Sexplanations

A Young Person’s Guide to STIs

You probably have herpes or HPV, but how much do you know about them and other STIs?
26 September 2017, 1:00am
Illustration by Ben Thomson

This article is supported by Durex's Sexual Health Education Month. In this series, we explore Kiwi sexual behaviour.

We hate to kill the mood, but more than one million STIs are acquired around the world every day. The majority of them have symptoms that are hard to detect, if they show symptoms at all. This means the person you're hooking up with could have anything from chlamydia to HPV without any noticeable signs.

"Symptoms are a bit tricky for a lot of STIs, especially for people with penises, as the majority of people with an infection like chlamydia won't be symptomatic, but will be able to transmit the infection," Auckland-based youth health nurse Mikey Brenndorfer tells VICE.

Figuring out where your STI came from isn't always as easy as it sounds. Your best bet is preventative: taking a trip to the undies drawer and fishing out a barrier protection such as condoms or dental dams, which are effective in reducing the risk of most STIs. But if you do wind up with one, here's what to look out for and how to treat a bunch of them.

CHLAMYDIA

Chlamydia is one of the most common STIs and only presents symptoms in half of males and 75 percent of women.

Earlier this year, Hanna* went through a phase she calls "the block", where she slept with four people who lived on the same Grey Lynn block within a short period of time. She's still not sure exactly who she contracted chlamydia from. To make it more confusing, the symptoms were vague. "For females, sometimes the symptoms come across as thrush-like so it's hard to know if it's just that or if it's something else," she says.

Contracted via unprotected oral, vaginal, or anal sex, if you do have symptoms, they'll typically appear one to three weeks after exposure. While the best way to find out whether you have chlamydia is through regular sexual health checks (a swab takes five minutes, don't stress), symptoms to look out for include pain when peeing, unusual discharge, lower back or abdominal pain, and unexpected bleeding between periods for women.

Marama* had experienced the latter symptom, and was bleeding after sex. She went to the doctor for a check. "The doctor said she wanted to do a throat swab, and I thought it was rather ridiculous," she says. "But I went with it and got a text a couple of days later telling me it came back positive. I was mortified when she told me I actually had chlamydia of the throat!".

If left untreated, chlamydia can lead to complications such as infertility in both men and women.

The good news? Chlamydia is no match to a course of antibiotics, which usually kills the infection between seven to ten days.

GONORRHOEA

Easily remembered by the fact it sounds kind of like you've got the runs, gonorrhoea is a common STI among under-25 year olds.

Referred to as "the clap", gonorrhoea is transmitted through unprotected oral, vaginal, or anal sex with an infected person and while it often shows no symptoms, it can be detected through a normal sexual health check-up.

If symptoms do arise, men will often have urethral discharge (discharge from the penis), women will have vaginal discharge, and all genders can experience pain when peeing.

Gonorrhoea can be treated with antibiotics, which involves an injection called cefriaxone and a single dose of tablets called azithromycin.

GENITAL HERPES

"I found out I had genital herpes in 2015 when I was travelling. It was purely from a really intense outbreak. I was really miserable: I had countless sores and blisters covering my entire genitals. It was incredibly painful and itchy, and trying to walk was torture," says Zoey*.

"I felt alienated from my body. I had continuous outbreaks for the first year, which I dealt with by taking acyclovir and applying zovirax creams," she says.

Her story is common, with 22 percent of the sexually active population having genital herpes, known clinically as HSV-2, and up to 80 percent having the cold-sore-type herpes, known as HSV-1.

So reassuringly, it's more common to have herpes than to not have herpes.

Unfortunately, many people with genital herpes don't actually know they have it, as symptoms can be very mild (although more prominent symptoms can be like that of Zoey's, occurring as blisters across the genitals). Routine sexual health checks don't actually test for herpes unless a swab is taken directly from a sore.

The best way to avoid it is through protected sex.

HUMAN PAPILLOMAVIRUS (HPV)

"I had a wart on my gooch once. It was the size of a pea", recounts Andrew*, who has Human Papillomavirus (HPV). He had the wart for two years before his doctor froze it off with liquid nitrogen.

HPV is a collective name for 150 different strains of the contagious skin condition, which people can have for their entire life without experiencing any complications.

There's no treatment once it is contracted and no actual test to see if you are HPV positive, so the main way people find out is through it developing into genital warts, which look like a raised lump or group of lumps, sometimes flat and sometimes cauliflower-textured.

HPV can go away on its own, but to avoid it altogether, the HPV vaccine is funded in New Zealand for those aged between 9 and 26. It involves a course of three immunisations for those over 15 (two for under 15) and protects against the strains of HPV that cause most cervical, anal, and genital cancers, including some mouth and throat cancers.

SYPHILIS

Syphilis might seem like a thing from the past (it first became known to physicians in the 1400s when it plagued Naples during a French invasion), but it's still present in current-day New Zealand. A New Zealand Medical Journal article published last year reports that the number of syphilis cases managed by the Auckland regional sexual health service are at their highest in recent decades.

Treatment for the disease—which can cause pustule-like sores across the body and even disfigurement in its late benign stage—was not developed until the mid-20th century and involves a course of penicillin prescribed by your doctor.

While there is no preventative vaccine against syphilis, the best way to avoid exposure is through the use of barrier protection, as the infection can be spread by any kind of sexual contact.

If caught, a skin lesion will typically appear at the point of unprotected contact. To confirm whether its syphilis and to stop it before the lesions elevate to a more advanced stage, a blood test can be taken by your GP.

TRICHOMONIASIS

"Trichomoniasis is a tricky one, because it is often missed out during screening," says Brenndorfer, referring to the contagious parasite being difficult to detect in men.

It is spread through penis and vaginal contact, or vaginal and vaginal contact, and is uncommon to be contagious through oral sex. A simple way to avoid being infected is through protected sexual activity.

Symptoms for this tricky-to-say infection (its nickname is trich, FYI) don't often present themselves and are rare in men. For women, if symptoms do arise, they're either a heavy or foamy discharge, burning in the vagina, or painful sex and urination.

Testing for trichomoniasis can be done at your GP: they'll take a fluid sample from your vagina or penis and test it under a microscope. Treatment is as easy as a course of medication called metronidazole.

*Name changed on request

If you relate to any of the issues raised in this article, know that help is out there. Family Planning New Zealand provide STI tests (and appointments are free if you're under 22 - NZ residents only). You can find out more info here__. The New Zealand Sexual Health Society also have a bunch of information and resources on their website__.__

This article is supported by Durex's Sexual Health Education Month. You can find out more info about it here__.