STIs are on the rise. Here’s everything you need to know

Troubling new stats show some sexually transmitted infections are on the rise in Australia. Here are some things to know before getting between the sheets.

Love may not last forever, but a sexually transmitted disease might.

In 2021, Australia reported a total of 86,916 cases of chlamydia, 26,577 for gonorrhoea and 5,570 for syphilis.

Now, recent statistics from the National Notifiable Diseases Surveillance System (NNDSS) suggest there has been a 24 per cent increase in chlamydia cases from 2021 to 2023, with a 45 per cent increase for gonorrhoea infections over the same period.

What are STIs?

They used to be called “venereal diseases” after Venus, the goddess of love, The House of Wellness resident doctor Dr Nick Carr says.

“They then became known as STDs or ‘sexually transmitted diseases’ before they were referred to as STIs in the last 25 years,” he explains.

“These ‘sexually transmitted infections’ are all infections caused by viruses, bacteria or others that can be transferred through close intimate sexual contact.”

What are some common STI symptoms?

While there is a list of possible symptoms, the most common one is having no symptoms at all, Dr Carr says.

“This is why it’s so important because diseases like gonorrhoea or herpes often have no symptoms,” he says.

“But there may be symptoms like discharge from the vagina or penis, pain when passing urine and sores breaking out for conditions like herpes, and rashes for syphilis.”

How long do STI symptoms take to appear?

“There’s a huge variation from a few days or more,” Dr Carr says.

“Sometimes with things like gonorrhoea and chlamydia, people could get discharged within days of contracting the infection.

“But there may be other diseases such as syphilis, which may take weeks or even months to show up.

And others like herpes, for instance, or hepatitis type viruses may take months or even years before you know you have them.”

Can you get an STI without having sex?

STIs are mainly transmitted through sexual intercourse, especially through practices such as unprotected sex and having multiple sexual partners.

“It’s virtually impossible to get an STI without close intimate contact with someone else,” Dr Carr says.

“So no, you can’t catch an STI from a toilet seat.”

How do you get tested for an STI?

“You can carry an STI without knowing, which is why you should get tested regularly,” Dr Carr.

A sexual health check-up can help you get tested for an STI, with physical examinations including genital examination, swabs, blood and urine tests and a pap smear.

How often should you get tested?

It depends on sexual activity, Dr Carr says, but it’s recommended to get tested at the end and start of a relationship.

This includes those in a long term relationships or partners who believe they are in a faithful relationship with one another.

“If someone frequently has new or different partners, then a regular check-up every three months would be wise.”

How can you prevent an STI?

Dr Carr says while abstinence works quite well, but this may not be an option for those who want a little more intimacy.

“First of all, there’s other things such as getting vaccinated for STIs like HPV, the wart virus and particularly for gay men, hepatitis B, hepatitis A and MPox.

“Secondly, have an honest conversation with your partner about the risks and then get tested.

“Thirdly, use condoms.”

Common STIs – and how to treat them

Chlamydia

In 2017, there were 100,775 notifications for chlamydia, with more than half of those affected being women and people between ages 15 to 29.

“Chlamydia is most often picked up with a screening test – a urine test or a vaginal swab for women,” Kathleen McNamee of Family Planning Victoria explains.

“Women may get irregular bleeding, especially after sex, and people can get discharge or a stinging sensation when passing urine.

Chlamydia can also cause pelvic pain.”

Treatment for chlamydia

A doctor may prescribe antibiotics such as amoxicillin or erythromycin.

Have your sexual partners tested and treated, and use condoms to reduce risk of infection.

Gonorrhoea

Gonorrhoea is most commonly diagnosed in men, and if often spread by having sex without condoms, which can cause infections in the urethra, cervix, anus and throat.

Cases has been on the rise since 2016, with reportedly 28,364 confirmed cases in 2017 in Australia.

“Men get a pus-like discharge and pain passing urine. It’s often without symptoms for women but it can cause discharge, irregular bleeding or bleeding after sex and pelvic pain,” Kathleen says.

Treatment for gonorrhoea

A doctor may prescribe an antibiotic shot or ceftriaxone if diagnosed.

Sexual partners also need to be tested.

Syphilis

Syphilis is a bacterial infection transmitted through unprotected sex and through skin-to-skin contact with an infected area.

It is one of the fastest-rising STIs in Australia, with people aged 25 to 29 having the highest rate of infection and more men than women being diagnosed.

The rate of women aged 15 to 44 infected by syphilis has also increased between 2015 and 2020 by 233 per cent.

“The first stage is an ulcer or sore – sometimes unnoticed – around the anus, genitals or your mouth. That sore goes away but the syphilis doesn’t go away,” Kathleen says.

Other symptoms of syphilis include skin rashes, fever, swelling of glands in the groin and armpits, a genital rash and feeling tired.

Treatment for syphilis

Penicillin or other medication, if you have a penicillin allergy.

Genital warts

Genital warts present as lumps around the genital area, anus, rectum and cervix.

These could be flat or raised in appearance, clustered or spread out, or single or multiple.

Treatment for genital warts

These could be treated with topical creams, cryotherapy or a laser.

“The wart virus can be found particularly in women who has just done their routine screen testing and that may need treatment from a specialist,” Dr Carr says.

“However, the best treatment for this is vaccination, which acts as a preventer.”

Since the HPV vaccination program in 2007, it’s been reported that there’s been a 90 per cent decline of genital warts in the younger population.

Genital herpes

Genital herpes is caused by a herpes simplex virus (type 1 or type 2) and can lead to small ulcers or blisters in the genital area, followed by a stinging or tingling sensation.

According to a recent study in 2023, nearly one third of genital herpes cases are caused by the type 1 virus among the youth in Australia and a few other Western countries.

Treatment for genital herpes

While there is no cure for genital herpes, some treatments may help alleviate the symptoms.

These include having salt baths, applying ice packs and taking medication for pain relief.

Hepatitis B

Hepatitis B is a viral infection that can cause serious liver infection which could last for several months to lifelong.

Symptoms can include dark urine, abdominal pain, joint pain and jaundice.

“Hepatitis B is less common because most people are vaccinated,” Dr Carr says.

Treatment for hepatitis B

“They can be treated with complicated antiviral medications,” Dr Carr explains.

“But again, with hepatitis B, the main treatment should be prevention because vaccination is so effective.”

HIV infection

HIV, or the human immunodeficiency virus, is an incurable disease that attacks the immune system and could lead to a severe condition called AIDS.

It can be presented with flu-like symptoms, which may last for days or several weeks, and some may not encounter symptoms at all.

In 2022, there were around 28,870 confirmed HIV cases in Australia.

Treatment for HIV infection

“Now, HIV is a treatable chronic illness because of antivirals that work,” Dr Carr says.

“We do have medications that stop people getting it and medications to treat it if they do too.”

This includes preventative medications such as PrEP, or pre-exposure prophylaxis, which reduces the risk of HIV from sex by around 99 per cent and 74 per cent from injection drug use.

Other treatments may involve antiretroviral therapy, which doesn’t cure HIV, but helps those affected lead longer and healthier lives.

Do STIs go away on their own?

“Unfortunately it’s often said that with something like herpes, for instance, it lasts forever,” Dr Carr says.

“All the other things like syphilis, gonorrhoea and chlamydia don’t just go away on their own.”

However, the wart virus is frequently killed and cleared out of the body by the immune system, with warts disappearing over time on their own.

For more on sexual health:

• Why vaginal microbiome is so critical for women’s health
• Why sexual consent chats with your kids don’t have to be weird
• Is sex causing pain rather than pleasure? Here’s what to do
• Why women need testosterone for good health

Written by Sarah Marinos. Updated by Melissa Hong, February 2024.