Fact or fiction? Clearing up myths and misleading information about STI's

Can you tell which STI you have from symptoms only?

No, at least in most cases. Many symptoms of different STIs overlap, such as unusual discharge, pain when urinating and soreness and swelling of the vulva in women or the head of the penis in men. (1) Some STIs do have their own specific symptoms, such as black powder in underwear with pubic lice, but it is also important to remember that not everyone with a particular STI will experience all of the symptoms, and some may have no symptoms at all! Furthermore, HIV and Hepatitis B don’t cause symptoms, other than a flu-like illness which may occur a few weeks after infection. All of this is why it’s important to get tested! (1, 2)

Is there a single treatment for all STI's?

No. There are certain STIs that are caused by bacteria, some are caused by viruses, and others are caused by parasites, so the same treatment won’t work for them all. Also, different STIs need to be treated for different lengths of time, ranging from just a week long course of doxycycline (an antibiotic) for some cases of chlamydia to lifelong treatment with a daily cocktail of antiviral drugs for HIV.

Can all STI's be cured?

No. As previously mentioned, people living with HIV need ongoing treatment with many different antiviral drugs to keep the level of the virus in their body as low as possible. Genital herpes, as with any other herpes virus, remains dormant in the body once contracted, undetectable by the immune system – and can flare up at any time, particularly during times of stress or ill health. Genital warts are caused by one of several human papilloma viruses (HPVs) which tend to remain in the skin, even if there are no visible warts present, and can cause flare ups – although in some people, the immune system may eliminate the virus eventually. (3)

Conversely, some STIs can be cured very easily with a simple course of antibiotics, such as chlamydia, gonorrhoea and trichomoniasis.

Can I catch an STI from kissing?

No. Still, beware of cold sores, which are caused by a type of herpes virus (usually a different strain to the genital herpes virus) – these can be passed on through kissing.

Can I catch an STI from a toilet seat?

No. STIs can’t survive outside of the body for more than a few seconds (an exception to this rule is Hepatitis B, which can survive outside the body for at least seven days - but it is not strictly classed as an STI due to there being several other ways to contract it). (4)

Can I get an STI again even if I’ve been treated before?

Yes. Courses of treatment for curable STIs are to treat the current infection and offer no protection against future infections. Likewise, your body cannot develop immunity to STIs.

Do I need a “test of cure” for all treatments?

No – only for gonorrhoea. For pubic lice, the affected area should be checked to ensure there are no live lice one week after treatment ends. However, for any STI that can be cured with a course of treatment, see your GP if symptoms persist after you have completed the course. (5, 6)

Are men or women more likely to catch an STI?

The proportions of men and women being diagnosed with the various different STIs vary based on the STI in question and also year by year. Several factors can affect how many men and women are diagnosed with STI's, including women tending to show fewer symptoms due to most of their genitals being internal and therefore less visible, and women being more likely than men to attend an STI test. STI's seem to disproportionately affect homosexual men, possibly due to less frequent condom use compared with the heterosexual population. (7)

I’m pregnant, will my baby be affected?

Many STIs can affect unborn babies during pregnancy or be passed to the baby during birth.

• Chlamydia can cause premature birth or low birth weight. Transfer from mother to baby during birth can lead to conjunctivitis and pneumonia. (8)

• Gonorrhoea can cause miscarriage or premature labour. The baby may contract the infection during birth and develop conjunctivitis (an eye infection). If this is left untreated or treatment is delayed, the child may suffer from permanent impaired vision or even blindness. (9)

• Trichomoniasis may cause low birth weight and premature birth. (10)

• Genital warts can occasionally infect babies during birth, leading to infection in either the throat or genitals. (3)

• Genital herpes can cause neonatal herpes in the baby. This is a very serious infection and is potentially fatal, but it usually only develops if the mother contracts genital herpes while she is pregnant. (11)

• Syphilis can cause serious complications during pregnancy, including miscarriage, stillbirth and syphilis infection in the baby (congenital syphilis). Routine testing for syphilis is available to all pregnant women in this country for this reason. (12)

If you are pregnant and are in doubt as to whether you may have an STI, consult your midwife or see your GP.

References

1. NHS. Sexually transmitted infections (STIs) [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/

2. NHS. Pubic lice [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/pubic-lice/

3. NHS. Genital warts [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/genital-warts/

4. CDC.Hepatitis B Questions and Answers for the Public [cited 1 May 2019]. Available at: https://www.cdc.gov/hepatitis/hbv/bfaq.htm

5. NICE CKS. Gonorrhoea [cited 1 May 2019]. Available at: https://cks.nice.org.uk/gonorrhoea#!scenario

6. NICE CKS. Pubic lice [cited 1 May 2019]. Available at: https://cks.nice.org.uk/pubic-lice#!scenario

7. FPA. Sexually transmitted infections factsheet [cited 1 May 2019]. Available at: https://www.fpa.org.uk/factsheets/sexually-transmitted-infections

8. NHS. Complications: Chlamydia [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/chlamydia/complications/

9. NHS. Complications: Gonorrhoea [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/gonorrhoea/complications/

10. NHS. Trichomoniasis [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/trichomoniasis/

11. NHS. Genital herpes [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/genital-herpes/

12. NHS. Syphilis [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/syphilis/

Author
Gabby Gallaher MPharm

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
7 May 2019