Sexually Transmitted Infections

Description

Sexually transmitted infections (STIs), also known as Sexually Transmitted Diseases (STDs), are caused by bacteria, viruses or parasites that are transmitted through unprotected sex (vaginal, anal, or oral) and skin to skin genital contact. Zika Virus can also be sexually transmitted.

Bacterial infections include bacterial vaginosis, chlamydia, gonorrhea, Lyphogranuloma venerum (LGV) and syphilis. Viruses cause genital herpes, Hepatitis B, Human Papillomavirus (HPV) and Human Immunodeficiency Virus (HIV). Parasites are responsible for trichomoniasis and pubic lice.

STIs occur worldwide, but some infections like chancroid, LGV, and Granuloma inguinale are more common in less industrialized countries.

Risk

Travellers are at high risk of acquiring STIs if they have unprotected sex outside a monogamous relationship, engage in casual sex, or use the services of sex workers. During travel, some people may be less inclined to follow social mores dictating their behaviour back home and look for adventurous opportunities involving sex. Long term travellers may also be at increased risk due to feelings of loneliness or being homesick.

Travellers should also be aware of sexual tourism and how it spreads STIs. Sexual tourism is travel for the procurement of sex abroad. Travellers participating in this type of exploitive tourism use the services of sex workers or children that are forced to engage in the trade as a result of deceptive practices or are part of human trafficking networks. It’s illegal in many countries and you can be prosecuted in your home country for engaging in sexual exploitation of minors abroad. Sexual violence such as rape can also increase risk of acquiring STIs.

Symptoms

In many cases, sexually transmitted infections can be transmitted unknowingly because a person can be asymptomatic – does not exhibit symptoms. Depending on the infection, symptoms can appear within days or weeks (chlamydia, gonorrhea, genital herpes), weeks or months (Hepatitis B, HIV, syphilis) after exposure to the mircroorganism. Common symptoms – which may appear alone or in combination – include abnormal genital discharge, burning sensation when urinating, bleeding after intercourse or between periods, rashes and sores in the genital or anal areas, swollen lymph glands in the groin, and sudden fever or appearance of flu-like symptoms.

Note that the sudden or eventual disappearance of symptoms does not mean you are cured from the infection since it can return or manifest itself in different symptoms. Many sexually transmitted infections can be treated with antibiotics (although gonorrhea is becoming increasingly resistant to antibiotics) or antivirals. If left untreated, infections can lead to infertility, pelvic inflammatory disease, cancer, chronic liver conditions, pregnancy complications, and birth defects.

Prevention

Travellers should take precautions to prevent STIs.

• Always practice safe sex – use a condom correctly and consistently or abstain from intercourse. If engaging in oral sex, use a male condom or dental dam.
• Pack male and / or female condoms. Note that condoms obtained abroad may have higher breakage rates, may be expired, or may have been stored in hot or humid places compromising their effectiveness. 
• Birth control methods such as oral contraceptives, injections, IUDs, or diaphragms do not prevent STI transmission and condoms are not fully effective from infections acquired through skin-to-skin contact like genital herpes.
• Avoid behaviour that increases the risk of contracting an STI such as casual sex with a stranger or a sex worker. Drinking heavily or taking mind-altering drugs will impair judgement and inhibitions during a sexual encounter, increasing the risk of making unsafe choices like not using a condom. 
• Avoid getting tattoos, body piercings, or acupuncture treatments. Also don’t share razors, toothbrushes, or needles. 
• If you have engaged in risky sexual activities or suspect that you may have an STI, visit a healthcare provider immediately. If the results confirm that you have an STI, inform all your sex partners and encourage them to seek testing and medical attention.

Hepatitis B and Human Papillomavirus (HPV) can also be prevented through vaccination.