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HIV AND STIs

Sexually transmitted infections (STIs) have been shown to be important co-factors in the transmission and acquisition of HIV infection.

The most common STIs include:
1. Chlamydia

• caused by the bacteria chlamydia trachomatis
• women can infect their newborn infant during delivery
• symptoms usually appear seven to 21 days after infection; symptoms differ for men, women and children

Men's symptoms

- stinging when passing urine

- clear discharge from the penis and itchiness around the opening

- pain or tenderness in the testicles

Women's symptoms

- stinging feeling when passing urine

- vaginal discharge

- pain caused by pelvic inflammation

- pain during intercourse

- bleeding between periods

Infants' symptoms

• Diagnosis is made by testing urine or cell samples from the infected area.
• Treatment consists of antibiotics for both partners. Follow-ups to be conducted after treatment.

2. Gonorrhoea

• caused by bacteria that multiply in warm and moist areas of the body
• infection can spread to the uterus and fallopian tubes
• can be spread during genital contact but also from the genitals to the throat through oral sex; babies can get it from their mothers
• symptoms usually appear two to 10 days after contact with the infected partner

Men's symptoms

- burning sensation during urination

- yellowish white discharge

- rectal symptoms are itching, painful bowel movements and discharge

Women's symptoms

- pain when passing urine 

- yellow or bloody vaginal discharge

- abdominal pain

- bleeding between periods

• Diagnosis is made on obtaining and testing samples from the urethra, cervix, throat or rectum.
• Treatment consists of antibiotics for both partners.

3. Genital herpes

• This is a highly contagious viral condition caused by a herpes simplex virus (HSV).
• It infects the skin, mucous membranes of the rectum and genitals, and the mouth. It is transmitted through physical and sexual contact.
• During birth, the presence of herpes on the genitals or in the birth canal is a threat to the baby.
• Infection of the newborn can lead to herpetic meningitis, herpetic viraemia and chronic skin infections.
• The symptoms usually occur a week after infection. Initially the skin becomes red and small blisters appear. Symptoms may also include a tingling sensation and increased sensitivity or pain at the site. Blisters are filled with straw-coloured fluid. The blisters burst leaving shallow, painful ulcers, which eventually scab and heal over a period of seven to 14 days. Other symptoms include fever, swelling and tenderness of the lymph nodes in the groin, and painful urination and discharge in women.
• Diagnosis is made on appearance of the lesions.
• There is no cure for herpes; once infected you are a carrier for life. Timely treatment with Acyclovir (antiviral drug) will abort the outbreak of blisters.

4. Genital warts

• Warts or condylomata acuminate are caused by a human papilloma virus (HPV).
• It can take up to nine months from the time of infection to the development of warts. In women, this virus can lead to changes in the cervix and development of cervical cancer. It is therefore important to diagnose this condition.
• The symptom is raised, wart-like growths. In men they appear mostly around the head of the penis and in women around the vaginal and rectal openings.
• In women they can appear on or near the cervix as flat, white lesions.
• The warts are very contagious and safe sex practices are advised.
• Diagnoses of ‘invisible warts' is made by swabbing the skin with 5% acetic acid - white patches will be visible.
• Treatment consists of freezing these lesions with liquid nitrogen. It is important to note that treatment does not offer complete cure.

5. Syphilis

This is a dangerous and life-threatening bacterial infection. After infection the bacteria travels through the bloodstream and affects vital organs such as the brain, heart, nervous system and spine.

Symptoms are divided into three stages:

• 12 weeks after time of infection
  - One or more red lesions develop on the penis, labia or anus. These lesions disappear after a week.

• After six months after infection
  - red rash appears on the chest, back, arms, legs, hands and soles of feet
  - high fever
  - sore throat
  - muscular fatigue
  - general feeling of discomfort
  (If not treated at this stage, symptoms will eventually disappear.)

• 20 years later (a more advanced stage of disease)
  - heart failure
  - paralysis
  - insanity
  - possible death

• Diagnosis is made through the detection of micro-organisms or the detection of antibodies in the blood.
• Syphilis can be treated with antibiotics.

Reference
1. METROPOLITAN FOUNDATION. 2009. B the Future cellbook. S