Sexually transmitted infections (STIs)

What are sexually transmitted infections (STIs)?

Sexually transmitted infections (STIs) can be spread from person to person and are caused by over 30 different bacteria, viruses, and parasites. Some are spread by skin-to-skin contact and others through semen, vaginal fluid, blood or other body fluids.

What is my risk?

STIs are present worldwide. The risk depends on behaviours while travelling rather than the region or country you visit.

Risk is higher among travellers who engage in:

• unprotected sex
• casual and/or anonymous sex
• sexual activity with sex trade workers

How are they transmitted?

• STIs are spread from person to person through:
  • semen, vaginal fluid, blood or other body fluids during unprotected vaginal, anal or oral sex
  • skin-to-skin contact during sexual activity
• Some STIs can also be passed from person-to-person through blood transfusions and organ transplantations. In some countries, the blood or organ supply might not be adequately screened, which increases the risk of virus transmission.
• Some STIs,as well as infections transmitted through blood (such as hepatitis C), can also be passed from person-to-person through the sharing of needles and other equipment during injection drug use.
• Some STIs, such as HIV, syphilis and Herpes Simplex Virus (HSV), can be transmitted from an infected mother to her child through pregnancy and childbirth. HIV can also be transmitted through breast feeding.
• An individual can have more than one STI at a time. In fact, if you have an untreated STI, such as chlamydia or syphilis, it increases the risk of getting or transmitting HIV.
• With some STIs, such as chlamydia or syphilis, you can get them more than once if you are exposed again.

What are the symptoms?

• Some people with STIs have few or no symptoms at all; others have obvious symptoms. If you have been sexually active with a new partner when travelling, be aware of any changes in your health during travel and after return, such as:
  • different or heavier discharge from the vagina
  • discharge from the penis
  • burning feeling when urinating.
  • sores, particularly in the genital or anal areas
  • itching feeling around the genitals or anus
  • appearance of a rash
  • swollen glands in the groin
  • sudden onset of flu-like symptoms
• These symptoms might appear alone or in combination. Refer to information on specific STIs for more details.

• There can be complications which can have serious effects on health, such as pelvic inflammatory disease, infertility, pregnancy complications, cancer (of the cervix, vulva, vagina, anus or penis), chronic degenerative disease of the liver, and/or birth defects in children.

Can sexually transmitted infections (STIs) be treated?

Management and treatment vary depending on the sexually transmitted infection. Some STIs can be cured while others can be life-long infections.

Early detection and treatment are important to help prevent long-term health effects and reduce the spread of infection.

Where are sexually transmitted infections (STIs) a concern?      

STIs occur worldwide. Some STIs, such as haemophilus ducreyi (chanroid), are not common in Canada, but are common in other parts of the world.

For more information on STIs worldwide, visit the World Health Organization (WHO).

Recommendations

Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

The most effective way to avoid becoming infected with or transmitting an STI is to avoid sexual activity or other activities where bodily fluids are exchanged. You can reduce your risk by following the recommendations below.

1. Practice safer sex:

• Always use latex or polyurethane male or female condoms correctly for every sexual contact.
• Use dental dams (rectangular pieces of thin latex) over the vagina or anus for a protective barrier during oral sex.
• Before travelling, pack your own supply of high quality condoms and dental dams.
• Other birth control methods do NOT protect you against HIV and other sexually transmitted infections.

2. Talk to your health care provider or visit a travel health clinic to discuss the benefits of getting vaccinated against:

• Human Papillomavirus (HPV).
• Hepatitis A and hepatitis B.

3. Avoid behaviour which may increase your risk of STIs, such as:

• unprotected sex (anal, oral, vaginal)
• sexual activity with commercial sex workers and/or strangers
• heavy partying, drinking or taking illegal drugs, which can lower your sexual inhibitions or alter your ability to make decisions
• sharing needles, syringes, razors, toothbrushes or shavers
• exposure to unsterilized needles for tattooing, body-piercing or acupuncture

4. Avoid injections, blood transfusions and organ transplantations unless it is an emergency:

• If you must receive blood or an organ while travelling, make sure that the donated blood/organ has been tested for HIV and other infections transmitted through blood.
• If you cannot ensure the blood/organ has been screened, and you do not require emergency care, return home for treatment.

5. Be aware of sexual violence:

• Occurrence of sexual violence varies around the world
• If you are raped or assaulted, find medical attention immediately so HIV and STI testing and counselling (and possible treatment) can be provided, as appropriate.

6. Get tested and monitor your health

• See a health care provider if:
  • You think you may have a sexually transmitted infection because you have symptoms.
  • You have engaged in activities that may have placed you at risk for a STI, even if you have no symptoms.
  • If you think you have been exposed to HIV infection, see a health care provider immediately to get tested, counselled and treated as appropriate.
• It is important to ensure that all sex partners receive treatment if an individual is infected.
• Be aware that some medical services overseas may not be at Canadian standards. Canadian consular services include limited medical assistance abroad, such as providing the names of local medical providers or contacting your family in Canada. Contact the Emergency Operations Centre or the local Canadian Embassy, Consulate, or High Commission.