Dr. Suchitra Dalvie answers some common questions pertaining to STI diagnosis, symptoms, treatment, and perception. Psst…she also has a few mind-blowing facts about these much-feared infections!
1. What is an STI? How does it spread?
Sexually Transmitted Infections (STIs) differ from Sexually Transmitted Disease (STDs). STDs conventionally include infections resulting in clinical diseases that may involve the genitalia and other parts of the body participating in sexual interaction; e.g., syphilis, gonorrhea, chancroid, donovanosis, nongonococcal urethritis, genital warts, herpes genitalis, etc. and which have become chronic.
STIs, include infections that may not cause clinical disease of the genitals but are transmitted by sexual interaction; e.g., all STDs and hepatitis B, HIV, HTLV-1, etc. Nowadays, the term STI is preferred, since it covers all diseases that can be transmitted by sexual intercourse and also let’s us know that these infections, like others, are treatable.
2. How do STIs spread?
You may get an STI by having sex with someone who has an infection. They are usually passed from person to person through intercourse -vaginal, anal, or oral- or skin-to-skin contact.
3. Can I get an STI by kissing or touching someone?
Only a few STIs can be transmitted through kissing. Herpes is known more for its genital variant but there is HSV-1 (Herpes Simplex Virus) which can be passed on through kissing; other common examples are the Cytomegalovirus (CMV) and Hepatitis B Virus (HBV). The most notable symptom is a small white or red blister on the mouth or genitals. The virus can also spread when no symptoms are present. For active infections, see your doctor for antiviral medications.
4. Can I get an STI by using a dirty toilet seat?
Most disease-causing organisms can survive for only a short time on the surface of the toilet seat; so, for an infection to occur, the germs would have to be transferred from the toilet seat to your urethral or genital tract, or through a cut or sore on the buttocks or thighs, which is possible, but very unlikely. So unless you are having sex on the toilet seat, it is unlikely to give you an STI!
You can of course, get other viral and bacterial infections like E. Coli or the common cold, or Covid-19, if the door handles are unclean and you don’t wash your hands thoroughly with soap afterwards.
5. What is HBV? Is HBV more infectious than HIV?
Hepatitis B (HBV) is 50 to 100 times easier to transmit sexually than HIV. HBV has been found in vaginal secretions, saliva, and semen. Since HBV has been found in saliva, the risk of transmission with deep kissing probably exists and the risk increases if one partner wears orthodontic braces or has open cuts or sores in the mouth.
India started vaccinating children against Hepatitis-B in 2011. It is now given at birth to babies born in hospitals. Those born after 2011 can get themselves vaccinated as adults.
6. How does one get HBV?
Vibrators and sex toys can also spread HBV because it can survive outside the body for a week or more. Immersing the vibrator in boiling water may reduce the risk. But the safest advice is to avoid the use of these products until your sexual partner is vaccinated. Unless you’re in a mutually monogamous relationship, it’s best to use a condom in every sexual encounter. Don’t use an oil-based lubricant, as it can cause a latex condom to tear.
7. How do I get an STI test?
If you think you have an STI, you should visit a doctor—either your family physician, a gynaecologist, or a skin specialist since their training includes a study of venereal diseases aka STIs. They will assess and recommend the tests you need to get done, for which you can then go to a hospital or diagnostics lab.
8. How much do STI tests cost? How often should I get tested?
The cost of the tests is variable depending on the possible diagnosis being considered. If you are likely to be repeatedly at risk, it is good to have a discussion with your doctor about protection methods you can use, and early signs and symptoms of STIs to be aware of. It is not recommended to self-medicate or undergo lab tests without any advice, since the interpretation of the test would need to be done by a trained healthcare professional.
9. How will I know if I have an STI?
The most common symptoms of STIs include:
- Itching around the vagina and/or discharge from the vagina/penis.
- Pain during sex or when urinating.
- Pain in the pelvic area.
- Sore throats in people who have oral sex.
- Pain in or around the anus for people who have anal sex.
- Chancre sores (painless red sores) on the genital area, anus, tongue, and/or throat.
- A scaly rash on the palms of your hands and the soles of your feet.
- Dark urine, loose, light-coloured stool, yellow eyes and skin.
- Small blisters/scabs on the genital area.
- Swollen glands, fever, and body aches.
- Unusual infections, unexplained fatigue, night sweats, and weight loss.
- Soft, flesh-coloured warts around the genital area.
Most STIs can be diagnosed through a medical examination of a culture of the secretions from your vagina or penis, or through a blood test.
10. What do I need to do if I have an STI ?
If you have been diagnosed with an STI, you should take the complete treatment and course of antibiotics or antivirals. You should inform you recent sexual partners so that they can also get themselves tested.
Drink plenty of fluids and wear loose comfortable garments. In India, we recommend that all persons wear cotton undergarments since the heat and humidity can make things uncomfortable even in the absence of an infection and can increase propensity for fungal infections and rashes.
11. Is an STI a life-long thing? What does curing an STI usually require?
Some STIs, unfortunately, are lifelong, such as Herpes and HIV. However, even if they cannot be cured, they can be managed with proper medication. STIs are caused mostly by bacteria or viruses and hence the cure would involve taking the full course of the recommended medication and any local applications advised.
12. Can both men and women get STIs? Am I less susceptible to STIs if I only have sex with one specific partner?
Both men and women can get and have STIs. Some STIs do not have any significant physical symptoms and are hence transmitted easily.
You can lower the risk of getting an STI by only having sex with someone who isn’t having sex with anyone else, and who doesn’t have an STI. If you are not in a mutually monogamous relationship, try to always use condoms during sex, including oral and anal sex. Don’t have sex if your partner(s) or you are being treated for an STI.
Wash your genitals with soap and water and urinate soon after you have sex. This may help clean away some germs before they have a chance to infect you; that said, none of this is an alternative to using condoms.