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The difference between STDs and STIs, and how to treat them

These terms are often taken to mean the same thing – they’re not.

27 January 2018
By Glynis Horning

An STI is a sexually transmitted infection you get through sexual contact with someone who harbours the bacteria, viruses or parasites that spread it. If you don’t have it treated, it will in time develop into an STD – a full-blown sexually-transmitted disease.

The trick is to get treatment before an STI develops into a STD. Otherwise full-blown chlamydia, for example, can cause infertility; HPV (human papilloma virus) can cause cancer of the cervix and throat; and syphilis can lead to paralysis, mental and heart problems, blindness and death.

Prevention is your best protection, and using a condom is key, even for oral sex, sex toys such as vibrators and finger play, says sexologist Prof Elna McIntosh, director of the Disa Sexual and Reproductive Health Care Clinic in Johannesburg. Performing oral sex on men is the most common cause of throat gonorrhea, and performing oral sex on women is the most frequent method of transmission of herpes – and both put you at increased risk of HIV.

“The female condom offers a wide protection over the vulva and pubic area and is under-used,” says Dr Tlaleng Mofokeng, vice-chairperson of the Sexual Health & Reproductive Justice Coalition. But condoms are not always enough, both say. With some STIs (HPV, herpes, syphilis) infection can take place even without penetration or exchange of bodily fluids, simply through skin-to-skin contact. This makes it vital to have regular sexual health checks if you are sexually active – every six months, or whenever you meet a new partner, whichever is sooner.

“Screening will depend on the types of sex you’re having, and it’s important to remember that some STIs remain latent,” says Mofokeng. “It’s best to consult your doctor to assess your risk and advise on the most beneficial tests and time frames as STIs’ incubation periods differ.”

But t’s also important to know the symptoms, so you can pick up on infections early and get treatment – for yourself, and if at all possible, for your partner. Type of treatment will depend of whether the infection is bacterial, viral or parasitic.

Bacterial STIs

Because these are caused by bacteria they can be treated by antibiotics, and the sooner the better. Treatment failures are usually due to re-infection – if you and your partner are not treated at the same time, you can pass the infection back and forth, and unlike some childhood infections where you built up immunity, with bacterial STIs you can easily be reinfected and require full treatment each time.

“It’s of utmost importance to get all sexual partners treated at the same time,” says Mofokeng. “Resistance to antibiotics and the shortages of some medications such as penicillin mean that the second line treatments are now being used for treatment.”

The signs

  • Chlamydia: Unusual discharge from the vagina or penis and pain when you pee, but most women and nearly half of infected men have no symptoms.
  • Gonorrhea: The same as chlamydia. Most men develop symptoms, but only about one in five women do.
  • Syphilis: Painless sores on the genitals in the primary stage of infection, progressing to a body rash and swollen lymph glands, then sores in the mouth, vagina or anus. Symptoms generally vanish in the third or ‘latent’ stage (full-blown STD), when they can cause tumours on the skin, bone or liver, and damage to organs, nerves and your brain.

Viral STISs

Antibiotics won’t work on infections caused by viruses, and antiviral medications are not yet capable of eliminating viral infections, but they can reduce severity and duration. “Viral infections are not curable,” says Mafokeng. “The antivirals manage the infections or breakouts later.”

There’s now a vaccine to prevent HPV, and its being administered to girls aged 9 to 12 at school, and is available at pharmacies. HIV is treated with increasingly effective ARVs, although these still have side effects.

The signs

  • Herpes simplex (HSV): Painful blisters and open sores in the genital area, but not everyone gets these. You’re most contagious when you have blisters.
  • HPV: There may be no signs at first, then genital warts may appear in men and women, and eventually cervical cancer in women.
  • HIV: Fatigue, muscle aches, slight fever, diarrhea and weight loss, and you become increasingly vulnerable to other infections, such as TB, as your immune system is destroyed.

Parasitic STIs

These are caused by microscopic parasites and are highly infectious. Treatment depends on the type.
Trichomoniasis (“trich”) can be eliminated with specific antibiotics. Lice and scabies respond to over-the-counter creams and in resistant cases, pills.

Bedding, towels and clothes must be machine-washed in hot water or sealed in plastic bags for two weeks. “Maintaining good hygiene is important, and getting treatment early,” says Mofokeng.

The signs

  • Lice and scabies: Intense itching and rash; sores may develop from scratching.
  • Trich: Itching, burning or sore genitals, and a smelly discoloured discharge, but two-thirds of those infected have no symptoms.

How Clicks Clinics can help you

Did you know Clicks offers testing and counselling at our clinics? To make an appointment call 0860 254 257 or book online at Clicks Clinics online

IMAGE CREDIT: Getty Images