Life / Health

Don't go viral: Your guide to 21st century sexually transmitted infections

STIs don't just happen to other people. They're increasing in almost every age group. It's time for a refresher.


Many of us think sexually transmitted infections only happen to other people. But outbreaks are popping up around the country, and infection rates, even of practically forgotten diseases like syphilis, are increasing in nearly every age group. Right now no one is quite sure why. It might have to do with unprotected oral sex, or increasing IV drug use. Even hookup apps like Tinder and Grindr have taken some of the blame (though no studies have yet shown they’re any more likely to result in STIs than meeting people the old-fashioned way). We all know using condoms and getting tested regularly are the best defence, but here’s what else you need to know.


What is it?
A bacterial STI that can cause itching, discharge and burning during urination in both sexes. Women sometimes have bleeding between periods or after sex, but often have no symptoms at all. In the long term, it can cause pelvic inflammatory disease in women and infertility in both sexes. It may infect the eyes, mouth and rectum as well.

What’s new?
Chlamydia has been rising in Canada since the 1990s. It increased by 72 per cent from 2001 to 2010 alone.


What is it?
A bacterial STI with very similar symptoms and long-term consequences as chlamydia, though it’s much less common. Only a lab test can tell the difference for sure. Unlike chlamydia, gonorrhea can, rarely, cause a serious disease with high fever and swollen joints.

What’s new?
Gonorrhea increased by nearly 40 per cent from 2003 to 2012. Some cities, like Toronto, have seen a jump since 2015.

What can be done?
Condoms and testing are the best defences against chlamydia and gonorrhea. Treatment is antibiotics. For gonorrhea, which is resistant to all but a few, you might need several different drugs.


What is it?
Human immunodeficiency virus (HIV) is a blood-borne virus that attacks the immune system, leaving you vulnerable to infections. You can get it through sex (anal, vaginal or oral), or blood, such as by sharing needles, or (historically) receiving a blood transfusion. It can also pass from mother to child. Drugs called antiretrovirals can prevent HIV from developing into life-threatening Acquired Immunodeficiency Syndrome (AIDS).

What’s new?
There’s good news and bad news. Thanks to modern medicine, HIV-positive people are living long, healthy lives with little to no chance of infecting others. On the other hand, there have recently been new outbreaks of HIV reported in places like Saskatchewan, the B.C. interior and London, Ont.

What can you do?
Use condoms and (obviously) don’t share needles. People at high risk can also consider pre-exposure prophylaxis (PrEp), a daily pill that can prevent HIV from taking hold in the body even if you’re exposed.


What is it?
Syphilis is a bacterial infection that can progress into a devastating disease if left untreated. It’s spread by sex as well as from mother to child, in which case it's called congenital syphilis. In adults, syphilis usually starts with a firm, painless, often-overlooked sore called a chancre on the genitals. Second-stage symptoms are fever, malaise, headache and a spotty red rash, it looked a lot like smallpox. The infection can then hibernate in the body for up to 15 years before reappearing in any number of nightmarish forms: As a progressive, severe neurological and psychiatric condition, as heart disease, or as large, tumour-like lumps all over the body.

What’s new?
Toronto has seen a scary spike in syphilis over the past year, mostly in gay men. Public health officials think unprotected oral sex may be to blame.

What can you do?
Use condoms! Thanks to antibiotics, syphilis is now curable. It has a nasty habit of showing up in people who have HIV, and it’s one reason it’s important to have safe sex even if you’re HIV positive and only have sex with other HIV-positive people. That’s true for many STIs: One type often leads to another, because sores or irritated skin give germs an easier path into the body.


What is it?
Human Papilloma Viruses (HPV) are sexually transmitted viruses that cause genital warts and can lead to head, neck, mouth, throat, cervical and penile cancers.

What’s new?
There’s been a big increase in mouth and throat cancers in Canadian men (56 per cent between 1992 and 2012). Smoking and drinking are definitely culprits. But emerging research shows HPV is a much more important risk factor than previously thought.

What can you do?

HPV is crazy common, and because it infects many parts of the body, condoms only provide partial protection. For women, getting a pap test every three years (or more often if you’re high risk) can catch HPV-related changes early, when they’re more treatable

Vaccinations are available (coverage varies by province) against the nastiest strains of HPV. They’ve been shown to dramatically reduce cervical changes caused by the virus.


What is it?
Genital herpes is a common infection caused by the same virus as cold sores. In some people, it appears as an outbreak of blisters around the genitals, rectum or mouth. They burst and leave painful sores that take weeks to heal. Others have few or no symptoms. Herpes is lifelong, but outbreaks usually become less severe and frequent as years pass. You can pass herpes on whether or not you’re having symptoms.

What’s new?
Several therapeutic vaccines (for people who already have herpes) are in the works. A 12-month clinical trial published last month found a 65 per cent reduction in outbreaks among people who had the vaccine. And there’s hope for a preventative vaccine in the future.

What can be done?
Condoms lower the risk of passing on herpes, but don’t eliminate it. Antiviral medications can help clear up an outbreak and reduce your chance of infecting someone else.


Asking a new partner about STIs, or telling them you have one, is just the worst. But it has to be done, says Jenelle Marie Pierce, founder of The STD Project.

On her site she cautions against the question “Are you clean?” because absolutely anybody who has sex can get an STI. Having the bad luck to contract one doesn’t make you dirty.

Deciding how and when to tell a partner you have an STI is even tricker: It’s not the most important thing about you, so disclosing on a first date seems like a bit much. But if you wait until you’ve gotten close, the news can come as a shock.  

Pierce has only one rule about when to disclose: You have to have the conversation before you have sex — any kind of sex. Other than that, it’s up to you. Her advice:

• Talk in person, and in private. No texts!
• Be honest and positive about yourself and your STI.
• Share the facts in a no-nonsense way and answer questions.
•Then leave, and give them some time to digest the facts on their own.
• Lastly, (this is easier said than done) do your best not to take their reaction personally.

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