Sexually transmitted infections (STIs)

Information on Chlamydia, Gonorrhoea and Syphilis infections including their signs and symptoms, transmission and treatment are listed below.

Chlamydia

The most common infection between the ages of 15 - 25 year olds.

Often has no symptoms, but if left untreated, can cause serious problems such as Pelvic Inflammation, ectopic pregnancy or rarely, infertility. Chlamydia can be passed on easily thorough sexual contact:

  • Vaginal, penile, anal, oral sex
  • Sharing sex toys
  • Pregnant women can pass the untreated infection to their baby at birth

The symptoms are rare.

70% of females have no symptoms. 50% of males have no symptoms. 

If you do notice symptoms, they are likely to be:

  • Pain when urinating
  • Discharge from the penis, vagina or rectum (back passage)
  • Women may experience lower abdominal pain, bleeding between periods, bleeding during sex, pain during sex
  • Men may experience pain or swelling of the testicles and painful sex

Testing is free easy and simple.

If you have a vagina, a self-taken swab is done. If you have a penis then a urine sample is collected. If you have ever had anal sex, a self-taken swab is done.

It can take up to 2 weeks for the infection to show up in your body, after the sex you are concerned about. This is called the incubation period.

If you have symptoms then a trained and qualified Nurse or Doctor will examine you and likely recommend some other tests. The Nurse or Doctor will discuss these with you.

Chlamydia and Gonorrhoea are both bacterial infections so are therefore treated with antibiotics.

You and your partner(s) should refrain from having sex for 7 days after treatment. This stops you both from being reinfected. This ensures enough time for the bacteria to be killed.

For gonorrhoea, we will offer you a repeat test after 3 weeks to make sure the infection has gone and the antibiotics have worked.

If left untreated, long-term effects of gonorrhoea can include:

  • Pain, discharge
  • Male and female infertility
  • Ectopic pregnancy
  • Miscarriage
  • Scarring of male urethra
  • Can be passed to the baby during pregnancy which may cause eye infections or genital infections in the newborn

Gonorrhoea

An infection that is very common between the ages of 15 - 25 year-olds, that can be passed on easily thorough sexual contact:

  • Vaginal, penile, anal, oral sex
  • Sharing sex toys
  • Pregnant women can pass the untreated infection to their baby at birth

The symptoms are rare.

50% of women with gonorrhoea have no symptoms. 1 in 10 men with the infection have no symptoms.

If you do notice symptoms, they are likely to be within 1 - 14 days of sexual contact and include: 

  • Yellow/greenish discharge from the penis, vagina or rectum (back passage)
  • Burning when urinating
  • Infection in the throat may be indicated by a sore throat
  • Less common but some women may experience lower abdominal pain, pain during sex, bleeding between periods
  • Men may experience pain or swelling of the testicles and painful sex and the need to urinate more

Testing is free easy and simple.

If you have a vagina, a self-taken swab is done. If you have a penis then a urine sample is collected. If you have ever had anal sex, a self-taken swab is done.

It can take up to 2 weeks for the infection to show up in your body, after the sex you are concerned about. This is called the incubation period.

If you have symptoms then a trained and qualified Nurse or Doctor will examine you and likely recommend some other tests. The Nurse or Doctor will discuss these with you.

 

Chlamydia and Gonorrhoea are both bacterial infections so are therefore treated with antibiotics.

You and your partner(s) should refrain from having sex for 7 days after treatment. This stops you both from being reinfected. This ensures enough time for the bacteria to be killed.

For gonorrhoea, we will offer you a repeat test after 3 weeks to make sure the infection has gone and the antibiotics have worked.

If left untreated, long-term effects of gonorrhoea can include:

  • Pain, discharge
  • Male and female infertility
  • Ectopic pregnancy
  • Miscarriage
  • Scarring of male urethra
  • Can be passed to the baby during pregnancy which may cause eye infections or genital infections in the newborn

Syphilis

An infection that is rising with more and more infections being diagnosed. Syphilis is a bacteria and can be passed on easily thorough sexual contact:

  • Vaginal, penile, anal, oral sex
  • Sharing sex toys
  • Pregnant women can pass the untreated infection to their baby at birth
  • Through direct skin to skin contact with someone with a syphilitic rash or sores

The symptoms have 3 stages.

Many people don't notice the symptoms in the early stages and only discover the infection from a routine STI blood test

 

If you do notice symptoms at the first stage, they are likely to include: 

  • Ulcers, often called Chancres on your genital area or mouth if you have had oral sex
  • May occur 1 week after infection or many months later

 

If left untreated the infection will progress. If you do notice symptoms at the second stage, they are likely to include: 

  • A painless rash that is normally not itchy
  • Spread all over the body or appear in patches, sometime on the trunk of the body but can also be seen on palms or soles of feet.
  • White patches on the roof of the mouth if you have had oral sex
  • Patchy hair loss
  • Flu-like illness including loss of appetite and tiredness
  • Swollen glands
  • This can last weeks and months
  • Less common but some women may experience lower abdominal pain, pain during sex, bleeding between periods
  • Men may experience pain or swelling of the testicles and painful sex and the need to urinate more

 

If left untreated for years, the infection will progress to the third stage. The infection can cause very serious damage to the brain, nervous system, heart and eyes. At this stage syphilis can be life threatening.

 

Testing is free easy and simple.

You can get tested at any time if you think you have been exposed to syphilis. A simple blood test is all that is required. If you have an ulcer then we may take a sample from that ulcer. Syphilis can take up to 3 months to show up in your body, this is called the window period.

You will be treated with antibiotics which will be injected into your glutes.

Once you have been diagnosed with syphilis you cannot be a blood donor. 

These 2 infections BV and Thrush are not sexually transmitted infections but can develop after you have had sex.

Genital Warts

What is it?
Genital warts are small lumps on the skin, which can affect the vaginal area, the penis, testicles and the area around the anus (back passage). Less commonly they can be seen inside the rectum, in the vagina or cervix.  Genital Warts are caused by the Human Papilloma Virus (HPV).

This is a common virus, but not everyone who has the virus develops genital warts. It is a STI that is passed on via skin-to-skin contact. You don’t need to actually have penetrative sex (vaginal, anal or oral) to pass it on. Most transmissions occur when warts are present, but it is still possible to transmit the virus when there are no visible warts.

 

Symptoms
Many people who get HPV don’t show any signs or symptoms (including genital warts) and over time the virus may go away on its own. If you do get genital warts they can develop from 3 weeks to many years after coming into contact with the virus, so it is impossible to say when and who you got it from.  They look like small growths, bumps or skin changes that appear in the genital area that weren’t there previously.

There can be one or several and usually do not cause any pain. They can occasionally itch or bleed depending on where they are. Testing There is no routine test for HPV (including genital warts). If you think you may have genital warts a doctor or nurse will examine you and confirm the diagnoses. 

 

Treatment 

Treatment depends on what your warts look like, where they are and how they are affecting you. We will also consider your general health and immune system before deciding the best treatment for you. 

Treatment usually involves creams at home or applying freezing therapy in clinic. Rarely they can be removed with surgery (using local anaesthetic).  

A vaccine is available that protects you from getting the main types of HPV. This is now given to all girls and boys aged 12–13 as part of the national vaccination programme. 

However the HPV vaccine is not something we routinely provide in our clinics for this age group.

Men who have sex with men aged 15-45 will be offered the vaccine at our clinics under the new HPV programme.  

 

Long Term Effects 

If untreated, genital warts may disappear, stay the same or grow larger in size or number. It is not usually harmful to your health if the warts are not treated but you may find them uncomfortable and may not like the way they look.

Hepatitis B

What is it?

Hepatitis B is a virus that infects the liver. It can be diagnosed by a blood test. The virus is present in body fluids such as blood, saliva, semen and vaginal fluid. It can be passed on easily through unprotected sex (vaginal, anal or oral), sharing sex toys, rimming and sharing injecting drug equipment or through a pregnant mother during childbirth.

We recommend and provide a vaccination for people who are particularly at risk of catching Hepatitis B sexually. This includes men who have sex with men, and those who may have a high-risk partner, pay or are paid for sex, had sex in high prevalence countries or an injecting drug user.  

 

Symptoms 

Many people who get Hepatitis B notice no symptoms or they are so mild that they may not realise they have it.

Sometimes after initial infection people may experience some symptoms such as nausea and vomiting, loss of appetite, itchy skin, diarrhoea, extreme tiredness, stomach pain, jaundice (where your skin and the whites of your eyes turn yellow, your urine turns dark and your faeces (poo) turn pale) or mild flu like illness.

Symptoms can last several weeks, taking months to get back to normal.

 


Testing

You can be tested for Hepatitis if you think you may have been at risk. A blood test is used to diagnose Hepatitis B. 

 

Treatment 

Treatment for Hepatitis B depends on how long you’ve been infected for –
• If you’ve been exposed to the virus in the last few days, emergency treatment can help stop you becoming infected 

• If you’ve only had the infection for a few weeks or months (acute Hepatitis B), 

• You may only need treatment to relieve your symptoms while your body fights off the infection. 

If you’ve had the infection for more than six months (chronic Hepatitis B), you may be offered treatment with medicines that can keep the virus under control and reduce the risk of liver damage. 

Chronic Hepatitis B often requires long-term or lifelong treatment and regular monitoring to check for any further liver problems.

 

Long Term Effects
Most people make a full recovery from Hepatitis B but up to one in 20 become ‘Carriers’ with chronic (long-term) infection.

They usually feel fine but stay infectious to others, with a small risk of going on to develop liver disease. Around one in 100 people get a more serious illness which can be fatal if not treated immediately.

HIV

HIV stands for Human Immunodeficiency Virus. This virus attacks the immune system and weakens your ability to fight infections.

 

What is it?
Human Immunodeficiency Virus (HIV) affects the immune system. It is the virus that can lead to Acquired Immune Deficiency Syndrome (AIDS) if it is left untreated. 

Anyone who has had unprotected sex including anal, vaginal and on rare occasions oral sex could be at risk of HIV. It can also be transmitted via sharing needles and from a HIV positive mother to her child through pregnancy, childbirth and breast milk. It cannot be passed on through;

• Hugging, kissing, shaking hands, sharing cups/cutlery, coughing or sneezing
• Toilet seats, swimming pools, showers, hot tubs, towels
• Mosquito bites


Symptoms
The symptoms for HIV can differ from person to person and not everyone will develop symptoms. It is possible to experience a short flu like illness which could occur 2-6 weeks after becoming infected.

Symptoms could include fever, rash, sore throat, swollen glands and headache. 

 

Testing
Testing for HIV is a simple blood test. Results are usually available within a few days. To arrange to have a test call the central booking line to book an appointment. 0300 131 7010. 

We routinely offer all patients who have a new sexual partner a blood test for HIV. The time it takes for your test to show a positive result for HIV is, in most cases, 4 weeks. You will be advised to have a test on the day you attend the clinic and again in 4 weeks from the time of the possible exposure i.e. when you had sex.


There are also rapid tests called Point of Care Tests (POCT) where you can obtain your results from a simple finger prick. Results take 20 mins. These are offered in some situations where an urgent result is required. 


Treatment
If the test is positive this means that you have HIV and will be referred to a HIV specialist within our department. 

There is no cure for HIV but there are a number of highly effective, easy to take treatments. This medication can help prevent people from becoming unwell. Taking this medication every day correctly will prevent further damage to your immune system and allow you to live a full and active life.

Once the virus becomes Undetectable within your system the virus becomes Untransmittable,  meaning you can’t pass on the virus to others.

This is known as U=U. 

Safer Sex Information

Some of the ways you can ensure that you are staying safe is:

  • by using condoms for vaginal or anal sex
  • by using condoms or dental dams for oral sex
  • avoid Sharing sex toys – but if you do – wash them between use or use them with condoms

Mpox information for patients

Mpox is a rare viral infectious disease.  

It is usually a mild self-limiting illness, spread by very close contact with someone with mpox and most people recover within a few weeks.

A sustained reduction in Mpox case numbers across England and the success of vaccination in helping to control the outbreak means the vaccination programme is no longer needed as an outbreak control measure and can now be wound down. 

 

More info ▶ Monkeypox in the UK | Terrence Higgins Trust (tht.org.uk)