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What You should know about STIs

What You should know about STIs

February is often called the Month of Love – blame it on old Saint Valentino. But February is also STI/Condom Month focussing on raising awareness about sexually transmitted infections (STIs) and their prevention. If you are using PrEP to avoid HIV infection, it won’t protect you from contracting other STIs so it is a good idea to carry on using condoms.

Here’s what you need to know about the STIs, (other than HIV) which commonly affect MSM (Men who have Sex with Men).


Syphilis is easily spread through oral or anal sex. Someone who has syphilis will get a sore where they have been infected. This could be on the penis, where they might see it, or in or around the anus, where they won’t. Men who also have sex with women can get infected if the woman has a syphilis sore inside her vagina. The syphilis sore is not painful and will go away by itself, but the person is still infected with syphilis.

Many men have syphilis without knowing they have it, and can spread it to others if they don’t use a condom during sex. Never do oral sex on a penis that has a sore on it; you can also get syphilis in your throat.

The Signs:

  • Stage 1: A syphilis sore develops between one and two weeks after the germ has entered your body. The sore will heal by itself but you are still infected.
  • Stage 2: Between two and six months after the sore has healed you might feel sick (as if you have flu), or develop a rash on your upper body and maybe on the palms of your hands.
  • Stage 3: You will still have syphilis (unless you were treated) but now there will be no signs of the infection. However you can still infect your sexual partners.
  • Stage 4: You can have syphilis for many years without knowing it. Now the germ will attack your nerves and can make you blind, deaf or cause brain damage. It can also attack your heart.

Syphilis can be a dangerous infection – get tested so that you can be treated.

What Can You Do?

  • Never put a penis that has a sore into your mouth.
  • If you only have sex with one partner and you don’t use condoms you should both be checked for syphilis so that you don’t infect each other.
  • Any public clinic can do a simple blood test to check for syphilis. At some clinics you will get the results within 15 minutes.
  • If you are having sex with more than one partner you should be checked for syphilis every six months.
  • If you are HIV positive you should also be checked for syphilis – having this infection is bad for your immune system.
  • If syphilis is found during Stage 1 or Stage 2 it is easy to treat at a public clinic. It can be difficult to treat syphilis if it is in Stage 3 or Stage 4 so rather don’t wait – get checked for syphilis as soon as possible.

WARTS / HPV (Human Papilloma Virus)

Warts are caused by the human papilloma virus (HPV) that affects the skin and mucous membranes. There are many strains of this virus, most of which are harmless. Some cause harmless warts (on the hands or feet). Warts can also occur on your genitals. There are more than 40 types of HPV that can be passed on through sex.

The Signs:

Genital warts appear as hard flesh-coloured bumps in or around your anus or penis. As they grow they develop a rough texture. They often appear in clusters of three or four, and may grow and spread rapidly. They are not usually painful, although they may cause discomfort, bleeding, itching or a bad smell. They can be embarrassing and might make you shy to have sex.

HPV is transmitted by skin-to-skin contact during sex. Any contact with the anus or penis can pass on the virus. Although you can become infected from somebody who has no visible warts, transmission is much easier if there’s direct contact with a wart.

If you are infected, the virus will remain in your body for life, but warts only tend to form when your immune system is compromised. HPV is therefore more problematic for HIV positive men.

What Can You Do?

  • Consult your healthcare provider if you suspect you have warts. They will likely spread and grow and become harder to remove if left untreated.
  • Non-surgical treatments include using special creams and physically removing the warts, usually by freezing them with liquid nitrogen. If these methods don’t work, or if the warts are too deep inside your anus, they may require surgical removal, there is no guarantee that the warts won’t return.
  • There is a vaccine against HPV but it should be administered before you have sexual contact for the first time.


Herpes is a virus that causes painful blisters. There are two kinds: blisters that commonly occur on your lips and around your mouth (usually called cold sores) and genital herpes, which causes blisters in your genital or anal area. The virus is easily released from the blisters, which burst and become sores, but also from skin that appears not to have any blisters or sores. Herpes is for life: even though the blisters and sores will disappear, they may come back at various times. The blisters are often the worst during the very first outbreak.

The Signs

Most people first realize they have genital herpes when they notice visible symptoms (blisters or sores) in their genital or anal area. An outbreak may occur only once a year or so often that the symptoms are continuous.

Some people never have an outbreak, but may have other symptoms associated with this infection. These include a tingling, burning or itchy feeling on the skin before blisters appear, swollen and tender lymph nodes in the groin area and painful urination.

What Can You Do?

  • Consult your healthcare provider if you notice any blisters or sores around your penis or anus.
  • There is no cure for genital herpes but it can be treated with prescription antiviral medications which help the sores heal quicker, lessen the severity of symptoms, and reduce the frequency of outbreaks. They may also help to prevent the spread of the virus.
  • Don’t have sex with someone who has visible blisters or sores.


Hepatitis is an inflammation of the liver. There are various types  –  A, B and C –  which are all caused by a virus and can be sexually transmitted They are spread through blood, semen or other body fluids and can be spread through unprotected anal sex, oral sex or by sharing needles to inject drugs. Hepatitis A is spread through minute traces of faeces entering your body, which may occur during rimming.

Depending on the type of hepatitis, ranging from mild to severe to chronic. Some people will not have any symptoms and a few will suffer serious liver damage.

Hepatitis is particularly dangerous for people who are HIV positive.

Many people with hepatitis do not develop any symptoms. If they do appear, they may include jaundice, fever, fatigue, loss of appetite, nausea or vomiting, dark urine, grey coloured stool and abdominal pain.

What Can You Do?

  • If you inject drugs, never share a needle with anyone else.
  • You can get vaccinated against Hepatitis A and Hepatitis B by your private doctor (public clinics do not provide this service). The vaccines are safe and effective, and require 2 to 3 doses within a six-month period depending on the type of vaccine used. You must receive the complete course of injections.
  • There is no vaccine against Hepatitis C.


Gonorrhoea and chlamydia, also know a drop or the clap, are easily spread through anal sex without a condom and oral sex.

You can get gonorrhoea or chlamydia in your throat (from sucking an infected cock), in your anus (from being penetrated by an infected top without a condom) or in your penis (from penetrating an infected bottom without a condom). You can also get them from a partner even if he doesn’t cum in your mouth or anus.

Having gonorrhoea or chlamydia makes it easier for you to get HIV, or to spread HIV to your partner if you are HIV positive.

What You Should Know

  • The germs that cause gonorrhoea and chlamydia can live in someone’s throat, their urethra (pee tube) or anus and are present in their semen if they are infected.
  • Not everyone shows signs of the infection, especially if the infection is in their throat or in their anus. Some men will develop a sore throat or a sore or itchy anus, and sometimes there will be a discharge (fluid, pus) leaking out of their anus. They may also bleed after anal sex or after using the toilet.
  • Men with gonorrhoea or chlamydia in their penis often get a burning feeling when they pee or cum, or a discharge leaking from their penis. This discharge can sometimes be seen on their underpants even if they don’t feel it. The discharge can be white, yellow or greenish in colour.

What Can You Do?

  • Avoid putting a penis in your mouth if it has a discharge. This can be difficult because the discharge could look like pre-ejaculate (pre-cum). If you get a sore throat that doesn’t go away see your doctor because you may have gonorrhoea or chlamydia in your throat.
  • Community clinics can treat you for gonorrhoea and chlamydia. If you get a burning feeling when you pee or ejaculate, or feel something is wrong with your anus, visit your nearest clinic as soon as possible.
  • Gonorrhoea and chlamydia are quite easy to treat but if you ignore them the infection can spread to your balls and prostate gland and can cause serious problems.

Even in the age of PrEP, your best defence against STIs is to always use a condom and water based lubricant when you have sex, and to reduce your number of sexual partners.