Young People and Sexual Health

What are sexually transmitted infections?

Sexually transmitted infections (STIs), otherwise known as sexually transmitted diseases, are, as the name suggests, infections (or diseases) that are usually acquired through contact of a sexual nature, including vaginal, anal and oral sex. However, some STIs can be passed through other means of contact, such as through blood transfusions, sharing injection needles with an infected person, or from mother to baby during pregnancy or childbirth. STIs are transmitted between people in semen, vaginal fluids, and other body fluids such as blood. They also result from skin-to-skin contact.

How common are STIs?

STIs are common and on the increase. Notably, over half of all STI diagnoses are in young adults aged 16–24 years. The Health Protection Agency reports that in 2011 the number of people with a new STI diagnosis was almost 427,000, representing an increase of 2% over the previous year. This increase was mainly associated with increases in new diagnoses of gonorrhoea (that rose by 25%), infectious syphilis (10%), genital herpes (5%), and non-specific genital infection (5%). Despite the 2% fall in the rate of chlamydia diagnoses, at 186,000 the numbers remain alarmingly high.

Who is most at risk?

Because STIs are transmitted from person-to-person through intimate contact, they can affect anyone. However, certain behaviours increase the risk of contracting a STI. Whether in a heterosexual or homosexual relationship, the risk is increased if you have lots of sexual partners (that being at the same time or at different times) or have casual sex. Your chances of acquiring an STI are also raised if you have unprotected/unsafe sex (i.e. do not where a condom). Risks are also taken if you share needles with an infected person when injecting drugs. Young people may be particularly vulnerable as they change their sexual partners and have more than one partner more often than older adults, as well as practising unsafe sex. Youngsters may have a basic lack of knowledge about sexual health or are subject to peer pressure to have sex before they are ready.

What causes STIs?

STIs are caused by a variety of organisms, including bacteria, fungi, viruses, and parasites.

For example, chlamydia, gonorrhoea and syphilis are STIs caused by bacteria; candida (a yeast infection) is caused by a fungus; genital warts (Human Papilloma Virus), hepatitis, herpes, and HIV (Human Immunodeficiency Virus) are caused by viruses; and public (‘crabs’) lice, scabies and trichomonas (‘trich’) are parasites.

What are the signs and symptoms of STIs?

Not all STI-infected people will show signs or symptoms. A person with chlamydia or gonorrhoea may have pain or a burning sensation when they urinate and an abnormal genital discharge. Women with chlamydia may also experience bleeding after sex or not associated with their period. Syphilis may cause sores on genitals or around the mouth. Occurring on or around the genital or anal area, genital warts are small growths on the skin while genital herpes appears as small painful blisters. HIV targets your immune system, reducing your resistance to infection and other diseases. It can ultimately lead to AIDS (Acquired Immune Deficiency Syndrome), which severely affects your ability to ward off life-threatening infections and diseases. Pubic lice are tiny blood-sucking insects living in coarse (usually public) hair, while scabies mites burrow into the skin – both cause intense itching and may lead to rash. In addition to genital itching, the parasite causing trichomoniasis can also cause painful urination and a smelly vaginal discharge.

How can you avoid an STI?

All sexually active people can reduce their chances of acquiring an STI by taking the precaution of always using a condom when having sex with anyone who has not been screened for an STI. Having one partner only, avoiding casual sex, and having regular sexual health checks will also minimise your risk.

Testing for STIs

You can have tests for STIs at a sexual health clinic or a genitourinary medicine (GUM) clinic. Your GP surgery may also be able to help. Whether you have symptoms or not, get tested if there is a chance that you might have an STI, or you and your partner want to have unprotected sex. Early treatment will minimise the possibility of the infection spreading to different areas of your body, serious complications such as infertility, and of transmitting the disease to another person.

How are STIs treated?

STIs caused by bacteria are treated with antibiotics and are curable. A range of antifungal medications are used to successfully treat fungal infections. You are also able to get rid of parasitic infections, which are treated with an insecticide (public lice) or anti-mite (for scabies) preparation, or an antibiotic (Trichomonas). Viral infections are most difficult to treat and, although there are antiviral medicines, you will not be totally cured. The medicines manage the symptoms of the infection but, once in your body, the virus remains there and you can still pass it on to other people. Treatment for genital warts usually involves freezing or putting medicine onto the warts. If you experience recurrent infections of, for example, genital herpes or hepatitis you may need to take medication on a daily basis. If you have HIV you are likely to be given a combination of antiviral medications to slow progression of the disease. Treatment for hepatitis B may be, and for HIV is likely, to be lifelong.