NHS PrEP trial

All Northern Sexual Health sites have now gone live for recruitment into the Impact PrEP trial. Please note there are limited places available for the service and dedicated waiting lists already in place across the sites. To be added to the waiting list or to find out if there are likely to still be places available please contact the following numbers. Hathersage : 0161 701 1504 Stockport : 0161 204 5884 Tameside : 0161 342 7101 Trafford : 0161 241 7582 Withington : 0161 217 3318 Please note due to longstanding overwhelming demand, places can not be guaranteed onto this trial. Please bear with staff as they try to get recruitment for the trial off the ground.

Type of STI

BV

What is it

Bacterial vaginosis (BV) is the most common cause of an abnormal vaginal discharge. It is not a sexually transmitted infection (STI).

How do I catch it

The cause of BV is not fully understood –it is not caught from a sexual partner but sexual activity may play a part. BV develops when there is an increase in the number of certain bacteria and the chemistry of the vaginal fluid is disturbed and becomes more alkaline. Some activities can upset the normal balance of bacteria in the vagina and put women at increased risk. These include:

  • Having a new sex partner or multiple sex partners
  • Douching (rinsing inside the vagina) or using vaginal washes or deodorants
  • Smoking
  • Oral sex (licking of the vulva)

What symptoms could I have

An abnormal vaginal discharge which may be:

  • Smelly – sometimes described as ‘fishy’ and often worse after sex
  • Thin and either white or pale grey in colour

How do you test for it

A sample of vaginal fluid will be examined under the microscope for bacteria associated with BV. The results are usually available during your first visit to the clinic.

How do you treat it

BV may settle down on its own or vary through the monthly cycle but it can be treated with an antibiotic called metronidazole.

Related Link

BASHH patient information leaflet

Chlamydia

What is it

Chlamydia is a curable sexually transmitted infection (STI) caused by bacteria called Chlamydia trachomatis. Itis the most common bacterial sexually transmitted infection in the UK.

How do I catch it

Chlamydia is passed on:

  • through unprotected sex (using no condom) whether vaginal, oral or anal sex (or sharing sex toys) with someone who has chlamydia
  • from an infected mother to her baby during childbirth (vaginal delivery)
  • sometimes from genitals to fingers to eyes, causing painful, red eyes (conjunctivitis)

What symptoms could I have

Most men and women do not notice anything wrong.
Some women may notice one or more of the following:

  • bleeding between periods or after sex
  • pain in the lower abdomen, particularly during sex
  • burning pain when passing urine
  • a change in the colour or amount of vaginal discharge

Some men may notice one or more of the following:

  • a discharge from the tip of the penis
  • a burning feeling or pain when passing urine

How do you test for it

Chlamydia tests are carried out by taking swabs from the penis, vagina, bum or throat. A urine sample can also be used with men.

How do you treat it

Chlamydia can be easily treated with antibiotics.

Related Link

BASHH patient information leaflet

Epididymo-orchitis

What is it

It is a condition affecting men characterised by pain and swelling inside the scrotum (ball bag) and is due to an infection either in the:

  • epididymis – tube carrying the sperm from the testicle to the vas deferens and then the urethra or water pipe (epididymitis)
  • testicle (orchitis)
  • epididymis and testicle (epididymo-orchitis)

How do I catch it

In men under the age of 35 years the most common cause is a sexually transmitted infection (STI). It can also be caused by a urine infection – with local spread of infection from the bladder.

What symptoms could I have

A rapid onset of pain and swelling in one or sometimes both of your testicles.
Some men may also notice a discharge from the tip of the water pipe and/or pain on passing urine.

How do you test for it

Epididymo-orchitis is diagnosed by physical examination, sexual health screen and urine test. It is treated immediately at your first visit to the clinic.

How do you treat it

Treatment is with oral antibiotics for an average of two weeks.Sometimes it may also include an injection.

Related Link

BASHH patient information leaflet

Genital Warts

What is it

Genital warts are the result of a viral skin infection caused by the human papilloma virus (HPV). They are usually painless and do not pose a serious threat to health. The types of HPV that cause visible genital warts do not cause genital cancer. Other strains of HPV can cause cervical cancer.

How do I catch it

Genital warts can be spread during vaginal or anal sex, and by sharing sex toys. But you don\\'t need to have penetrative sex to pass the infection on because HPV is spread by skin-to-skin contact.

What symptoms could I have

Most people who have an HPV infection will not develop any visible warts. If genital warts do appear, it can be several weeks, months or even years after you first came into contact with the virus. So if you\\'re in a relationship and you get genital warts, it does not necessarily mean your partner has been having sex with other people.
The warts may appear as small, fleshy growths, bumps or skin changes anywhere on the genitals or around the anus. In some cases, the warts are so small they are difficult to notice.

How do you test for it

There is no routine test available for the HPV virus. It is diagnosed by physical examination.

How do you treat it

Most people do opt for treatment even though the warts may get better by themselves.
Using a cream or a lotion on the warts a few times a week at home is the most common treatment option. These treatments can take from weeks to months to work. Other options include freezing (cryotherapy) or surgery.
Once the warts have gone, there is a chance that they may come back.

Related Link

FPA patient information leaflet

Gonorrhoea

What is it

Gonorrhoea is a sexually transmitted infection (STI) caused by bacteria called Neisseria gonorrhoeae or gonococcus. It used to be known as 'the clap'.

How do I catch it

Gonorrhoea is easily passed between people through:

  • unprotected vaginal, oral or anal sex
  • sharing vibrators or other sex toys that haven't been washed or covered with a new condom each time they're used

What symptoms could I have

Typical symptoms of gonorrhoea include a thick green or yellow discharge from the vagina or penis, pain when urinating and (in women) bleeding between periods.
However, around 1 in 10 infected men and almost half of infected women don't experience any symptoms.

How do you test for it

Gonorrhoea tests can be done by taking swabs from the penis, vagina, back passage or throat, or by taking a urine sample in men. The sexual health clinic will recommend the best test for you depending on whether you have symptoms (and what they are), as well as where you have sex.

How do you treat it

Gonorrhoea is treated with antibiotics, most commonly a combination of an injection and some tablets.

Related Link

BASHH patient information leaflet

Hepatitis B

What is it

Hepatitis B, sometimes called hep B or HBV, is a virus carried in the blood and body fluids which infects and damages the liver.

How do I catch it

Hepatitis B is present in bodily fluids such as semen, vaginal fluid, saliva and blood.
It is transmitted through unprotected sex or sharing needles for injecting drugs. Infected mothers can also transmit hepatitis B to their babies during pregnancy, childbirth or breastfeeding.
There is also a small risk of catching hepatitis B from sharing towels, razors and toothbrushes that might be contaminated with blood.

What symptoms could I have

Many people with hepatitis B never have any symptoms and may not know they are infected.
Some people may only have a mild illness and feel they are not ill enough to see a doctor. There are many general symptoms, some of which may be confused with flu:

  • tiredness
  • aches and pains
  • fever
  • loss of appetite
  • nausea (feeling sick) and sickness
  • stomach ache
  • some people find they can’t tolerate cigarettes or alcohol

How do you test for it

A blood test is used to diagnose hepatitis B.

How do you treat it

You will be referred to the liver specialist for further assessment if you have acute or chronic hepatitis B. They will discuss the management with you.

Related Link

BASHH patient information leaflet

Hepatitis C

What is it

Hepatitis B, sometimes called hep B or HBV, is a virus carried in the blood and body fluids which infects and damages the liver.

How do I catch it

It is spread by blood to blood contact.
In the UK the virus is often passed on by the sharing of drug injecting equipment.
Other causes include sharing notes for snorting drugs, transmission from mother to child and sexual transmission. Sexual transmission is more common when having unprotected anal sex, fisting and the use of sex toys.

What symptoms could I have

Many people with hepatitis B never have any symptoms and may not know they are infected.
Some people may only have a mild illness and feel they are not ill enough to see a doctor. There are many general symptoms, some of which may be confused with flu:

  • tiredness
  • aches and pains
  • fever
  • loss of appetite
  • nausea (feeling sick) and sickness
  • stomach ache
  • some people find they can’t tolerate cigarettes or alcohol

How do you test for it

A blood test is used to diagnose hepatitis C.

How do you treat it

You will be referred to the liver specialist for further assessment if you have active hepatitis C. They will discuss the management with you.

Related Link

British Liver Trust patient information leaflet

Herpes

What is it

Genital herpes is caused by two viruses called Herpes simplex, types 1 and 2.

How do I catch it

Herpes spreads by skin to skin contact, through touching or rubbing. This can happen during any kind of sex: vaginal, anal and oral.
Herpes cannot be caught from towels, swimming pools, saunas or from toilet seats.

What symptoms could I have

Most people with herpes infection don’t have any symptoms.
If you do get symptoms these can start with a flu-like illness. An area of skin on the genitals then becomes red and bumps develop which change into blisters. These then break open to leave painful ulcers. Some people get swollen glands in the groin. After several days the ulcers may develop crusts and after a few weeks the skin heals completely.
These symptoms usually disappear without any treatment. The herpes virus then remains in the body, but it is inactive. The virus could occasionally become active again, causing further genital herpes outbreaks.

How do you test for it

The doctor or nurse will take a swab from a sore.

How do you treat it

It’s not always necessary to treat it.
If you have a severe outbreak of genital herpes, it can be treated with antiviral tablets as these will help to speed up the healing process and ease the pain.
Other things you can do to ease the pain are:

  • Apply local anaesthetic cream. It is important that you don’t use any other lotions, ointments or creams unless they are prescribed
  • Bathe the area with diluted salt water
  • Painkillers such as paracetamol and anti-inflammatory tablets can be used to ease any pain
  • Pass urine in a warm bath if it’s really painful

Related Link

BASHH patient information leaflet

HIV

What is it

HIV (human immunodeficiency virus) is a virus that affects the immune system. It can lead to AIDS if it is left untreated.

How do I catch it

HIV is transmitted from one person to another by:

  • having unprotected sex - this includes anal, vaginal and on rare occasions, oral sex
  • sharing sex toys
  • sharing injecting equipment for drug use
  • sometimes a mother can pass HIV on to her baby during childbirth and/or breast feeding

What symptoms could I have

Many people who are living with HIV have no obvious signs and symptoms at all.
You might experience flu-like symptoms when you are first infected. This is called the seroconversion illness, or primary HIV infection.

How do you test for it

A blood test is used to diagnose HIV.

How do you treat it

If your test is positive, you will be referred to the HIV specialist clinic.
Even though HIV is not curable at present, it is a treatable infection. You should be able to lead a healthy life with appropriate treatment and monitoring.

Related Link

FPA patient information leaflet

Lymphogranulomavenereum (LGV)

What is it

LGV is a sexually transmitted infection caused by certain types of chlamydia bacteria.
LGV can infect the genitals, anus, rectum (back passage), throat or lymph glands in the groin. LGV in women is very rare in the UK.

How do I catch it

Unprotected anal, vaginal or oral sex with someone who has LGV.

What symptoms could I have

You may notice one or more of the following:

  • Blood or pus from the anus on underwear or after using toilet paper
  • Pain in the anal area
  • Constipation or painful straining when trying to open the bowels
  • A feeling of incomplete emptying after opening the bowels
  • Swollen lymph glands in the groin on one or both sides
  • An ulcer or sore on the penis or vulva or around the anus

How do you test for it

A swab is taken from the rectum, vagina, throat, or an ulcer (if you have one).

How do you treat it

It is treated with an antibiotic called doxycycline for three weeks.

Related Link

BASHH patient information leaflet

Molluscumcontagiosum (MC)

What is it

Molluscumcontagiosum (MC) is a viral skin infection.

How do I catch it

This virus can be spread through:

  • close direct contact – such as touching the skin of an infected person
  • touching contaminated objects – such as towels, flannels, toys and clothes
  • sexual contact – this includes intimate physical contact as well as sexual intercourse

What symptoms could I have

You may notice small spots on the skin. The spots are usually firm and dome-shaped, with a small dimple in the middle. They are typically pink or red, although they may have a tiny white or yellow head in the centre.

How do you test for it

It is diagnosed by physical examination.

How do you treat it

Treatment is not routinely recommended because most cases clear up in around 6 to 18 months. They can be treated with cryotherapy (freezing) with liquid nitrogen if necessary.

Related Link

NHS Choices patient information

Non-specific urethritis (NSU)

What is it

NSU (Non-specific urethritis) is a non-specific inflammation of a man’s urethra (water passage).
Most cases are caused by sexually transmitted infections (STI) of which chlamydia is the most common. In about one third of cases, no infection can be found.

How do I catch it

About two thirds of cases of NSU are caused by an STI. It can be passed on through unprotected vaginal, oral or anal sex.
In about a third of NSU cases, no STI is found.

What symptoms could I have

Men will usually notice:

  • a discharge from the tip of the penis
  • a burning pain when passing urine
  • irritation or itching at the tip or opening of the penis

How do you test for it

If you have symptoms a doctor or nurse will take a swab from the tip of the penis and make a slide for examination under the microscope.

How do you treat it

It is treated with antibiotics.

Related Link

BASHH patient information leaflet

Pelvic inflammatory disease (PID)

What is it

It is usually caused by a bacterial infection that spreads from the cervix (neck of the womb) up into the womb, fallopian tubes and ovaries.
In about a quarter of women it is caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhoea.

How do I catch it

PID develops when bacteria is introduced into the womb, fallopian tubes and ovaries. This can happen during childbirth, an abortion, a miscarriage, unprotected sex or even as a result of a medical procedure (such as fitting an IUD).

What symptoms could I have

Men will usually notice:

  • Lower abdominal pain or aching – a bit like a period pain
  • Pain deep inside during sex Bleeding in-between periods or after sex
  • Unusual vaginal discharge
  • A few women become very ill with severe lower abdominal pain, a high temperature and nausea and vomiting

How do you test for it

PID is diagnosed by a medical assessment/examination and STI screening.

How do you treat it

PID is treated with a mixture of antibiotics to cover the most likely infections for 2 weeks.

Related Link

BASHH patient information leaflet

Pubic lice (crabs)

What is it

Pubic lice are tiny parasitic insects that live on coarse human body hair, such as pubic hair.
As well as being found in pubic hair, the lice are also sometimes found in:

  • underarm and leg hair
  • hair on the chest, abdomen and back
  • facial hair, such as beards and moustaches
  • eyelashes and eyebrows (very occasionally)

How do I catch it

They're usually spread through close bodily contact with an infected person.
It can also be possible to pass on pubic lice by sharing towels, bedding and clothing.

What symptoms could I have

  • itching in the affected areas
  • inflammation and irritation caused by scratching
  • black powder in your underwear
  • blue spots or small spots of blood on your skin, such as on your thighs or lower abdomen (caused by lice bites)

How do you test for it

It is diagnosed by physical examination.

How do you treat it

Pubic lice can be treated at home with insecticide cream, lotion or shampoo.

Wash clothing, towels and bedding in a washing machine. This should be on a hot cycle (50C or higher) to ensure the lice are killed and to prevent reinfection.

To prevent re-infestation, anyone you have had close bodily contact with, including any sexual partners you've had in the past three months, should also be treated, even if they don't have symptoms.

Related Link

FPA patient information leaflet

Scabies

What is it

Scabies is a contagious skin condition caused by tiny mites that burrow into the skin.

How do I catch it

Scabies is usually spread through prolonged periods of skin-to-skin contact with an infected person, or through sexual contact.
It's also possible for scabies to be passed on by sharing clothing, towels and bedding with someone who's infected.

What symptoms could I have

The main symptom of scabies is intense itching that\\'s worse at night. It also causes a skin rash on areas where the mites have burrowed.

How do you test for it

It is diagnosed by physical examination.

How do you treat it

The two most widely used treatments for scabies are permethrin cream and malathion lotion (brand name Derbac M).

Related Link

FPA patient information leaflet

Syphilis

What is it

Syphilis is a curable sexually transmitted infection (STI) caused by a bacterium called Treponemapallidum.

How do I catch it

  • through unprotected vaginal, anal or oral sex with someone who has syphilis
  • by touching ulcers or weeping rashes in someone who has syphilis
  • through blood transfusions, although this is very rare in the UK
  • from an infected mother to her unborn baby

What symptoms could I have

Some people do not notice anything wrong and the infection is discovered only when they have a blood test.
Some develop one or more of the following:

  • Ulcers on the genitals, near the anus (back passage) or in the mouth
  • A skin rash
  • Swollen lymph glands, for example in the groin or neck

How do you test for it

The most important test for syphilis is carried out on a sample of blood.
Some sexual health clinics can perform microscope or other laboratory tests on a sample taken from a skin ulcer if one is present.

How do you treat it

A course of antibiotic tabletsor injections are used. You will be given the tablets if you are allergic to penicillin injections.

Related Link

BASHH patient information leaflet

Thrush

What is it

Vaginal thrush is a common yeast infection that affects most women at some point.

How do I catch it

Many women have Candida in their vagina without it causing any problems, but thrush can develop if the natural balance of micro-organisms in the vagina is disrupted. It is not classed as an STI.

You're more likely to get thrush if you:

  • are in your twenties and thirties
  • are pregnant
  • take antibiotics
  • have poorly controlled diabetes

What symptoms could I have

  • itching and soreness around the entrance of the vagina (itchy labia)
  • vaginal discharge – this is usually odourless and may be thick and white or thin and watery
  • pain during sex, which may make you worry about having sex
  • a stinging sensation when peeing

How do you test for it

Swabs are taken from the affected area.

How do you treat it

Thrush can go away on its own, especially in people without symptoms.
However, you can buy a cream, pessary or anti-fungal tablets from the chemist who will advise you on how to use these treatments.

Related Link

FPA patient information leaflet

Trichomonas vaginalis (TV)

What is it

It is a curable sexually transmitted infection (STI) caused by a protozoon called Trichomonasvaginalis, or ‘TV’. Protozoa are tiny germs similar to bacteria.

How do I catch it

  • through unprotected vaginal sex, insertion of fingers into the vagina or sharing sex toys with someone who has TV
  • from an infected mother to her baby during normal childbirth (vaginal delivery)

What symptoms could I have

  • increased vaginal discharge
  • an unpleasant vaginal smell
  • pain during sex, which may make you worry about having sex
  • ‘cystitis’ or burning pain when passing urine
  • vulval itching or soreness
  • pain in the vagina during sex

How do you test for it

It is not a routine test in all clinics, but is usually done if you have symptoms.
If you do have symptoms, a swab is taken from the upper vagina.

How do you treat it

TV can be easily treated with oral antibiotics.

Related Link

BASHH patient information leaflet

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