Sexually transmitted infections (STIs)
STIs are a broad group of infections passed on during vaginal, anal and oral sex, and some of them simply through close skin and mucous membrane contact.
On this page
- Why "nothing is bothering me" proves nothing
- What can put you on notice
- When this cannot wait
- You can be tested anonymously and without a referral
- Why a test straight after the risk may show nothing
- What the appointment involves
- Treatment: finish it, treat the partner, no sex during the course
- What lowers the risk in advance
- After the risk: emergency HIV prophylaxis, where hours decide
- Online consultation
Medicines commonly prescribed for Sexually transmitted infections (STIs)
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 800 mgActive substance: aciclovirManufacturer: Laboratorios Cinfa S.A.Prescription requiredDosage form: TABLET, 200 mgActive substance: aciclovirManufacturer: Laboratorios Normon S.A.Prescription requiredDosage form: ORAL SOLUTION/SUSPENSION, 200 mg/5 mlActive substance: azithromycinManufacturer: Sandoz Farmaceutica S.A.Prescription required
STIs are a broad group of infections passed on during vaginal, anal and oral sex, and some of them simply through close skin and mucous membrane contact. They have far less to do with how many partners someone has had than people assume: one partner who does not know they are infected is enough. Two things make this subject different from most. First, the majority of STIs cause nothing at all for a long time, so "nothing hurts" does not mean "I am fine". Second, you can be tested anonymously, without a referral and without having to explain yourself.
Why "nothing is bothering me" proves nothing
Chlamydia causes no symptoms whatsoever in most women and in half of men. Gonorrhoea in the throat and rectum almost always passes unnoticed. HPV cannot be felt. HIV, after a short flu-like episode, can stay silent for years. Syphilis begins with a painless sore that heals on its own, so the person concludes it is over while the infection carries on.
Meanwhile an untreated infection is doing its work. In women, chlamydia and gonorrhoea travel upwards and inflame the womb and the tubes: that is where chronic pelvic pain, ectopic pregnancy and a share of infertility come from. In men the epididymis is affected. Syphilis reaches the nervous system and the heart after years. Some types of HPV eventually cause cancer of the cervix, anus, penis and throat many years later. All of these are quiet processes, and they can only be stopped at the stage when the person still feels nothing. The one way to know is to be tested — not by how you feel, and not by how a partner looks.
What can put you on notice
When symptoms do appear, they are usually these:
- unusual discharge from the vagina, penis or anus — changed in colour, amount or smell;
- burning or pain on passing urine, and needing to go often;
- sores, blisters, splits or small wart-like growths on the genitals, around the anus or in the mouth;
- itching, irritation and rash in the groin;
- bleeding between periods or after sex, and pain during sex;
- pain low in the abdomen, or pain and swelling of a testicle;
- rectal pain and discharge, or a sore throat that will not clear;
- painlessly enlarged glands in the groin, with a rash on the trunk, palms and soles — that is how syphilis shows itself.
None of these signs names an infection on its own: different STIs look alike, and so do conditions with nothing to do with them, from thrush to ordinary skin irritation. Treating yourself by symptom, on internet advice or with somebody else's leftover antibiotics, is worse than useless — the blurred picture then gets in the way of a diagnosis.
When this cannot wait
See a doctor the same day rather than next week if you develop:
- lower abdominal pain with fever, shivering or heavy discharge in a woman — this may be inflammation of the womb and tubes, and how quickly treatment starts decides whether the tubes stay open;
- sudden pain and swelling of a testicle;
- inability to pass urine;
- a genital ulcer with a high temperature and rapidly spreading swelling;
- eye pain, sensitivity to light and redness alongside purulent genital discharge;
- joint pain and a rash together with discharge — this is how disseminated gonorrhoea behaves.
Pregnancy is a separate matter. Any STI symptoms in pregnancy are looked into without delay: some of these infections pass to the baby during birth, and nearly all of that is preventable if it is known about in advance. For the same reason, tests for syphilis, HIV and hepatitis B are part of routine antenatal care everywhere, and declining them is unwise.
You can be tested anonymously and without a referral
This is the second barrier worth removing. Everywhere there are services people go to with exactly this question: public clinics, specialist centres, non-profit organisations, laboratories. The rules are broadly similar wherever you are:
- a referral is usually not needed, and often neither is an appointment;
- you can be tested anonymously, under a code, without giving your real name; anonymous HIV testing is available almost everywhere;
- the result is not passed to your employer, your family or your regular doctor unless you ask for it to be;
- you can ask to see a doctor or nurse of a particular sex;
- in many places testing is free, and a rapid HIV test almost always is;
- there are kits for taking your own samples at home, and HIV self-tests sold in pharmacies.
On the embarrassment, it is worth being blunt: the people who do this work hear these questions every day. Holding things back only harms you, because to take the right samples the doctor needs to know what kind of sex you have had. Throat and rectal swabs are not taken from everyone as a matter of course, only from those who mention it, and without them infection at those sites simply will not be found.
Why a test straight after the risk may show nothing
Every infection has a period during which it is already in the body but the test cannot yet see it. Being tested the morning after unprotected sex means checking yourself for what came before, not for that night. Rough guides are:
- chlamydia, gonorrhoea, trichomoniasis and mycoplasma — about two weeks;
- HIV — modern tests that detect antibody and antigen together become reliable at around six weeks; a final negative result is usually confirmed at three months;
- syphilis — from three to four weeks, reliably by three months;
- hepatitis B and C — from a few weeks to three months.
Exact intervals depend on which test is used, so it is best to ask at the laboratory. If you have symptoms, there is no waiting for the window to pass: you are examined straight away and any missing tests are repeated later. And until the results are back, it is sensible to avoid sex or to use a condom.
What the appointment involves
There is nothing frightening about it. The doctor or nurse will ask what sex you have had and when, whether you have any symptoms, and what medicines you have already taken. Then an examination if one is needed, and samples:
- urine, the first part of the stream, for chlamydia and gonorrhoea in men;
- swabs from the vagina, cervix and urethra and, depending on the sex you have had, from the throat and rectum as well; in many places a vaginal swab can be taken by the woman herself;
- blood, for HIV, syphilis and hepatitis B and C;
- examination or scraping of skin lesions, sores and wart-like growths.
It is worth testing for several infections at once, because they travel together and finding chlamydia says nothing about syphilis. Women should also keep up regular cervical screening — cytology and an HPV test. That runs through the national programme, and it complements STI testing rather than replacing it.
Treatment: finish it, treat the partner, no sex during the course
Bacterial and parasitic infections — chlamydia, gonorrhoea, syphilis, trichomoniasis, pubic lice, scabies — are cured completely, with antibiotics or with treatments applied to the skin. With the viral ones it is fairer to be plain: HIV is very well controlled with medication today, and on regular treatment the virus stops being detectable in the blood and is not passed to a partner, but it does not leave the body. Herpes stays too, though outbreaks can be made rare and short. HPV is cleared by the body itself in most people, and what is treated is not the virus but its consequences — warts and changes on the cervix.
Three rules on which things usually come apart:
- finish the course. Symptoms go before the infection does, and a course abandoned halfway leaves it in the body while getting the bacteria used to the antibiotic;
- be treated together with your partner. If only one of you is treated, the other hands the infection straight back, and round it goes. All partners from the past few months need treating; how far back depends on the infection and the doctor will say. You can tell them yourself, or a service can do it anonymously without naming you;
- do not have sex during treatment, oral sex included, nor for a while afterwards until the doctor says it is safe. A condom does not count as sufficient protection during that period.
After treatment for some infections a follow-up test is arranged. It is worth having even if nothing is bothering you.
What lowers the risk in advance
- Condoms, for vaginal, anal and oral sex. They sharply reduce transmission of HIV, chlamydia and gonorrhoea. Against infections spread by skin contact — herpes, HPV, syphilis — they protect only partly, because they do not cover the whole area of contact. For oral sex with a woman there is a latex sheet placed over the area; a condom cut open lengthways will do instead.
- Vaccination. There are vaccines against two STIs: human papillomavirus and hepatitis B. The HPV vaccine works best when given before someone becomes sexually active, and it is offered to adolescents of both sexes; in some circumstances it still makes sense later. The timing and ages are set by your country's national immunisation schedule.
- Pre-exposure prophylaxis for HIV. A person without HIV takes an antiretroviral medicine in advance so as not to become infected. This approach exists, a doctor prescribes it, and it is intended for people whose risk of infection is high.
- Regular testing when partners change — and for both of you before you stop using condoms with a new regular partner.
After the risk: emergency HIV prophylaxis, where hours decide
This is the least widely known part, and what it costs is precisely time. After sex during which HIV could have been transmitted, there is emergency prophylaxis: a 28-day course of antiretroviral medicines that stops the virus establishing itself. It works on one condition — speed. It should be started as early as possible, ideally within the first hours, and no later than 72 hours after the exposure; the longer the delay, the less it achieves, and after three days there is no point starting.
So if there has been unprotected sex with someone whose status you do not know, if a condom broke, if there has been a sexual assault or a needlestick injury from someone else's needle, go to a hospital or an HIV service immediately, at night and at weekends too. This is exactly the situation where "I will wait until Monday" means "the chance has gone". At the same visit they will assess the hepatitis B risk and, if needed, vaccinate and give immunoglobulin, offer emergency contraception, and arrange the tests to be repeated after the appropriate interval.
Online consultation
A great deal here is settled by talking, and talking is easier without someone sitting opposite you. The Oladoctor doctor will help you work out what you should be tested for and when, so you do not test inside the window period; will explain results you already have, including the lines on the form that make no sense; will advise on how to talk to a partner and what to do if only you have been given treatment; and will judge whether your symptoms fit an STI or whether the answer lies elsewhere. Prevention is a separate conversation: who benefits from the vaccine, what pre-exposure prophylaxis is, and where to go after a risky encounter. If the situation calls for urgent face-to-face care, you will be told so straight away.
This material is for information only and does not replace medical advice.
Consult with a doctor about Sexually transmitted infections (STIs)
Discuss your symptoms and possible next steps with a doctor online.
Online doctors for Sexually transmitted infections (STIs)
Discuss your symptoms and possible next steps for Sexually transmitted infections (STIs) with a doctor online.
