Sexually Transmitted Infections (STIs)

• Pelvic inflammatory disease (PID) when the infection spreads to other reproductive organs
• Difficulty getting pregnant
• Long-term pelvic/abdominal pain
• Ectopic pregnancy (pregnancy outside the uterus)
• Pain in the testicles
• Reiters Syndrome (rash, sores and joint pain)
• Higher risk of getting another STI, including HIV

How you can get it
Chlamydia is spread by having unprotected oral, vaginal or anal sex with a person who has the infection.  

Symptoms
Most people who have chlamydia do not show any symptoms. If you do have symptoms, they might not appear for weeks and may include:

• A change in vaginal discharge, or discharge from the penis
• Vaginal bleeding between periods or after having sex
• Pain or swelling in the testicles
• Burning or pain when going to pee
• Pain during sex
• Abdominal or lower back pain

People can also get chlamydia in the rectum or throat. Symptoms include pain, discharge or bleeding in the affected area. 

Testing
Chlamydia testing is done with a pee test or by swabbing the infected area (cervix, urethra, rectum or throat).

Treatment and follow-up
Chlamydia can be cured with antibiotics. Medications must be taken as directed. If you have been treated for chlamydia, you should:

• Talk to your partner
• Avoid having any type of sex for seven days after your treatment
• Use condoms for all sexual activity
• Test again 3-4 weeks after your treatment
• Notify any sexual partners you have had in the last 60 days

• Pelvic Inflammatory Disease (PID) when the infection spreads to other reproductive organs
• Difficulty getting pregnant
• Long-term pelvic/abdominal pain
• Ectopic pregnancy (pregnancy outside the uterus)
• Pain in testicles
• Reiters Syndrome (rash, sores and joint pain)
• Higher risk of getting an another STI, including HIV

How you can get it
Gonorrhea is spread by having unprotected oral, vaginal or anal sex with a person who has the infection. 

Symptoms
People with gonorrhea may have no symptoms at all. If you do have symptoms, they usually start within 2-7 days and may include:

• Burning when peeing
• A change in vaginal discharge or yellowish/white discharge from the penis
• Pain in the lower abdomen
• Pain during sex
• Vaginal bleeding between periods or after sex
• Burning or itching at the opening of the penis
• Pain or swelling in the testicles

People can also get gonorrhea in the rectum or throat. Symptoms include pain, discharge or bleeding in the affected area.

Testing
Gonorrhea testing can be done with a pee test or by swabbing the infected area (cervix, urethra, rectum or throat).

Treatment and follow-up
Gonorrhea has become resistant to certain types of antibiotics, but can be cured with the right antibiotic. If you have been treated for gonorrhea, you should:

• Talk to your partner
• Avoid having any type of sex for seven days after your treatment
• Use condoms for all sexual activity
• Test again 3-4 weeks after your treatment
• Notify any sexual partners you have had in the last 60 days

How you can get it
Hepatitis B is spread through contact with blood and other body fluids of a person with the infection, including:

• Unprotected oral, vaginal or anal sex with someone who has the infection
• Sharing needles or other drug use equipment
• Sharing needles, ink or other equipment for body piercing and tattooing
• Sharing personal items like razors, nail clippers or toothbrushes
• Needlestick injuries in health care workers

The hepatitis B virus can live on surfaces for days and remain infectious.

Symptoms
About half of the people who get hepatitis B will not have any symptoms but can still spread the virus to others. If you do have symptoms, they may include:

• Tiredness
• Loss of appetite
• Stomach pain
• Nausea
• Yellowish skin and eyes
• Dark pee

Testing
Hepatitis B testing is done through a simple blood test. It can take up to three months after becoming infected to detect the virus in a blood test.

Treatment and follow-up
Your health care provider can speak to you about treatment options and the necessary follow-up for your situation.

How you can get it
Hepatitis C is spread through blood to blood contact. It is a strong virus that can live outside the body for many days. This means that dried blood can also spread the virus. Some of the ways blood contact can happen include:

• Sharing drug use equipment (needles, syringes, filters, cookers, acidifiers, alcohol swabs, tourniquets, water, pipes for smoking crack or crystal meth, and straws for snorting)
• Sharing needles, ink or other equipment used for tattooing or piercing
• Sharing personal items such as razors, nail clippers or toothbrushes
• Having a blood transfusion before 1990
• Needlestick injuries in health care workers
• Unprotected sex where blood could be present such as rough sex, anal sex, from sores or having sex on your period
• During pregnancy or childbirth

Symptoms
People with hepatitis C often do not have symptoms. If you do have symptoms, they may include:

• Tiredness
• Loss of appetite
• Pain in stomach
• Nausea
• Yellowish skin and eyes
• Dark pee

Testing
Hepatitis C testing is done through a simple blood test. It can take up to three months after becoming infected to detect the virus in a blood test.

Treatment and follow-up
The Canadian Liver Foundation has found that newer hepatitis C treatments can achieve cure rates of over 90%. Your health care provider can speak to you about treatment options and the necessary follow-up for your situation.

Herpes in a common STI caused by a virus. There are two types of herpes viruses: HSV-1 and HSV-2. Both types can cause painful sores on the genital area. After the sores from the first outbreak heal, the virus goes into ‘hiding’ but does not leave the body. The virus can become active again, causing what are called recurrent outbreaks.

How you can get it
Herpes is spread through skin to skin contact, including oral, vaginal or anal sex with a person who has the infection. It spreads most easily when there are sores that you are able to see, but can still spread when there are no sores.

Symptoms
Many people with herpes have no symptoms or only mild symptoms. If you do have symptoms, they usually show about 2-20 days after being infected and may include:

• Itching, tingling and/or burning in the genitals (early symptoms)
• Small blisters on the vulva, vagina, cervix, anus, penis, testicles, thighs, buttocks or mouth
• Tender lumps on the groin
• Fever or headache
• Pain when peeing
• Body aches

Testing
Herpes testing can be done by swabbing a blister or sore.

Treatment and follow-up
Herpes cannot be cured, but it can be managed well with antiviral medications. Medications can help make symptoms less severe, prevent future outbreaks, and reduce your chance of spreading the virus. Your health care provider can speak to you about your options.

Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). HIV attacks the immune system, making it difficult to fight off infections and other serious illness. Without treatment, you can get sick with life-threatening disease. A person with HIV may not develop AIDS for many years, if at all. Learn more about HIV basics from CATIE.

How you can get it
HIV is spread when one of the following body fluids of someone with HIV gets into the bloodstream (through broken skin, the opening of the penis, vagina, rectum or foreskin):

• Blood
• Semen (including pre-ejaculate)
• Rectal fluid
• Vaginal fluid
• Breast milk

HIV is most commonly spread by:

• Unprotected oral, vaginal or anal sex
• Sharing needles and other drug use equipment

HIV can also be spread by:

• Sharing needles, ink or other equipment for tattooing or body piercings
• Sharing acupuncture needles
• Needlestick injuries in health care workers
• Pregnancy or childbirth 

HIV is not spread by kissing, hugging, shaking hands, toilet seats, coughing or sneezing.

Symptoms
People with HIV may not have symptoms for many years. If you do have symptoms, they may be similar to a flu-like illness 2-4 weeks after being infected, and may include:

• Weight loss
• Rash
• Muscle aches
• Diarrhea
• Night sweats
• Loss of appetite that may last a few days or weeks)

Since these symptoms are common with other illnesses, the only way to know if you have HIV is to get tested.

Testing
HIV testing is done through a simple blood test. It can take up to three months after being infected to detect the virus in a blood test.

Treatment and follow-up
There is no cure for HIV, but with treatment, most people can avoid getting AIDS and live a long, healthy life. People who test positive for HIV need to tell their partner(s).

HPV is a very contagious STI. About 75% of sexually active Canadians will have at least one HPV infection in their lifetime. The highest rates of HPV infection are in young people aged 15-24.

There are many different types of HPV. Some types can cause genital warts or may clear up on their own. Other types have been linked to cancer of the cervix, vulva, vagina, penis, anus, mouth, throat.

How you can get it
HPV is spread easily by skin-to-skin contact in the genital area (penetration is not required) or during vaginal, anal or oral sex.

Symptoms
Most people who have HPV don’t have any symptoms. Genital warts are often the only sign of infection, and may be:

• Small growths that can show up weeks, months or even years after infection
• Itchy and burning (but usually painless)
• Pink, white, brown or grey and have a cauliflower-like appearance
• Flat or feel like a raised bump
• Present in clusters or there may only be one or two
• Found where or where you cannot see them (e.g., on the cervix or anus)

Testing
If you think you might have genital warts, a doctor will need to look at them. A doctor can also provide cervical cancer screening (Pap test) to detect changes in the cervix caused by HPV. There is an HPV test available to women over 30 in some provinces in Canada. Learn more about the HPV test from the Canadian Cancer Society.

Treatment and follow-up
For most people, HPV infection goes away on its own within two years. This does not mean that a person cannot become infected again. Genital warts can be treated by:

• Cryotherapy (freezing)
• Medications (creams that can be applied to the warts)
• Laser surgery

Molluscum is a common skin infection cause by a virus.

How you can get it
Molluscum can spread through direct contact with a molluscum sore (bump) on a person with the infection. It can also be spread through contact with objects like towels, clothing or toys that have come into contact with the virus. A person with molluscum can spread it to another part of their own body by scratching or picking at the bump or shaving the affected area. 

Symptoms
Molluscum can appear anywhere on the body. Symptoms can take a week to six months to appear and may include:

• Small, round, white/pink/flesh coloured bumps on the skin, often with a dip in the middle and filled with a firm, white substance
• One or many bumps, usually with no pain, swelling or redness unless they have been scratched

Testing
A health care provider can usually tell if you have molluscum by looking at the bumps.

Treatment and follow-up
Bumps usually disappear on their own in 6-12 months. In some cases, it can take up to four years to disappear completely. Molluscum on the genitals can be treated by freezing with liquid nitrogen to help prevent spreading it.

• Permanent damage to the brain, heart, bones and/or blood vessels
• Mental disorders or neurological problems
• Blindness
• Death in rare cases
• Higher risk of getting another STI, including HIV

How you can get it
Syphilis is spread through unprotected oral, vaginal or anal sex with a person who has the infection. If you are pregnant and have syphilis, you can pass it to your baby during pregnancy or childbirth.

Symptoms
The first symptom is often a painless sore, called a chancre. The sore can be confused with an ingrown hair or other harmless bump. The sore goes away without treatment but the bacteria stays in your body. Later, you may get a rash on your body and feel like you have the flu. The rash can show up all over your body or just in a few places.

Testing
Syphilis testing can be done by a special blood test or a swab of any visible sores. 

Treatment and follow-up
Syphilis can be cured with antibiotics, usually penicillin. Follow-up testing is important to make sure the infection has been cured. If you have been treated for syphilis, you should follow your health care provider’s instructions to:

• Talk to your partner
• Avoid having any type of sex until your health care provider says it is safe  
• Use condoms for all sexual activity
• Test again according to your health care provider’s instructions
• Notify any sexual partners you have had that may need to be tested too