STI Screening

A sexually transmitted infection ( STI ) is an infection that can be passed from person to person when having sex. You can get an STI by having vaginal sex, anal sex, or oral sex. There are several different types of STI.

The ten most common STIs in Ireland are:

Anogenital warts are small lumps that develop on the genitals and/or around anus ( back passage ). They are sometimes just called genital warts. They are caused by a virus called the human papillomavirus ( HPV ). However, most people infected with HPV do not develop visible warts. You can be a ‘carrier’ of the virus without realising it, and you may pass on the virus to others who then develop warts. Treatment options include applying chemical to the warts or freezing the warts to destroy them.

Chlamydia is caused by a bacterium ( germ ) called Chlamydia trachoma is. It is the most common STI in Ireland. Symptoms include a vaginal discharge in women, and a discharge from the penis in men. You can be infected with Chlamydia for months, even years, without realising it as it often causes no symptoms. However even if you have no symptoms, you can still pass on the infection and complications may develop if it is left untreated (such as pelvic infection and infertility in woman). A short course of an antibiotic clears Chlamydia in most cases.

Genital herpes is caused by the herpes simplex virus. Once you catch this virus it stays with you for life but lies dormant without causing symptoms for most of the time. In fact, many people who are infected with this virus never have symptoms. If symptoms occur, they can range from a mild soreness to many painful blisters on the vulva or penis and surrounding area. A first episode of symptoms can last 2-3 weeks, but may be shorter. Recurrent episodes of symptoms then develop in some cases from time to time, but are usually less severe than the first episode. (It is similar to having ‘cold-sore’ on the genitals from time to time.) Antiviral medication can ease symptoms when they develop.

Gonnorrhoea is caused by a bacterium called Neisseria gonorrhoeae. Symptoms include a vaginal discharge in women, and a discharge from the penis in men. Again, some people infected with gonorrhoea do not develop symptoms. However, even if you have no symptoms, you can still pass on the infection and complications may develop if it left untreated (such as pelvic infection and infertility in woman). A short course of an antibiotic clears gonorrhoea in most cases.

HIV (human immunodeficiency virus) is most commonly passed on by sexual contact. HIV attacks cells of the immune system. Over time (usually several years) the immune system ‘weakens’ so that you cannot defend your body against various bacteria, viruses and other germs. This is when AIDS develop (acquired immunodeficiency syndrome). Many infections and conditions can develop if you have AIDS. Treatment with antiretroviral drugs can reduce the ‘viral load’ of HIV and allow your immune system to work effectively. However, treatment does not clear the virus from the body. Therefore, if you are infected with HIV you will need monitoring for the rest of your life, and treatment is longterm.

Hepatitis B is a virus that primarily attacks the liver. The virus is mainly passed on by sexual cantact, sharing contaminated needles or from an infected mother to her baby. The hepatitis B virus can cause a short term (acute) infection, which may or may not cause symptoms. Following an acute infection, some people develop a persistent infection called chronic hepatitis B. Many people with chronic B remain well, but can still pass on the virus to others (as they are ‘carrier). Some develop serious liver damage. If needed, antiviral medication may prevent or reduce the severity of liver inflammation and liver damage.

Hepatitis C is a virus that primarily attacks the liver. Most cases occur in people who share needles. There is a small risk that an infected person can pass on the virus while having sex. Some people clear the infection naturally. Some people with persistent infection remain free of symptoms, but some have symptoms. After many years of infection some people develop cirrhosis (a severe scarring of the liver), and some develop liver cancer. Treatment is difficult but it can clear the infection in up to half of cases.

Pubic Lice (often called ‘crabs) are tiny insects about 1-2mm long (smaller than a match-head). They lay eggs which hatch into lice after several days. Pubic lice attach strongly to hairs, and do not wash or brush off with normal cleaning. Pubic lice are passed on by close bodily contact, especially when having sex. The main symptom is itch mainly in the pubic hair area. However, you may not have any symptoms, but may still pass on the lice to others. Treatment with a lotion or cream usually clears the lice.

Syphilis is caused by a bacterium called Treponema pallidum. If it is not treated, it can spread in the bloodstream from the genital region to cause various symptoms and problems in different parts of the body over many years. A short course of antibiotics usually clears syphilis infection.

Trichonmonas is a protozoan, which is a tiny germ similar to bacteria. It can cause an infection that is not normally serious but symptoms can be unpleasant. Symptoms include a vaginal discharge in women, and a discharge from the penis in men. A course of antibiotics usually clears trichomonas infections.

Symptoms of each STI can vary from local symptoms affecting the genitals, to symptoms that affect various other parts of the body. The following is not a full list of all possible symptoms. However, these are the most common symptoms to look out for:

A vaginal discharge Abnormal vaginal bleeding A discharge from the penis A sore, ulcer, rash or lump that appears on the penis or around the vagina, vulva or anus. Pain when you have sex Pain when you pass urine (although the common reason for this is a urine infection and not an STI) Swelling of the glands in your groin.

But remember, in many cases of STI, no symptoms may develop. However, you can still pass on the infection to others even if you have no symptoms. Therefore, if you think you may have an STI, it is best to get it checked out.

Contact Killarney Medical centre and make an appointment

You will be seen initially by a doctor. They will ask you some questions to try to assess the situation and to determine what tests (if any) you may need. Examples of questions that you may be asked include:

What symptoms and/or concerns do you have? How many people have you had sex with in the last few weeks and were they male or female? What type of sex have you had – vaginal, oral, anal sex? Have you previously had an STI? What is the state of your general health? Do you take any regular medication? Do you have any allergies?

If you are a woman you may be asked about the date of your last period and whether there is a chance that you may be pregnant as this might affect treatment options.

A doctor will usually examine you. You can ask for a male or female doctor. The examination includes looking carefully at your genitals for signs of discharge, redness, lumps or ulcers. If necessary, the doctor may also do a general examination to check on your general health.

Depending on the initial assessment and examination, the doctor may advise on some tests and ask for your consent to do the tests. Tests may include:

A urine test. For this test you will be asked to pass some urine into a sterile pot. (It is best not to go to the toilet just before attending the clinic in case you are asked for a urine sample).

Swabs. A swab is a small ball of cotton wool on the end of a thin stick. It can be gently rubbed in various places to obtain a sample of mucus, discharge, or some cells. The sample can be looked at under a microscope and sent away to the lab for testing.

Depending on what is suspected, a swab can take a sample from: just inside the urethra, inside the vagina, the cervix (neck of the womb), throat, and rectum (back passage). Swabs are used to detect Chlamydia, gonorrhoea, trichomonas and genital herpes. A swab sample can also detect thrush, bacterial vaginosis, and various other bacteria which may not be sexually transmitted infections.

Blood tests. A sample of blood from a vein may be taken. This is mainly used to test for syphilis, hepatitis B, hepatitis C, and HIV.

Sometimes a doctor will be able to diagnose an STI from the examination. Sometimes you will need to wait for the results of some tests. You may be given an appointment to come back for the results of tests, or in some situations you may be able to phone for the results.

The treatment that you will be offered depends on what STI is found. For example, a short course of antibiotics can usually clear away Chlamydia, gonorrhoea, syphilis and trichomonas. A cream or lotion can clear pubic lice and scabies. Topical treatment can usually clear most anogenital warts. Treatment for genital herpes, hepatitis B, hepatitis C, and HIV are more involved and complex. You will be given advice about what treatment options you have and given time to ask questions.