By Dr Brian*

Sexually transmitted infections (STIs) are mostly acquired by sexual contact. The organisms that cause sexually transmitted diseases may pass from person to person through blood, semen or vaginal and other bodily fluids. STIs commonly (but not exclusively) include Human Papilloma Virus (HPV), chlamydia, herpes, gonorrhoea and, less frequently, HIV and syphilis. Occasionally, STIs can be transmitted non-sexually too, such as from mother to infant during pregnancy or childbirth.

STIs can have a range of symptoms, sometimes including no symptoms at all. Some of the signs that might indicate an STI include:

• Painful or burning urination
• Discharge from the penis
• Genital, oral or rectal nodules or ulcers
• Unusual vaginal discharge or bleeding
• Pain during sex
• Painful groin lymph nodes
• Lower abdominal/pelvic pain
• Fever
• Rash
• Neurological symptoms

The symptoms may appear a few days after exposure and sometimes after many years. If you think you may have been exposed to an STI or are experiencing any of the above symptoms, get tested/screened immediately.

Factors increasing the risk of transmission of STIs

Having unprotected sex. Vaginal or anal penetration by an infected partner who does not use a latex condom significantly increases the risk of STI. Oral sex may be less risky, but infections can still be transmitted without a condom.

Sexual contact with multiple partners. The more people you have sexual contact with, the greater your risk.

The presence of one STI makes it much easier for another STI to be transmitted.

Substance abuse (alcohol) can cloud your judgment, making you more likely to participate in risky behaviour.

Sharing of needlescan spread many serious infections, including HIV, hepatitis B and hepatitis C.

Age: Fifty per cent of STIs occur in people between the ages of 15 and 24.

Screening

As many people in the early stages of an STI experience no symptoms, screening for STIs is important to prevent complications.

Untreated STIs can manifest weeks or even years later as:

• Infertility
• Eye inflammation
• Arthritis
• Painful pelvic inflammatory disease
• Complications in pregnancy
• Heart disease
• HPV-associated cervical and rectal cancers

Prevention

Here is how to avoid or reduce your risk of sexually transmitted infections:

• Abstain from unprotected sex. This is the most effective way to avoid STIs.
• Have a long-term mutual monogamous relationship with a partner who is not infected.
• Think before you act. Avoid vaginal and anal intercourse with new partners until you have both been tested for STIs. Screening tests are now accurate and precise but much less so for genital herpes for both the genders. Moreover, screening for HPV is not available for men.
• Vaccinate. HPV vaccination is available and should ideally be administered to both boys and girls aged 11-12. If that is not possible, then both should get vaccinated by the age of 26.
• Communicate. Before any serious sexual contact, communicate with your partner about practising safe sex. Reach an explicit agreement about what sexual activities will and won’t be acceptable.

* Living in Hà Nội since 2006, Dr Brian is presently Medical Director of Family Medical Practice Hà Nội. Graduated in the UK, he has practiced medicine principally in Canada (1981-2005) until coming to Việt Nam. Post graduate medical training includes Cambridge University (Chronic Disease Epidemiology and Biostatistics), University College London (Tropical and Infectious disease) and University of Toronto Hospitals (Hospital for Sick Children – Hematology and Bone Marrow Transplant) and Mt Sinai Hospital (Hepatology – Clinical trials experimental liver/virology unit 1997-2006). He has conducted medical research, worked and lectured in various countries on infectious disease topics, epidemiology and liver disease (Canada, Việt Nam, Cambodia, Philippines). He is also weekly co-host of Radio the Voice of Việt Nam’s (VOV5) ‘Doctor at Home’.

For more advice on any medical topics, visit Family Medical Practice (FMP) Hà Nội at: 298, I Kim Mã, Ba Đình. Tel: (024) 3843 0748. Email: hanoi@vietnammedicalpractice.com.

FMP’s downtown Hồ Chí Minh City location is: Diamond Plaza, 34 Lê Duẩn, District 1; 95 Thảo Điền St, Dist 2. Tel: (028) 38227848. Email: hcmc@vietnammedicalpractice.com

FMP Đà Nẵng is located at 96-98, Nguyễn Văn Linh St, Hải Châu Dist, Đà Nẵng. Tel: (0236) 3582 699. Email: danang@vietnammedicalpractice.com