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Sexual Transmitted Infections
Chlamydia is a bacterial infection and is the most commonly notified STI in Ireland. In over 50% of cases patients have no symptoms. Untreated it can cause pain, fever and infertility. It is currently treatable with antibiotics, either a once off dose of Azithromycin or a one-week course of Doxycycline. Untreated chlamydia can cause a number of complications, including infertility. The test will identify urethral chlamydia. Rarely these infections can involve the throat and anus. Men who have sex with men are more at risk of having these infections in the throat and anus. This test will not detect anal or pharyngeal chlamydia. If you are concerned about this, please talk to one of our clinicians.
It is very important that contacts are informed, particularly as it is frequently asymptomatic. Videodoc can facilitate contact tracing for patients who test positive if patients do not wish to inform their contacts themselves and this will be discussed when your results are discussed.
Gonorrhoea is a bacterial infection and the rates of notification have increased significantly in Ireland in the last number of years.
It commonly has no symptoms but can present with painful urination, urethral discharge and testicular pain in men or painful urination, vaginal discharge and pelvic pain in women. Untreated chlamydia and gonorrhoea can cause a number of complications, including infertility. The test will identify urethral gonorrhoea. Rarely these infections can involve the throat and anus. Men who have sex with men are more at risk of having these infections in the throat and anus. This test will not detect anal or pharyngeal gonorrhoea. If you are concerned about this, please talk to one of our clinicians.
It is treatable with antibiotics but is resistant to many antibiotics. The treatment is a tablet and an intramuscular injection and both treatments must be taken. If patients test positive for gonorrhoea the Videodoc clinician will refer you to your GP or local STI clinic for swabs, to ensure the infection is not resistant to the treatment, and the intramuscular injection. Videodoc can facilitate contact tracing for patients who test positive if patients do not wish to inform their contacts themselves and this will be discussed when your results are discussed.
Hepatitis B&C, HIV
These are viruses that can be spread several ways, including by sexual contact. Anal sex is the highest risk behaviour.
Hepatitis B can cause acute or chronic infection. Acute infection can cause life threatening hepatitis. Chronic infection can cause cirrhosis and liver cancer. There is a very effective vaccine available for the prevention of hepatitis B.
Hepatitis C can be transmitted sexually and can also cause acute and chronic disease. Acute infection is usually asymptomatic. Chronic disease is associated with high rates of cirrhosis and cancer. Antiviral medications can cure hepatitis C in over 90% of cases. There is currently no vaccine for hepatitis C.
HIV is a virus that attacks the immune system and untreated can cause acquired immunodeficiency syndrome (AIDS). There are treatments available but currently there is no cure and the body cannot get rid of HIV. With today’s treatments patients with HIV can live normal healthy lives and lower the chance of infecting others with HIV.
Syphilis is a sexually transmitted disease caused by a bacterium. There are 4 stages to syphilis. The primary phase presents with a sores or sore at the primary site of infection. The sores are usually painless, round, firm ulcers. Secondary syphilis can present with fevers, swollen nodes and a skin rash. Primary and secondary syphilis may often be mild and symptoms may not be recognised. There is then a latent phase, with no symptoms, before the final tertiary service which can cause severe medical problems affecting the brain, heart and other organs. Syphilis can be treated with antibiotics but if damage has been done from tertiary syphilis this may be irreversible.
Genital herpes is a viral disease spread by sexual contact. It is usually spread when an active ulcer is present but can be spread just before the ulcer presents. There are two herpes simplex viruses (HSV1 and HSV2) and both can cause genital herpes. HSV1 commonly causes cold sores but can cause genital herpes. Herpes usually causes painful ulcers but can present with pain passing urine, discharge or stinging/itching in the anal region. Treatment is recommended when you have the first outbreak of herpes. The treatment can reduce the severity of symptoms and may reduce the frequency of recurrent herpes in the future. There is no cure for herpes and recurrences are more common when people are run down. Suppression therapy is sometimes given if recurrences are frequent or severe.
Trichomoniasis is an uncommon cause of notified STIs in Ireland. It is caused by a parasite, trichomonas vaginalis. Around 70% of patients with trichomonas have no symptoms. When patients do have symptoms, they can include painful urination, smelly vaginal discharge, penile discharge, pain or burning in the penis/genital area, pain during intercourse. Trichomonas is treatable with oral antibiotics.
Gardnerella vaginalis is commonly involved in bacterial vaginosis (BV). It can present with vaginal discharge and odor. It is more common in sexually active people but can occur in people who are not sexually active so it is not classified as a sexually transmitted disease. Complications can rarely include pelvic inflammatory disease and pregnancy complications. It is treated with oral antibiotics or vaginal gels.
Mycoplasma vaginalis is a bacterium that lives on the urinary and genital tract in humans. Like other sexually transmitted disease in can be asymptomatic. When symptoms do occur, they are usually pain passing urine and urethral discharge in both sexes. Women also can complain of painful intercourse and bleeding after intercourse. It is a risk factor for the spread of HIV. It is treated with antibiotics, but resistance is common.
Ureaplasma urealyticum is a normal bacterium that people have in their genital tracts. It can sometimes cause symptoms. When symptoms do occur, they are usually pain passing urine and urethral discharge in both sexes. Women also can complain vaginal discharge and Ureaplasma urealyticum has been linked to prostatitis in men. It is more common in patients who are sexually active but can occur in people who have never had sex. It can be treated with antibiotics if symptomatic.
Contact tracing if you test positive
It is very important that any sexual contacts are informed if you are diagnosed with a sexually transmitted disease. This is to prevent you being re-infected, others being infected and irreversible, serious harm being done by untreated STIs.
We will discuss how to inform your sexual partners and provide an information leaflet to you if you wish to inform your sexual partners yourself. Alternatively, if you are uncomfortable discussing this with a previous or current sexual partner we will be happy to do this completely confidentially.
Reduce your risk
You can reduce your risk of sexually transmitted disease by
- Don’t have sex
- Reducing your number of sexual partners
- Not having sex with someone who has had an STI or used intravenous drugs, “know your partner”
- Using barrier contraception, e.g. condoms
- Not sharing sex toys
- Get vaccinated for Hepatitis B and HPV
- Anal sex is at higher risk because tissues in the rectum tear more easily