# Saturday, 25 February 2017
Posted: Saturday, 25 February 2017 | Categories: HIV

For many years after the AIDS crisis of the 80s and 90s, being HIV-positive was considered a death sentence. Many of those who discovered they had the virus – which slowly attacks the immune system – were shunned, unfairly associated with immoral behaviour, and considered too "contagious" to be around.

Today, attitudes towards those who are HIV-positive have changed for the better, in no small part due to the incredible medical advances that have been made.

Currently, an HIV-positive person can expect to live a long and healthy life, provided they are diagnosed early enough, follow a healthy lifestyle and take the recommended antiretroviral medicines. For this reason, it’s now relatively uncommon for an HIV-positive person to develop AIDS, the final stage of infection where the immune system becomes totally compromised.

Of course, while many advances have been made with HIV treatment, a full cure still eludes scientists. However, recent research could play a hugely important role in the development of a working vaccine.

New Antibody Research

According to two new studies published in Science Translational Medicine, antibodies could be the key to the HIV vaccine. Antibodies are proteins created by the immune system and sent out whenever antigens (harmful bacteria or viruses) enter the body. Antibodies identify and bind to a specific type of antigen; this allows the immune system to identify the "intruder" and destroy it. Researchers have long stressed the importance of antibodies in the fight against HIV; these new studies have revealed that antibodies could be even more important than first thought.

One of the studies saw scientists create a special type of antibody that seeks out hidden HIV cells. When cultured together with an "HIV-killer" cell, these antibodies proved effective in destroying previously hidden cells of the virus.

The second study discovered three different antibodies that have a "neutralising" effect on HIV. It's hoped that this means that they can be administered to HIV-positive patients to prevent the virus from progressing.

With studies like this going on all the time, it is possible that we will see an HIV vaccine within the next decade. Currently, however, there are many treatments available to keep HIV infection properly managed and under control. To find out more, read on.

Diagnosing, Treating & Preventing HIV 

The first thing to know about HIV is that it is spread through bodily fluids (semen, vaginal and anal fluid, blood and breast milk). The most common mode of transmission is unprotected vaginal or anal sex.

HIV can also be spread in the following ways:

  • sharing drug needles or other injecting equipment
  • from mother to baby before or during birth
  • from mother to baby when breastfeeding

The instance involving mother and baby can be controlled so the risk is higher where the mother is infected and it is not known.

If you think you might have been exposed to the virus, or if you fall into an at-risk group (men who have sex with men, black African men and women), you should get tested for HIV.

There are different types of HIV test available – normally you will have your blood taken at a clinic and sent away for testing. Order a home test kit through The STI Clinic and you can take a blood sample at home and return it to our lab for testing; our test can detect HIV as early as 10 days after exposure but a negative result is not considered conclusive until 6 weeks after the point of potential infection.

If you think you have been infected in the past 72 hours, you should talk to a doctor about getting post-exposure prophylaxis (PEP); an emergency treatment that can prevent infection from setting in.

For people who are diagnosed with HIV, the treatment programme will involve regular blood tests to monitor the amount of virus in your system, and how healthy your immune system is. At a certain point, you will start treatment with antiretroviral medicines, which work by preventing the virus from multiplying. 

If you’re concerned about contracting HIV, make sure you always use condoms when having sex with someone who may be infected, and never share needles. If your partner is HIV-positive, it is possible to have safe sex – consult the resources available at Terence Higgins Trust to learn more.

 
# Thursday, 26 January 2017
Posted: Thursday, 26 January 2017 | Categories: General Sexual Health

STI Rates Up in Older People

In the UK, most people tend to associate sexually transmitted infections with irresponsible teenagers and drunken students. But while the statistics certainly support this stereotype to some degree (in this 2016 Public Health England report, 16 to 24-year-olds were found to be most at risk for chlamydia, genital herpes and genital warts), it’s worth bearing in mind that STIs affect every age category. In fact, when it comes to gonorrhoea and syphilis, men over the age of 25 seem to be most at risk.

In perhaps the most surprising news of all, sexually transmitted infections are actually on the rise amongst the oldest age categories. In the last decade, STI diagnoses in people aged between 50 and 70 have risen by a third. To get more specific with the numbers, 2010 saw sexual health clinics recording 11,366 new infections in this age group; by 2014 that number had risen to 15,726.

It’s hard to pin down exactly why we’re currently seeing this trend, but there are a few factors to consider.

Safe Sex Campaigns

The first thing to think about is the fact that safe sex campaigns tend to be targeted towards young people. As a result, the average 18-year-old may well know more about the STI symptoms and where to get tested than the average 62-year-old. In fact, in a study by the Office for National Statistics carried out between 2008 and 2009, it was found that only 19% of men aged 50-69 could correctly answer a series of questions about chlamydia symptoms (as opposed to 37% of men aged 30-34).

Consider too that a lot of sexual education material can be found online, and the fact that youngsters tend to be more proficient with computers and the internet than their parents and grandparents.

Divorce rates

Another factor in rising STI rates amongst older people is divorce. As shown by another Office for National Statistics study, the average age at which people are getting divorced has risen in the UK in recent years – in 2013, the average age for a man to get divorced was 45. But how does that relate to STI rates?

Well, following a divorce, it’s common for newly single people to begin dating and enjoying casual sex. But after many years of marriage, divorced men and women who may be used to having unprotected sex may find it difficult to readjust and start taking precautions again.

Women in the 50 - 70 age bracket may also be more careless when it comes to sex if they have been through the menopause. When the risk of pregnancy is taken out of the equation, it can be tempting to forgo condoms – despite the threat of STIs.

Overcoming the Stigma

When it comes to sex, older people may also feel more reluctance in talking to their doctor, or getting advice about doing things safely. They may even feel embarrassed walking into a pharmacy to buy condoms, particularly if they have not done so in a long while.

The important thing to remember is that the consequences of unprotected sex can be far worse than the slight embarrassment of getting advice from your GP or pharmacist. This is also the case when it comes to getting tested and treated properly.

If you have engaged in unprotected sex and you aren’t sure that your sexual partner or partners were STI-free, you should get tested. You can do this for free by visiting an NHS clinic, or by ordering a home test kit through a private service like The STI Clinic (click here to learn more about our Full STI Screen).

It’s also important to get an STI test if you are experiencing any of the following symptoms:

  • pain or a burning sensation when urinating
  • unusual discharge from the penis or vagina
  • fleshy growths around the genitals or anus
  • sore red blisters around the genitals or anus
  • in women, irregular bleeding, heavy periods, pain in the abdomen or pain during sex
  • in men, pain or tenderness in the testicles

Be aware that this is not an exhaustive list of STI symptoms, and that many infections are initially symptomless, so if you think you may have been exposed to something, you should get tested regardless.

 
# Saturday, 07 January 2017
Posted: Saturday, 07 January 2017 | Categories: Women's Sexual Health

Can Gardnerella bacteria increase HIV risk?

The vagina is not a body part that many people feel comfortable talking about. But, as with many medical issues, the more we educate ourselves, the better equipped we are to stay healthy.

In the case of bacterial vaginosis, for instance, it’s important to understand that there’s a link between this common, but not life-altering, condition and the transmission of more serious infections – most critically HIV.

New studies have found that the microflora of a woman’s vagina has a direct effect upon how susceptible she is to the human immunodeficiency virus. To understand this connection, it’s important to elaborate a little on what we mean by vaginal microflora.

The first thing to know is that a healthy vagina is slightly acidic, as this keeps unwanted bacteria from multiplying. The second thing to know is that this acidity level is, strangely enough, maintained by a type of (good) bacteria called Lactobacillus.

In women who have lower levels of Lactobacillus, the acidity of the vagina can become compromised, and unwanted bacteria can begin to develop. One common type of bacteria that develops under these circumstances is Gardnerella vaginalis. Its presence can lead to bacterial vaginosis, which causes unusual, unpleasant-smelling vaginal discharge.

The question is: what does this all have to do with HIV?

Well, as described here, HIV transmission is more likely when there is inflammation in the vagina. In turn, vaginal inflammation is closely associated with low levels of Lactobacillus. When researchers examined which types of bacteria were linked to decreasing levels of Lactobacillus and inflammation, one in particular was singled out: Prevotella bivia. Shockingly, women whose vaginal microflora contained more than 1% P. bivia showed the highest levels of inflammation; these women were 13 times more likely to contract HIV.

Gardnerella was also found to play a role in HIV transmission when it comes to pre-exposure prophylaxis (where medication is taken to prevent infection). In one study looking at tenofovir, an anti-HIV drug applied to the vagina in the form of a gel, it was found that the efficacy of the medication dropped by half when Gardnerella was introduced to the vagina.

This research could lead to much progress being made in the HIV/AIDS crisis, particularly in African countries. If bacterial infections in the vagina can be effectively treated with antibiotics, and if greater awareness can be spread about the importance of vaginal health, then we could start to see a decrease in HIV diagnoses.

Maintaining a Healthy Vagina

The first thing to know about vaginal health is that vaginal discharge is a completely natural feature of a healthy vagina. It is produced by the cervix to keep the vagina moist and free from infection. Normal vaginal discharge is clear or white, and thick and sticky for the majority of your menstrual cycle (it may become wetter around ovulation). Normal vaginal discharge should not smell strong or unpleasant.

Unusual vaginal discharge is characterised by any significant change in colour, consistency or smell. If it smells fishy, becomes lumpy, or turns green, yellow, or grey and watery, this is typically a sign of a sexually transmitted infection or a condition such as bacterial vaginosis.

Bearing this information in mind, it’s advised that you follow these guidelines to keep your vagina healthy:

  • Keep the vagina, anus and perineum clean, particularly during your period
  • Wash your hands before and after changing your sanitary towel, tampon or menstrual cup
  • Avoid using vaginal douches, as these can disrupt your vaginal microflora
  • Avoid using perfumed or antiseptic products on your vagina as these can also disrupt the microflora
  • Use condoms and dental dams during sex when you aren’t sure that your partner is free from STIs
  • Get tested for STIs if you might be at risk, even if you are not experiencing symptoms
  • Get checked out if you experience any significant change in your discharge, or experience irregular bleeding or pelvic pain
  • Attend a cervical screening every three years

The STI Clinic can supply safe home sampling kits for all kinds of STIs, including HIV and chlamydia. We can also supply a test for bacterial vaginosis. Click here to visit our clinic and find out more.

 
# Sunday, 27 November 2016
Posted: Sunday, 27 November 2016 | Categories: Chlamydia

According to a recent Public Health England report, chlamydia was the most commonly diagnosed sexually transmitted infection in 2015. Over the year, 200,288 diagnoses were made, accounting for almost half of all STI diagnoses in England. Despite being one of the most common STIs globally, chlamydia is also one of the easiest to treat – or at least, it is for now. In the past few years, we’ve heard about the emergence of antibiotic-resistant gonorrhoea. Now it looks as though chlamydia could be headed the same way.

Recent research has shown that chlamydia diagnoses are at an all-time high in the USA, having risen by 6% from 2014 to 2015. Professor David Gondek, an expert in sexually transmitted infections, has elaborated on this rise by explaining that many American STD clinics have faced under-funding and closure in recent years. He has also warned that "As antibiotic resistance continues to spread …our ability to control these diseases will falter".

The question is: just how susceptible is chlamydia to antibiotic resistance and how concerned should we be? To answer these queries, we need to first take a closer look at the specifics of this common sexually transmitted infection.

Facts & Misconceptions About Chlamydia

Chlamydia is spread through infected genital fluids (i.e. semen or vaginal fluid). You can catch it by having unprotected penetrative sex or by coming into contact with infected semen or vaginal fluid. That means you can contract chlamydia through vaginal, anal or oral sex, as well as through sharing sex toys. It’s also possible to become infected through close (but not penetrative) sexual contact. You can even get chlamydia if infected fluids get into your eye. Therefore, the widespread belief that chlamydia can only be caught through penetrative sex is untrue.

Another common misconception surrounding chlamydia is that if it doesn’t cause symptoms, it doesn’t pose a risk to your health. It’s true that chlamydia can be symptomless – in fact, it tends to be symptomless in 70% of women and 50% of men. However, even when it is causing no symptoms, it can still lead to serious health complications such as pelvic inflammatory disease.

When chlamydia does cause symptoms, they include pain when urinating, unusual discharge from the vagina, penis or rectum, pain in the testicles, and – in women – pain in the abdomen and irregular bleeding. Unfortunately, many people who find themselves experiencing these symptoms will be reluctant to seek medical help. That’s not only because there’s still a stigma surrounding STIs, but because many people believe that testing and treatment is invasive and embarrassing.

The truth is that testing for chlamydia is quick and easy, and can even be done at home with a posted test kit. It normally only involves a swab or a urine sample. Once a chlamydia infection has been confirmed, treatment typically only involves one dose of azithromycin antibiotics.

Antibiotic Resistant Chlamydia

Currently, when it comes to global antibiotic resistance, gonorrhoea is what the STI doctors are focusing on. The problem is that the medical community is concerned about chlamydia’s potential to develop resistance to the two main antibiotics used to treat it: azithromycin and doxycycline.

In other words, caution surrounding chlamydia infection is tied up in trying to prevent antibiotic-resistant strains emerging. It’s not always easy to prevent this, but there are some things that can help:

  • Always practise safe sex by using condoms/dental dams when you aren’t 100% certain your partner is free from infection
  • Get regular STI tests if you might be at risk of infection
  • Get tested after unprotected sex even if you are experiencing no symptoms

  • Get tested as soon as you develop symptoms
  • Receive medical treatment as soon as you have been diagnosed
  • Ensure that you take all of your antibiotics

Many people believe that they can become resistant to antibiotics by taking too many. This is untrue; in fact, this practice actually contributes to antibiotic resistance. If you are prescribed treatment for chlamydia, you should make sure that you take all the recommended medication. This will ensure that the infection is eradicated and will prevent any "leftover" bacteria from developing a resistance to the antibiotic.

Learn more about chlamydia and send off for a home test kit from The STI Clinic here.

 
# Saturday, 05 November 2016
Posted: Saturday, 05 November 2016 | Categories: General Sexual Health

In the popular imagination, syphilis is a disease that belongs to another time: an age before modern medicine, plumbing and hygiene practices. But according to the latest reports, this "old-fashioned" STI is actually experiencing a comeback.

Earlier this year, the European Centre for Disease Prevention and Control released new data showing that syphilis diagnoses have been steadily increasing across Europe since 2010. As reported here, the ECDC found that gay and bisexual men contract syphilis most frequently; in fact, 63% of all diagnosed cases of syphilis occurred in men who have sex with men (MSM). Perhaps most surprising, though, is that the largest percentage increases in diagnoses year on year were seen in those aged 45 or over.

This increase in syphilis diagnoses can be seen not only across Europe as a whole, but in the UK as well. This year’s STI study from Public Health England reported a 20% increase in syphilis diagnoses from 2014 to 2015 – and an increase of a startling 76% from 2012.

Potential Causes for the Increase in Syphilis Diagnoses

One of the key causes for the increase in syphilis diagnoses may be that many people consider it to be a largely extinct disease. For this reason, they may not be familiar with the symptoms and how it is spread. This may be particularly the case for older people (i.e. the at-risk over-45 age category). Most sex education is targeted towards young people, meaning that older people may be missing out on key information.

As for men who have sex with men, it is thought that better screening programs have contributed to more diagnoses – which puts a positive spin upon these startling numbers. However, many doctors also believe that more and more men in the MSM group are having condomless sex. This may be attributed to the decline of the AIDS crisis, and the sophisticated developments in modern HIV treatment. Bacterial STIs such as syphilis are also on the rise in HIV-positive men who have sex with men (this is because HIV makes you more susceptible to other sexually transmitted infections).

Lastly, although syphilis usually causes symptoms, it can be entirely symptomless in some people. This means that you may be infected and not be aware of it.

Syphilis: Symptoms & Transmission

Syphilis can be contracted through sexual contact with someone who has been infected. In its early stages, the disease is known as "primary syphilis" and causes a small, painless sore or ulcer to develop, usually on the vagina, penis or anus. Because you usually only get one sore and it isn’t painful, it can be easy to ignore this symptom. Another sign that you might have contracted syphilis is swollen glands in the neck, armpits or groin.

Primary syphilis usually passes within a few weeks. However, when left untreated it can develop into secondary syphilis. The symptoms of this stage include:

  • A blotchy red rash
  • Skin growths on the vulva or anus
  • White patches inside the mouth
  • Flu-like symptoms
  • Swollen glands
  • Hair loss

In the first two years after contracting syphilis, it is possible to pass on the infection to other people. This usually happens during sex when coming into contact with an infected sore – for this reason, it’s important to practise safe sex (by using condoms and dental dams) when having sex with someone who may be infected.

The problem is that, after its initial stages, syphilis can progress in the body without causing symptoms. If left to develop untreated, it can lead to tertiary syphilis, which is often associated with neurological diseases such as meningitis, dementia, stroke and blindness. At this point, the damage caused by the disease is difficult to reverse.

Testing For & Treating Syphilis

The good news to take away from the ECDC’s scary report is that, because syphilis is a bacterial infection, it can usually be treated with antibiotics.

It’s also very easy to get tested for syphilis. You can get tested for free at an NHS centre such as a GUM clinic. You can also obtain a home test kit from The STI Clinic. Click here to learn more.

 
# Saturday, 15 October 2016
Posted: Saturday, 15 October 2016 | Categories: General Sexual Health

Pain or a burning sensation when you urinate often indicates a sexually transmitted infection. Chlamydia, gonorrhoea and the herpes virus can all cause pain when urinating (also known as dysuria). However, there are a number of other things that can cause this specific symptom.

Urinary Tract Infections

One common cause of dysuria is a urinary tract infection. This is where bacteria enters the urethra, the tube that passes urine and, in men, seminal fluid out of the body. This can happen during sex or when wiping your bottom after a bowel movement. It is more common in women than in men because women have a shorter urethra that is closer to the anus.

If the infection affects the urethra or bladder it can cause pain when urinating, cloudy or bloody urine, abdominal pain, and the need to urinate frequently. This type of UTI can clear up on its own within a few days, though you can also get a prescription for antibiotics to help the healing along.

The infection is more serious if it affects the kidneys or the tubes connecting the kidneys to the bladder. Symptoms of this include those listed above, as well as pain in the sides and back, a fever, and feeling sick. These symptoms require more urgent medical care, and shouldn’t be left untreated.

Urethral Syndrome

Urethral syndrome is where the urethra becomes inflamed, but not as a result of a bacterial or viral infection. It causes pain in the abdomen and frequent, painful urination.

Urethral syndrome is thought to be caused by a number of different things, including injury to or irritation of the urethra. The urethra can become irritated by:

  • Using scented products around the urethral opening (e.g. soap, perfume or fragranced sanitary towels)
  • Using spermicidal lubricant during sex
  • Drinking too much caffeine
  • Chemotherapy or radiation treatment

Injury to the urethra, meanwhile, can happen as a result of:

  • Sexual intercourse/activity
  • Riding a bike
  • In women, using tampons
  • In women, using a diaphragm or cap as contraception

In some cases, urethral syndrome is caused by constriction in the urethra, which can happen as a result of inflammation, injury or scarring. If this is the cause of your symptoms, then surgery to widen the urethra may be the best course of action.

Adenoviruses

An adenovirus can cause bladder infection and inflammation, leading to dysuria. These viruses can be spread through close personal contact, but they are not classed as sexually transmitted.

Lesser-known STIs

If you are suffering from painful urination but a doctor has ruled out the major STIs, it's still possible that your symptoms have been caused by a sexually transmitted infection. STIs such as mycoplasma aren’t as common or as well-known as chlamydia or gonorrhoea, but they can still cause dysuria. You can order a home test kit for mycoplasma at The STI Clinic.

Protecting Yourself in the Future

If you are frequently experiencing pain when urinating, you should take some steps to protect yourself. This involves:

  • Using condoms during sex to avoid sexually transmitted infections
  • Not sharing sex toys unless they have been washed or covered in a new condom
  • Not using scented bath products around your genitals
  • Wiping from your urethra back to your anus after a bowel movement, to avoid the spread of bacteria
  • Urinating after sexual intercourse to help expel bacteria from the urethra
  • Avoiding wearing tights or jeans that are too close-fitting
  • Avoiding underwear that isn’t made from cotton

It’s also important to get regular STI tests if you think you might be at risk (e.g. if you don’t use condoms or you have multiple sexual partners). STIs can normally be treated easily if they are diagnosed early on. You can get a full urine screening test at The STI Clinic, by ordering one of our home test kits. Click here to find out more.

It’s not always easy to avoid getting an infection, or incurring injury to the urethra, particularly if you are a woman. However, if you stick to the rules above and visit a doctor when symptoms don’t go away on their own, you should be able to avoid any serious health complications.

 

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