The Complications of Unprotected Sex

8/17/2019 The Complications of Unprotected Sex

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Illustrated by imi Ridley


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this is an illustrated

guide and informative

issue about sexually

transmitted diease.

the purpose of this

issue is to hilight

the complications and

risks of having

unprotected sex with

an infected person.

inside is information

guideing you on what

could happen to your

body if you become

infected in and whatyou can do about it.

Sexual health is an

important part of

physical and mental

health as well as your

emotional and social

well-being. It’s

important to take care

of your sexual health

and, if you have

children, it’s good to

talk about sex and

relationships.

Intro


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Chlamydia

Gonorreha

Syphilis

Hepatitis

B

HIV

Herpes

HPV

(Gential

Warts)

Further

Help Links

p.4-7

p.8-11

p.12-15

p.16-19

p.20-23

p.32

p.28-31

p.24-27


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Chlamydia.the most common STI diagnosed in the uk.

You may have heard of chlamydia, but

many people are not sure what it is.

Chlamydia is an infeon caused by a kind

of bacteria that is passed during sexual

contact. About three million Brish women

and men become infected with chlamydia

every year. It is especially common among

women and men under 25.

What is chlamydia?


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Symptoms in

men

• White, cloudy or watery

discharge from penis

• burning or itching in

• urethra

• pain in tescles

• pain when urinang

chlamydia in men

What are the risks

in men?

if chlamydia is le untreated, the

infecon can cause swelling in

the epididymis (tubes that carry

sperm from the tescles) and the

tescles. This could aect your ferlity. In

extreme cases of chlymdia being le

untreated within males it can devel-

op into Reiters Rarely chlyamia leadsto a condion called reacve arthris.

Reacve arthris causes a varietWy of

condions, including swelling and pain

in the joints that can be disabling.

In both women and men,

chlamydia may cause the anus

to itch and bleed. It can also

result in a discharge and

diarrhea. If chlamydia infects

the eyes, it may cause redness,

itching, and a discharge.

If chlamydia infects the

throat, it may cause

soreness. Chlamydia symptoms

may only appear in the morning

and may be mild, especially for

men. That's why many people do

not realize they have an infecon.

chlamydia

symptoms in

men

The symptoms of chlamydia in men can be dicult to spot. Symptoms may be infrequent and

random, which somemes leads paents to believe that they are not caused by an infecon. Men

with chlamydia have 3 mes the normal level of DNA fragmentaon in sperm (which means that the

genec material is not packed ghtly enough and the long strands become suscepble to breakage).

Around

25 - 50% of

all male

chlamydia cases

go completely

unnoticed


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how can

chlaymdia be

treated?

Chlamydia can usually be treated easily

with anbiocs. You may be given some

tablets to take all on one day, or a longer

course of capsules to take for a week.

You shouldn’t have sex unl you and

your current sexual partner have

nished your treatment. If you hadthe one-day course of treatment, you

should avoid having sex for a week

aerwards. The two most commonly

prescribed anbiocs for chlamydia are:

azithromycin – given as two or four

tablets at once

doxycycline – given as two capsules a

day for a week

of chlamydia.

It’s important that your current sexual

partner and any other sexual partners

you’ve had during the last six months

are also tested and treated to help stop

the spread of the infecon.

Sexual health or GUM clinics can help

you contact your sexual partners.


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Gonorrhea.Also known as the 'Clap'.

What is Gonorrhea?

Also called the “clap” or “drip,”

gonorrhea is a contagious disease

transmied most oen through sexual

contact with an infected person.

Gonorrhea may also be spread by

contact with infected bodily uids,

so that a mother could pass on the

infecon to her newborn during childbirth.

Both men and women can get gonorrhea.

The infecon is easily spread

and occurs most oen in

people who have many sex partners.


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What are the risks for men?

In men, gonorrhoea can cause painful infecon in the tescles and prostate gland, which

may lead to reduced ferlity in a small number of cases. In rare cases, when gonorrhoea

has been le untreated, it can spread through the bloodstream to cause life-threatening

infecons in other parts of the body like sepcaemia. Occasionally, widespread or

disseminated gonococcal infecon may occur. this is where usually a skin rash has small

papules that turn into pustules on broad erythematous bases and necroc centres.

Symptoms in

men

gonorrhea in men

gonorrhea

symptoms in

men

The rst symptoms may appear about

a week aer transmission of the

disease and usually involve an infecon

of the urethra, which causes pain when

urinang (or a burning sensaon when

peeing). While the gonorrhea symptoms

may go away aer a few weeks, the infecon

remains in your system and can cause

further damage to your urethra

or other parts of your body. Less

common symptoms of gonorrhea in

men include pain in the tescles, and

possibly anal pain or discomfort if

the infecon spreads to the rectum

• greater frequency or urgency of

urinaon.

• a pus-like discharge (or drip)

from the penis (white, yellow,

beige, or greenish)

• swelling or redness at the

opening of the penis.

• swelling or pain in the tescles.

• a persistent sore throat.

90% of

men with

gonorrhea have

symptoms, which

makes it easierto identify the

infection


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if women

get symptoms

they are often

mistaken for

bladder

infections

gonorrhea in women.

• Greenish yellow or whish

discharge from the vagina

• Lower abdominal or pelvic pain

• Burning when urinang

• Conjuncvis (red, itchy eyes)

• Bleeding between periods

• Spong aer intercourse

• Swelling of the vulva (vulvis)

• Burning in the throat (due to

oral sex)

• Swollen glands in the throat

(due to oral sex)

symptoms in

women

gonorrhea

symptoms in

women

These symptoms in women can

go unnoced or be mistaken for

another type of infecon such as

a common yeast infecon, which

can be treated with over-the-

counter medicaon. However, an

abnormal vaginal dischargecan

be the sign of a variety of

condions and infecons

Untreated gonorrhea can spread into the uterus and fallopian tubes, causing pelvic

inammatory disease (PID), which may result in scarring of the tubes, greater risk of

pregnancy complicaons and inferlity. PID is a serious infecon that requires immediate

treatment. Women who have gonorrhea during pregnancy tend to have higher rates of

miscarriage, infecon of the amnioc sac and uid, preterm birth, and preterm premature rupture of membranes (PPROM),

although prompt treatment reduces the risk of these problems. An untreated gonorrhea infecon makes you more

suscepble to HIV and som other sexually transmied infecons (STIs), if you’re exposed to them, and raises your risk of a

uterine infecon aer you have your baby. If you have a gonorrhea infecon when you go into labor, you can pass the

bacteria to your baby. Gonorrhea in newborns most commonly aects the eyes, and babies may eventually go blind if le

untreated.


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how can

gonorrhea be

treated?

In most cases, treatment involves having

a single anbioc injecon (usually in

the buocks or thigh) followed by one

anbioc tablet. It's somemes possible

to have another anbioc tablet instead

of an injecon, if you prefer.

If you have any symptoms of

gonorrhoea, these will usually improve

within a few days, although it may take

up to two weeks for any pain in your

pelvis or tescles to go away completely.

Bleeding between periods or heavy

periods should improve by the me of

your next period.

Aending a follow-up appointment a

week or two aer treatment is usually

recommended, so another test can be

carried out to see if you're clear of

infecon.


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Syphilis.a highly contagious diseasespread by sexual activity.

Syphilis is a sexually transmied infecon (STI). There are

four stages of the disease: primary, secondary, latent, and

terary (also known as neurosyphilis). Primary syphilis is

the rst stage of the disease. It causes one or more small,

painless sores in or around the genitals, anus, or mouth

Syphilis is a highly contagious disease spread primarily by

sexual acvity, including oral and anal sex. Occasionally,

the disease can be passed to another person through

prolonged kissing or close bodily contact. Although this

disease is spread from sores, the vast majority of those

sores go unrecognized. The infected person is oen

unaware of the disease and unknowingly passes it on to his

or her sexual partner.

Early or primary syphilis. People with primary syphilis will

develop one or more sores. The sores are usually small

painless ulcers. They occur on the genitals or in or around

the mouth somewhere between 10-90 days (average three

weeks) aer exposure. Even without treatment they heal

without a scar within six weeks.


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primary

symptoms of

syphilis

syphilisprimary stage • In men, a chancre oen appears inthe genital area, usually (but notalways) on the penis. These sores are

oen painless.

• In women, chancres can develop on

the outer genitals or on the inner

part of the vagina. A chancre may

go unnoced if it occurs inside the

vagina or at the opening to the

uterus (cervix). The sores are usually

painless and are not easily seen.

• Swelling of the lymph nodes may

occur near the area of the chancre.

• A chancre may also occur in an area

of the body other than the genitals.

• The chancre usually lasts for 3 to

6 weeks, heals without treatment,

and may leave a thin scar. But even

though the chancre has healed,

syphilis is sll present and a person

can sll pass the infecon to others.

During the primary stage of

syphilis, a sore (chancre) that is

usually painless develops at the

site where the bacteria entered

the body. This commonly occurs

within 3 weeks of exposure but

can range from 10 to 90 days.

A person is highly contagious

during the primary stage.

Men suffer

1.5 times

more

of syphilis

than women.


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Syphilis

can be spread

from an infected

mother to

her unborn

baby. Syphilissecondary stage

secondary

symptoms of

syphilis

The symptoms of secondary

syphilis develop two to eight weeks

aer a person rst becomes

infected with primary syphilis. The

secondary stage is usually marked

by a nonitchy rash. The rash might

be conned to one part of your

body, or it could spread over

several parts. The appearance of

the rash varies. One common man-

ifestaon is rough, reddish-brown

spots on the booms of your feet

and on the palms of your hands.

Other symptoms of secondary

syphilis include:

• sore throat

• fever

• swollen lymph glands

• headaches

• fague

• muscle aches

• wart-like patches around skin

folds or genitals

• loss of appete

• joint pain

• enlarged lymph nodes

If you don’t receive treatment duringthis inial appearance of symptoms,

the bacterium that caused this STI

will spread through your

bloodstream, and you’ll soon have

secondary syphilis. Without

treatment, your syphilis will l ikely

connue to progress. It can be 10 or

20 years before you experience the

worst eects. Eventually, untreated

syphilis will lead to damage to the

brain, eyes, heart, nerves, bones,

joints, and liver. You could also

become paralyzed, blind, demented,

or lose feeling in the body. Untreated

syphilis can also lead to sllborn or

developmentally delayed babies.


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A short course of anbiocs can

usually cure syphilis. These are only

available on prescripon, so you’ll need

to be tested for syphilis to get them.

The type of treatment you need

depends on how long you’ve hadsyphilis.

• Syphilis that has lasted less than

two years is usually treated with

an injecon of penicillin into your

buocks, or a 10-14 day course of

anbioc tablets if you can’t have

penicillin.

• Syphilis that has lasted more than

two years is usually treated with

three penicillin injecons into your

buocks given at weekly intervals, or

a 28 day course of anbioc tablets if

you can’t have penicillin.

how can

syphilis be

treated?


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Hepatitis B.likely to effect people who inject drugs and who

have unprotected sex with multiple partners.

Hepas B is a virus that infects the liver. Most adults who

get it have it for a short me and then get beer. This is called

acute hepas B. Somemes the virus causes a long-term

infecon, called chronic hepas B. Over me, it can damage

your liver. Babies and young children infected with the virus

are more likely to get chronic hepas B.

how can


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You can have hepas B and

not know it. You may not havesymptoms. If you do, they can

make you feel like you have

the u. But as long as you have

the virus, you can spread it to

others. It's causeby the

hepas B virus. It is spread

through contact with the blood

and body uids of an infected

person.

You may get hepas B if you:

• Have sex with an

infected person without

using a condom.

• Share needles (used for

injecng drugs) with an

infected person.

• Get a taoo or piercing with

tools that weren't sterilized.

• Share personal items like

razors or toothbrushes with

an infected person.

how can

you get

Hepatitis B?

Injury to the liver by hepas B

virus is caused by the body's immune

response as the body aempts to

eliminate the virus. Those who acquire

the infecon in childhood are much

more likely to have chronic infecon.

Chronic hepas B may lead to cirrhosis

or liver failure. Approximately 15% to 25%

of people with chronic infecon will die

prematurely as a result of the infecon.

Hepatits Bliver damage

Most

people who

have chronic

infectionshave no

symptoms


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what are the

symptoms

hepatitis B?

if you do have symptoms, they may

include:

• Extreme redness.

• Mild fever.

• Headache.

• Loss of appete, nausea, and

voming.

• Constant discomfort on the

right side of the belly under the

rib cage. (That’s where the liver

is located.)

• Tan-colored bowel

movements (stools).

• Dark urine.

• Jaundice. This means that the

skin and whites of the eyes look

yellow. Jaundice is a major sign

of liver damage.

You may get infected without knowing it. You may not nd out that you

have an infecon unl you have a roune blood test or donate blood.

Finding out that a family member or someone you live with is infected

also may cause you to be tested. Some people never know they havehepas B unl a doctor nds that they have cirrhosis or liver cancer.

A mother who has the virus can pass it to her baby during delivery.

Medical experts recommend that all pregnant women get tested for

hepas B. If you have the virus, your baby can get shots to help

prevent infecon with the virus.

Hepatits BSymptoms

It is

spread

through contact

with the blood

and body fluids

of an infected

person.


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how can

hepatitis B

be treated?

In most cases, hepas B goes away onits own. You can relieve your symptoms

at home by resng, eang healthy foods,

drinking plenty of water, and avoiding

alcohol and drugs The hepas B vaccine

is the best way to prevent infecon. The

vaccine is a series of 3 or 4 shots. Adults

at risk and all babies, children, and

teenagers should be vaccinated.

A combinaon vaccine (Twinrix) that

protects against both hepas B and

hepas A also is available.

To avoid geng or spreading the virus to

others:

• Use a condom when you have sex.

• Don't share needles.

• Wear latex or plasc gloves if you have

to touch blood.

• Don't share toothbrushes or razors.

• Don't get a taoo, or make sure that

the needles used have been cleaned

properly and are sterile.


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HIV.an incureable disease that weakens yourability to fight infections and disease.

HIV is a virus that aacks the immune system, and weakens your ability to ght infecons and

disease. It's most commonly caught by having sex without a condom. AIDS is the nal stage

of HIV infecon, when your body can no longer ght life-threatening infecons. With early

diagnosis and eecve treatment, most people with HIV will not go on to develop AIDS.


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The u-like illness that

oen occurs a few weeks aer

HIV infecon is also known as

seroconversion illness. It's

esmated that up to 80% of

people who are infected withHIV experience this illness.

The most common symptoms

are:

• fever (raised temperature)

• sore throat

• body rash

Other symptoms can include:

• redness

• joint pain

• muscle pain

• swollen glands (nodes)

what are the

symptoms of

HIV? HIV

inital symptomsThe symptoms usually last one to two weeks but can be longer. They are

a sign that your immune system is pung up a ght against the virus.

We all have lymph nodes throughout our bodies, including the neck,

back of the head, armpits, and groin. As part of the immune system, our

lymph nodes fend o infecons by storing immune cells and ltering for

harmful substances. As the HIV infecon begins to spread, the

immune system kicks into high gear. The result is enlarged lymph nodes,

commonly known as swollen glands. It’s oen one of the rst signs of HIV.

Highest

rates of HIV

are gay and

bisexual men and

heterosexual

BlackAfricans


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Aer the inial symptoms

disappear, HIV will oen not

cause any further symptoms for

many years. During this me,

known as asymptomac HIV

infecon, the virus connues to

be acve and causes progressive

damage to your immune system.

This process can take about 10

years, during which you will feel

and appear well.

Factors that may shorten the

me between HIV and AIDS:

• Older age

• HIV subtype

• Co-infecon with other

viruses (like tuberculosis or

hepas C)

• Poor nutrion

• Severe stress

• Your genec background

HIV

asymptomaticinfection

During the third stage of HIV

infecon there is usually a lot

of damage to your immune

system. At this point, you

are more likely to get serious

infecons or bacterial and

fungal diseases that you

otherwise would be able to

ght o. These infecons are

referred to as ‘opportunisc

infecons’. If a person is

experiencing opportuisc

infecons they are

now said to have AIDS

Once the immune system

becomes severely damaged

symptoms can include:

• weight loss

• chronic diarrhoea

• night sweats

• skin problems

• recurrent infecons

• serious life-threatening

illnesses

what are the

syptomatic

symptoms of

HIV?

An

estimated

17% of people

with HIV do not

know they areinfected.

h HIV


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how can HIV

be treated?

There is no cure for HIV, but there are

treatments to enable most people with

the virus to live a long and healthy life.

Treatment is usually recommended to

begin when your CD4 cell count falls

towards 350 or below, whether or not you

have any symptoms. In some people with

other medical condions, treatment may

be started at higher CD4 cell counts. When

to start treatment should be discussed

with your doctor. The aim of the treatment

is to reduce the level of HIV in the blood,

allow the immune system to repair itself and

prevent any HIV-related illnesses. If you are

on HIV treatment, the level of the virus in

your blood is generally very low and it is

unlikely that you will pass HIV on to

someoneelse.

HIV treatment can have side

eects. If you get serious side eects

(which is uncommon) you may need

to try a dierent combinaon of ARVs.

Common side eects include:

• nausea

• diarrhoea

• skin rashes

• sleep dicules


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Herpes.is a common infection caused by the herpessimplex virus (HSV)

Genital herpes is a chronic (long-term) condion. The virus remains in your body and

can become acve again. The average rate of recurrence is four to ve mes in the

rst two years aer being infected. However, over me, it tends to become acve less

frequently and each outbreak becomes less severe.

h i


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There are two types of herpes simplex virus (HSV), type 1 and type 2. Both types

are highly contagious and can be passed easily from one person to another by

direct contact. Genital herpes is usually transmied by having sex (vaginal, anal or

oral) with an infected person. Even if someone with genital herpes doesn't have

any symptoms, it's possible for them to pass the condion on to a sexual partner.

Genital

herpes is a

common condition,

especially in

people from

20 to 24

years old.

herpes

primaryinfectionMost people who get a

primary aack directly

following the infecon

experience symptoms

within 1-2 weeks aer exposure

(sexual intercourse with

an infected partner).

During this so-called incubaon

period, the virus mulplies

inside your cells, unl its

presence causes an outbreak.

During the rst aack, the

early symptoms of genital

herpes include the following:

• Fever & u-like symptoms

• Nausea or feeling sick

• Muscle aches

• Painful urinaon• Tingling, burning or itching

sensaon in the area where

blisters will appear

the primary

stage

symptoms of

herpes?

th t


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Aer the inial ngling and

itching, one or more clusters of

small blisters (somemes painful)

appear, which are lled with

slightly cloudy liquid. The blisters

can be located in dierent areas:

In men:

• genital herpes sores can

appear inside or on the

penis, scrotum, groin & thighs,

buocks and around the anus

In women:

• these blisters can appear

on the labia, inside the

vagina, groin & thighs, on the

buocks and around the anus

Through dierent sexual acvies

it is possible to get genital herpes

in the mouth, tongue, lips and on

other parts of the body. However,

this type of transmission is quite

rare and it is most likely to happen

when the virus is very acve – i.e.

when blisters or sores have

appeared or are about to form.

Although the inial symptoms of genital herpes clear up, the

virus remains dormant (inacve) in a nearby nerve. The virus may

be reacvated from me to me, travelling back down the nerve

to your skin and causing recurrent outbreaks. Recurrent outbreaks

are usually shorter and less severe. This is because your body has

produced protecve anbodies (proteins that ght infecon) in

reacon to the previous infecon. Your body now recognises the

virus and mounts a response that is able to ght HSV more eecvely.

herpesrecurrent

infections

the recurrent

symptoms of

herpes

Up to 50%

of herpes is

caused by the

oral cold sore

type of herpes

simplex

how can


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how can

herpes be

treated?

Treatment for genital herpes will

depend on whether you have the

infecon for the rst me (a primary

infecon) or your symptoms keep

coming back (a recurrent outbreak)

If you have genital herpes for the rst

me, see your GP or visit your local

GUM clinic (also called sexual health

clinics). They may prescribe anviral

tablets, such as aciclovir, which you will

need to take ve mes a day.

You should visit your GP if you have

been diagnosed with genital herpes

before and are experiencing a recurrent

outbreak. If the symptoms are mild,

your GP may suggest things you can do

at home to help ease your symptoms

without the need for treatment.

• Keep the aected area clean using

either plain or salt water. This will

help prevent blisters or ulcers from

becoming infected and may encour-

age them to heal quicker. It will also

stop aected areas from scking

togethe


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Genital Warts (HPV).fleshy growths that appear

on or around the genitals.

Genital warts are very common. In England,

they are the second most common type

of sexually transmied infecon (STI) aer

chlamydia. Genital warts are the result of

a viral skin infecon caused by the human

papilloma virus (HPV). They are usually

painless and do not pose a serious threat to

health. But they can be unpleasant to

look at and cause psychological distress.

There is no evidence that yourferlity will be aected by genital warts.


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The HPV is not a single virus, but a family of more than 100 dierent strains of viruses.

Dierent strains usually aect dierent parts of the body, including the hands or feet.

Although around 30 dierent types of HPV can aect the genital skin, most cases of

infecon with HPV cause no visible symptoms. Around 90% of all cases of genital warts are

caused by two strains of the virus – type 6 and type 11

genitalwarts inmen

genital wart

symptoms in

men

Warts are usually painless,

although on some people

they can become itchy and

inamed. If a wart becomes

inamed, it may lead to

bleeding from the urethra,

vagina or anus.The urethra is the

tube connected to the bladder,

which urine passes through.

Warts that develop near or

inside the urethra can also

disrupt the normal ow of urine.

The most common places for

genital warts to develop in

men are:

• anywhere on the penis

• on the scrotum• inside the urethra (tube

where urine comes out)

• around or inside the anus

• on the upper thighs

about one

in 100

sexually

active adultshave genital

warts

Warts can


30/33

genital

warts inwomen

genital wart

symptoms in

women

The warts may appear as small,

eshy growths, bumps or skin

changes anywhere on the

genitals or around the anus. In

some cases, the warts are so

small they are dicult to noce.

A person can have a single wart

or clusters of mulple warts that

grow together to form a kind

of "cauliower" appearance.

The most common places for

genital warts to develop in

women are:

• around the vulva (the

opening of the vagina)

• on the cervix (the neck of the

womb)

• inside the vagina

• around or inside the anus• on the upper thighs

Most people who have an HPV

infecon will not develop any

visible warts. If genital warts

do appear, it can be several

weeks, months or even years

aer you rst came into

contact with the virus. One study

has shown having both herpesand HPV infecon may increase

the risk of cervical cancer, aer

taking into account HPV infecon

and the number of sex partners

women had and their use of

the pill.

vary in

colour, from

pink to brown

depending

your skin.


31/33

how can

genital warts

be treated?

Treatment for genital warts depends on

the type of warts you have and where

they are located. You do not need

treatment if there are no visible warts.

There are two main types of treatment

for genital warts:

• applying a cream, loon or chemical

to the warts (topical treatment)

• destroying the ssue of the warts by

freezing, heang or removing them

(physical ablaon)

Most topical treatments tend to work

beer on soer warts, and physical

ablaon tends to work beer on harder

and rougher-feeling warts. Somemes,

a combinaon of topical treatments

is recommended. For some people,

treatment can take several months to

remove the warts, so it is important to

persevere.

Sexual Health &


32/33

Sexual Health &

STI Help links

NHS - Sexual Health Line

hp://www.nhs.uk/Livewell/Talking-

aboutsex/Pages/Ineedhelpnow.aspx

Condenal advice (anonymous if

required) about sexual health,

including informaon about local

centre for Sexually Transmied Infec-

ons. Helpline: 0300 123 7123 (lines

open 9am-5pm)

GUM Clinics Northern Ireland

hp://www.nidirect.gov.uk/genitouri-

nary-medicine-gum-clinics (opens in a

new window)

Emergency Contracepon –Morning Aer Pill.

hp://www.nhs.uk/condions/

contracepon-guide/pages/

where-can-i-get-emergency-contra-

cepon.aspx (opens in a new win-

dow)

NHS informaon on emergency con-

tracepon ( morning aer pill) andwhere to get it.

Live Well

hp://www.nhs.uk/Livewell/Sexu-

alhealth/Pages/Sexonholiday.aspx

(opens in a new window)


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The Complications of Unprotected Sex

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