STIs: Facts, Prevention, Outcomes

Sexually Transmitted Infections (STIs)
Everything in life has risks associated with it and sexual
behaviour is no different.If a person is not sexually active STIs
will not pose a risk,although it is still important to be aware of
the following information.
(B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes
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Transmission/rate
of infection
Prevention Symptoms of the infection Methods of
treatment/testing
Possible consequences
if untreated
(B)
- through vaginal, anal or oral sex
- mother to baby during childbirth
RATE:
80% of reported cases are in 15-29
year olds
Rising trends in 15-19 years:
• 2002: 5,652 cases
• 2008: 14,560 cases
• 2011: 21,661 cases
Rising trends in 10-14 years:
• 2002: 251 cases
• 2008: 508 cases
• 2011: 711 cases
2011 - 80,800 diagnoses in all
groups
Because the infection usually
doesn’t cause symptoms and
many people remain untested,
numbers may be even higher.
- Increasing rates of diagnosis
of chlamydia are reported in all
States and Territories.
Ref: (A) (1) (2) (3) (4) (5) (36)
ALWAYS USE CONDOMS
and water based lubricant
during vaginal, anal and
oral sex
Use Dental Dams during
oral sex.
Regular testing is
recommended, especially if
sex has occurred with more
than one partner.
Chlamydia can be
transferred to the eyes
through rubbing or
touching with unwashed
hands.
The greater the number of
sex partners, the greater
the risk of infection.
Because the cervix
(opening to the uterus) of
teenage girls and young
women is not fully matured
and is more susceptible
to infection, they are at
particularly high risk for
infection if sexually active.
If symptoms are present, they usually appear
1-3 weeks after exposure
Females:
Please note: Over ¾ of women have no
symptoms
• Abnormal discharge from the vagina
• Pain when passing urine
• Menstrual changes such as longer, heavier,
more painful periods
Other symptoms occur if it travels to the
fallopian tubes (see Infertility below)
Males:
Please Note: about ½ of men have no
symptoms
• Discharge from the penis
• Pain when passing Urine
• Burning and itching around opening of
penis or pain
• Pain and swelling in the testes is uncommon
Other symptoms occur if it travels to the
epididymis (see Infertility below)
• Men or women who have receptive anal
intercourse may acquire chlamydial
infection in the rectum, which can cause
rectal pain, discharge, or bleeding.
• Chlamydia can also be found in the throats
of women & men having oral sex with an
infected partner.
Antibiotics through a single oral
dose or twice daily for 7 days
Abstain from sexual intercourse
for 7 days after single dose of
antibiotics or during the 7 day
course of antibiotics
No sexual activity until follow-up
testing reveals no signs of infection
and effectiveness of treatment
All sexual partners need to be
notified and treated
Re-testing within 3 months is
recommended
High Risk** Groups should be
tested every 12 months
Since chlamydia can be
transmitted by oral or anal sex,
men who have sex with men are
also at risk for chlamydial infection
and need regular testing
Babies born to mothers with
untreated chlamydia may develop
eye or lung infections, hence the
importance for pregnant women
to have a test for chlamydia early
in pregnancy.
Females:
Inflammation of the cervix,
which if untreated can spread
to the uterus, fallopian tubes,
ovaries and other parts of the
lower abdomen causing Pelvic
Inflammatory Disease (PID) and
possible infertility (see Infertility
below)
Males:
Epididymitis (inflammation of the
epididymis) and non-gonococcal
urethritis (urethral infection) and
possible infertility (see Infertility
below)
NOTE: Often called the“silent”
disease because the majority
of infected people have no
symptoms. If symptoms do occur,
they usually appear within 1 to 3
weeks after exposure.
Substantially higher rates of
diagnosis of chlamydia are
recorded in the Aboriginal and
Torres Strait Islander population
compared with non-Indigenous
population.
Chlamydia

Transmission/rate
of infection
treatment/testing
if untreated
Infertility may result from
untreated Chlamydia or
Gonorrhoea
Females:
Pelvic Inflammatory Disease
Males:
Epididymitis
RATE:
Females:
• 10 - 40% of women with
untreated chlamydia will
develop PID
• Post-infection tubal damage
is responsible for 30 – 40% of
female infertility
• Women who have had PID
are 6 – 10 times more likely to
develop and ectopic pregnancy
• 30 – 40% of ectopic pregnancies
relates to previous PID
Ref: (2) (7) (8) (9) (10) (35)
• Treatment of
Chlamydia and
Gonorrhoea with
antibiotics.
• Follow-up
testing within 3
months is highly
recommended.
Females:
If the infection travels from the cervix to
the fallopian tubes:
• Often no symptoms
• Pain in lower abdomen indicating
infection and damage of uterus (womb),
fallopian tubes (tubes that carry eggs
from the ovaries to the uterus) and
other reproductive organs
• Low back pain
• Nausea or fever
• Pain during intercourse
• Bleeding between menstrual periods
Males:
• Abdominal, lower back or groin pain
• Scrotal pain and swelling
• Pain/blood on urination
• Discharge
• Fever and chills / nausea
Advanced stages are untreatable
The risk of infertility following
chlamydia infection depends on:
• Time frame of infection
• Whether the infection had
spread, before treatment, into
the uterus or fallopian (egg-
conducting) tubes (females),
or into epididymis (sperm-
conducting tubes), (males.)
Females:
Irreversible consequences:
• infertility
• ectopic pregnancy (a pregnancy in the
fallopian tube or elsewhere outside the
womb, requiring emergency surgery
and can be fatal)
Other complications:
• abscess formation
• chronic pelvic pain
Males:
• Increased DNA fragmentation in male
sperm and lower fertility rates
• Sterility
• Prostatitis (infection and swelling of the
prostate gland)
• Abscess – (ball of pus accumulating
inside epididymis or nearby structures -
surgery is needed to drain the pus)
• Destruction of the epididymis. The
inflammation can permanently damage
or destroy the epididymis and testicle,
leading to infertility.
• Spread of infection – the infection can
spread from the scrotum to any other
structure or system of the body.
Infertility

Transmission/rate
of infection
treatment/testing
if untreated
(B)
Through vaginal, anal or oral sex
RATE:
• It’s the second most commonly
reported STI in Australia
• The number of diagnoses of
gonorrhoea increased by 25% from
7987 cases in 2009 to 10,007 in 2010,
and again rose to 12,119 cases in
2011.
Males:
Diagnosis increased from 49 in 2008
to 61.7 in 2010 to 72.9 in 2011 (per
100,000)
Females:
• Diagnosis increased from 23.7 in
2009 to 27.8 in 2010 to 35.6 in 2011
(per 100,000)
• In 2011, 61% of reported cases were
in 15-29 year olds
• There was a slight drop in rates
during 2007, however overall there
is an upward trend in the number of
infections from 2003 onwards.
Ref: (A) (6) (7) (11) (12)(13) (14) (36)
• ALWAYS USE CONDOMS
oral sex
• Use Dental Dams during
oral sex.
• Regular testing is
recommended, especially
if sex has occurred with
more than one partner.
PLEASE NOTE:
There are often no obvious symptoms.
If symptoms do occur, they usually
develop a few days to a week after the
bacteria have been introduced into
genital area while having sex with an
infected person
Females:
• Cramps/pain in lower abdomen just
above the pubic bone
• Change in vaginal secretions (may be
more secretion or may change in colour
and/or smell) - Pain and/or burning
sensation when passing urine
• Bleeding or spotting between periods
and after having sex
• Pain during or after sex
Males:
• Yellow discharge from penis
• Pain / burning sensation when passing
urine
• If the infection travels up the urethra,
testes may become swollen and sore
• Urine Sample
• Swab from cervix
• Swab from opening of penis
• Swab from anus
• Swab from throat
• Antibiotics through a single
does or a course of treatment
Other Infected areas:
Rectal infections:
• Pain in the rectum
• Discharge or mucus from the
anus
Throat infections:
• Sore throat - however, there may
be no symptoms at all
Females:
• PID (see infertility notes above)
• Babies born to mothers
infected with gonorrhoea
may be born early, have low
birth weights or develop eye
infections. Pregnant women are
encouraged to have STI check
early in their pregnancy
Males:
Infection can spread to the testes,
causing pain and some risk of
infertility. (see infertility notes
above)
Rare complications in both men
and women include septicaemia
and arthritis
Substantially higher rates of
diagnosis of gonorrhoea were
recorded in the Aboriginal and
Torres Strait Islander population
compared with non-Indigenous
population
Gonorrhoea

Transmission/rate
of infection
treatment/testing
if untreated
(V)
Human Papillomavirus (Genital
Warts)
Highly Transmissible
• through vaginal, anal or oral sex
• skin to skin contact
• mother to baby during childbirth
RATE:
• 4 in 5 (80%) of sexually active
men and women will acquire HPV
infection at some time in their lives
• Some estimates of prevalence
amongst women are much lower,
ranging from 2% - 44%, depending
on age
• If current incidence trends
continue, the annual number
of HPV-positive Oropharyngeal
(mouth and throat) cancers is
expected to surpass the annual
number of cervical cancers by the
year 2020. (USA)
Ref: (15) (16) (17) (18) (19) (20)
oral sex.
oral sex.
• Condoms reduce risk
but only protect the skin
which is covered.
• There is no evidence that
condoms reduce the
chance of getting HPV
during oral or anal sex.
PLEASE NOTE: Most people have no
symptoms; or:
• Genital warts which can multiply,
grow and bleed
• Usually appear as small bumps or
groups of bumps, usually in the
genital area or thighs. Can be raised;
flat; single; multiple; small; large;
cauliflower shaped
• May appear within weeks or months
after sexual contact with an infected
person
• Over 90% of genital warts are caused
by HPV genotypes 6 and 11
PLEASE NOTE: Even when the warts
have gone, the virus remains.
• Most people with HPV do not
develop symptoms or health
problems from it.
• In 90% of cases, HPV is cleared
by the body’s immune system
within 2 years
• If left untreated, genital
warts may go away, remain
unchanged, or increase in size or
number. They will not turn into
cancer
• Genital warts can be removed:
painting with a solution; burning
off using a laser or diathermy;
freezing with liquid nitrogen or
nitrous oxide.
• Get tested regularly: especially if
you or your partner has had sex
with more than one partner.
• Maintain good general levels of
health.
The Gardasil Vaccination for girls
and boys protects against HPV 16
& 18 which cause cancers – see
below
Regular Pap Smears – see below
The two most common“high-risk”
genotypes are 16 and 18 - they cause
approximately 70% of all cervical
cancers.
• Over 100 known HPV genotypes.
30 of these are sexually transmitted.
At least 13 of which can cause
cancer of the cervix.
• HPV can also contribute to Anal
Cancer.
Oropharyngeal:
• 70% of all new oral cancer cases
are linked to HPV: those who have
given oral sex six or more times are
at greatest risk, with men also at
high risk for the disease.
• Men who have multiple sex
partners are at higher risk for oral
cancers.
• Survival rates are better for those
with HPV-positive oral cancers than
those of HPV-negative oral cancers.
HPV

Rates Prevention Protects against Things to consider Vaccine side effects
National Vaccination Coverage (3
Dose) for girls aged 15 in 2009:
QLD – 71.1% NSW – 73%)
VIC – 76.1% SA – 72.4%
WA – 64.7% TAS – 63.7%
NT – 76.1% ACT - 79.6%
National - 70.8%
Since GARDASIL, diagnosis rate in
young Aust. women with genital warts
dropped: from 12.1% (2007) to 2.2%
(2011)
Ref:(6) (21) (22) (23) (24) (25) (36)
A Pap Smear does not diagnose
cancer. It looks for pre-cancers (cell
changes on the cervix that might
become cervical cancer if not treated).
• Approximately 1 in 179 Aust. women
will develop cervical cancer by age
85 (2007)
• It can present at any age after a
woman becomes sexually active, but
is extremely rare before the age of
20 years
Ref: (26) (27)
• Vaccine available through the National
Immunisation Program in Schools.
• It has the potential to reduce, but not
eliminate, the risk of cervical cancer.
GARDASIL may not fully protect
everyone, and does not prevent all
types of cervical cancer.
• GARDISIL is available for use in young
men with associated fees: inquire with
local GP.
• The national school-based HPV
Vaccination Program, has been extended
to include males. From February 2013,
males and females aged 12-13 years will
receive the HPV vaccine at school. Males
aged 14-15 years will also receive the
vaccine as part of a catch-up program
until the end of the 2014 school year.
• Simple procedure when cells are collected
from the cervix (the neck of the womb
at the top of the vagina) and placed
(smeared) onto a slide.
• The slide is sent to a laboratory where the
cells are tested for anything unusual.
• If abnormal changes are found at
screening, further tests will be done to see
if treatment is needed.
• Gardasil helps protect
against 4 types of HPV,
including:
• 2 types (16 and 18) that
cause 75% of cervical
cancer cases
• 2 more types (6 and 11)
that cause 90% of genital
warts cases.
• The effectiveness of
GARDASIL is much lower if
a woman is infected prior
to getting the vaccine.
• A regular Pap Smear
can find precancerous
changes early so
treatment is more
effective.
• A Pap smear only takes a
few minutes. No drugs or
anaesthetics are required
and it can be done by a
general practitioner, nurse
or women’s health worker.
• GARDASIL will not protect
against diseases caused by
other HPV types or against
diseases not caused by HPV.
• Women will still be at risk from
other high-risk genotypes,
so it’s important to continue
routine cervical cancer
screenings (Pap Smears).
• Those severely allergic to yeast
or other GARDISIL ingredients,
and pregnant women, should
not receive the vaccine.
• All women over 18 who have
ever had sex are advised to
have a Pap smear every two
years (even if they no longer
have sex.)
NOTE:
• The Pap smear does not check
for other problems in the
reproductive system. It is not a
check for sexually transmitted
infections. STIs require
different tests.
• Side effects can include pain,
swelling, itching, bruising and
redness at the injection site;
headaches; fever; nausea; dizziness;
vomiting and fainting, paralysis.
• These symptoms may happen even
months after getting the vaccine.
It is recommended to see a GP if
any of these symptoms or general
unwell feelings occur.
In addition to persistent HPV
infection, other factors associated
with increased risk of cervical cancer:
• High parity (large no. children)
• High no. sexual partners
• Young age at first sexual intercourse
(<18 years)
• Prior history of abnormal cytology
tests or cancer of the vagina or
vulva
Low socio-economic status
• History of smoking
• Women with immunodeficiency
disorders
• Indigenous women.
GardasilPapSmear

Transmission/rate
of infection
treatment/testing
if untreated
(B)
• Sexual contact with a person who
has syphilis.
• Spread through skin-to-skin
contact with an infected area and
oral, vaginal or anal sex without a
condom.
• Can also be passed from mother to
baby during pregnancy.
RATE:
• 29% of reported cases are in 15-29
year olds
• Rate across all age groups (2009)
5.8 per 100,000
• The rate of diagnosis of infectious
syphilis increased by 60%, from 4.2
in 2006 to 6.7 in 2007 and declined
to 4.9 in 2010.
• Syphilis infections doubled in
NSW and Victoria between 2004
and 2007 almost entirely through
increased numbers of cases among
homosexual men.
Ref: (6) (28) (29) (30) (31)
oral sex
oral sex.
• Condoms provide some
protection but only if they
cover the infected area.
• Sexual activity should be
avoided after treatment
until any rashes or sores
have gone.
Three stages: Primary, Secondary and
Tertiary
Primary Syphilis
• May be no symptoms; or
• Early stages (3 – 4 weeks):
development of a painless ulcer
which can turn into a rash across the
whole body.
• Flu-like symptoms and swollen
glands.
• Infectious
Secondary Syphilis
• 2 to 4 months: flat red skin rash may
develop on back, chest, hands and
feet.
• Fever, swollen glands, genital rash
and lethargy
• Symptoms may come and go for 2
years.
• Highly infectious.
• Effectively treated with
penicillin.
• Tested by a swab from initial
sore or a blood test.
• If it is not treated, a sore or ulcer
will heal and go away; however
the syphilis infection remains in
the body.
Late (tertiary) syphilis
May develop after many years and
cause:
• Nervous system problems
• Other organ system problems
• Heart failure
• Shooting pains
• Dementia
• Widespread ulcers
At this stage specialist management
is required. Latent and late syphilis
are not infectious.
• Estimated 2- to 5-fold increased risk
of acquiring HIV if exposed to that
infection when syphilis is present.
Note:
• The increased rates in recent
years are particularly in men who
have sex with men, and some
Aboriginal and Torres Strait Islander
communities
Syphilis

Transmission/rate
of infection
treatment/testing
if untreated
(V)
Herpes Simplex Virus (HSV)
HSV-1 – Herpes on the mouth
HSV-2 – Genital Herpes
• Transmitted through vaginal, anal and
oral sex as well as genital skin to skin
contact.
• Shed from genital tract even when
sores are not present so it’s not possible
to predict when a person is infectious.
• Passed from mother to baby through
childbirth
RATE:
• Approximately 1 in 8 sexually active
Australians has genital herpes.
• Of these, 20 per cent are aware that
they have the virus, 60 per cent are
unaware that they have it, but have
symptoms, while another 20 per cent
have no symptoms.
• Approximately 12% of Australian adults
are infected with HSV-2, and 76% are
infected with HSV-1.
Ref: (32) (33) (34) (35)
• ALWAYS USE CONDOMS and
water based lubricant during
vaginal, anal and oral sex
• Use Dental Dams during oral
sex.
recommended, especially if sex
has occurred with more than
one partner.
• Condoms may provide limited
protection from transmission of
genital herpes, but only protect
the skin that is covered.
• Although HSV-1 prefers the
mouth and lips and HSV-2
prefers the genitals, both can
affect both sites (although
the symptoms may not be as
severe.)
• This means a person can
become infected with HSV-1 on
their genitals if they receive oral
sex from a person with HSV-1 on
his or her lip.
• HSV is highly contagious.
• Can occur on genitals, around the
anus or on the mouth.
• Can be asymptomatic; or
• May cause itching, tingling, or pain
in the genital area, which is followed
by blisters.
• May be accompanied by flu-like
symptoms.
• Symptoms usually appear within 4
days but can appear anywhere from
2 to 12 days
• Sores can last anywhere from 8 to 10
days and form a scab.
• The amount of pain ranges from
mild to severe.
• Recurring outbreaks can be
triggered by things like fatigue,
stress and low self-esteem.
• A swab is taken from an
open blister.
• There is no cure for genital
herpes, however there
are medications that
help manage outbreaks
and reduce the risk of
transmission
• After an initial outbreak
some people will have
further outbreaks. This
generally becomes less
frequent and less severe.
• www.herpes.com.au has
comprehensive information
• Sexual health clinics often
list local support groups
• Sometimes herpes can cause
dysuria or urinary retention.
• (HSV2) is estimated to affect
12% of adult Australians
and can cause significant
psychological morbidity and
some physical morbidity
• If left untreated, the herpes
virus can cause meningitis
• Infection with HSV2 also
increases the risk of acquiring
HIV several-fold (particularly
exposed blisters), but efforts
to treat HSV2 to prevent HIV
infection have so far proved
ineffective.
• Transmission to neonates is
rare, but potentially fatal.
Herpes

Transmission/rate
of infection
treatment/testing
if untreated
(V)
• It can be spread sexually through
exposure to infected blood or body
fluids including breast milk, saliva,
vaginal secretions and semen.
• Primary risk factors are unprotected
sex with an infected partner, birth to
an infected mother, unprotected sex
with more than one partner, men who
have sex with other men (MSM), history
of other STIs, and illegal injection drug
use.
RATE:
• The population rate between 2005 –
2009 has been stable.
• Diagnosis of hepatitis B infection – 31
per 100 000
• Diagnosis of newly acquired hepatitis B:
1.2 per 100 000
• An estimated 209,000 people in
Australia were living with the Hepatitis
B infection in 2011
Ref: (6) (36)(37) (38)
• A vaccination against hepatitis B
is available.
sex.
one partner.
• Condoms may provide limited
protection from transmission
of Hepatitis B only if no bodily
fluids are exchanged
• Risk increases with drug
injection use
• Presence of signs and symptoms
varies by age.
• Most children under age 5 years and
newly infected immunosuppressed
adults are asymptomatic.
• 30%–50% of persons aged >5 years
have initial signs and symptoms.
Signs and symptoms may be:
• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colour bowel movements
• Joint pain
• Jaundice
• There are several types
of medication available
to treat hepatitis B and
most adults will recover
completely
• Can cause inflammation of the
liver. It can lead to severe liver
diseases and liver failure.
• Premature Death
• Based on reported cases, hep
B and hep C transmission in
Australia continue to occur
predominantly among people
with a recent history of
injecting drug use.
HepatitisB

Transmission/rate
of infection
treatment/testing
if untreated
(P)
Trichomonas vaginalis (TV)
It is estimated that 1 in 5 sexually active
women will contract trichomoniasis
during her life time
• Transmitted through penis-to-vagina
intercourse or vulva-to-vulva (the
genital area outside the vagina) contact
with an infected partner.
• Women can acquire the disease from
infected men or women.
• Men usually contract it only from
infected women.
RATE:
• Previously reported at an incidence of
1.1%, however new reports indicate a
higher prevalence of 4.8%
• Likely underdiagnosed in urban STI
clinic settings using only traditional
methods of detection. This may
present re-emergence with important
Public Health consequences.
• Some data suggest that trichomonal
infection is endemic in Aboriginal and
Torres Strait Islander populations
Ref: (39) (40) (46)
• A single celled parasite that
infects the urogenital tract
sex.
one partner.
• Condoms provide some
protection but only if they cover
the infected area.
• Sexual activity should cease
until completion of treatment
and resolution of symptoms
Whilst it infects both men and women
it is unusual for men to have any
symptoms
Women
• 1/3 asymptomatic
• Symptoms can include discharge,
pain when urinating and during sex
and itching of the genital area.
Men
• Usually asymptomatic but may
develop urethritis.
• The infection can usually be
cured with antibiotics
• The symptoms in infected
men may disappear within
a few weeks without
treatment. However, an
infected man, who has
never had symptoms or
whose symptoms have
stopped, can continue
to infect or re-infect a
female partner until he has
been treated. Therefore,
both partners should be
treated at the same time to
eliminate the parasite.
• Having trichomoniasis once
does not protect a person
from getting it again. They
may still be susceptible to
re-infection.
Associated with adverse
outcomes of pregnancy. These
include:
• Infertility
• Preterm delivery
• Low birth weight babies
• Premature rupture of the
membranes
Trichomoniasis can cause
genital inflammation that
makes it easier to get infected
with the HIV virus, or to pass the
HIV virus on to a sex partner
Trichomoniasis

Transmission/rate
of infection
Prevention Symptoms of the
infection
Methods of
treatment/testing
if untreated
(V)
Human Immunodeficiency Virus
• Transmitted through bodily fluids, including
semen, vaginal fluid, passing on from mother
to baby through pregnancy or breast milk; and
sharing needles or infected blood.
• Oral Sex is also a mode of transmission (low risk)
RATE:
The annual number of new HIV diagnoses in
Australia has remained relatively stable at around
1 000 cases per year in previous years
From 2005 – 2009, diagnoses occurred among:
• 66% men who have sex with men
• 23% heterosexual contact
• 3% injecting drug use
However, new diagnosis of HIV in 2011 was 1,137:
an increase of 8.2% over the number in 2010
In Australia it is estimated 20,956 people are living
with diagnosed HIV
Tasmania and Qld have experienced that largest
relative increases in HIV diagnosis over the past 10
years
Ref: (6) (36) (41) (42) (43) (44) (45) (47)
• Testing and treatment of STIs
can be an effective tool in
preventing the spread of HIV
• Chlamydia, gonorrhoea, syphilis,
and genital herpes all increase
the risk of HIV acquisition and
transmission.
• Consistent and Correct use
of Condoms is an effective
protection against HIV.
• You can’t get HIV from casual
contact such as shaking hands
or hugging.
• PEP (Post Exposure Prophylaxis),
is a course of anti-HIV drugs
taken shortly after possible
exposure to HIV infection.
These drugs may help reduce
the risk of acquiring HIV after
unprotected sex, sharing
needles or needlestick injury.
• Please note: Safe injecting and
safe sexual practices have been
important in keeping Australia’s
HIV infection rate low. Post
Exposure Prophylaxis is not
intended to replace these safe
practices.
After infection, the virus
may lay dormant and
cause no symptoms, so
a person who is infected
may not realise it.
Even without symptoms,
an infected person can
pass on HIV.
Some people experience:
• Flu-like illness
• Develop a rash
• May be asymptomatic
• The only way to know
for certain if someone
is infected with HIV is
for them to be tested.
• Without treatment,
people with HIV
develop AIDS, which
can be fatal.
• AIDS invades the immune system and
slowly destroys it. Reduces ability to
fight off infections and cancer.
• The body becomes more vulnerable to
infections, which it will have difficulty
in fighting off. It is at the point of very
advanced HIV infection that a person
is said to have AIDS. It can be years
before HIV has damaged the immune
system enough for AIDS to develop.
• Some people may experience flu-like
symptoms, extreme fatigue, weight
loss and mouth ulcers.
• There is no cure for AIDS. Antiretroviral
treatment can prolong the time
between HIV infection and the onset of
AIDS.
• In 2009, the number of AIDS diagnosis
dropped to 100 partly due to the wide
availability of effective antiretroviral
treatment for HIV infection.
HIVandAIDS

**High Risk Groups: Young people, particularly women aged 15-25 years; Aboriginal and Torres Strait Islander people; men who have sex with men; those with a pattern of inconsistent
or no condom use; or a recent change in sexual partner.
- Notifiable diseases such as chlamydia, gonorrhoea, syphilis, and HIV will have accurate statistical records available. There are many other STIs which are not notifiable and therefore rates are
concluded from research reports – not surveillance. The rates may be higher than indicated due to the asymptomatic nature of many STIs.
- Gonorrhoea, syphilis, chlamydia, anogenital herpes, anogenital warts, enteric pathogens (eg. giardiasis, shigellosis) and HIV are currently common among homosexually active men in large cities of
the world. Lymphogranuloma venereum (LGV) has also recently emerged among some HIV+ gay men
- Women who perform receptive anal sexual practices are also at risk of similar problems.
- STIs may be spread through anal sex when blood, semen or other body fluid is shared even if there is no anal penetration.
- Oral-anal contact, kissing or oral contact with fingers that have been touching the anus or genitals and/or the sharing of sex toys may also transmit certain infections.
- The rates of notification of chlamydia, gonorrhoea and infectious syphilis in the Northern Territory continue to be substantially higher than those in other State/Territories
Important notes to highlight:
- Any unusual discharge, sore, or rash, particularly in the groin area, should be a signal to refrain from having sex and to see a doctor immediately
- The surest way to avoid transmission of sexually transmitted infections is to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be
uninfected.
- Avoiding alcohol and drug use may also help prevent transmission because these activities may lead to risky sexual behaviour.
- It is important for open communication to be encouraged between sex partners so that preventive action can be taken.
- Partner notification: It is important to encourage infected individuals to inform all their sexual partners from at least the past six months so they may be tested and treated if necessary. Refer to
www.letthemknow.org.au for advice and assistance with partner notification.
Useful Websites and documents:
- (A) National Notifiable Diseases Surveillance System: http://www9.health.gov.au/cda/Source/CDA-index.cfm
- Australian Government; Department of Health and Aging; STI Facts: http://www.sti.health.gov.au
- Centers for Disease Control and Prevention; CDC Fact Sheets: http://www.cdc.gov/std/healthcomm/fact_sheets.htm
- Queensland Government; Queensland Health; I Stay Safe: http://www.health.qld.gov.au/istaysafe/be-safe-with-sex/sti/
- Young Australians: Their Health and Wellbeing; 2011; Australian Institute of Health and Welfare; Available for download from
URL: http://www.aihw.gov.au/publication-detail/?id=10737419261
- Magnus Hirschfeld Archive for Sexology; Falling and rising STD rates; Available from URL: http://www2.hu-berlin.de/sexology/ECE4/html/falling_and_rising_std_rates.html
- Sexual Health; Society of Victoria; National Management Guidelines For Sexually Transmissible Infections; 2008; p 53 (60); p 115 (122); Available from
URL: http://www.mshc.org.au/portals/6/nmgfsti.pdf
- Second National Sexually Transmissible Infections Strategy: 2010–2013; Australian Government: Department of Health & Aging; 2010; Available from
URL: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-national-strategies-2010-sti/$File/sti.pdf
- SEXUAL HEALTH SERVICES - AUSTRALIA AND NEW ZEALAND - A comprehensive list of Sexual Health Clinics can be found on Pages 66 – 82 of the 2010-2011 Directory of HIV, Viral Hepatitis & Sexual
Health Services, available for download from: http://www.ashm.org.au/images/Publications/2010-11_Directory.pdf
- Register of Public Sexual Health Clinics in Australia and New Zealand (updated September 2012) http://www.racp.edu.au/page/sexual-health-publications
Otherinformation

(1) Department of Health & Ageing; Australian Government; STIs – Chlamydia; Available from URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/content/Chlamydia
(2) Centers for Disease Control and Prevention; Chlamydia Fact Sheet; Updated February, 2013 Available from URL: http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm
(3) Carroll, J.L; Sexuality Now – Embracing Diversity; 3rd Edition; University of Hartford ; 2010; p 428; Wadsworth Cengage Learning; Belmont, CA, USA.
(4) A Queensland Health Fact Sheet; 2009; Available from URL: http://access.health.qld.gov.au/hid/InfectionsandParasites/SexuallyTransmittedDiseases/chlamydia_fs.pdf
(5) Guy, R; A,H, Wand, H; Franklin, N; Fairley, C.K; Chen, M.Y; O’Connor, C.C; Marshall, L; Grulich, A.E; Kaldor, J.M; Hellard, M; Donovan, B; Re-testing for chlamydia at sexual health services in
Australia, 2004–08; ACCESS Collaboration; Available from URL: http://www.publish.csiro.au/?act=view_file&file_id=SH10086.pdf
(6) HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2011; p 7, 8, 15, 16, 17; Available from
URL: http://www.med.unsw.edu.au/NCHECRweb.nsf/resources/2011/$file/KIRBY_ASR2011.pdf
(7) Centers for Disease Control and Prevention; Epididymitis: Sexually Transmitted Diseases Treatment Guidelines, 2010; Available from
URL: http://www.cdc.gov/std/Treatment/2010/epididymitis.htm
(8) Gallegos, G; Ramos, B; Santiso, R; Goyanes, V; Gos alvez, J; Fernandez, JL; Sperm DNA fragmentation in infertile men with genitourinary infection by Chlamydia trachomatis and Mycoplasma;
2007; Available from URL: http://cat.inist.fr/?aModele=afficheN&cpsidt=20573037
(9) Government of Western Australia; Department of Health; Chlamydia: Most people haven’t got a clue; Available from URL: http://couldihaveit.com.au/media/Chlamydia_Fact_Sheet.pdf
(10) Family Planning Victoria; Better Health Channel; Epididymitis Fact Sheet; Updated March, 2013; Available from
URL: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Epididymitis
(11) Department of Health & Ageing; Australian Government; STIs – Get the Facts; Gonorrhoea – Why Worry?; Updated January 2011; Available from
URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/Content/Gonorrhoea
(12) Queensland Government; Queensland Health; Gonorrhoea; Available from URL: http://access.health.qld.gov.au/hid/InfectionsandParasites/SexuallyTransmittedDiseases/gonorrhoea_is.pdf
(13) Centers for Disease Control and Prevention; Gonorrhea Fact Sheet: Updated February, 2013 Available from URL: http://www.cdc.gov/std/Gonorrhea/STDFact-gonorrhea.htm
(14) Stancombe Research and Planning; QUANTITATIVE RESEARCH REPORT: Measuring awareness and attitudes among young Australians towards STIs, including HIV/AIDS; p 1; prepared for
Department of Health and Ageing; 2009; Link to page available from URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/content/campaign3
(15) Department of Health & Ageing; Australian Government; STIs – Get the Facts; Updated December, 2010 http://www.health.gov.au/internet/sti/publishing.nsf/Content/hpv
(16) Centers for Disease Control and Prevention; HPV Fact Sheet: Updated February, 2013 Available from URL: http://www.cdc.gov/std/HPV/STDFact-HPV.htm
(17) Chaturvedi, A; Engels, E.A; Pfeiffer, R.M; Hernandez, B.Y; Xiao, W; Kim, E; Jiang, B; Goodman, M.T; Sibug-Saber, M; Cozen, W; Liu, L; Lynch, C.F; Wentzensen, N; Jordan, R.C; Altekruse, S; Anderson,
W.F; Rosenberg, P.S; Gillison, M.L; Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States; 2011; Journal Clinical Oncology 29:4294-4301; doi: 10.1200/
JCO.2011.36.4596 Available from URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221528/
(18) Perrett, L; Studies uncover associations between Human Papilloma Virus and Oral Cancer; 2010; National Cancer Institute;
http://benchmarks.cancer.gov/2010/10/studies-uncover-associations-between-human-papillomavirus-and-oral-cancer/
(19) Carroll, J.L; Sexuality Now – Embracing Diversity; 3rd Edition; University of Hartford ; 2010; p 434; Wadsworth Cengage Learning; Belmont, CA, USA.
(20) Skinner et al; Human papillomavirus vaccination for the prevention of cervical neoplasia: is it appropriate to vaccinate women older than 26? 2008; The Medical Journal of Australia; Available
from URL: https://www.mja.com.au/journal/2008/188/4/human-papillomavirus-vaccination-prevention-cervical-neoplasia-it-appropriate
(21) Human Papilloma Virus and HPV Vaccines: technical information for policy makers and health professionals; 2007; World Health Organisation; Department of Immunization, Vaccines and
Biologicals; p 16; Available from URL: http://whqlibdoc.who.int/hq/2007/WHO_IVB_07.05_eng.pdf
References

(22) Gardasil Website: About Gardasil; Available from URL: http://www.gardasil.com/about-gardasil/about-gardasil/
(23) Klein, R; Gardasil: The Denial Continues; ON LINE Opinion: 30th June 2009; Available from URL: http://www.onlineopinion.com.au/view.asp?article=9112
(24) Department of Health and Ageing; Australian Government; Immunise Australia Program; Updated February, 2013 Available from
URL: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-hpv
(25) Robbins, S.C.C; Bernarda, d; McCaffery, K; Brotherton, J; Garlandd, S; Skinner, R;“Is cancer contagious?”: Australian adolescent girls and their parents: Making the most of limited information
about HPV and HPV vaccination; 2010; Journal of Vaccine; doi:10.1016/j.vaccine.2010.02.078
(26) Medical Services Advisory Committee (MSAC); Human papillomavirus triage test for women with possible or definite low-grade squamous intraepithelial lesions; March 2009; MSAC reference
39; p 6,7 (24,25); Available from URL: http://www.msac.gov.au/internet/msac/publishing.nsf/Content/8FD1D98FE64C8A2FCA2575AD0082FD8F/$File/39_MSAC_Assessment_Report.pdf
(27) Australian Government; Department of Health & Ageing; National Cervical Cancer Screening; Updated March, 2012 Available from
URL: http://www.health.gov.au/internet/screening/publishing.nsf/Content/papsmear#1
(28) Queensland Government; Queensland Health; Syphilis; 2011; Available from URL: http://access.health.qld.gov.au/hid/InfectionsandParasites/SexuallyTransmittedDiseases/syphilis_fs.pdf
(29) Centers for Disease Control and Prevention; Syphilis Fact Sheet; Updated February, 2013: Available from URL: http://www.cdc.gov/std/Syphilis/STDFact-Syphilis.htm
(30) Ward, J.S; Guy, R.J; Akre, S.P; Middleton, M.G; Giele, C.M; Su, J.Y; Davis, C.A; Wand, H; Knox, J.B; Fagan, P.S; Donovan, B; Kaldor, J.M; Russell, D.B; Epidemiology of syphilis in Australia: moving
toward elimination of infectious syphilis from remote Aboriginal and Torres Strait Islander communities? 16 May, 2011; Medical Journal of Australia; Volume 194, Number 10; Available from
URL: https://www.mja.com.au/journal/2011/194/10/epidemiology-syphilis-australia-moving-toward-elimination-infectious-syphilis
(31) Australian Government; Department of Health & Ageing; STIs – Get the Facts; Updated December, 2010 Available from
URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/Content/syphilis
(32) Australian Government; Department of Health & Ageing; STI facts: Herpes; Updated December, 2010 Available from
URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/content/Herpes
(33) Reducing the Sexual Transmission of Genital Herpes: Clinical Guideline; 2011; Australian Herpes Management Forum (AHMF); Available from
URL: http://www.austhmf.com.au/guidelines/
(34) Carroll, J.L; Sexuality Now – Embracing Diversity; 3rd Edition; University of Hartford ; 2010; p 432,433; Wadsworth Cengage Learning; Belmont, CA, USA.
(35) Aust. Govt.; Dept. of Health & Ageing; Second National Sexually Transmitted Infections Strategy: 2010-2013; p 4, 5; Available from
URL: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-national-strategies-2010-sti/$File/sti.pdf
(36) Australian Government; Department of Health & Ageing; Blood borne viruses and STIs: Data on Blood Borne Viruses and Sexually Transmissible Infections; Hep B; Updated November, 2012
Available from URL: http://health.gov.au/internet/main/publishing.nsf/Content/ohp-bbvs-data
(37) Centers for Disease Control and Prevention; Hepatitis B Information for Health Professionals; Updated June, 2010 Available from
URL: http://www.cdc.gov/hepatitis/HBV/PDFs/HepBGeneralFactSheet.pdf
(38) Virtual Medical Centre: Hepatitis B Virus; Updated January, 2011 Available from URL: http://www.virtualmedicalcentre.com/diseases.asp?did=122
(39) Trichomonas vaginalis: underdiagnosis in urban Australia could facilitate re-emergence M Josephine Lusk, Zin Naing, Ben Rayner, et al. Sex Transm Infect 2010 86: 227-230; June, 2010; doi:
10.1136/sti.2009.039362; Available from URL: http://www.ncbi.nlm.nih.gov/pubmed/19880969
References

(40) Centers for Disease Control and Prevention; Trichomonas Fact Sheet: Updated August, 2012 Available from URL: http://www.cdc.gov/std/trichomonas/STDFact-Trichomoniasis.htm
(41) Centers for Disease Control and Prevention; Oral Sex and HIV Fact Sheet; June 2009; Available from URL: http://www.cdc.gov/hiv/resources/factsheets/PDF/oralsex.pdf
(42) Avert; AVERTing HIV and AIDS; What is HIV? Available from URL: http://www.avert.org/hiv.htm
(43) Avert; AVERTing HIV and AIDS; Australia HIV and AIDS Statistics; http://www.avert.org/aids-hiv-australia.htm
(44) Centers for Disease Control and Prevention; The Role of STD Detection and Treatment in HIV Prevention - CDC Fact Sheet; Updated September, 2010 Available from
URL: http://www.cdc.gov/std/hiv/STDFact-STD-HIV.htm
(45) Aids Action Council; PEP - Post Exposure Prophylaxis; Available from URL: http://aidsaction.org.au/content/hiv_sti_health/post_exposure_prophylaxis-pep.php
(46) Sexually Transmitted Infections Diseases Services; Royal Adelaide Hospital; Trichomoniasis: Statistics; Updated 12 April, 2010;
Available from URL: http://www.stdservices.on.net/std/trichomoniasis/details.htm#Statistics
(47) Mapping HIV outcomes: geographical and clinical forecast of numbers of people living with HIV in Australia; National Centre in HIV epidemiology and Clinical Research; University of New
South Wales; Available from URL: http://www.kirby.unsw.edu.au/publications/mapping-hiv-outcomes-geographical-and-clinical-forecasts-numbers-people-living-hiv
References
For more great resources, visit our website: www.youthwellbeingproject.com.au
You can also connect with us on Facebook, Twitter and LinkedIn!
Youth Wellbeing Project has taken every measure to ensure all references and links are correct at the time of publication. This document is
intended as a guide only and cannot replace or substitute the services of trained professionals in any health field. © April, 2013

STIs: Facts, Prevention, Outcomes

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