Friday 25 October 2024

Sexually Transmitted and Bloodborne Infections  

Sexually transmitted and bloodborne infections (STBBIs) are infections that can be transmitted through oral, vaginal or anal sex and/or blood.  It is a topic that can be considered taboo for some; however, it is a part of overall health and deserves attention.  In 2023, there were over 3440 cases of Chlamydia and over 960 cases of Gonorrhea in Ottawa.  You can reduce the risk of getting STBBIs by using a condom every time you have sex and include testing for STBBIs with your regular check-ups or if you have symptoms.  

Chlamydia and Gonorrhea  

These infections can be passed through oral, vaginal or anal sex.  Symptoms can include burning with urination, discharge from the genitals, testicular pain and lower abdominal pain.  Some people may have no symptoms.  Left untreated, it can lead to chronic pelvic/testicular pain or infertility.  Both are bacterial infections and treatable with antibiotics.   

Hepatitis A, B and C     

Symptoms of Hepatitis can include stomach pain, fever, loss of appetite, nausea, vomiting, fatigue, dark coloured urine, and jaundice. Untreated and chronic hepatitis can lead to liver failure.  

Hepatitis is an infection of the liver.  Hepatitis A is transmitted when the feces of someone with Hepatitis A gets into the mouth of another person, such as through improperly sanitized drinking water or eating food prepared by someone with Hepatitis A who did not thoroughly wash their hands after using the toilet.  For sexual contact, it can be transmitted through rimming (mouth-to-anus contact), or oral contact with a penis/finger/sex toy that has penetrated the anus.  There are vaccines to protect against Hepatitis A, but there is no treatment.  The infection runs its course and, in most cases, the liver heals itself without any lasting damage. 

Hepatitis B is transmitted when the blood, semen, vaginal fluids or rectal fluids of a person with Hepatitis B enters the body of a person without Hepatitis B.  There are vaccines to protect against Hepatitis B.  In Ontario, students are offered the vaccine in Grade 7 as part of the School Immunization Program. Some people can recover from Hepatitis B without treatment, others may require antiviral medication. 

Hepatitis A and B vaccines are available through your family doctor, walk-in clinics, and travel clinics.  They are also available at Ottawa Public Health’s Sexual Health Clinic for those who qualify.  

Hepatitis C is transmitted through blood, for example, sharing needles to inject drugs. Getting Hepatitis C through sexual contact is less common but can occur if there is exposure to blood during “rough sex” or menstruation.  There is no vaccine, but there are highly effective treatments. 

Hepatitis B and C are endemic in certain parts of the world such as Sub-Saharan Africa.  It is recommended that people who were born in a country with high Hepatitis B or C prevalence get tested.  Unlike Syphilis and HIV, Hepatitis is not routinely tested for upon immigration to Canada. 

Syphilis  

Syphilis is a bacterial infection that is transmitted through direct contact with an infectious lesion, usually through oral, vaginal or anal sex.  It can also be transmitted through the placenta during pregnancy.  There are three stages of syphilis, each with different symptoms.  Primary Syphilis: a painless open lesion on the genitals, mouth, skin, or rectum that heals by itself in 3 to 6 weeks and enlarged lymph nodes.  Secondary Syphilis: skin rash, fever, malaise, loss of appetite, muscle/joint pain, vision changes and hair loss.  Latent Syphilis: no symptoms and no longer infectious, but if left untreated, it can lead to severe organ damage.  Syphilis can be treated with antibiotics.  

HIV 

HIV (Human Immunodeficiency Virus) is a viral infection that makes your immune system weaker, so it becomes harder to fight off other infections.  HIV can be transmitted when the virus from blood, semen, rectal fluids, vaginal fluids or breastmilk of a person with HIV enters the blood stream of a person without HIV through mucous membranes or broken skin.  This can happen through sexual activity, sharing equipment used to inject drugs, tattooing or piercing, and through pregnancy, childbirth, or infant feeding.  Symptoms include fever, headache, rash, swollen lymph nodes, weight loss, fever, and diarrhea.  Left untreated, HIV can result in severe infections from other viruses or bacteria.  HIV can be treated with antiretroviral medications.     

Testing 

Testing for STBBIs is done through a urine test or swabs for Chlamydia and Gonorrhea, and blood tests for Hepatitis A/B/C, Syphilis and HIV.  These tests can be done with your family doctor who is the best resource for your overall healthcare. Another option for those without a family doctor is a walk-in-clinic. Visit Health811.ontario.ca for a list. Should you have symptoms, and they turn out not to be an STBBI, these practitioners can provide additional testing.  For STBBI testing, Ottawa Public Health has a Sexual Health Clinic that can provide testing for those who are eligible.  Another option is GetaKit.ca where tests can be ordered online. Requisitions are sent through the mail or available online and tests are completed at a lab.   

Testing for STBBIs regularly is recommended if you have multiple partners or if you have STBBI symptoms. 

Prevention is key.  Using a condom every time you have sex reduces the chances of getting an STBBI.  Ottawa Public Health offers free condoms through Sex it Smart.  Orders can be placed using our on-line order form. 

Jennifer Vo, RN, BSc, MSc(A) is a Nursing Project Officer with Ottawa Public Health | Santé publique Ottawa