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HIV & STIs

Having a sexually transmitted infection (STI) can increase a person's risk of becoming infected with HIV, whether the STI causes open sores or breaks in the skin (e.g. Syphilis, Herpes, Chancroid) or does not cause the skin to break (e.g. Chlamydia, Gonorrhea).

If the STI causes irritation of the skin, breaks or sores, this may make it easier for HIV to enter the body during sexual contact.  Even when the STI causes no breaks or open sores, the infection can stimulate an inflammatory reaction in the genital area that can make HIV transmission more likely.

In addition, if an HIV infected person is also infected with another STI, that person is three to five times more likely than other HIV infected persons to transmit HIV through sexual contact, because the blood, semen, or vaginal fluids will contain more HIV virus.
Not having (abstaining from) sexual intercourse is the most effective way to avoid STIs, including HIV. For those who choose to be sexually active, the following STI/HIV prevention activities are highly effective:

• Engaging in sex that does not involve vaginal, anal, or oral penetration
• Having intercourse with only one uninfected partner or
• Using condoms every time you have sex

basics about the most common STIs.

Chlamydia
Chlamydia Trachomatis is a bacterium that causes one of the most common STIs. Symptoms of Chlamydia include a burning feeling when you are urinating (peeing) and sometimes a (slight) discharge from your penis or vagina.

Chlamydia can also infect your throat, rectum, and eyes. The majority of people, especially women, will not have any symptoms at all. If left untreated in men, Chlamydia can cause an inflammation of the epididymis: the thin storage-tube that connects your testes (balls) to your urethra (the tube you pee through).

In women, it can cause pelvic inflammatory disease (PID) and cause sterility. Chlamydia can be treated with antibiotics. If you have Chlamydia, anyone you are having sex with should be treated; otherwise, you and they can get re-infected repeatedly. To determine infection, you may take a blood test, a urine tests or cervical swabs (women).

Gonorrhea
Gonorrhea is caused by the bacterium Neisseria gonorrhea. It may cause a thick discharge (stuff that comes out) from your penis or from your vagina, and sometimes a burning feeling while you are urinating (peeing). In many people there may be no symptoms, especially for women.

Gonorrhea can also occur in your rectum or throat. It can develop into a chronic, serious infection if not treated. It can spread through your blood to other parts of your body, and can lead to sterility (inability to have children) in women; it can also cause pelvic inflammatory disease (PID).

Gonorrhea is treatable with antibiotics. If you have it, anyone you are having sex with should be checked, and if necessary, treated.

There is no blood test for this infection. Usually your doctor will treat you based on the symptoms, he/she can do a swab and look under the microscope for clues of the bacterium, does a culture test or take a urine test.

Herpes
A virus called Herpes Simplex, causes herpes. There are two strains, HS 1 and HS 2. It used to be that HS 1 especially caused fever blisters around the mouth (cold sores), and HS 2 was called genital Herpes.

Because of freer sexual practices, HS 1 and 2 have partially exchanged places, and it has become more obscure and less important which type is causing your infection. They both lead to a grouped area with small clear fluid filled blisters, usually on a painful red underground. The blisters usually dry up within days to weeks without treatment, but the virus stays in the body lifelong, and can cause recurrences of such outbreaks.

The virus is especially transmittable when having active blisters, but can also be transmitted to others without having active blisters visible. Treatment can shorten the course of an outbreak, and make it less painful, but it cannot cure the infection. Once infected with Herpes a person will stay so life long.

Pregnant women known to have Herpes should always inform their doctor, because if she has an outbreak in the vaginal area during labor, she can transmit the virus to her baby. The baby should then be born by C-Section to prevent infection.

It is advisable to use condoms or abstain from sex when having active outbreaks. It can even be advised to continue using condoms when not having an outbreak.

When having regular outbreaks it is sometimes recommended to start maintenance therapy, where you would take daily medicine to prevent future outbreaks. This treatment will however not cure the infection, but only suppress its effects. There is a blood test to determine if you have the Herpes infection.

Genital Warts
Genital Warts are caused by Human Papilloma Virus (HPV). The warts are not dangerous, but can be cosmetically unpleasant. The virus can be transmitted through direct contact with the wart, but also when there are no warts visible, there is a small chance the virus might transmit from one person to the next.

Warts can be treated in several ways (application of a medicine, usually repeatedly needed, freezing, burning, operation, etc). Treatment will however not cure the infection. Once you are infected, you will stay so for life.

Condoms can only prevent transmission to a certain extent if the warts are covered by the condom, and there is no direct skin contact between wart and skin of the partner. Some (not all) strains of Human Papilloma Virus, can increase a woman’s chance of developing Cervical Cancer. There are more than 100 different types of HPV.

There is presently no blood test for HPV. A special cervical swab can determine clues about the existence of an infection.

Syphilis
Syphilis is caused by the bacterium Treponema Pallidum. If untreated, it goes through three stages, with different symptoms at each stage.

During the first stage, a single chancre (painless sore) forms on your genitals, rectum, or mouth or throat. It will disappear on its own in a few weeks, without treatment; however, the bacterium will stay in your body, and can later cause the later stages of the disease. Not all persons will recognize that they have such a sore, and may not know they are infected.

The second stage occurs about six months later. Sores and a rash may occur anywhere on your body. You may feel like you have the flu, with headache and aches and pains in your joints or bones. Without treatment, these symptoms may come and go, but again the bacterium will stay in your body.

Symptoms of the third stage may take 10 to 20 years to develop. They can be very serious and can result in blindness, heart or brain damage, and, in some cases, death. People with HIV/AIDS seem to develop third stage syphilis much faster than others.

Syphilis is diagnosed by a blood test, and is treatable with antibiotics.