Treatment is simple and involves the application of a cream or lotion. Because lice can survive in bedding and clothing, these items must be washed before reuse. Sexual partners should also be treated to avoid reinfection.
NON-SPECIFIC URETHRITIS
Non-specific urethritis (NSU) is an inflammation of the urethra (the tube that leads from the bladder to the tip of the penis) and occurs in men.
Symptoms
The symptoms of urethritis can include pain or a burning sensation on passing urine, a white cloudy discharge and the urge to pass urine more frequently. However there are often no symptoms.
Causes
Urethritis can be caused by a number of organisms including gonorrhoea, chlamydia, trichomonas, herpes and candida. It is important to note that NSU can also be triggered by a number of non-infectious causes, including urethral stricture, foreign bodies, trauma, and various allergic conditions. Other causes may include physical damage, e.g. very vigorous sex or squeezing or chemical irritation from disinfectants.
Because of the number of different causes, treatment involves using a broad range antibiotic. It is important that sexual partners are also given antibiotics, and that sexual contact is avoided, even with condoms, until all partners are adequately treated. Women who are infected by their partner with NSU may develop pelvic inflammatory disease. If left untreated, complications may include infertility. Consistent and correct use of a condom during sexual intercourse greatly reduces the risk of infection.
SYPHILIS
Syphilis is a sexually transmitted infection caused by a bacterium called Treponema pallidum. Syphilis can be treated with penicillin or other antibiotics. If not treated, syphilis can cause serious medical problems such as damage to the nervous system, heart, or brain. Untreated syphilis can be fatal.
Stages Of Syphilis:
Primary Syphilis:
About 50% of people who have syphilis will have no symptoms at all. Someone with syphilis can be infectious to others for up to 2 years without appearing to show any symptoms. If symptoms do occur the first sign is a sore called a chancre. It is usually painless and located at the point of initial exposure to the bacteria. It is often on the penis, vagina or rectum. Local lymph node swelling may occur. The primary lesion may persist for 4 – 6 weeks and then heal spontaneously.
Secondary Syphilis:
Without treatment, the infection develops into the secondary stage. It is characterized by a skin rash that appears 1-6 months (average 6-8 weeks) after primary infection. This is a reddish-pink non-itchy rash on the trunk and extremities, which may involve the palms of the hands and soles of the feet. Other symptoms common at this stage include fever, sore throat, malaise, weight loss, headache and enlarged lymph nodes.
Tertiary Syphilis:
Untreated infection can lead to tertiary syphilis. This stage can remain asymptomatic for many years but those affected may develop a number of serious illnesses affecting the brain, heart, bones, liver and eyes.
Treatment
The first choice of treatment for primary, secondary and early latent infections remains penicillin. There are alternative antibiotics available for those allergic to penicillin. It is important that any sexual partners are tested and treated to avoid re-infection and that sexual contact is avoided until everyone involved is treated. Using condoms will reduce the risk.
Prevention
Avoidance of sexual contact with an infected person is the only completely reliable method of prevention. Regular screening for those at risk is advisable. Using condoms every time you have sexual intercourse will reduce the risk. All women in Ireland are offered a blood test at ante-natal appointments to ensure they do not have the infection, as it could be passed on to their unborn baby.
TRICHOMONAS VAGINALIS
Trichomonas vaginalis is neither bacterial nor viral but actually a tiny parasite found in the vagina and urethra of women. The majority of men are asymptomatic but can carry and pass on the infection.
Symptoms
Women may not have any symptoms but if they do they may include greenish-yellow frothy discharge, itching and irritation.
Diagnosis
Trichomonas vaginalis can be detected from a vaginal swab in women but can be hard to isolate in men.
Prevention
Condoms will reduce the risk of infection.
Treatment
The infection can be easily treated with antibiotics. Sexual partners should also be treated to prevent re-infection.
