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Sexually Transmitted Infections and HIV

When it comes to sexually transmitted infections (STIs) sometimes it’s harder for youth to access safer sex supplies (condoms, for example), or to know where to get accurate info. This helps to explain why 15-24 year olds have high rates of STIs. There’s also a lot of misinformation about STIs and stereotypes about who can get one. Myths (like only “those” people get STIs) and wrong information put us at risk. If we don’t have accurate info we might not use barriers (like condoms) or get tested if we are deciding to have sex.

The good news is, there are lot’s of things we can do to help keep ourselves and our partner(s) to be safer. Choosing not to have sex (abstinence), doing lower risk activities, using barriers like condoms and sex dams each and every time and getting tested regularly can all help to prevent the spread of STIs. You don’t have to be having sex to get accurate info. Ideally, people get safer sex information before they decide to have sex. Read on to find out more!

Types of STIs
STIs are common in Manitoba so it can be helpful to know a bit about them. What’s listed below is basic information for both curable and treatable STIs. “Curable” means that the STI can be cured with medication or treatment and the person does not have an STI anymore but could get it again. “Treatable” means that the STI cannot be cured, but the symptoms can be treated. There are three types of STI: bacteria like gonorrhea, chlamydia and syphilis; parasites like trichomoniasis and pubic lice; and viruses like HIV and Hep B/C.

Curable STIs

Chlamydia is a bacterial infection that is curable with antibiotics and there are rarely any signs or symptoms, which is why it is important to get tested!

Gonorrhea is a bacterial infection that is curable with antibiotics. Some of the more common signs and symptoms include irritation when peeing and sex organ discharge, but some people will not have any signs.

Trichomoniasis, “trich” for short, is a parasite that can be spread during sex. It can cause vaginitis in women – an inflamed, sore and itchy vagina, sometimes with an unusual discharge. Trich is curable with antibiotics.

Hepatitis C, Hep C or HCV for short, is a virus that can damage the liver, which filters our blood. It is spread through blood so any behaviour involving blood is high risk for transmission. Hep C can live outside of the body for up to four days. This makes sharing things like toothbrushes, razors, glass or metal pipes, drug works, nail clippers, tweezers and earrings (if piercing is not healed) a risk. There is treatment for Hep C that can cure it most of the time. Click here to find out more about Hepatitis C.

Syphilis is a bacterial infection passed on by contact with an open sore. Sometimes the sores go unnoticed as there is no pain but like most other STIs, it can cause complications if left untreated. Syphilis is curable through a series of injections, given at a clinic.

Pubic Lice are parasites that are very itchy and live in your pubic hair. They are cured with a shampoo that anyone can get at a pharmacy or teen clinic. Shaving pubic hair to get rid of lice doesn’t work and can cause a rash making it worse! It’s important to wash all the clothing, towels and sheets that have been used since lice can live away from the body for 1-2 days and can be passed on.

Treatable STI

Genital Herpes are painful sores that only have treatments such as creams and pills. A person can try to reduce herpes outbreaks by taking extra good care of themselves, lowering stress and wearing loose clothing. If someone put their mouth on someone’s genitals and that person has genital herpes, the virus can be passed on and they could get cold sores, and vice versa. However, that doesn’t mean if someone has a cold sore, they got it from sexual activity. Cold sores are common.

Genital Warts, also Human Papilloma Virus (HPV), have over 100 types, and about 40 of them can cause genital warts. Certain types of HPV can cause cervical cancer in women, which is why it’s important for women who have ever been sexually active to get a Pap Test every 3 years starting at age 21. Like other warts, genital warts are often treated by freezing or lasering and some people can clear HPV from their body. A wart on a hand can’t give that person genital warts because it’s a different kind of HPV.

Hepatitis A and B are viruses that can damage the liver, which filters our blood. Many people can clear Hep A and B on their own. There are vaccines for Hep A and B which can prevent people from getting them. People have said Hepatitis feels like the flu. Hep A can be passed by bacteria and unsanitary conditions, Hep B is mainly passed through sex fluids.

HIV is another virus that can be passed through unprotected sex and blood. Click here to find out more.

If you want to know more about how STIs can spread, check out ‘STI Transmission’ section below. The earlier STIs are recognized, the more easily they are cured or treated and don’t lead to long term complications. Often there are no signs or symptoms, which is why STI testing and finding ways to stay safer is so important.

Signs of STIs
You can’t tell by looking at someone if they have a sexually transmitted infection and often STIs don’t show many signs. If someone does have signs, they might notice…

  • Sex organ discharge: Fluids like semen (cum or ejaculate), pre-ejaculate (pre-cum), vaginal fluid and discharge, menstrual blood and rectal (anal) fluid are common and healthy. However, if anything changes, looks different, is a different consistency, or smells different it could be a sign of a STI.
  • Irritation when peeing: pain when you pee, feeling like you have to pee all the time, or trouble peeing.
  • Genital itching: lots of itching in the genital area.
  • Noticeable pelvic pain: dull aching in the pelvic or abdominal (stomach) area.
  • Skin changes: rashes, lumps, bumps, or sores on your anus, penis, testicles, vulva, or vaginal area.

Checking out all your body parts is a great way to find out what you normally look like, but it isn’t a reliable way to tell whether or not you have a STI. The way to find out for sure is to get tested at a teen clinic or health centre. Testing for STIs can be quick, easy, and confidential, scroll down to find out more.

HIV

HIV is a virus that attacks the immune system, which then weakens the body’s ability to fight disease and infection. It can be passed through unprotected sex and blood.  A common infection like the flu or a cold can be very difficult for the body to fight off after the immune system has been weakened by HIV. There is no cure for HIV but there are treatments.

Click here to learn more about HIV

Hepatitis

Hepatitis means inflammation of the liver and is usually caused by a virus. The most common viruses are Hepatitis A, B and C.

  • Hepatitis A is spread through fecal matter (poop). Usually through contaminated water systems or from someone not washing their hands properly and then preparing food.
  • Hepatitis B is transmitted through blood or sex fluids

Often the body can fight off an infection of A or B on it’s own. There is also a vaccine available to prevent both of these infections.

  • Hepatitis C does not have a vaccine. It is transmitted through sharing blood. This includes risks such as sharing needles, but also things like sharing personal health hygiene items including toothbrushes, shaving tools, and nail clippers.

Click here to learn more about Hepatitis C including prevention and treatment

STI Transmission

Anyone who is sexually active can get an STI.

Most STIs are spread through sex fluids or unprotected sexual contact like…

  • Oral sex (mouth on vulva, vagina, penis, testicles or anus)
  • Anal sex (penis in anus)
  • Vaginal sex (penis or sex toy in vagina)
  • Skin-to-skin contact (like when partners rub their genitals together)
  • Sharing sex toys

 

HIV and hepatitis C are also spread through blood. Check the HIV and hep C pages for more info.

STI Testing
At most of the teen clinics in Manitoba they usually do either a urine or blood test to check for STIs, HIV, or Hepatitis C. The health care provider may also do a visual exam and might take a swab if necessary. You can ask for an STI or HIV test at a teen clinic or other health care centres or nursing stations. If you’d like to be tested for everything, let whoever is doing the test know.

Teen clinics can be especially great places for younger people to get confidential, free, friendly and non-judgemental STI testing without permission from a parent/guardian. To find out where the closest teen clinic is to you (Winnipeg and all of Manitoba), check out our interactive maps here!

Getting tested gives you the chance to get the cure or treatment as soon as possible. If you get tested with your partner even better! You’re partner will be able to show you the same respect you are showing them.

Urine Test

To take a urine test, all you have to do  is pee in a cup. They can test for chlamydia and gonorrhea by testing the urine. Try not to pee for an hour or two before a test. This is because the test looks for the STI which builds up inside the urethra (pee hole). If you’ve recently peed then the STI may need the time to rebuild within the urethra.

Swab Test

Sometimes they do a swab test of body parts that have been used for sex. This can include a swab of the anus, mouth or any other opening that has been used for sex.

Visual Exam

If any noticeable signs were present on someone’s skin (like a sore or rash), a healthcare provider might want to do a visual exam to see it. A sample of cells can also be taken by a soft Q-tip like swab. If you’re uncomfortable at any point you can always arrange to come back another time when you feel more ready.

Blood Test

A blood test is when they take a small sample of blood. It’s how they test for STIs like HIV, Hepatitis C and Syphilis. If you have gotten a blood test for other things like checking your iron, it will not automatically test for HIV.

The Results…

STI test results generally take two weeks. If you do not return in person for your results, and your test results are positive (you have an STI), you will receive a phone call asking you to return to the clinic for treatment. You can give the clinic the best way to contact you, and most clinics will try to be as professional and confidential as possible.

For blood tests, it can take 1-3 months for HIV and Hepatitis C to show up on a test since it takes time for antibodies to show up in someone’s blood. This period of time is called the ‘window period’. It’s important to remember that a person can spread HIV and Hep C during the window period. In other words, as soon as they are infected with the virus, they can be spreading the virus. A second blood test is recommended after the window period for blood tests to get an accurate result. Typically, blood test results aren’t given over the phone. In order to get HIV/Hep C test results (negative or positive) you usually go back to the clinic.

Teen clinics are great places for young people to get free, friendly and non-judgemental STI testing by a healthcare provider without permission from a parent/guardian. To find out where the closest Winnipeg teen clinic is to you or where to get tested outside of Winnipeg in Manitoba check out our interactive maps here!

Reportable STIs

Manitoba Public Health requires all past and current sexual partners to be informed if someone they had sexual contact with has Chlamydia, Gonorrhea, Syphilis, Hepatitis or HIV. If you are under 18 or if you don’t feel safe telling your partner, a Public Health Nurse will contact partners for you. They do this confidentially and don’t provide names. They want to make sure that anyone at risk for one of these STIs gets tested so that they can get the cure or treatment.

As for other STIs (like herpes, HPV/warts or Pubic Lice) it may be a good idea for someone to let their partner(s) know, so they can also get tested and any treatment needed. Keeping track of reportable STIs is important since a lot of times there aren’t any noticeable signs that someone has one. Untreated STIs can cause permanent damage in the body if left untreated. Always assess your safety first when telling partners that you have or may have an STI.

Ways to Stay Safer

We can keep ourselves and our partner(s) safer from STIs by…

  • Choosing abstinence (which is the fancy way of saying not having sex). If you aren’t sharing sex fluids with someone the risk is much lower. Some STIs are spread through skin-to-skin contact (like genital warts and herpes) so the lowest risk activities are ones where genitals aren’t rubbing up on each other or touching. Click here for more info on abstinence.
  • Use a barrier between you and your partner during sexual activity. One of the most common barriers is a condom, but there many others: “female” condoms, sex dams, gloves, and finger condoms (cots) all help to prevent STIs from being spread. Used correctly, barriers are very effective at preventing the spread of STIs. Click here for instructions on how to use barriers.
  • If you share sex toys, wash and dry them according to the instructions in between partners and use a barrier (like a condom or sex dam) on them if possible.
  • Talk to your partner about using barrier methods (condoms and/or sex dams, for example) and getting tested together.
  • Get tested for STIs regularly. Many STIs don’t have noticeable signs and you can’t tell by looking if you or a partner has one. Testing is quick, easy, and confidential at any teen clinic.
  • Limit the number of sex partners you have (and get tested with every new partner). This can reduce your exposure to STIs.
  • Use new needles every time for drug use, tattoos and piercing. This can reduce the risk of HIV and Hep C.

 Questions About STIs

If you get an STI will you have it forever?
It depends on the STI.

Some are curable, which means you would no longer have it but you could get it again if you came in contact with it later. Chlamydia, Gonorrhea, Pubic Lice, Trichomoniasis (trich), and Syphilis are all curable STIs.

If an STI cannot be cured, then it is treatable. This means you will live with it for the rest of your life. However, treatment has gotten really good. People who follow their treatment can (and do!) live otherwise healthy lives. They can (and do!) still have healthy sexual relationships and (if they want) healthy pregnancies. HIV, Genital Warts, and Genital Herpes are examples of treatable STIs.

All STIs now have a cure or treatment.

I have a vagina and am only interested in having sex with someone who also has a vagina. I heard that means I can't get an STI, is this true?
This is not true. STIs do not care about people’s gender, sexuality or what genitals are involved. STIs are spread through sex fluids, including vaginal fluid, and genital skin-to-skin contact. They can also be passed through sharing sex toys. This means that anyone who is having sex may be at risk of an STI. Regular testing at a health centre or Teen Clinic and using protection is recommended for all types of sex. Check out the Condoms and Sex Dams page for more info on how to make sex safer. 
Can you get an STI without having sex?
Yes and no, it depends on a few things. Some STIs are spread through skin-to-skin contact so genital warts and herpes, or pubic lice are spread by rubbing or touching genitals together (check out the Types of STIs section above for more info). HIV and Hepatitis C can be spread through sex fluids and also through blood, so other activities like sharing needles can put someone at risk. Having said that, if you aren’t having sex or sharing sex fluids with someone your risk for STIs is very low. In fact abstaining from sex (aka, not doing it) is the most effective way of avoiding an STI. Check out the Sexuality page for more info on abstinence.
Can you get an STI from oral sex? What about anal sex or sharing sex toys?

Yes, you can get an STI from oral, anal sex or through sharing sex toys. STIs are passed through skin-to-skin contact and through sex fluids. Both of these things can happen as part of oral sex (mouth on genitals) and anal sex. Sex fluids will be on a sex toy during use so if the sex toy is shared between people, then the sex fluid will be too.  Some STIs can also live in the mouth and be passed to the genitals.

To stay safer with oral or anal sex (and penis-vagina sex), it’s important to use condoms or sex dams. Condoms can help prevent STIs with penis-vagina sex, penis-anus sex or mouth on penis sex. Click here to learn more about condoms. Sex dams can help prevent STIs with mouth on vagina, mouth on anus or mouth on testicle sex. Click here to learn more about sex dams including how to make one out of a condom.

There are three ways to stay safer if you are using sex toys with a partner

  1. Don’t share. Have at least one sex toy for each person
  2. If you do share, then clean the sex toy really well (according to its instructions) between it going near different bodies
  3. If the shape allows, use a new condom on the sex toy and change the condom between people.
Can I get an STI from masturbating?
Nope. You cannot get an STI from masturbation (aka, touching yourself for sexy pleasure). Masturbation can be a healthy part of someone’s sexuality and it’s totally no risk for STIs and pregnancy. Some people masturbate and some people don’t, whatever you choose is fine.

When you sit on a toilet seat, can you catch something?

No, this is not a risk for STIs. STIs are transmitted through sex fluids and direct skin-to-skin contact. The main way you get STIs is from having unprotected oral sex (mouth on genitals), penis-vagina sex, penis-anus sex, or by sharing sex toys.

Check out the Condoms and Sex Dams page for more info on how to make sex safer.

What if you have an STI but didn’t go to a doctor to get it checked out?

STIs left untreated/uncured may negatively affect someone’s health over time. Some STIs such as Chlamydia and Gonorrhea can cause scarring on the internal reproductive organs. This may affect someone’s ability to create a pregnancy.

When HIV is left untreated, it lowers someone’s immune system until it is hard for the body to fight off other infections. At this point they may be diagnosed AIDS. AIDS is also known as advanced HIV where someone has one or more infection they can’t fight off. Once HIV develops into AIDS, people can get very sick, this can sometimes lead to death. Check out our section on HIV to learn more.

It’s because of the risk of STIs that we recommend getting tested regularly if you are sexually active. The sooner someone finds out they have an STI, the sooner they can get the cure or start treatment. The general recommendation is every 6 months or with each new partner. You can get tested at your local health centre or at a Teen Clinic

What’s the difference between an STI and an STD?

STI and STD are talking about the same thing. STI or sexually transmitted infection is the newer term. STD or sexually transmitted disease is the older term. STD is still in use in some places in the world (like the USA) so you may still see it around.

The change happened for a couple of reasons. The first reason is that the word infection is more accurate than disease. An infection is something that either has a cure or treatment, which now a days, all STIs have. The other reason for the change was to decrease stigma. Stigma is negative thoughts, feelings or judgments that come up about something. The word disease tends to sound scary and have lots of stigma. When something has stigma, it may make it harder for people to feel comfortable getting tested, accessing treatments or cures and talking openly with partners.

What is a Pap test?
A pap test checks for abnormal cells around the cervix that could be or could become cervical cancer. Cancer Care Manitoba suggests that if you are 21 or over, have had sex and your body has a cervix, then you should get a pap test about every 3 years.

When you get tested they’ll use a speculum to gently open the vagina so that they can take a swab from around the cervix. The test usually doesn’t hurt, but some people might find it slightly uncomfortable (if you feel uncomfortable let the health care provider know). It’s a really common test and it’s very quick, and being relaxed can make it even easier. If you are worried about it try taking deep breaths, daydreaming, or listening to music in earphones. You can also bring a friend if you think it will make you more comfortable. At teen clinics they know that lots of people feel nervous so they try to answer any questions you have and will do their best to help you to feel comfortable.