Sexually transmitted infections (STIs) are infections that commonly spread by sex, all types of sex i.e. vaginal, oral and anal sex. The organisms (bacteria, viruses or parasites) that cause sexually transmitted infections may pass from person to person in blood, semen or vaginal and other body fluids.
Sexually transmitted infections don’t always cause symptoms. Because of this, they may go unnoticed until complications occur or a partner is diagnosed.
If STIs do cause symptoms in men, these include
- Burning on passing urine
- Discharge from the penis
- Sores or bumps on the genitals or in the or rectal area
- Itching of the genitals
- Rashes over the trunk, hands and feet
- Bleeding and discharge from the back passage
If STIs do cause symptoms in women, these include
- Changes in colour or smell or consistency of vaginal discharge
- Lower abdominal pain
- Pain when having sex
- Bleeding in between periods
- Bleeding after sex
- Sores or bumps on the genitals
- Rashes over the trunk, hands and feet
Anyone who is sexually active risks some degree of exposure to an STI.
Factors that may increase that risk include:
- Having unprotected sex i.e. sex without condoms (including inconsistent and improper use of condoms)
- Having sexual contact with multiple partners. The more people one has sexual contact with, the greater the risk.
- Having sex under the influence of drugs and alcohol including chemsex.
- Having a history of STIs. Having one STI makes it easier for another STI to take hold.
Although most STI’s are curable if they are left untreated they can have serious consequences beyond the immediate impact of the infection itself. STIs such as Chlamydia and gonorrhoea are major causes of inflammation of testicles (epididymo-orchitis) in men and pelvic inflammatory disease and infertility in women. Several STIs, in particular HIV and syphilis can also be transmitted from mother to child during pregnancy and childbirth. Symptoms are unpleasant and may cause considerable pain, and have systemic complications. HIV, Hepatitis B and C may have an aggressive course and can lead to lifelong morbidity and death. Some human papilloma virus (HPV) types are a cause of cervical, penile, anal and oropharyngeal cancers
STI’s are a major individual, societal and public health concern. Their social, health and economic costs are substantial and affect the lives and well-being of individuals, relationships, communities and societies with disproportionate impacts among the young, socioeconomically deprived, or those with high levels of risk behaviours and their partners. Understanding the nature and determinants of this burden is the first step in articulating its importance to the public and policy makers, and justifying scarce health resources for their management.
STIs are among the most commonly diagnosed infectious diseases in many parts of the world. 450 million new cases of curable STIs occur in adults each year1.Being diagnosed with an STI can have a tremendous physical, emotional and psychological toll on individuals. Chlamydia and gonorrhoea are both the most serious, and also most preventable, threats to women’s fertility worldwide. The World Bank estimated that STIs (excluding HIV) were the second most common cause of healthy life lost after maternal morbidity in 15 to 44 year old women2.
STI testing at a GU clinic is recommended before the start of a new sexual relationship or if there is a change in sexual partner/s or if the person notices any of the above symptoms.
In Malta we have seen an increase in the number of sexually transmitted infections over the years. The cause for this rise is multifactorial. This can be the result of increased awareness and increased testing but also the result of changes in sexual practices. The way modern society is forming partners is now through using a lot of social media, and this is affecting the sexual transmission dynamics we are seeing. Technology has complicated matters because most partners are anonymous and so it’s difficult or impossible to contact them. People do not know their sex partners as intimately as they once did; they may be individuals they know mostly through a profile photo and short blurb. People sometimes delete their profiles before they can be contacted to be informed that they have been exposed to an STI.
Counselling and behavioural interventions are crucial in preventing STIs. This includes safer sex advice, risk-reduction counselling and condom promotion.
In addition, counselling can improve people’s ability to recognise the symptoms of STIs and increase the likelihood they will seek care or encourage a sexual partner to do so.
Contact Information of GU Clinics in Malta – MDH and Private.
GU Clinic at Mater Dei Hospital – 25457494/21227981
GU Clinic at St James Hospital -23291000
GU Clinic at St Thomas Hospital – 21482482
GU clinic at Da Vinci Hospital – 21491200
GU clinic at Persona – 21340366
St Julian’s Pharmacy, St Julian’s – 21369426
Sex Clinic by Willingness – 79291817
References
- World Health Organisation. Sexually transmitted infections (STIs) Fact sheet No 110. 3rd August 2016. Available from: http://www.who.int/en/news-room/fact-sheets/detail/sexually-transmitted-infections- (stis); Accessed 11/08/2020.
- Rogstad K. ABC of Sexually Transmitted infections 6th Edition. West Sussex, UK Wiley and Blackwell Publishing Ltd; 2011.
Dr Donia Gamoudi graduated from the Malta Medical School as a doctor of medicine and surgery in 2011, and later on furthered her specialist training in Genitourinary Medicine at the Nottingham University Hospital NHS Trust for 3 years.
She is keen on teaching and taught the HIV and STI modular courses to various medical students and other healthcare professionals.
