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Sexually transmitted infections - The shocking facts

Hepatitis B virusIn the 1970s, only two STIs were common, and both were curable. Now as many as 25 STIs have been identified, and several are incurable, including human papilloma virus (HPV), human immunodeficiency virus (HIV) and genital herpes. No drugs can cure these diseases. Contrary to popular belief, HPV, syphilis and genital herpes can be transmitted by skin-to-skin contact, and condoms provide very little protection.

Every year in the UK alone, over 700,000 new STI cases are diagnosed (and that figure only includes those seen at GUM clinics – the real figure is undoubtedly much higher!)

Latest figures show that someone is diagnosed with an STI every 15 seconds.

Children as young as eleven are contracting gonorrhoea, genital warts and other STIs in increasing numbers. Two thirds of people with STIs are under 25 years old.               

Human Papilloma Virus (HPV)

Human Papilloma Virus (HPV) causes 90% of all cervical cancer cases. It is the most common viral disease and can cause genital warts, which are often very difficult to treat. Warts are spread through skin-to-skin contact. HPV is incurable and condoms are of only limited use. Not everyone who comes into contact with the virus will develop symptoms, which include itchiness, white small lumps or larger cauliflower shaped lumps on the genital area. Warts can appear on the vulva, penis, scrotum, anus, in the vagina, on the cervix and in rare cases, in the mouth. It usually takes between 1-3 months from infection for the warts to appear, but it can take much longer. Treatment can be uncomfortable and take a long time, and most people will have a recurrence of warts that will need further treatment.  In the UK, about 3000 women per year are diagnosed with cervical cancer.  It is the second most common form of cancer in women under 35 years of age.

Chlamydia

It is estimated that 1 in 10 teenage girls and one in five sexually active teen boys has chlamydia. It is a very common infection and also one of the most serious. There are very often no symptoms, and an infected person might never know until serious complications develop. In those women who have symptoms, they might notice increased vaginal discharge, frequent or painful urination and/or irregular periods. Men, who are more likely to notice symptoms, might see a discharge from the penis and pain/burning on urination. It is one of the causes of pelvic pain and inflammation and also a major cause of infertility in women. Even the eyes can become infected in which case both men and women may experience painful swelling and irritation. Recent evidence indicates that it might also play a role in the development of cervical cancer. The risk of getting chlamydia through a single episode of vaginal sex with an infected partner is as high as 1 in 3

Syphilis

Syphilis is the most rapidly spreading STI in the UK and, if left undetected for many years, it can result in brain damage, heart disease and/or death. Can be spread by skin-to-skin contact alone. The first signs are painless sores, which are followed by flu-like symptoms. In pregnancy, syphilis can cause miscarriage or stillbirth and it can be passed from mother to unborn child in the womb

Gonorrhoea (‘The Cap’)

Gonorrhoea (also known as ‘the clap’) can cause widespread infection of the joints and skin. It is becoming increasingly resistant to treatment with antibiotics. The risk of getting gonorrhoea through a single episode of vaginal sex with an infected partner is as high as 1 in 2. Like chlamydia, it can cause infertility and serious health problems if left untreated. In women, it can lead to pelvic inflammatory disease which can in turn cause fever; pain and can lead to infertility or ectopic pregnancy. Man are much more likely to notice symptoms than women, but many who are infected have no symptoms at all. In women, symptoms include pain or burning sensation when passing urine, irritation and/or discharge from the anus, and/or increased discharge which could be of a yellow or greenish colour with increased odour. In men, symptoms may include a yellow or white discharge from the penis, irritation and/or discharge from the anus and/or inflammation of the prostate gland and testicles.

HIV and AIDS

The risk of getting Human Immunodeficiency Virus (HIV) from a single episode of vaginal sex with an infected partner is around one in a thousand. HIV can lead to Acquired Immune Deficiency Syndrome (AIDS), which is fatal. Over 68,500 cases of HIV have been diagnosed in the UK alone since surveillance began in 1982. To date, over 21,000 individuals have been diagnosed with AIDS, and deaths have been recorded for over 16,000 HIV infected individuals, including those with AIDS. There is no available vaccine against HIV, and many people with HIV look and feel healthy for a long time.

Trichomonas Vaginalis

Trichomonas Vaginalis (or TV for short) often has no symptoms but can cause discharge and painful urination.

Pubic lice/crabs

There is no protection against crabs/pubic lice, which are tiny insects that live on the skin, often infecting the hairy areas of the body. Contracted through skin-to-skin contact, they cause persistent itching, and it may be possible to see droppings from the lice in underwear and eggs from the lice in pubic hair. They are usually sexually transmitted but can occasionally be transmitted by close physical contact or by the sharing of sheets or towels with an infected person.

Scabies

Scabies also appears in the form of an itchy rash. Caused by a female mite laying her eggs beneath the surface of the skin, the main symptom of scabies is an itchy rash on hands, elbows, breasts, genitals, wrists and buttocks. Any close physical contact can spread the infection, and so it is not necessarily sexually transmitted.

Non-specific Urethritis

Non-specific urethritis (NSU) is usually caused by a sexual infection, and very rarely by allergy or excess alcohol. It only infects men and symptoms may include inflammation of the urethra, causing a burning sensation or pain when passing urine, discharge from the penis and/or frequent urination. Several different types of infection can cause NSU, but often it is caused by chlamydia.

Genital Herpes

Genital herpes causes painful sores on and around the genitals. It is spread by direct contact with sores during sex, but can also be passed on when no sores are present. Symptoms include itching or tingling sensation in the genital or anal area, small fluid filled blisters which burst and leave painful sores, pain when urinating if the urine passes over the sores, and a flu-like illness, swollen glands, backache, headache or fever. You can catch herpes just from kissing an infected partner. There is no known cure.

Hepatitis

Hepatitis is inflammation of the liver. This is often, but not always, caused by a viral infection. Other causes are excessive alcohol consumption and certain drugs. There are several viruses that can cause hepatitis, identified by letters:

Hepatitis A (HAV) is common in some parts of the world but only about 1300 cases were reported in England in 1997. It can come from eating or drinking contaminated food or water, and contact with an infected person’s faeces. Some people have no symptoms. Symptoms, if manifest, can include nausea, diarrhoea, loss of appetite, weight loss, itchiness, fatigue, jaundice and a short flu-like illness. Immunisations are available.

Hepatitis B (HBV) is very common throughout the world and is also very infectious. It is passed on through sex, sharing of contaminated needles or piercing instruments, from blood an infected blood transfusion and/or from an infected mother to her baby. It can also be transmitted through using the toothbrush or shaving equipment of an infected person. Some people have no symptoms. Symptoms, if manifest, can include nausea, diarrhoea, loss of appetite, weight loss, jaundice, itchiness, fatigue and a short flu-like illness.

Hepatitis C virus (HCV) can be spread by sharing contaminated needles or other drug injecting equipment, by using unsterilised equipment for body piercing, through blood transfusion in which the blood is contaminated (all blood in the UK is tested first), and by unprotected sex. Infected mothers can pass it onto their child during pregnancy or at birth. Some people have no symptoms. Symptoms, if manifest, can include nausea, diarrhoea, loss of appetite, weight loss, itchiness, fatigue and a short flu-like illness. Current evidence indicates that only about 20% of those infected by HCV clear the virus from the blood. The other 80% will remain infected and can pass it onto other people. After some years, they could develop liver cirrhosis, liver cancer or chronic hepatitis

Oral sex linked to throat cancer

In May 2007, US researchers found that a common virus, believed to be transmitted during oral sex, is the cause of a rare throat cancer in both males and females.  Researchers at Johns Hopkins University in Maryland studied 100 men and women who had been diagnosed with oropharnygeal cancer, which affects the throat, tonsils and the back of the tongue.  They found that a common strain of HPV - HPV 16 - was present in 72 percent of tumours.  What's more, patients whose blood or saliva samples showed that they had prior HPV infection were 32 times more kiley to develop the cancer, and those who had had more that six oral sex partners were 8.6 times more likely to develop the HPV-linked cancer.   The findings were reported in the New England Journal of Medicine.

The solution?

Many speak of ‘safe’ sex, as if there is such a thing. Yet the only safe sex is sex between two people who are uninfected. Still, the myth, perpetuated by the manufacturers and those in the industry, is that condoms result in safe sex, which in turn leads to a false sense of security. A false sense of security will in many cases lead to more acts of intercourse occurring.

However, people are increasingly realising that condom promotion not only hasn’t worked (since STIs are continuing to rise at an alarming rate) but is also a questionable approach.

The fact is that even if being used consistently, contraceptives are not 100% failsafe and fall down on at least two counts – method failure (due to a defect in the product itself) and user failure (due to incorrect or inconsistent use by the user). Both of these combined comprise the total contraceptive failure rate. The method failure rate for condoms is 3% but the user failure rate is a shocking 14%. This means that, even among condom users, one in seven women using the condom will still become pregnant each year. This also means that condom promotion, without addressing changes in sexual behaviour, will inevitably result in the increase in STIs and unplanned conceptions that we have already seen in the UK.

As far as the prevention of STIs is concerned, when used correctly every time, condoms are 85-95 percent effective in preventing the transmission of HIV, but the risk of HIV infection from vaginal sex is very low. Condoms are much less effective in providing protection from other STIs, especially common ones such as herpes and HPV that are spread by skin-to-skin contact of parts not covered by a condom. In fact, condoms have little or no benefit in preventing HPV transmission. Having regular sex, despite using condoms, is likely to lead to infection within a year or two if you have a partner with chlamydia, gonorrhoea, genital warts, syphilis or herpes.

The World Health Organisation has stated that the best way to avoid catching an STI is to stay faithful to one person for life whom you know is uninfected. Actually, this is not entirely true. Since we cannot always know for sure that someone is uninfected, the best way to avoid catching an STI is by practicing sexual abstinence – which is also the only 100% failsafe contraception around!