Sexually Transmitted Infections (STI):

These infections spread mainly through sexual contact. Infective bacteria and viruses or parasites can be found in body fluids such as semen, on the skin of the genitals and areas around them.

Common STIs in Sri Lanka:

  • Syphillis
  • Genital Herpes
  • Gonorrhoea
  • Non Gonococcal urethritis
  • Trichomoniasis
  • Genital warts
  • Genital discharge
    • Urethral discharge
    • Vaginal discharge
  • Genital ulcers
  • Blisters in the genital areas
  • Genital growth or lump
  • Redness and swelling over the genital area
  • Scrotal swelling
  • Lower abdominal pain in the female
  • Associated urinary symptoms such as pain during urination, increased frequency in urination
  • Important: Some sexually transmitted infections can be present in the body without showing any symptoms.
  • Those who have multiple sexual partners
  • Sex workers
  • Sex with a partner who has STI
  • Sex with unknown partner or multiple partners
  • Sex with a partner who has unprotected sex with others
  • Those who have multiple sexual exposures for money,food,gifts,shelter or favours
  • During sexual contact
  • Mother to child transmission – during pregnancy, child birth and lactation
  • Sharing of needles
  • Transfusion of unscreened blood products
  • During medical procedures if universal precautions are not followed

Some sexually transmitted infections such as HIV can result in early death

Sexually transmitted infections are important causes of Fallopian tube damage that may lead to infertility in women.

In pregnancy, untreated early syphilis is responsible for 1 in 4 stillbirths and 14% of neonatal (newborn) deaths.

Human papilloma virus (HPV) infection aggravates the risk of cervical cancer.

Some common sexually transmitted infections

Signs and Symptoms:
Women:
Often, there are no symptoms though they may complain of vaginal discharge, pain during urination, spotting after sexual intercourse, lower abdominal pain.

Men:
Urethral discharge and pain during urination.

Signs and symptoms:
Women:
Painful blister like lesions in and around vagina, anus or on thighs may appear. Pain may be more severe than in men. It may cause painful urination, watery vaginal discharge.

Men:
They may complain of painful lesions on the penis. It may also cause urethral discharge and painful urination.

Vague symptoms such as headache, backache, fever and malaise also may be present.

There are no symptoms in as many as 70% of cases. The first episode will clear in 2 – 4 weeks.

Half of those infected will have recurrent episodes. Compared to the initial infection, the recurrent episodes have fewer and smaller lesions. Pain, numbness or tingling in buttocks, legs or hips may precede a recurrent attack.

Signs and symptoms:
Women:
Often, there are no symptoms. Those infected may complain of vaginal discharge, pain during urination, spotting after sexual intercourse, lower abdominal pain.
Men:
It may sometimes show no symptoms at all, though urethral discharge and pain during urination may at times be complained of.

Signs and symptoms:
Women:
Painless ulcer (chancre) at the site of exposure may appear on the vulva, cervix, nose, mouth or anus. Internal lesions may be missed and the first apparent symptom may be the rash of secondary syphilis.

Men:
Painless ulcer on penis, nose, mouth, testicle or anus.
Syphillis, if not treated can be complicated by secondary/tertiary Syphillis.

The initial lesion heals in a few weeks followed by a non itchy body rash, malaise, fever, lymph node enlargement, hepatitis, and arthritis and hair loss. These symptoms last several weeks or months.

If not treated, the non infectious stage of tertiary or late stage develops in about 25% of persons. Gummas (large lesions) in soft tissue and viscera, neurosyphilis and cardiovascular syphilis begins 1 to 20 years later. If left untreated, this can lead to death.

HIV is the virus that leads to acquired immune deficiency syndrome (AIDS). HIV slowly damages the body’s immune system, reducing its ability to fight other diseases.

People can live with HIV for many years without any signs or symptoms of infection. Eventually, they develop AIDS—the condition when the body’s immune system breaks down and is unable to fight certain infections, known as opportunistic infections.

HIV is mainly transmitted from one infected person to another through unprotected sexual contact. It can also get transmitted from an infected pregnant mother to a child during pregnancy, delivery or breast feeding. Sharing unsterilised injection equipment that has previously been used by someone who is infected, is another way
HIV is transmitted. It can also get transmitted through the transfusion of contaminated blood products.

There are no permanent drugs for HIV infection, but antiretroviral (ARV) therapy can slow progress of the disease, improve the health of those with AIDS, and prolong life. ARV also can reduce mother-to-child transmission at the time of delivery.
Opportunistic infections could be treated with relevant drugs.

Nothing but the truth….

583 individuals are infected with HIV every hour

14,000 new cases are detected every day

More than 333 individuals die of AIDS every hour

More than 8000 individuals die every day of AIDS

Natural history of HIV infection

HIV infection may remain silent in the body for many years. During this time, he or she may infect many other people through unprotected sexual contacts.When the viral load  increase, the body’s immune system is weakened and then gives rise to various symptoms.

Things you should know about HIV/AIDS

 

It is possible to become infected with HIV through oral sex.

Person could become infected with HIV, if infected semen or sexual secretions come into contact with damaged and receding gums, or any cuts or sores they might have in their mouth.

The likelihood of either a man or a woman becoming infected with HIV as a result of receiving oral sex is extremely low, as saliva does not contain infectious quantities of HIV.

HIV is only present in saliva in very minute amounts, insufficient to cause infection with HIV.

It is theoretically possible if infected vaginal secretions or blood from an HIV positive partner enters the other woman’s vagina (perhaps on fingers or sex toys).

Unprotected anal intercourse does carry a higher risk than most other forms of sexual activity. The lining of the rectum has fewer cells than that of the vagina, and therefore can be damaged more easily, causing bleeding during intercourse. This can then be a route into the bloodstream for infected sexual fluids or blood.

The presence of STDs in an HIV infected person can increase the risk of HIV transmission. This can be through a genital ulcer which could bleed or through increased genital discharge.

An HIV negative person who has an STD, can be at increased risk of becoming infected with HIV through sex. This can happen if the STD causes ulceration or breaks in the skin (e.g. syphilis or herpes). HIV transmission is more likely in those with ulcerative STDs than non-ulcerative.

Using condoms during sex is the best way to prevent the sexual transmission of diseases, including HIV.

No. HIV is not an airborne, water-borne or food-borne virus, and does not survive for very long ,outside the human body. Therefore ordinary social contact such as kissing, shaking hands, coughing and sharing cutlery does not result in the virus being passed from one person to another.

If instruments contaminated with blood are not sterilised between clients then there is a risk of HIV transmission.When visiting the barbers there is no risk of infection unless the skin is cut and infected blood gets into the wound. Traditional razors used by barbers now have disposable blades, which should only be used once, thus eliminating the risk from blood-borne infections such as Hepatitis and HIV.

No, it is not possible to get HIV from mosquitoes. When taking blood from someone, mosquitoes do not inject blood from any previous person. The only thing that a mosquito injects is saliva, which acts as a lubricant and enables it to feed more efficiently.

There is a possibility of becoming infected with HIV if you share injecting equipment with someone who has the virus. If HIV infected blood remains within the bore (inside) of the needle or in the syringe and someone else then uses it to inject themselves, that blood can be flushed into the bloodstream.

An HIV-infected pregnant woman can pass the virus on to her unborn baby either in pregnancy or delivery. HIV can also be trnsmitted through breastfeeding.The risk of mother to child transmission can be reduced with caesarean section and the use of antiretroviral drugs when an infection of mother is known by HIV testing.

All the blood used for transfusions is now tested for HIV, therefore infection through blood transfusions is now extremely rare.
Donating blood at an approved donation centre should carry no risk, as all equipment should be sterile and blood collection needles are not reused.

Even if your tests show that you have very low levels of HIV in your blood, the virus will not have been totally eradicated and you will still be capable of infecting others.

  • Raise awareness
  •  If you have any of the above symptoms,see a doctor immediately for treatment.
  •  If you have been detected to have a STI, make sure that your partner is also treated.
  •  Practice safe sex (condoms, be faithful, single partner)
  •  If you have had unprotected sex, get yourself screened for STIs.
  •  Do not share needles
  •  Adhere to universal precautions
  •  Screen all blood and blood products before transfusion

Prevention is better than cure! However, since most STI’s are treatable, please seek medical help immediately if you have any of the above mentioned symptoms or you have had a high risk exposure. Those caused by organisms such as bacteria & parasites generally can be cured. STIs caused by viruses may develop recurrences later.