STI
Information

What is chlamydia?

Chlamydia is the most common STI in the UK and is caused by the bacterium Chlamydia trachomatis.

How is chlamydia transmitted?

Chlamydia is spread through contact with an infected person’s bodily fluids. This can happen during:

• Unprotected oral, vaginal, or anal sex
• Close genital contact (even if there’s no penetration, orgasm, or ejaculation)
• Sharing sex toys with an infected person

What are the symptoms of chlamydia?

Most people with chlamydia--up to 70% of women, and 50% of men--have no symptoms, even though they can still pass the infection on to others. Those who develop symptoms usually do so within 1 - 3 weeks after exposure, though chlamydia symptoms can occur at any time, from days to months after infection. Symptoms of chlamydia can include:

• Pain in your lower abdomen
• Unusual vaginal bleeding (e.g. after sex, between periods)
• Unusual discharge from your vagina (e.g. more than usual) or penis (e.g. white, watery)
• Painful or swollen testicles
• Pain or burning when you pee
• Pain when you have sex
• Pain or discharge from your back passage (if you have a rectal chlamydia)
• Pain in your throat (if you have pharyngeal chlamydia, though usually this is asymptomatic)
• Pain or redness in your eye (if you have conjunctival chlamydia)

When should I get tested for chlamydia?

Don’t delay getting tested if you think you have chlamydia (i.e. you or your partner(s) have any of the above symptoms, a partner tells you they have an STI, or you had unprotected sex with someone new, etc). You can get tested for chlamydia at any time, though you may be advised to repeat the test 2 weeks after the date of any potential exposure, as chlamydia can take up to 2 weeks from the time of exposure to show up positive in tests. Unless you have symptoms, we recommend that you wait 2 weeks from the time of exposure to test for chlamydia.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have chlamydia, you should not use an at-home test kit and should seek immediate attention and/or advice from a medical professional.

How is chlamydia treated?

Chlamydia is treated with a course of antibiotics. If left untreated, chlamydia can cause long-term health complications, including:

• Pelvic inflammatory disease
• Fertility problems
• Arthritis

What if I test positive for chlamydia?

• If you test positive for chlamydia, you should not engage in sexual activity (e.g. oral, vaginal, or anal sex, genital contact, or use sex toys) until after you and your partner(s) have been tested and completed any treatment. When you can safely resume sexual activity is dependent on the type of treatment you receive.
• If you test positive for chlamydia, it’s important that your recent sexual partner(s) are also tested and treated. This includes anyone you are currently having sex with, anyone you’ve had sex with in the last 6 months, and your last sexual partner. You can provide their details to certain confidential services (e.g. GUM clinics), who may contact them to let them know they may have been exposed to an STI and suggest that they go for a check-up. These services will not tell past or present partners your name, so your anonymity is protected.
• If you test positive for chlamydia and take the antibiotic treatment correctly, you may not need to be retested for chlamydia immediately afterwards to make sure the infection has gone (e.g. also known as a “test of cure” or “TOC”).

However, we do recommend you have a TOC if:

• You’ve been diagnosed with rectal chlamydia
• You had sex before you or your partner(s) finished treatment
• You or your partner(s) forgot to take the medication, or didn’t take it properly
• Your symptoms didn’t go away
• You’re pregnant

If you do need a TOC for chlamydia, it should be 6 weeks after you’ve completed the first course of antibiotic treatment. If you’re younger than 25 years of age, you should have a repeat chlamydia test 3 months after finishing treatment, because you have a higher risk of catching it again.

What is gonorrhoea?

Gonorrhoea is the second most common STI in the UK and is caused by the bacterium Neisseria gonorrhoeae.

How is gonorrhoea transmitted?

Gonorrhoea is spread through contact with an infected person’s bodily fluids. This can happen during:

• Unprotected oral, vaginal, or anal sex
• Close genital contact (even if there’s no penetration, orgasm, or ejaculation)
• Sharing sex toys with an infected person

What are the symptoms of gonorrhoea?

Many people with gonorrhoea--up to 50% of women and 10% of men--have no symptoms, even though they can still pass the infection on to others. Those who develop symptoms usually do so within the first 2 weeks after exposure (women usually develop symptoms in 2-10 days, and men in 2-5 days), though gonorrhoea symptoms can occur at any time, from days to months after infection. Symptoms of gonorrhoea can include:

• Pain in your lower abdomen
• Unusual vaginal bleeding (e.g. during sex, between periods, heavier periods)
• Unusual discharge from your vagina (e.g. more than usual, and which could be green or yellow) or penis (e.g. which could be white, yellow, or green)
• Painful or swollen testicles
• Pain or difficulty when you pee
• Pain when you have sex
• Itching or discharge (e.g. blood or mucus) from your back passage (if you have rectal gonorrhoea)
• Pain in your throat (if you have pharyngeal gonorrhoea, which is usually asymptomatic)
• Pain or redness in your eye (if you have conjunctival gonorrhoea)

When should I get tested for gonorrhoea?

Don’t delay getting tested if you think you have gonorrhoea (e.g. you or your partner(s) have any of the above symptoms, your partner tells you they have an STI, or you had unprotected sex with someone new, etc). You can get tested for gonorrhoea at any time, though you may be advised to repeat the test 2 weeks after the date of potential exposure, as gonorrhoea can take up to 2 weeks from the time of exposure to show up positive in tests. Unless you have symptoms, we recommend that you wait 2 weeks from the time of exposure to test for gonorrhoea.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have gonorrhoea, you should seek immediate attention and/or advice from a medical professional.

How is gonorrhoea treated?

Gonorrhoea is treated with a course of antibiotics. If left untreated, gonorrhoea can cause long-term health complications, including:

• Pelvic inflammatory disease
• Fertility problems
• Arthritis

What if I test positive for gonorrhoea?

• If you test positive for gonorrhoea using an at-home testing kit, a second test is required to determine which antibiotics will successfully eliminate the infection. The second test should be performed at a GUM clinic, where they will also test for other STIs, assist with partner notification, administer appropriate treatment and help organise follow-up.
• If you test positive for gonorrhoea, you should not engage in any sexual activity (i.e. oral, vaginal, or anal sex, genital contact, or use sex toys) until after you and your partner(s) have been tested and successfully treated. When you can resume sexual activity is dependent on the type of treatment you receive, but usually it's 7 days after you and your partner(s) have completed treatment.
• If you test positive for gonorrhoea, it’s important that your most recent sexual partner(s) are also tested and treated. This includes anyone you are currently having sex with, anyone you’ve had sex with in the last 3 months, and your last sexual partner. You can provide their details to certain confidential services (e.g. GUM clinics), who will contact them to let them know they may have been exposed to an STI and suggest that they go for a check-up. These services will not tell past or present partners your name, so your anonymity is protected.
• If you test positive for gonorrhoea and take the antibiotics correctly, you need to be re-tested for gonorrhoea after completing treatment (e.g. also known as a “test of cure” or “TOC”), to make sure that the infection is gone. The TOC is usually recommended 14 days after you complete your treatment, unless you still have symptoms, in which case you should be retested earlier.

What is trichomoniasis?

Trichomoniasis is an STI which is often present alongside other STIs and is caused by the parasite Trichomonas vaginalis.

How is trichomoniasis transmitted?

Trichomoniasis is spread through contact with an infected person’s bodily fluids. This can happen during:

• Unprotected vaginal sex
• Close genital contact (even if there’s no penetration, orgasm, or ejaculation)
• Sharing sex toys with an infected person

What are the symptoms of trichomoniasis?

Many people with trichomoniasis--up to 50% of women and 50% of men--have no symptoms, even though they can still pass the infection on to others. Those who develop symptoms usually do so within the first 4 weeks after exposure, though trichomoniasis symptoms can occur at any time, from days to months after infection. Symptoms of trichomoniasis can include:

• Pain in your lower abdomen
• Pain, itching, and/or redness around the vagina
• Unusual discharge from your vagina (e.g. often frothy and yellow, though it may be green, thin or thick, sometimes with an unpleasant smell) or penis (e.g. often thin and white)
• Pain, swelling, and/or redness around of the tip of your penis (glans)
• Pain when you pee, or peeing more often than usual
• Pain when you have sex
• Pain when you ejaculate

When should I get tested for trichomoniasis?

Don’t delay getting tested if you think you have trichomoniasis (i.e. you or your partner(s) have any of the above symptoms, your partner tells you they have an STI, or you had unprotected sex with someone new, etc). You can get tested for trichomoniasis at any time, though you may be advised to repeat the test 4 weeks after the date of potential exposure, as trichomoniasis can take up to 4 weeks from the time of exposure to show up positive in tests. Unless you have symptoms, we recommend that you wait 4 weeks from the time of exposure to test for trichomoniasis.

Trichomoniasis is often present alongside other STIs. If you test positive for trichomoniasis, we recommend that you and your recent sexual partner(s) are also tested for a range of other STIs, including chlamydia, gonorrhoea, syphilis, HIV and hepatitis B.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have trichomoniasis, you should seek immediate attention and/or advice from a medical professional.

How is trichomoniasis treated?

Trichomoniasis is treated with a course of antibiotics. If left untreated, trichomoniasis infection can increase your risk of other health problems, including:

• Contracting or transmitting other STIs, including HIV (Note: being infected with trichomoniasis may put you at greater risk of contracting HIV if you are exposed. If you are living with HIV, being infected with trichomoniasis may raise your viral load, thus increasing the risk of you passing on HIV, even if you are taking antiretroviral medications. However, if someone HIV positive has an undetectable viral load, there is no evidence to suggest that trichomoniasis makes them more likely to pass on HIV.)
• Complications in pregnancy (Note: a trichomoniasis infection in pregnant women may cause a pre-term delivery or low birth weight)

What if I test positive for trichomoniasis?

• If you test positive for trichomoniasis, you should not engage in sexual activity (e.g. vaginal sex, genital contact, use sex toys) until after you and your partner(s) have have been tested and treated. Ideally you and your partner(s) should receive treatment at the same time. When you can resume sexual activity is dependent on the type of treatment you receive, but usually it's 7 days after you and your partner(s) have completed treatment.
• If you test positive for trichomoniasis, it’s important that your most recent sexual partner(s) are also tested and treated. This includes anyone you are currently having sex with, anyone you’ve had sex with in the last 4 weeks, and your last sexual partner. You can provide their details to certain confidential services (e.g. GUM clinics), which will contact them to let them know they may have been exposed to an STI and suggest that they go for a check-up. These services will not tell past or present partners your name, so your anonymity is protected.
• If you test positive for trichomoniasis and take the antibiotic treatment correctly, you may not need to be re-tested for trichomoniasis immediately afterwards, to make sure the infection has gone (e.g. also known as a “test of cure” or “TOC”).

However, we do recommend that you have another trichomoniasis test if:

• You had sex before you or your partner(s) finished treatment
• You or your partner(s) forgot to take the medication, or didn’t take it properly
• Your symptoms didn’t go away

What is bacterial vaginosis (“BV”)?

Bacterial vaginosis (BV) is the most common cause of an unusual vaginal discharge in women of childbearing age, and reflects an imbalance of naturally occurring vaginal bacteria. BV is not defined as an STI because it is not sexually transmitted, but sexual activity has been linked to the development of BV.

How do I develop BV?

Certain bacteria maintain a naturally acidic environment in the vagina, which helps to protect against infection. In BV the balance of vaginal bacteria shifts, causing it to become less acidic, and thus more prone to infection--including other STIs. Other factors associated with developing BV include:

• Ethnicity (BV is more common in females of Afro-Carribean descent)
• Vaginal douching
• Bubble baths
• Receiving oral sex (in particular, females who have sex with females often have concordant vaginal flora patterns, which may increase their risk of BV)
• Having new sexual partner(s)
• Having another STI
• Having a copper intrauterine device (IUD)
• Smoking

What are the symptoms of BV?

Many females (up to 50%) with BV have no symptoms. Symptoms of BV can occur at any time, from days to months after infection, and can include:

• Unusual discharge from your vagina (e.g. often thin, white/grey, often with an unpleasant smell)

When should I get tested for BV?

Don’t delay getting tested if you think you have BV. You can get tested for BV at any time.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have BV, you should seek immediate attention and/or advice from a medical professional.

How is BV treated?

BV is treated with a course of antibiotics, gels, or creams. Pregnant females should seek medical advice from their doctor if they test positive for BV. If left untreated, BV infection can increase your risk of other health problems, including:

• Contracting or transmitting other STIs, including HIV
• Complications in pregnancy (e.g. BV infection in pregnant females may cause late-term miscarriage, pre-term delivery, low birth weight, or premature rupture of membranes)

What if I test positive for BV?

If you test positive for BV, you should not engage in sexual activity (e.g. vaginal, oral) until after you (and your partner(s), if they are the same sex) have completed Ideally you and your partner(s) would receive treatment at the same time. When you can resume sexual activity is dependent on the type of treatment you receive, but usually it's 7 days after you and your partner(s) have completed treatment.

If you test positive for BV, it’s important that your current, same-sex sexual partner(s) are also tested and treated. If you test positive for BV and take the treatment correctly, you may not need to be re-tested for BV immediately afterwards, to make sure the infection has gone (e.g. also known as a “test of cure” or “TOC”). However, we do recommended that you take another BV test if:

• Your symptoms don’t go away
• You’re pregnant

Avoiding potential triggers for BV is important for preventing recurrence (e.g. take showers instead of baths, don’t use vaginal douches, avoid using perfused products or deodorants around your gavinal area, etc.). It is common for BV to come back, usually within 3 months. If you keep developing BV you should be seen by your GP or NHS GUM clinic to help identify if something is triggering the BV (e.g. sex, your period, etc.) and how long you need to remain on treatment.

What is Mycoplasma genitalium (“MG”)?

Mycoplasma genitalium (MG) is an STI which is often present alongside other STIs, and is caused by the bacterium Mycobacterium genitalium.

How is MG transmitted?

MG is spread through contact with an infected person’s bodily fluids. This can happen during:

• Unprotected oral, vaginal, or anal sex
• Close genital contact (even if there’s no penetration, orgasm, or ejaculation)
• Sharing sex toys with an infected person

What are the symptoms of MG?

Most people with MG--up to 75% of females, and 80% of males--have no symptoms, though they can still pass the infection on to others. Those who develop symptoms usually do so within 4 weeks of exposure, though MG symptoms can occur at any time, from days to years after infection. Symptoms of MG can include:

• Pain in your lower abdomen
• Unusual vaginal bleeding (e.g. if you have cervicitis; after sex, during sex, between periods)
• Unusual discharge from your vagina or penis (e.g. watery, cloudy)
• Painful or swollen testicles (if you have epididymo-orchitis)
• Pain or difficulty when you pee (if you have urethritis)
• Pain when you have sex
• Pain when you ejaculate
• Pain or discharge from your anus (if you have proctitis)

When should I get tested for MG?

Don’t delay getting tested if you think you have MG (i.e. you or your partner(s) have any of the above symptoms, a partner told you they have an STI, you had unprotected sex with someone new, etc.). You can get tested for MG at any time, though you may be advised to repeat the test 4 weeks after the date of potential exposure, as MG can take up to 4 weeks from the time of exposure to show up positive in tests. Unless you have symptoms, we recommend that you wait 4 weeks from the time of exposure to test for MG. 

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have MG, you should seek immediate attention and/or advice from a medical professional.

How is MG treated?

MG is treated with a course of antibiotics. If left untreated, MG can Increase your risk of contracting or transmitting other STIs, including HIV, and cause other long-term health complications, including:

• Pelvic inflammatory disease
• Fertility problems
• Pregnancy complications (e.g. miscarriage, preterm delivery, stillbirth)
• Arthritis

What if I test positive for MG?

• If you test positive for MG, you should not engage in sexual activity (i.e. oral, vaginal, or anal sex, genital contact, use sex toys) until after you (and your partner(s), if they tested positive) have successfully been treated. When you can safely resume sexual activity is dependent on the type of treatment you receive, but usually it's 14 days after you (and your partner(s)) started treatment and after symptoms have resolved.
• If you test positive for MG, it’s important that your current sexual partner(s) are also tested and treated. You can provide their details to certain confidential services (e.g. GUM clinics), who will contact them to let them know they may have been exposed to an STI and suggest that they go for a check up. These services will not tell your partner(s) your name, so your anonymity is protected.
• If you test positive for MG and take the antibiotics correctly, you need to be retested for MG after completing treatment (e.g. also known as a “test of cure” or “TOC”), to make sure that the infection is gone. You should be re-tested for MG 5 weeks after starting treatment. If the follow-up test shows that you still have MG, this could be because you've been infected again, or because your infection was resistant to the first antibiotic used. We recommend you revisit a GUM clinic, because you may need to try treatment with a different type of antibiotic.

What is syphilis?

Syphilis is an STI caused by the bacterium Treponema pallidum. There are 4 stages of syphilis: primary, secondary, latent, and tertiary. Without treatment, syphilis can progress through all 4 stages.

How is syphilis transmitted?

 Syphilis is spread primarily through contact with an infected lesion or sore. This can happen during:

• Unprotected oral, vaginal, or anal sex
• Close genital contact (even if there’s no penetration, orgasm, or ejaculation)
• Sharing sex toys with an infected person

What are the symptoms of syphilis?

Some people with syphilis have no symptoms, though they can still pass the infection on to others. Syphilis symptoms can occur at any time, from days to years after infection. The symptoms of syphilis depend on the stage, though all 4 stages of syphilis can be infectious.

Primary syphilis: the first symptoms often develop 2-3 weeks after initial infection.

• Small, painless ulcer at the site of infection (penis, vagina, anal area, mouth, lips, fingers), which may go unnoticed
• Swollen glands in the neck, armpits, or groin

Secondary syphilis: these symptoms develop within 6 months of infection, and can come and go for several months before disappearing.

• Blotchy red rash that can appear anywhere on the body, but is most often on the palms of the hands or the soles of the feet; these symptoms may disappear while the infection continues
• Small skin growths (like warts) on the vulva or around the anus
• White patches in the mouth
• Swollen glands in the neck, armpits, or groin
• Flu-like symptoms (i.e. fatigue, headaches, joint pains, fever)
• Patchy hair loss

Latent (hidden) syphilis: this period can be from 1 to 20 years after infection. During this time the person may have no symptoms, or they may have relapses of secondary syphilis symptoms

Tertiary (late) syphilis: this period can be anywhere from 1 to 45 years after infection, and can cause a variety of symptoms.

• Skin and bone lesions
• Cardiovascular problems, such as heart failure, heart murmurs, angina, aneurysms, or strokes
• Neurological problems, such as dementia, psychosis, lightning pains, numbness, loss of coordination, vision problems, or blindness

When should I get tested for syphilis?

Don’t delay getting tested if you think you have syphilis (i.e. you or your partner have any of the above symptoms, your partner told you they have an STI, you had unprotected sex with a new partner, etc). You can get tested for syphilis at any time, though you may be advised to repeat the test 12 weeks after the date of potential exposure, as syphilis can take up to 12 weeks from the time of exposure to show up positive in tests. Unless you have symptoms, we recommend that you wait 12 weeks from the time of exposure to test for syphilis.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have syphilis, you should seek immediate attention and/or advice from a medical professional.

How is syphilis treated?

Syphilis is treated with a course of antibiotics, but the type of treatment you need depends on how long you’ve had syphilis. If left untreated, syphilis can ultimately be fatal.

What if I test positive for syphilis?

• If you test positive for syphilis using an at-home test, a second blood test is required to confirm the diagnosis. The second test needs to be performed at a NHS GUM clinic, where they can also test for other STIs, advise and assist with partner notification, and administer appropriate treatment and follow up.
• If you test positive for syphilis, you should not engage in sexual activity (i.e. oral, vaginal, or anal sex, genital contact, use sex toys) until after you (and your partner(s)) have completed When you can resume sexual activity is dependent on the type of treatment you receive, but usually it's 2 weeks after you and your partner(s) have completed treatment.
• If you test positive for syphilis, it’s important that your current and previous sexual partner(s) are also tested and treated. How far back you need to go depends upon how long you’ve had syphilis before it was diagnosed and treated. You should attend a GUM clinic or see your GP for further guidance on partner notification. You can provide past partners’ details to certain services (i.e. GUM clinics), who will contact them to let them know they may have been exposed to an STI and suggest that they go for a check-up. These services will not tell your partner(s) your name, so your anonymity is protected.
• If you test positive for syphilis and take the antibiotics correctly, you need to be retested for syphilis after completing treatment (e.g. also known as a “test of cure” or “TOC”), to make sure that the infection is gone. This TOC usually happens 6-12 weeks after treatment, but may happen more or less often, depending on how long you’ve had syphilis.

What is genital herpes?

Genital herpes is an STI caused by one of two viruses, which can infect the mouth to cause cold sores and/or anus and genital area.

The two viruses that can cause genital herpes are herpes simplex virus I (“HSV-I” and herpes simplex virus II (“HSV-II”).

• HSV-I is the usual cause of sores in and/or around the mouth (cold sores). It is now the most common cause of genital herpes in the UK.
• HSV-II can also cause sores in and/or around the mouth (cold sores), anus, and genital area. Of the two viruses, It is more likely to cause recurrent genital infections (infections that come and go).

How is genital herpes transmitted?

Both HSV-I and HSV-II are very contagious, and can be spread by sexual and non-sexual means--even through non-sexual oral-to-oral contact, for example kissing, or by sharing drinks or lip balm.

It is important to note that if you test positive for oral herpes you may not have contracted it through sexual contact or from a previous sexual partner. In fact, many people with oral herpes may have contracted it as a young child, for example in nursery if two children, one of whom was infected, were to share toys, touch each others’ faces or mouths, etc.

It can also spread through contact with infectious secretions or lesions of the mouth, genitals or anus. This can happen during:

• Unprotected oral, vaginal, or anal sex
• Close genital contact (even if there’s no penetration, orgasm, or ejaculation)
• Sharing sex toys with an infected person

Genital herpes is very contagious. A person infected with genital herpes is most likely to spread the virus when they have lesions (e.g. blisters, ulcers). However, they can also spread the virus even when they have  NO symptoms (e.g. lesions).

What are the symptoms of genital herpes?

About 80% of people with HSV-I and HSV-II are unaware they are infected. This is because many people with HSV have no symptoms, though they can still pass the infection to others. HSV symptoms can occur at any time, from days to years after infection. The timing and type of symptoms depend on whether it is the first (“primary”) infection, or a flare (“recurrent episode”). With primary genital infections, those who develop symptoms usually develop genital lesions 4-7 days after exposure to HSV. For those who contracted recurrent HSV-I, they often have 1 flare over the next 12 months. For those who contracted HSV-II, they often have 4 (or more) flares over the next 12 months. Symptoms of HSV can include:

Primary infection: These symptoms can last up to 4 weeks if not treated, and are often more severe than with a “recurrent” episode.

• Flu-like illness (lasting 5 - 7 days), with muscle aches and fever
• Tingling pain in the genital area, buttocks, lower back, or legs
• Multiple painful blisters, which burst to leave ulcers in/on the anus or genital area (e.g. vagina, cervix, urethra, penis, rectum, thighs, buttocks--usually on both sides) and can last up to 20 days
• Swollen and/or tender glands in the groin (i.e. lymphadenopathy), usually on both sides
• Pain or burning when you pee
• Unusual discharge from your vagina or penis

Recurrent episode: These episodes can last up to 2 days, and symptoms are often less severe than during the primary infection.

• Recurrent infections usually recur in the same area, and may be preceded by localized pain, burning, or tingling up to 48 hours before lesions appear
• Painful blisters/ulcers in the anus or genital area (usually on one side), which typically crust and heal in about 10 days
• Swollen and/or tender glands in the groin (i.e. lymphadenopathy), usually on one side

When should I get tested for herpes?

You can get tested for HSV at any time -- though you may be advised to repeat the test 12 weeks after the date of potential exposure, as HSV can take up to 12 weeks from the time of exposure to show up positive in tests. Unless you have symptoms, we recommend that you wait 12 weeks from the time of exposure to test for HSV.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have genital herpes, you should seek immediate attention and/or advice from a medical professional.

How is herpes treated?

There is no vaccine or cure for HSV. Infection is lifelong, though with time most people stop experiencing flares. Treatment may be administered to alleviate symptoms, and may include a short course of antivirals.

HSV can sometimes cause long-term health complications, including:

• Neurological problems which may make it difficult for you to pass urine
• Infection in the brain and spinal cord (e.g. aseptic meningitis)
• Herpes sores can be vulnerable to other infections caused by yeasts or bacteria
• The spread of HSV to other parts of the body, for example when someone touches a sore and then touches another part of their face (e.g. touches a cold sore and then touches their eye)
• Pregnancy complications

What if I test positive for herpes?

It is important to remember that testing positive for HSV cannot tell you how you contracted the infection (sexually or non-sexually), or for how long you’ve had it.

• If you test positive for herpes using an at-home test and you develop any symptoms of genital herpes, we recommend that you attend a GUM clinic, where they will also test for other STIs, advise and assist with partner notification, and administer appropriate treatment and follow up.
• If you test positive for HSV and feel warning signs of an outbreak (e.g. burning, itching, tingling), or have an active outbreak (i.e. cold sores, genital lesions), you should stop all sexual activity (i.e. kissing, oral, vaginal, or anal sex, genital contact, the use of sex toys, etc), even with a condom. You should not resume sexual activity until at least 7 days after the sores heal. Use condoms between flares to reduce the risk of transmission, though note they do not completely prevent transmission. There are also antiviral drugs which may reduce the transmission risk to your partner(s).
• If you test positive for HSV, it’s important that you inform your current sexual partner(s). It may change your sexual practices (e.g. using condoms), and your partner(s) may also wish to be tested.

What is human immunodeficiency virus (“HIV”)?

HIV is an STI that attacks the immune system and weakens your ability to fight off everyday infections.

How is HIV transmitted?

HIV can be spread through sexual and non-sexual means. HIV is spread through the exchange of bodily fluids with an infected person. This can happen during:

• Unprotected oral, vaginal, or anal sex
• Close genital contact (even if there’s no penetration, orgasm, or ejaculation)
• Biting or being bitten by an infected person
• Sharing toothbrushes, razors, or needles
• Sharing sex toys with an infected person

It has been established that people living with HIV who take antiretrovirals as prescribed and maintain an undetectable viral load have effectively no risk of sexually transmitting HIV to their partner(s).

Recent years have seen the development of pre-exposure prophylaxis (PrEP), an antiretroviral drug taken by people living without HIV to help protect them against infection. People living without HIV who take PrEP consistently and correctly reduce their risk of sexually contracting HIV to near-zero.

Currently some parts of the UK are trialling the free provision of PrEP, and we encourage you to consult with your NHS GUM clinic about its availability. This site may also provide helpful information with respect to obtaining PrEP.

What are the symptoms of HIV?

Some people with HIV have no symptoms and may not know they are infected, even though they can still pass the infection to others.

In the early stages of HIV infection, not all individuals develop symptoms. Those who do often present with a flu-like illness about 2 to 6 weeks after infection. After this time, HIV symptoms may not re-present until months or years later, although the virus is still actively destroying the immune system. Symptoms of HIV can include:

• Swollen lymph nodes
• Diarrhea
• Unintentional weight loss
• Recurrent infections
• Night sweats
• Skin rashes

When should I get tested for HIV?

Don’t delay getting tested if you think you have HIV (i.e. you or your partner have any of the above symptoms, your partner told you they have an STI, you had unprotected sex with a new partner, etc). You can get tested for HIV at any time, though HIV tests are most accurate 4 weeks after potential exposure. You may be advised to repeat the test 12 weeks after the date of potential exposure, as HIV can take up to 12 weeks from the time of exposure to show up positive in tests. We recommend that you wait 4 weeks from the time of exposure to test for HIV, with a repeat test at 12 weeks, though you don’t need to wait that long to seek support.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have HIV, you should seek immediate attention and/or advice from a medical professional.

How is HIV treated?

You should immediately seek medical advice if you think you may have been exposed to HIV. There are emergency medications (i.e. post-exposure prophylaxis [“PEP”]) which may stop you from becoming infected if started within 24-72 hours of exposure. You can get PEP from GUM clinics or A&E departments.

• To find your nearest GUM clinic, click here.
• To find your nearest A&E department, click here.

While there is currently no cure for HIV, it can be well-managed with a combination of daily antiretroviral medications. These medications are prescribed by a GUM clinic or a specialist HIV clinic because they require regular monitoring. Antiretrovirals help to stop the virus from replicating in the body, allow the immune system to repair itself, and prevent further damage. The goal of HIV treatment is to have an “undetectable” viral load, meaning that the level of HIV in your body is so low that it can’t be detected by a test. For people with HIV who have been taking effective HIV treatment and who have a viral load that has been “undetectable” for 6 months or more, it has been established that they cannot pass the virus on through sex.

If left untreated, HIV can develop into Acquired Immune Deficiency Syndrome (AIDS), which can be fatal. As HIV weakens your immune system, it makes you much more likely to develop other infections and certain types of cancers.

What if I test positive for HIV?

• If you test positive for HIV using an at-home test, a second blood test is required to confirm the diagnosis. The second test needs to be performed at a GUM clinic, where they may also test for other STIs, provide counselling, advise and assist with partner notification, administer appropriate treatment and organize referral to a specialist HIV clinic for regular follow up.
• If you test positive for HIV, you should not engage in unprotected sexual activity (i.e. unprotected oral, vaginal, or anal sex, share sex toys) until you have been advised by a medical professional that it is safe to do so (i.e. your viral load remains undetectable, your partner is regularly taking PrEP, etc.).
• If you test positive for HIV, it’s important that your current and previous sexual partner(s) are also tested and treated. This includes anyone you are currently having sex with, anyone you’ve had sex with in the last 6 months, or your last sexual partner. You should attend a GUM clinic or see your GP for further guidance on partner notification. You can provide past partners’ details to certain services (i.e. GUM clinics), who will contact them to let them know they may have been exposed to an STI and suggest that they go for a check-up. These services will not tell your partner(s) your name, so your anonymity is protected.

What is hepatitis B ("HBV")?

Hepatitis B (HBV) is a virus that affects the liver and can cause acute (i.e. less than 6 months) or chronic (i.e. more than 6 months) infection.

How is HBV transmitted?

HBV is very contagious and can be spread through sexual and non-sexual means. HBV is spread through the exchange of bodily fluids with an infected person. This can happen during:

• Unprotected oral, vaginal, or anal sex
• Biting or being bitten by an infected person
• Sharing toothbrushes, razors, or needles
• Sharing sex toys with an infected person

HBV can live outside the body (in bodily fluids) for up to a week, and it is about 50 - 100 times more infectious than HIV.

The best way to prevent getting HBV is to get vaccinated. Since 2017, HBV vaccination has been part of the routine immunization schedule for all children in the UK, and is also available for adults in the UK who are considered “high risk.” Sometimes people need a “booster” to make sure the vaccine still provides sufficient immunity against HBV. Whether or not you need an HBV booster can be determined by a simple blood test. If you’re not sure whether or not you’ve had the HBV vaccine, or if you want to know if you need a booster, you should contact your GP or GUM clinic.

What are the symptoms of HBV?

Many people with HBV have no symptoms and may not know they are infected, though they can still pass the infection on to others.

HBV symptoms can occur at any time, from weeks to years after infection. In the early stage of HBV infection, not all individuals develop symptoms. Those who do develop symptoms often experience a flu-like illness, including vomiting and diarrhoea, abdominal pain, or jaundice (yellowing of the skin/eyes) about 2-3 months after exposure. approximately 90% of adults are able to clear the HBV infection and have no ongoing health problems after about 3-6 months. During the acute stage of the HBV infection (i.e. the first 6 months), people are infectious and can spread the disease to others, whether or not they have symptoms. After the first 6 months, those who clear the acute HBV infection are usually immune for life.

However, approximately 10% of people with HBV go on to develop it chronically. People with chronic HBV are still infectious. Chronic HBV can cause severe liver damage (e.g. cirrhosis, liver failure, liver cancer).

When should I get tested for HBV?

Don’t delay getting tested if you think you have HBV (i.e. you or your partner have any of the above symptoms, your partner told you they have an STI, you had unprotected sex with a new partner, etc). You can get tested for HBV at any time, though HBV tests are most accurate 4 weeks after potential exposure. You may be advised to repeat the test 12 weeks after the date of potential exposure, as HBV can take up to 12 weeks from the time of exposure to show up positive in tests. We recommend that you wait 4 weeks from the time of exposure to test for HBV, with a repeat test at 12 weeks, though you don’t need to wait that long to seek support.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have HBV, you should seek immediate attention and/or advice from a medical professional.

How is HBV treated?

 As stated above, the best way to prevent getting HBV is to get vaccinated. The vaccine is available for adults in the UK who are considered “high risk.” If you’re not sure whether or not you’ve had the HBV vaccine you should contact your GP or GUM clinic.

You should immediately seek medical advice if you think you may have been exposed to HBV. There are emergency treatments which may stop you from becoming infected if started within a few days of exposure. 

Acute HBV may not require treatment, but it does require review by a doctor and repeat blood testing to make sure the infection has cleared. Acute HBV may sometimes cause health complications, including:

• Sudden liver failure
• Chronic HBV infection

Chronic HBV is sometimes treated with medications to reduce the risk of developing long-term liver problems, and requires regular review by a doctor. These medications help keep HBV under control, although they will not necessarily cure the infection, and some people will need lifelong treatment. Some long-term health complications of chronic HBV include:

• Scarring of the liver (i.e. cirrhosis)
• Gradual liver failure
• Liver cancer

What if I test positive for HBV?

• If you test positive for HBV (acute or chronic) using an at-home test, a second blood test is required to confirm the diagnosis. The second test should be performed at a GUM clinic, where they may also test for other STIs, advise and assist with partner notification, and administer appropriate treatment and follow up.
• If you test positive for HBV, you should not engage in unprotected sexual activity (i.e. unprotected oral, vaginal, or anal sex, share sex toys) until you have been advised by a medical professional (e.g. GP, GUM clinic) how and when it is safe to do so (e.g. you are sure that your partner(s) has been adequately vaccinated against HBV, your doctor informs you that you are no longer infectious, etc.). If you live with others, there are other precautions you can take to avoid the spread of HBV; for example, don’t share toothbrushes or razors, always appropriately wear plasters to cover cuts, exercise caution with blood spill cleanup, etc. (for more information, click here), etc.
• If you test positive for HBV, it’s important that your close contacts (e.g. friends, family, flat/house mates) and your most recent sexual partner(s) are also tested and treated. This includes anyone you are currently having sex with, anyone you’ve had sex with in the last 6 months, or your last sexual partner. You can provide their details to certain services (e.g. GUM clinics), who will contact them to let them know they may have been exposed to an STI and suggest that they go for a check-up. These services will not tell your partner(s) your name, so your anonymity is protected.

What is hepatitis C ("HCV")?

Hepatitis C (HCV) is a virus that affects the liver and can cause acute (i.e. less than 6 months) or chronic (i.e. more than 6 months) infection.

How is HCV transmitted?

HCV is extremely contagious and can be spread through sexual and non-sexual means. HCV is spread through contact with the blood of an infected person. For HCV to be transmitted, the blood from someone with HCV has to get into the bloodstream (e.g. via a cut or open wound) of someone else. Because HCV is transmitted via blood-to-blood contact, sexual activities that increase the potential for exposure to blood increase the risk of spreading HCV. This can happen during:

• Unprotected oral, vaginal, or anal sex
• Sex during menstration
• Biting or being bitten by an infected person
• Rough sex, group sex, or chem sex
• Having sex whilst being infected with another STI (e.g. herpes, gonorrhoea, or particularly HIV)
• Sharing toothbrushes, razors, clippers, scissors, or needles
• Sharing sex toys with an infected person

Hepatitis C is extremely contagious. HCV can live outside the body (in dried blood) for up to 6 weeks, and it is at least 10 times more infectious than HIV.

The best way to prevent spreading HCV is to remain aware and minimize any risk of blood-to-blood contact. With respect to sexual transmission, the best way to avoid spreading HCV is to use protection during any sexual activity. However, extra caution should be exercised as condoms and gloves can break.

What are the symptoms of HCV?

Some people with HCV have no symptoms, while others may have vague symptoms (e.g. depression, skin problems, pain, digestive disorders), which can easily be attributed to other illnesses. Thus, many people with HCV may not realize they’re infected, even though they can still pass the infection to others, whether or not they have symptoms.

HCV symptoms can occur at any time, from weeks to years after infection. In the early (or acute) stage of HCV infection, most people (about 65%) do not develop symptoms. Those who do develop symptoms often experience a high fever (38° C or more), tiredness, loss of appetite, nausea and vomiting, abdominal pain, or jaundice (yellowing of the skin/eyes) a few weeks after exposure. Approximately 30% of people are able to clear acute HCV infection on their own and will have no further symptoms unless they become infected again. This means that people who clear HCV on their own do not become immune to future HCV infection.

During the acute stage of HCV infection (i.e. the first 6 months), people are infectious and can spread the disease to others, whether or not they have symptoms. However, approximately 55-85% of people with acute HCV do not clear the virus and remain infected with it for 6 months or more, meaning they go on to develop it chronically.

People with chronic HCV (i.e. more than 6 months) rarely clear the infection on their own. Because HCV stays in their body for many years, they can pass the virus to others. Chronic HCV can cause severe liver damage (e.g. cirrhosis, liver failure, liver cancer), and affect other areas of the body, including the digestive system, lymphatic system, immune system, and the brain.

When should I get tested for HCV?

Don’t delay getting tested if you think you have HCV (i.e. you or your partner have any of the above symptoms, your partner told you they have an STI, you had unprotected sex with a new partner, etc). You can get tested for HCV at any time, though HCV tests are most accurate 4 weeks after potential exposure. You may be advised to repeat the test 12 weeks after the date of potential exposure, as HCV can take up to 12 weeks from the time of exposure to show up positive in tests. We recommend that you wait 4 weeks from the time of exposure to test for HCV, with a repeat test at 12 weeks, though you don’t need to wait that long to seek support.

Importantly, if you are pregnant or suspect you may be pregnant, and are concerned you may have HCV, you should seek immediate attention and/or advice from a medical professional.

How is HCV treated?

You should immediately seek medical advice if you think you may have been exposed to HCV. While there is no vaccine for HCV, it can often be successfully treated by taking certain medications for several weeks. You can get relevant advice and medications from your GP or a GUM clinic 

Acute HCV may not require any treatment, but it will require review by a doctor and repeat blood testing to see if your body has fought off the virus and the infection has cleared. If the infection continues for several months and becomes chronic, treatment is usually recommended. Acute HCV may sometimes cause health complications, including chronic HCV infection.

Chronic HCV treatment involves medications, tests to see if your liver is damaged, and lifestyle changes to prevent further damage. Medications, which are usually taken between 8-12 weeks, are very effective at clearing the HCV infection, and can cure more than 90% of people. However, successful treatment does not give you protection against future HCV infection. Some long-term health complications of chronic HCV include:

• Scarring of the liver (cirrhosis)
• Liver cancer

What if I test positive for HCV?

• If you test positive for HCV (acute or chronic) using an at-home test, a second blood test is required to confirm the diagnosis. The second test should be performed at a GUM clinic or by your GP, where they may also test for other STIs, advise and assist with partner notification, and administer appropriate treatment and follow up.
• If you test positive for HCV, you should not engage in unprotected or high-risk sexual activity (see section above on HCV transmission) until you have been advised by a medical professional how and when it is safe to do so.
• If you live with others, there are other precautions you can take to avoid the spread of HCV; for example, don’t share toothbrushes or razors, always appropriately wear plasters to cover cuts, exercise caution with blood spill cleanup, etc. (for more information, click here).
• If you test positive for HCV, it’s important that your close contacts (e.g. anyone you may have had blood-to-blood contact with, including friends, family, current and previous sexual partners) is also tested and treated. It can be difficult to know who to tell, or how far back to go, so you should seek advice from a GUM clinic or your GP. You can provide contacts’ details to certain services (e.g. GUM clinics), who will contact them to let them know they may have been exposed to an STI and suggest that they go for a check-up. These services will not tell your partner(s) your name, so your anonymity is protected.