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Health Library - Sexual Health

Anytime Doctor has published this health library as a resource to provide an accurate and modern view on Sexually Transmitted Infections (STIs) / Sexually transmitted Diseases (STDs).

We have intentionally not provided details for the symptoms of HIV. The symptoms of HIV are very similar to infections such as tonsillitis, chest infections, common colds etc. If you have these symptoms it is much more likely you have one of these infections than HIV. Anxiety is powerful emotion. If you are worried, the best thing to do is to get the required tests done through Anytime Doctor or within the NHS.


General Information on STDs/STIs

Why are STDs/STIs increasing so rapidly?

We are currently in the grip of an UK epidemic of STDs, new cases of herpes, chlamydia, syphilis, HIV and gonorrhoea are at record levels.

There were 621,300 diagnoses of STDs in 2006, up 70% percent on 1997, of which 376,508 were new infections (Health Protection Agency). NHS GUM clinics cannot cope, there were over 1.8million attendances at NHS GUM clinics in 2006 an increase of 350 percent from 1997 (400,000 attendances).

The Government's Independent Advisory Group on Sexual Health and HIV is calling for urgent action to tackle this epidemic.

A number of reasons have been put forward as to why STDs are increasing so rapidly:

1Age of first intercourse is decreasing. A 30 year old woman has now potentially been sexually active for 15 years.
2The proportion of men and women who have concurrent relationships (having more than one sexual partner) has increased.
3The proportion of the population who reported two or more partners in the past year and who did not use condoms consistently has increased since 1990 from 13.6% to 15.4% for men and from 7.1% to 10% for women.
4The proportion of men in the United Kingdom who have ever had a homosexual partner in the last five years increased between 1990 and 2000. Unsafe sex in homosexual men has increased, particularly in London.
5Populations are now more mobile nationally and internationally. Certain groups (tourists and professionals business travellers) are at risk. They are separated from their families and social restraints and are more likely to have sexual contact outside a stable relationship.

Common Symptoms for STDs/STIs

The following symptoms could indicate a STD. However, some infections, while still spreadable, may have no symptoms:
ʼn  an unusual vaginal discharge in women

ʼn  a discharge from the urethra (the tube that runs from the bladder to the tip of the penis) in men

ʼn  bleeding after intercourse or between periods in women

ʼn  sores, blisters, warts, rashes, irritation or itching near the genitals or anus

ʼn  pain on passing urine, or needing to pass urine more often

ʼn  pain during sex

ʼn  pelvic or lower abdominal pain


Safer Sex

Anyone who is having sex can pick up a STD. Whether you are young or old, straight or gay, do it once in a while or all night every night, unprotected sex will put you at risk of getting a STD so it makes sense to make your sex safer.

Safer sex is any sex that does not allow an infected person's blood, semen, pre-ejaculatory fluid (precum) or fluid from the vagina to get inside the other person's body.

Use a condom every time you have sex. Only condoms provide 'all-in-one' protection against unintended pregnancy and most STDs, including HIV.

It seems obvious, but the more sexual partners you have the more chance you have of getting an STD - so be careful who you sleep with.

Just because you've been with someone for a while, don't stop using a condom until you've both had a check-up. Some of the most common STDs have no noticeable symptoms. Don't forget to use another form of contraception to avoid unplanned pregnancies.

Always carry condoms with you when you go out, not just when you are going to a party or a club. Sex isn't something you always plan in advance.

For more information on sexual health (including HIV), call the Sexual Health Line free (from the UK) on 0800 567 123, textphone (for people with hearing impairments) 0800 521 361.

 

Specific Information on common STDs/STIs


Bacterial Vaginosis
Chlamydia
Genital herpes
Genital Herpes in pregnancy
Genital warts
Gonorrhoea
HIV & AIDS
Non-specific urethritis (NSU)
Pelvic inflammatory disease – PID
Syphilis
Trichomonas
Ureaplasma & Mycoplasma
Viral Hepatitis - Type A
Viral Hepatitis - Type B
Viral Hepatitis - Type C

HIV & AIDS

What is HIV?
HIV (Human Immunodeficiency Virus) is a virus which destroys the body's natural ability to fight infections and some cancers.

What is AIDS?
AIDS (Acquired Immune Deficiency Syndrome) is a group of illnesses which occurs as a result of a weakened immune system in people who are infected with HIV. Without treatment of HIV, AIDS can occur several years after a person becomes infected with HIV.

How does someone become infected with HIV?
An infected person can pass the virus on to someone else by the exchange of body fluids such as blood, semen and vaginal fluids.

HIV is transmitted by:
- vaginal or anal sexual intercourse without a condom
- sharing drug injecting equipment
- an infected mother to her baby during pregnancy, childbirth, or breast-feeding.

HIV is rarely transmitted by:
- vaginal or anal sex using condoms correctly
- oral sex without a condom (though ejaculation could increase the risk)
- sharp injuries or splashes (e.g. needle-stick injuries for health care workers)

HIV has never been reported as being transmitted by:
- kissing or cuddling
- shaking hands/social contact
- sharing knives and forks, cups or glasses
- toilet seats or mosquitoes

Remember:
Always use condoms for anal and vaginal sex
Use new needles every time

What is the HIV antibody test?
It is a blood test which detects HIV antibodies. Antibodies are produced by the body in response to an infection. If you are infected with HIV, then HIV antibodies will be present in your blood.

When should testing be done?
You are most likely to get an accurate test result if you wait for 3 months after the time you though you were at risk of getting HIV. This is because it can take some time for your body to develop antibodies. You need to make sure that you do not expose yourself to HIV in that 3 month period otherwise you will need to start the 3 months again.

 

 

 


It can take up to three months for HIV antibodies to develop after a person has been infected.

 

 


Having a HIV test is entirely optional. If you decide to have an HIV test it is completely confidential.



What does a negative HIV antibody test result mean?

It means either:
that a person has not been infected with HIV

or

that a person has been infected with HIV but has not yet produced antibodies. Remember it can take up to three months for antibodies to develop after infection with HIV. This means the test may become positive in the following weeks, so you may need to do the test again.

What does a positive HIV antibody test result mean?
A positive test means that a person has been infected with HIV. All positive tests are confirmed by further testing to eliminate the possibility of false positives (tests that are negative but show up as positive)

Things to consider:

- Receiving a positive HIV antibody test result can be a traumatic event.
- All people thinking of being tested for HIV are invited to discuss any concerns with a doctor.
- Any medical information or anything within the Clinic is confidential.
- There is a legal requirement for people infected with HIV to inform present and future sexual partners.
- If the test result is positive, early management of HIV can make a difference to how the disease affects the body. Lifestyle changes including good nutrition, exercise, stress management, emotional support and drug treatment can all make a difference. Having HIV means that if you are sharing needles or practising unsafe sex, you could pass on the virus.
- Blood should not be donated by someone with HIV.
- A negative result may be a great relief BUT ensure that you protect yourself from risk in the future.

Things to consider before having an HIV test
Have you ever had unprotected anal or vaginal sex?
Have you ever shared needles?
Have you had a blood transfusion before 1985?
Have you had a surgical procedure overseas?
Have you given your consent to having the test performed?
Have you thought about what you will do if the test result is positive?
Have you checked that the place where you are going to be tested has strict guidelines about keeping your name and your results confidential?

Remember:
Always use condoms for anal and vaginal sex
Use new needles every time


PEP - Post Exposure Prophylaxis

PEP, or Post Exposure Prophylaxis, is a course of anti-HIV drugs that is taken shortly after possible exposure to HIV infection. It is thought that the drugs may help reduce the risk of acquiring HIV after unprotected sex, sharing needles or a needle-stick injury.

Who should take PEP?
Anyone who has had risky contact with someone who has HIV or who may have HIV. This risky contact may include:

- having unsafe sex
- sharing drug injecting equipment
- getting a needle-stick injury

It is important to discuss the need for PEP with a doctor trained in using the medications, or with emergency health services. Together with your doctor, you can decide whether you are at risk of HIV infection and whether you should take PEP.

Things that you and your doctor will need to consider in making the decision include details of the exposure, how much time has passed since the event and whether you know anything about the HIV status of the other person or people involved.

How do I get access to PEP?
The PEP drugs can only be prescribed by a doctor with specific training in using this kind of medication.

It is not available from us as it is very expensive privately. These drugs are free of charge from an Accident & Emergency Dept in the UK.

When should I take PEP?
It seems likely that PEP will work most effectively if it is started as soon as possible after the exposure to HIV - preferably within one or two hours. This gives the drugs the best chance to work against HIV before it becomes established in the immune system.

There may still be significant benefit in taking PEP if it is started within 24-48 hours after possible exposure. In some situations PEP may still be of use up to 72 hours after the risk event.

What is involved in taking PEP?
PEP involves taking a 2 or 3 drug combination. The drugs need to be taken at certain times of the day and may need to be taken with or without food. This should be maintained on a daily basis for one month. Taking PEP properly is a big commitment and requires some effort. It means sticking to a strict drug and food regime.

Does PEP have any side effects?
Yes. Taking drugs used in PEP can cause side effects such as nausea, diarrhoea, headaches, tiredness and a rash.

Does PEP work?
At this stage no studies have been done to test whether the likelihood of getting HIV after unprotected sex or unsafe injecting is reduced by taking PEP.

But there are some encouraging signs from studies done with health care workers, which show that their risk of becoming HIV positive after a needle-stick injury is significantly reduced by using PEP.

These studies suggest that it may be possible to reduce the risk of HIV transmission by prompt use of PEP after possible sexual or injecting exposure.

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