Sexually transmitted and blood-borne infections (STBBIs) were formerly known as sexually transmitted diseases (STDs) or venereal diseases. Whatever they may be called, they are mainly transmitted during unprotected sex and are the most serious infections of the genitals.
STBBI can be classified into three types.
Bacterial STBBIs (caused by bacteria)
Viral STBBIs (caused by a virus)
Unlike other types of sexually transmitted infections (STBBIs), lice are parasites, not bacteria or viruses. In fact, a louse (singular of lice) is a hematophagous insect (which feeds on blood) specially adapted to pubic hair. The scientific name for it is Phtirius inguinalis. It is most often transmitted during intimate physical contact (sexual or not), but it can also be spread from soiled clothes or bed sheets since the parasite can survive for up to two days on fabrics.
The symptoms are discomfort and itching. Pubic lice are also visible to the naked eye, since their size is close to that of a pinhead and their colour is in shades of light brown. It is also possible to detect shiny, oval-shaped whitish eggs clinging to hair. Treatments in the form of shampoo, cream, or lotion are available over the counter. To avoid lesions on the skin, treatments should be carried out as soon as possible. It is also necessary to limit the spread by avoiding intimate contact and by properly washing soiled fabrics.
Scabies is also a highly contagious parasitic infection, but not necessarily linked to sex. It is actually a skin disease linked to the female Sarcoptes scabiei that burrows under the skin to lay eggs. This mite can infest warm, moist folds of the skin, such as the armpits, buttocks, groin, and genitals. The symptoms are basically rashes and itching, and the treatments are basically the same as for pubic lice.
Gonorrhea is a bacterial infection caused by a gonococcus called Neisseria gonorrhoeae. This bacteria infects the mucous membranes of the genitals and urinary organs. It is also transmitted by contact with the mucous membrane of an infected person. The majority of those affected are adolescents and young adults.
The most common symptom associated with gonorrhea and the most common in men is urethritis, an inflammation of the urethra also known as "hot urine." Urethritis causes a painful burning sensation during urination, as well as the discharge of pus from the urinary meatus. In women, 20% of cases are asymptomatic (without symptoms). In the other 80% of cases, gonorrhea manifests the same symptoms as men: vaginal discharge, abdominal discomfort, or abnormal bleeding from the uterus.
If left untreated, it can lead to complete constriction of the male urinary tract, meaning that the circular muscles around the urinary tract are contracted thus blocking the ducts. In women, the outcome of untreated gonorrhea is pelviperitonitis and infertility. Fortunately, since it is a bacterial infection, it can be treated with antibiotics. Nevertheless, the emergence of strains resistant to known antibiotics is increasing.
During childbirth, the baby can be infected and contract serious eye infections.
Chlamydia is the most common infection in Canada and is caused by the Chlamydia trachomatis bacterium. Most often, transmission is through sexual contact. Furthermore, about 30% of people infected with gonorrhea are also infected with chlamydia. Bacteria require a host cell to reproduce, just like viruses. An incubation period of about a week occurs before the onset of symptoms. It can be detected by cell cultures.
Symptoms are similar to those of gonorrhea: urethritis, painful and frequent urination, painful sexual intercourse, vaginal discharge, abdominal, rectal and/or testicular pain, and irregular menstrual cycle. In women, the worst consequence is infertility, while in men, infection with chlamydia is associated with joint inflammation and extensive infection of the genitals. Since it is a bacterial infection, it can also be treated with an antibiotic, usually tetracycline.
During childbirth, the baby can be infected and subject to conjunctivitis as well as respiratory inflammation such as pneumonia if the mother is infected with chlamydia.
The bacterium responsible for syphilis is Treponema pallidum, also known as pale treponema. This infection is contracted through unprotected sexual intercourse. The infection penetrates both intact and damaged mucous membranes.
Symptoms emerge in several stages. First, an asymptomatic primary stage begins only a few hours after the infection has spread. After two or three weeks, a lesion called a chancre appears at the site of infection. In men, it is noticeable on the penis, while in women, it may be more difficult to detect if it is located in the vagina or at the cervix. The chancre ulcerates, crusts and eventually heals before disappearing after a few weeks.
Without treatment, other symptoms surface after several weeks or months in the secondary stage. One of the first symptoms is roseola covering the whole body. Fever and joint pain also occur. However, all these effects disappear after three to twelve weeks. If one is lucky (or unlucky from an epidemiological point of view), the infection enters a latent stage. Screening for syphilis can then only be done by a blood test. Subsequently, the infection either remains latent until death, or it is destroyed by the immune system, or it enters the tertiary stage. This third stage of the disease is much more critical. This is because severe lesions develop in the central nervous system, blood vessels, bones, and on the skin. Nowadays, this disease is treated fairly well with penicillin, regardless of the stage of the disease.
This infection can also be congenital, or transmitted from mother to baby during childbirth. Infected fetuses are usually stillborn or die soon after birth.
The hepatitis virus, part of the Hepadnaviridae family, is transmitted through blood, semen, vaginal fluids, and more rarely through saliva. The main routes of transmission are sexual intercourse, sharing needles, tattooing, and body piercing. The virus causes liver inflammation.
Some infected individuals can become permanent carriers throughout their life, whether or not they have symptoms, and can transmit the virus without realizing it. Hepatitis B has an incubation period (time between infection and the onset of symptoms) that varies between 2 and 6 months. Symptoms of hepatitis B include jaundice (which can last about 2 weeks), fatigue, loss of appetite, nausea, dark urine, joint pain, and abdominal pain.
Usually, this infection does not require treatment as individuals are naturally resistant to the virus and it clears by itself. The virus on the other hand can be very aggressive (less than 1% of cases) and then treatment with antivirals may be necessary. As a preventive measure, a vaccine can be administered.
Again, this infection is transmissible during childbirth. In fact, the baby is likely to contract the virus when it passes through the mother's birth canal.
Genital herpes is caused by the Herpes simplex virus. Transmission occurs through sexual contact, but also through simple contact with the skin, even in the absence of symptoms.
This infection can remain latent for months or even years and then reappear suddenly. Small blisters can then be observed at the infection area. These are not harmful to health; however they are painful and cause unpleasant tingling and itching sensations. It is important to note that once a person is infected, the virus remains in the body for life. Current treatments only reduce symptoms. While 20 to 30% of adults are unaware that they are carrying the antibodies, the others can be treated with an antiviral drug, called acyclovir, which helps reduce the frequency of rashes and speeds up their healing. Good personal hygiene, including keeping infected areas dry and clean, helps prevent contamination.
The herpes virus can be passed from mother to fetus during pregnancy and from mother to newborn during childbirth. A fetus that contracts herpes could have serious malformations.
Another type of herpes is oral herpes, commonly known as "cold sores." Oral herpes is spread by kissing or sharing utensils or towels with an infected person. The virus usually shows up as lesions around the mouth.
This virus is part of the Papillomaviridae family. HPV is spread through direct sexual contact or through skin contact with warts. Once infected, the virus is present in the body of the infected person for the rest of their life. Most infected people have no symptoms. The virus can have an incubation period ranging from 3 weeks to 7 months, or even a few years. HPV can mainly cause cauliflower-like warts (also called "condylomas"), which mainly appear in the genital area. However, this virus can lead to cervical cancer.
As a preventive measure, there is currently a vaccine against certain types of HPV that is available in Québec. Unlike bacteria, viruses cannot be destroyed by antibiotics; furthermore, there is currently no medical method to eliminate an HPV infection. However, it is possible to treat HPV-related warts with a cream or with various chemical treatments. Only doctors can perform these treatments, such as cryotherapy, electrosurgery, and laser therapy.
HIV, or human immunodeficiency virus, is transmitted primarily through blood, semen, and vaginal fluids. Infection with the virus is detectable three months after infection, and the onset of infection usually occurs 10 years after infection. It is then called acquired immunodeficiency syndrome (AIDS), which is a fatal disease. It attacks the immune system and makes the affected individual unable to protect themselves against bacteria and viruses from any disease.
AIDS by itself does not cause death, but it weakens the immune system so that a person's body cannot fight off other diseases. There are several causes of death for people with AIDS, including opportunistic infections, cancers, pneumonia, hepatitis, as well as lung, cardiovascular, and kidney conditions.
HIV infection is primarily characterized by constant weight loss, night sweats, loss of appetite, and fatigue. However, these symptoms are often linked to other illnesses. The HIV test is therefore the only reliable way to know if a person is infected or not.
Although several drugs and vaccines are being developed, none are currently able to get rid of the virus. In addition, this virus is subject to several mutations which allows it to quickly develop drug resistance. This is why current treatments aim to delay the onset of the first symptoms and above all to slow down the progression of AIDS with antivirals. One example is triple combination therapy (on all 3 fronts) which improves life expectancy and quality of life, but does not cure the patient.
An infected mother can transmit the virus to her child during pregnancy, childbirth, or through breastfeeding.
Most STBBIs are asymptomatic, that is, either they present no symptoms or the symptoms are difficult to recognize. This is why it is difficult to know whether a person is infected or not.
The male or female condom offers the best protection against most STBBIs. It is the only effective contraceptive method to protect both partners during sexual intercourse.
Before stopping condom use, both partners should be tested to prevent further spread of an STBBI.
The screening test is free. To find out where to get tested, contact: Info-Santé (8-1-1), the school nurse or CSSS (CLSC) nurse, or a doctor.
Doctors are bound by patient confidentiality for anyone aged 14 and over: from this age, doctors do not have to notify parents that a screening test has been requested.
It is important to remember that an STBBI can also be transmitted through contact with the secretions or blood of a person with an STBBI. It is therefore important to avoid sharing needles when consuming drugs, or for tattooing or piercing.
The person who learns that they have an STBBI should tell their sexual partner(s) so that they can be tested as well. This will decrease the risk of re-infection while allowing them to get treatment as quickly as possible.
Furthermore, the doctor's recommendations for the STBBI treatment should be observed. It is also recommended to abstain from unprotected sex in order to prevent the spread of STBBIs to others.