Sexually Transmitted Infections

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.

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.

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

Hepatitis B and HPV are the only STIs for which a vaccine is available.

• 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)

HIV Transmission

Contrary to some peoples' beliefs, HIV is NOT transmitted by:

• mosquitoes
• sharing food or plates
• handshakes
• coughing or sneezing
• toilet seats
• swimming

Condoms

Condoms won't protect against:

• Genital herpes
• Genital warts
• Pubic lice
• Scabies

Condoms do help protect against:

• HIV
• Hepatitis B and C
• Gonorrhoea
• Chlamydia
• Syphilis