Could you have an STI? Here’s what to do

You’d know if you had a sexually transmitted infection (STI), right?

Not so fast, says Dr Kathleen McNamee, Medical Director of Family Planning Victoria. Most people who are diagnosed with STIs have no symptoms at all.

“People think they’d know if something was wrong. They don’t realise they might be susceptible, or they feel they’d have a symptom if they had a sexually transmitted infection, but sometimes they don’t have any symptoms at all,” Dr McNamee says.

Take chlamydia, for example. It’s one of the most common STIs in Australia and the number of confirmed cases has increased five-fold since 1999, but 85-90% of people are asymptomatic.

Yet the infection can be silently lurking in your body, and can lead to serious health issues like pelvic inflammatory disease, which can cause long term pain, as well as infertility and problems during pregnancy—including miscarriage and stillbirth.

Are you at increased risk?

STIs are most common in people under 30, so if that’s you, and you are sexually active, regular screening is recommended.

Men who have sex with men are also at much higher risk – more than 90% of syphilis and gonorrhoea cases in cities and regional areas and more than 80% of new HIV cases occur in men who have sex with men. 3-month testing is recommended in all men who have had any type of sex with another man in the past 3 months. People who have more than one sexual partner are also much more likely to get an STI, and the risk goes up the more partners you have.

Talk to your doctor or visit a sexual health or family planning clinic if you’ve had unprotected sex or someone you’ve been intimate with has told you they’ve had a STI — or if you have symptoms you’re worried about.

You have an STI – now what?

First of all, don’t freak out. Most STIs are easy to diagnose and treat. Your doctor or nurse might ask you detailed questions about your sexual history to get a better idea of your overall level of risk and decide whether you need to be tested for other STIs.

The next steps will depend on what type of infection you have.

Will I need more tests?

Depending on the STI, you may need another test to check whether the infection has been cured, or to make sure you haven’t caught it again.

With gonorrhoea, there’s a risk that the bacteria will be resistant to antibiotics, so your doctor may recommend you come back for a test after two weeks to make sure the treatment worked. That’s not an issue with chlamydia—but there’s a different common annoyance—you clear the infection but get it again.

“For chlamydia the treatment is effective, but the chances of being reinfected in the next three months are higher than the antibiotics not working,” Dr McNamee explains. “We recommend testing again in three months because there’s quite a high rate of reinfection.”

Spreading the word (but not the infection)

It’s essential that your partner gets treated too – in Victoria, the Northern Territory and New South Wales, health professionals may be able to prescribe for partners of people who have been diagnosed with chlamydia without actually seeing them. As awkward as it may seem, telling past (and present) partners is important.

“Try to contact any person you’ve had sexual contact with in the last six months if you can and you feel safe to,” Dr McNamee says.

Not sure what to say? The website letthemknow.org.au can help ease some of the dread —it offers tips to break the ice for the conversation, templates and even the last resort option to send an anonymous text or email through the site.

Prevention is better than cure

Of course, we’d all prefer to prevent STIs in the first place. You’re probably well aware that using a condom is one of the most effective ways to do that. Even if you’re in a committed relationship, condoms are recommended prior to both partners getting the all-clear on an STI check.

“Condoms give good protection, but not 100%,” Dr McNamee says. “Even if you’re really careful about bodily fluids and use barrier methods every time, things like herpes virus that are carried on larger areas of skin can still be transmitted… and of course a condom can always break.”

Are you using condoms correctly?

“It’s really important to check the expiry date and be careful with opening the condom because things lie jewellery or opening the packet with your teeth can cause little tears that you might not notice. The penis needs to be erect when you put it on and make sure the top is pinched and rolled down.”