STI's

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STI's

Sexually-transmitted infections such as HIV/AIDS, gonorrhoea, herpes, and chlamydia may present a greater risk during travel. These diseases are more prevalent in less developed countries and the relative freedom and lack of inhibition travel offers can lead to a more casual attitude towards sex.

Blood-borne diseases such as HIV, Hepatitis B and C can be spread by:

unprotected sex.
blood transfusion.
tattooing.
body-piercing.
unsterile needles, razors and scissors.

Hepatitis B and C can also be transmitted during treatment for illness or injuries, so travellers on adventure-style holidays are at higher risk.

Incidence

HIV

Travellers are estimated to be over 200 times more likely to contract HIV while abroad than at home. HIV infection, which leads to AIDS, is now a global health problem. The ease of international travel has undoubtedly been a major contributor to the rapid spread of HIV. In 2010 the World Health Organisation estimated that more than 34 million adults and children were HIV positive and this number increases by over 2.5 million each year. Cases have been reported from over 160 countries. The vast majority of these cases have occurred in developing countries where the major route of transmission is now heterosexual contact. 40% of cases now occur in females.

In countries where health officials screen for HIV, the extent of the problem is becoming increasingly evident:
Over 60% of prostitutes in Thailand are HIV positive after working for one year.
30-60% of Indian prostitutes are HIV positive.
In other countries, including many in Africa screening for HIV is limited. However, the problem is enormous: up to 50% of the general population is infected in some African countries.

Symptoms

HIV
It can take many years from the time of infection until symptoms develop, consequently the absence of obvious symptoms is no guarantee that a person in not infected with HIV.

STI's

DISEASE	INCUBATION	SYMPTOMS
Gonorrhoea	2-7 days	Males – creamy discharge from penis and painful urination. Diagnosed by swab or urine test. Females – often no symptoms. May have vaginal discharge. Diagnosed by swab.
Chlamydia	5-7 days	Males – discharge, usually thin and clear and painful urination. Diagnosed by swab or urine test. Females – often none. May have vaginal discharge. Diagnosed by swab.
Herpes virus	2-12 days	Painful blisters/ ulcers on penis or vagina. Can be transmitted when no ulcers visible. Diagnosed by swab.
Hepatitis B	2-6 months	Diagnosed by blood test and associated symptoms.
Syphilis	10-90 days	Primary – ‘chancre’ (painless ulcer) on penis or vagina. Secondary – flu like illness with rash. Diagnosed by blood test or swab.
Wart virus	1-20 months	Visible warts or vaginal irritation. Diagnosed by swab.

Prevention

Always use condoms (specifically latex) with any new sexual partner.
Use water-based lubricants (e.g. K-Y Jelly® or glycerine) with latex condoms, as oil-based lubricants (petroleum jelly, shortening, mineral oil, or massage oils) can weaken latex.
Consider taking your own needle and syringe or emergency kit.
Do not share razors and other implements.
Ensure sterile equipment and sterilisation procedures before any surgery.
Avoid unnecessary procedures (have a dental check before leaving).

Treatment

Seek early medical review if you suspect any exposure.

Because STI's can go unnoticed, it is important to get a check-up when you get home if you have had unprotected intercourse with a new partner while away.

Hepatitis B and HPV are the only STI's for which a vaccine is available.