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Sexually transmitted infections (STIs) are conditions that can be transferred from one person to another through any type of sexual contact.

Many STIs are treatable, but others are very difficult to cure with some causing infertility and even death. It is therefore important to practice safer sex to help to avoid catching any STIs. Safer sex isn't just about HIV (the virus that causes AIDS). There are other infections you can get which are less well known. Details of some different types of STIs are below.

Getting and giving sexual pleasure without putting each other at risk of an STI

Telling your partner if you think that you, or he, has an STI.

If you're in a one to one relationship, have had a clear sexual health check-up, and neither of you have other sexual partners, then you may not need to practise safe sex. Otherwise, it's a must - use a condom for vaginal, oral or anal sex even if you're using another method of contraception to prevent pregnancy, such as the pill. Being safe is all about being honest with each other as well as what kind of contraception you use.

If you have had unprotected sex you may be concerned about the risk of STIs. Some STIs have symptoms, such as discharge, odour and itching, however many STIs are 'silent' which means they don't have any symptoms, particularly early on. Some infections can appear to clear up on their own, but the underlying condition is still there. The only way to be sure, is to go for a check-up. If they're not treated quickly, certain STIs can damage your reproductive system and make it difficult or even impossible to have children later in life and in severe cases some can be life threatening. Don't let embarrassment delay a check-up. You can either speak with your own doctor or go to a specialist clinic who can give you the tests that are needed and provide the most suitable treatment. You should check local information to find the nearest, most appropriate place for you to go. 

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Gonorrhoea is a bacterial infection which can have no symptoms at first. Later on, it can cause burning when urinating, a yellowish vaginal discharge, redness and swelling of the genitals, and a burning or itching of the vaginal area. If untreated, gonorrhoea can lead to a severe pelvic infection and inflammation of the urogenital tract. It carries a risk of infertility in women. In both men and women it can result in septicaemia, arthritis and meningitis and it can cause blindness in newborn babies. Gonorrhoea is relatively common, but can be treated using antibiotics.

Chlamydia is a bacterial infection that causes similar symptoms to gonorrhoea. The majority of women with Chlamydia do not have symptoms, but can easily spread the infection to others. Chlamydial infection is often untreated and can result in extensive damage of the Fallopian tubes leading to infertility and premature births. In men, Chlamydia infection can cause genital tract infection. It can be treated with antibiotics.

Syphilis is a bacterial infection that has been around for centuries. It is a worm-like bacteria which infects a person by burrowing into the moist, mucous-covered lining of the mouth or genitals. It then produces a painless ulcer. Syphilis is highly contagious when the ulcer is present. In most women, a syphilis infection resolves on its own, even without treatment. However, 25% will proceed to the second stage of the infection called ''secondary'' syphilis, which develops weeks to months after the primary stage and lasts from 4 to 6 weeks. This can result in a skin rash on the hands and feet. Tertiary syphilis can develop after an interval of several years without any symptoms, and may cause severe damage to the nerves and central nervous system, and can affect the internal organs. Syphilis is a serious disease, and can be potentially life threatening. It is usually treated with penicillin or alternative antibiotics, and can be cured if treatment is started early enough.

Trichomoniasis (TV) are small parasites transmitted primarily through sexual contact. In women, infection mainly causes inflammation of the vagina which can spread to the cervix. Symptoms such as itching, discharge (often greenish and frothy), burning on urination, frequent urination and painful intercourse may occur. Some women have no symptoms. In pregnant women, birth complications are more common, such as premature labour, and the infection can be transmitted to the child. Men usually have no symptoms, however some may have inflammation of the urethra, white discharge from the penis, and inflammation of the bladder and prostate region. Trichomoniasis facilitates the spread of HIV. The infection can be treated by an antibiotic.

Genital herpes is a viral infection which causes redness and blistering of the genitals or mouth. Once the virus enters the body, it is inactive for 3 to 7 days. During this time, there are no symptoms and the virus cannot be transmitted to others. An outbreak usually begins as an itching or tingling sensation followed by redness of the skin. Finally, a blister forms. These blisters are usually very painful to touch and may last from 7 days to 2 weeks. The virus is contagious from the time of itching to the time of complete healing of the ulcer. In pregnant women, there is a risk of the child becoming infected during delivery, which can cause encephalitis (brain inflammation) which can be fatal. Herpes can be treated using antiviral creams.

There are 340 million new cases of curable STIs (syphilis, gonorrhoea, Chlamydia and trichomoniasis) estimated worldwide every year. ¹ If left untreated, these infections can cause serious health complications.

HIV (human immunodeficiency virus) transmission occurs through body fluids, and can be transmitted in a number of ways, including unprotected sexual intercourse and blood-to-blood transmission (for example, through contaminated syringes or transfusion of contaminated blood). The virus can be passed from mother to child during pregnancy. A person infected with HIV does not usually notice any initial symptoms as they are unspecific and can be mild. The virus multiplies and attacks blood cells, causing the immune system to become increasingly weak. HIV causes AIDS (acquired immunodeficiency syndrome). AIDS refers to the stage of the disease in which the immune system is so weak that infectious diseases and tumours can develop. Without treatment, it usually takes around nine years from infection with HIV to manifestation of AIDS. The first symptoms of AIDS are non-specific, as the disease progresses, the weakened immune system means that severe diseases of major organs can develop, such as tuberculosis, pneumonia and cancers. AIDS cannot yet be cured, but there are only drugs available (including anti-retrovirals, or ARVs) that can significantly delay the manifestation of AIDS and improve patient life expectancy and quality of life.

Many millions of incurable viral STIs, including an estimated 5 million HIV infections occur annually? ¹

Hepatitis B (HBV), a form of the hepatitis virus, is found particularly in body fluids (saliva, semen, vaginal mucus, blood or plasma), so can be transmitted by sexual contact and contact with infected blood, and is highly contagious. An infected pregnant woman can also pass on the infection to her child. Initially, there may not be any obvious symptoms. Acute infections will begin with loss of appetite, aversion to certain foods, nausea, mild fever and muscle and joint pain. Jaundice develops and faeces lose colour and urine becomes dark. The disease usually lasts four to six weeks before recovery. A possible complication is chronic hepatitis, which can be characterised by tiredness, joint pain and aching muscles. Patients with long standing chronic hepatitis B have a considerable increased risk of developing liver cirrhosis or liver cancer. There is a vaccination against hepatitis B. There is no causal treatment. If chronic hepatitis B has been diagnosed antiviral drug treatment is given. If chronic hepatitis B has progressed to liver cirrhosis liver transplantation is often the only option.

Hepatitis C (HCV), a form of the hepatitis virus, is spread though contact with infected blood. Sexual transmission is rare, but a risk nonetheless. Symptoms can be mild, and the infection can be asymptomatic. It leads to chronic hepatitis which can later result in cirrhosis and liver cancer. Some patients can be cleared of the virus by a long course of anti-viral medicines.

Hepatitis is an inflammation of the liver, most often caused by a virus, and also by toxic agents, e.g. alcohol and some drugs. There are different types of the hepatitis virus (hepatitis A, B, C, D, E and G), each form has different characteristics and different routes of infection. ²

Sexually transmitted strains of HPV can infect the genital area of men and women including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Some people who become infected with HPV will not have any symptoms and the infection will clear.

Some of these viruses are called ''high-risk'' types, and may cause abnormal Pap smear tests. They may also lead to cancer of the cervix, vulva, vagina, anus, or penis. Others are called ''low-risk'' types, and they may cause mild Pap smear test abnormalities or genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area and can be removed by medications applied by the patient, or by treatments performed by a health care provider.

A vaccine against HPV infection, the infection which causes cervical cancer, is now available in many countries around the world including the US, Australia, New Zealand, Canada, Mexico, Croatia, Malaysia, Brazil, Serbia, and countries of the European Union. The vaccine is designed to HPV vaccine" prevent infection with HPV types 16, 18, 6, and 11. HPV types 16 and 18 cause approximately 70% of HPV-related cervical cancer cases and HPV types 6 and 11 cause around 90% of genital wart cases. Human papillomavirus (HPV) infection causes virtually all cases of Cervical cancer, the 7th most common cause of death from cancer among women worldwide. ^{4, 5}

Human papilloma virus (HPV) is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted.³

A Pap test is the primary cancer-screening tool for cervical cancer or pre-cancerous changes in the cervix (neck of the womb). Pre-cancerous changes are common in all age groups and cause no symptoms. This means that women will not be aware of them unless they have a smear test. The smear test is taken in conjunction with a pelvic examination by a doctor, and only takes a few minutes. First of all the patient lies down on an exam table with knees bent. The doctor gently inserts an instrument called a speculum into the vagina. A sample of surface cells is taken from the cervix with a small flat spatula or a small brush. The specimen is placed on a small glass slide and sent away to a laboratory to be examined under a microscope. A new method of analysing samples using liquid based cytology is now becoming common. This provides clearer samples for analysis, reducing the incidence of equivocal or uncertain results.

Further information. 

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http://www.who.int" http://www.who.int

1. WHO. Global prevalence and incidence of selected curable sexually transmitted infections: overview and estimates. Geneva: World Health Organization, 2001.
2. http://en.wikipedia.org/wiki/Hepatitis 
3. http://www.cdc.gov/std/HPV/STDFact-HPV.htm
4. D'Souza, Gypsyamber (May 10, 2007). ''Case-Control Study of Human Papillomavirus and Oropharyngeal Cancer''. New England Journal of Medicine 356: 1944-1956.
5. Cancer Research UK. The most common causes of death from cancer worldwide, 2002 estimates. accessed 22 May 2007