The information contained on this page was written by MESMAC and New Croft Sexual Health staff.
The information here is written for gay and bisexual men, for sexual health information for lesbian and bisexual women, please read the information on the LesBisexy website.

 

Men who have sex with men.
Having unprotected penetrative sex is the easiest way to pass on a sexually transmitted infection (STI).
Using a condom not only helps protect against HIV, but it also cuts the risk of getting many other STIs.
There are more gay men living with HIV than ever, so having sex without using a condom is extremely risky.
Many STIs are more difficult to treat if you’ve got HIV. Some, like syphilis, may even accelerate HIV’s progression.
Screening for Hepatitis C isn’t routinely carried out, but if you think you’re at risk or have been exposed, speak to your GP.
Gay men should have a sexual health check-up at least every six months. Some STI’s have no symptoms!

 

STI’s – Signs, Symptoms and Treatments.

There are many different STI’s, here we cover the most common:
• Chlamydia
• Genital Herpes
• Genital Warts
• Gonorrhoea
• Hepatitis A/B/C
• HIV
• LGV
• NSU (Non-Specific Urethritis)
• Scabies
• Pubic Lice (or crabs)
• Syphilis

At times we will mention sex with women as well as men for the bisexual men and men in relationships with women who read this website.

 

CHLAMYDIA

Chlamydia is a STI caused by small bacteria that live inside human cells. It is the most common STI in people under 25. Left untreated, Chlamydia can permanently damage the sexual organs leading to infertility in women and in men.
Symptoms
Chlamydia is called the ‘silent’ disease as around 50% of men and 70-80% of women do not experience any noticeable symptoms. Because of this lots of people do not know they have got it. Symptoms in men may include pain when pissing, a discharge from the cock or pain or discomfort in the balls. In women there may be pain when having sex, bleeding between periods or after sex.
Treatment
Chlamydia can be easily diagnosed through a ‘pee in a pot’ test or having a swab taken from inside the tip of your knob, once diagnosed it can be treated with antibiotics. Under 25s can get a free, confidential chlamydia test through the National Chlamydia Screening Programme or check the local website: www.checkyourbits.org People over 25 can visit their GP or a local Sexual Health Service to arrange a test. You can also collect a ‘Pee in the pot’ kit from MESMAC for free.

 

GENITAL HERPES

Genital herpes is an infection of the genital skin (below the waist and between the legs) that is caused by the herpes simplex virus (HSV). HSV lives in nerve endings and is the same as cold sores on the face. HSV can be easily passed from person to person by close, direct skin to skin contact. Genital herpes is passed on by having sex with some one who already has it. Genital herpes is a long-term (chronic) condition.
Symptoms
At least 80% of people who carry the virus don’t know that they’ve been infected because there are often few or no symptoms to begin with. Other people may develop symptoms very soon after getting the infection. These usually start as an area of small blisters that may be itchy and then burst leaving the area sore and uncomfortable. Sometimes it can be impossible to pee (more likely to occur in women) resulting in the need for a hospital admission. Even if someone with genital herpes doesn’t have any symptoms, it’s possible for them to pass the condition on to a sexual partner as the virus is present in the skin cells (that are shed) in the area where the infection has been.
Treatment
When herpes is first diagnosed, medication can be given to treat it along with painkillers if necessary.
Some people will only ever have one outbreak although the virus will still remain in their body, others may have further outbreaks. For others the virus starts up again, causing a further outbreak of herpes. The symptoms of genital herpes also tend not to happen as often and not be as bad each time someone has the condition. If an outbreak happens more than 6 times in 12 months you or if you prefer the sexual health service can talk to your GP about treating the virus with medication, usually over 6 months, in an attempt to reduce the amount of outbreaks.

 

GENITAL WARTS

Genital warts are the result of a viral skin infection that is caused by the human papilloma virus (HPV). Genital warts are usually painless and are not a serious threat to a person’s health. However, they can look unpleasant and make you feel unhappy or upset. Genital warts can be spread during sex, and by sharing sex toys. You do not need to have penetrative sex to pass the infection on because HPV is spread by skin-to-skin contact. Condoms do not provide complete protection because it is possible for the skin around your genital area (that is not covered by the condom) to become infected. HPV is most likely to be passed on to others when warts are present, although it is still possible to pass the virus on before the warts have developed and after they have disappeared.
Symptoms
Genital warts are small fleshy growths, bumps or skin changes that appear on or around the genital or anal area. It can take up to a year for symptoms to develop after getting an infection, so if you are in a relationship and you get genital warts, it does not necessarily mean that your partner has been having sex with other people! Warts may grow in clusters and cause pain when you are having sex.
Treatment
Treatments for warts usually work well. Several treatments are available, such as using medicated creams and freezing the warts (cryotherapy). However it is important to know that many treatments can take up to three months before they work properly.

 

GONORRHOEA

Gonorrhoea is a STI caused by bacteria called Neisseria gonorrhoea or gonococcus. It used to be known as “the clap”. Gonorrhoea is easily passed between people through unprotected vaginal, oral or anal sex, and sharing vibrators or other sex toys, that have not been washed or covered with a new condom each time they are used. Anyone who has sex with another person can get gonorrhoea, however it is more common with people who change partners more often and people who do not use a condom when having sex.
Symptoms
Typical symptoms are a yellow/green discharge from the cock or vagina, pain when pissing and sometimes a burning sensation and itching. Some people get no symptoms at all when they have Gonorrhoea.
Treatment
Gonorrhoea can be easily diagnosed through a ‘pee in a pot’ test or swab and is treated with antibiotics. You are likely to be asked to come back for repeat tests after your treatment to check that the infection has gone. If you don’t get treatment, it may lead to more serious long-term health problems and infertility. Successful treatment for gonorrhoea does not stop you from catching it again in the future.

 

HEPATITIS A, B and C

You get Hepatitis when there is inflammation (swelling ) of the liver, often caused by a virus. The three main types of hepatitis are described here:
Hepatitis A
Caused by the Hepatitis A virus, it’s the most common type of viral hepatitis. It is more common in countries with poor cleanliness and sanitation (sewage and rubbish). Hepatitis A is caught by putting something in your mouth that has been contaminated with shit containing the virus, so can commonly be transmitted through rimming (licking the bum hole for pleasure) for example.
Hepatitis B
Caused by the Hepatitis B virus, it’s present in body fluids such as blood, saliva, semen and vaginal fluid. It can be passed from person to person through unprotected sex or by sharing needles or drug injecting equipment, for example. Hepatitis B is not very common in the UK: about one in 1,000 people are thought to have the virus, MSM (Men who have Sex with Men) are more at risk of this virus through unprotected sex.
Hepatitis C
Caused by the Hepatitis C virus, it’s present in the blood and, to a much lesser extent, the saliva and semen or vaginal fluid of an infected person. It is particularly concentrated in the blood, so it is usually caught through blood-to-blood contact. The most common way you can become infected is by sharing contaminated needles or drug taking equipment.
Symptoms
There are often no symptoms for Hepatitis A, B, or C, which is why it is important to get checked regularly. Symptoms, if you get any, can include feeling tired, aches, nausea, being sick, pissing darker pee than usual and being jaundiced (yellowish skin tone). Blood tests are needed to confirm if you have an infection, which type it is and whether the infection has cleared itself or needs further investigation.
Treatment
Hep A: In certain parts of the UK sexual health services will offer all MSM vaccination against Hepatitis A, if there have been a lot of people infected locally.
Hep B: A course of vaccinations, which can prevent getting the virus, is recommended for all MSM and is available from sexual health services.
Hep C: There is currently no vaccine to prevent Hepatitis C. If you show signs of Hepatitis you are most likely to be referred to a Liver Unit at a hospital where more tests will take place and you may be offered drugs that fight the virus, these can clear the infection for about half of those who are infected.

 

HIV

The Human Immunodeficiency Virus (HIV) is a virus that attacks the body’s immune system. A healthy immune system provides a natural defence against disease and infection. HIV infects special cells, called CD4 cells, which are found in the blood and are responsible for fighting infection. After becoming infected, the CD4 cells are destroyed by HIV. Although the body will attempt to produce more CD4 cells, their numbers will eventually go down and the immune system will stop working. This leaves a person who is infected with HIV with a high risk of developing a serious infection or disease, such as cancer because the immune system is no longer able to prevent it happening. How is HIV spread? HIV is spread through the exchange of bodily fluids. This most commonly happens during sex, including oral, vaginal and anal sex. HIV can also be passed on through sharing needles. There is no cure for HIV and no vaccine to stop you from becoming infected. However, since the 1990s, treatments have been developed that help most people with HIV to stay well and live relatively normal lives. The sooner you know you have HIV the better as treatment can keep you healthy. What is AIDS? Acquired Immune Deficiency Syndrome (AIDS) describes the later stages of HIV, when the immune system has stopped working and the person develops a life-threatening condition, such as pneumonia (infection of the lungs). The term ‘AIDS’ was first used by doctors when the exact nature of the HIV virus was not fully understood. It is not used as much because it is too general to describe the many different conditions that can affect somebody with HIV. Specialists now prefer to use the terms advanced or late-stage HIV infection.
Symptoms
The first stage of HIV is known as primary HIV infection. In people who are infected with HIV, 60% will develop associated symptoms, usually two to six weeks after they are first infected with HIV. Symptoms of primary HIV infection may include: Fever, sore throat, tiredness, joint pain, muscle pain, swollen glands (lymph nodes), or a blotchy rash on the chest. These early symptoms are often very mild, so it is easy to mistake them for something else, like a cold or glandular fever. After this HIV will often not cause any other symptoms for many years. This is known as asymptomatic HIV infection. During this time, the virus is still reproducing and damaging your immune system. Late-stage HIV infection Left untreated, HIV will lower the number of CD4 cells in your body to a dangerously low level, and your immune system will stop working. On average it takes 10 years for the virus to damage the immune system in this way. A damaged immune system will result in you developing a serious infection. Possible symptoms of a serious infection caused by a damaged immune system include: feeling tired all the time, night sweats, unexplained weight loss, diarrhoea that won’t go away, blurred vision, white spots on your tongue or mouth, dry cough, shortness of breath, a fever of above 37C (100F) that lasts a number of weeks, or swollen glands that last for more than three months.
AIDS-related illnesses, such as tuberculosis, pneumonia and some cancers, may appear. Many of these, though serious, can be treated to some extent and some are likely to improve if you start treatment and your CD4 cell levels increase.
Monitoring
If you are diagnosed with HIV, you will be offered an appointment to a HIV or Sexual Health Service. You will also be offered counselling. You will need to have regular blood tests to check how the HIV is affecting your body. As part of the blood testing two main things are checked: Your CD4 count – which is the number of CD4 cells in your blood. Your viral load – which is the amount of HIV in your blood. These tests allow the staff at the HIV service to see how far the disease has progressed, and whether you might develop an infection.
Treatment
If the level of CD4 cells fall below a certain level (currently 350) you will be advised to start medication called HAART. This holds back the growth process of the HIV and allows CD4 levels to increase. Once HAART is started it should not be stopped without discussing it with your doctor because the disease can then come back quickly and the medication may not work again.
Outlook
There is no cure or vaccine for HIV and researchers believe it will be many years before either is found. However, special medicines that are used in what is known as Highly Active Antiretroviral Therapy (HAART) have been really successful in slowing down HIV and helping people to live longer. Researchers are confident that improvements in therapy will mean that a person with HIV will live as long as somebody who does not.
There is a treatment for exposure to HIV called PEP, it is only effective within 72 hours of exposure (split condom, unprotected sex with someone who is HIV+ etc). For more information, check our PEP page.

 

LGV

LGV stands for ‘lymphogranuloma venereum’. It’s a serious STI caused by a type of chlamydia bacteria. In 2004 the first cases were noticed in gay and bisexual men and is now seen more in MSM.
Symptoms
A few people have had LGV without noticing but most get symptoms within a few weeks. Most gay and bisexual men get infected with LGV inside their bum. This can cause painful swelling (proctitis). Going to the toilet might become difficult and painful, and you may get an abscess or ulcer. Some people feel ill, get a fever and might lose weight. If you get LGV in your cock you might also get a discharge or pain when you piss and the glands in your groin can swell. You don’t often get LGV in the mouth or throat. There may be a small, painless sore where the bacteria got into your bum or penis but most people don’t get or notice a sore. Untreated LGV can cause lasting damage for example: the inside of your bum can be so seriously damaged that you might need surgery and your penis and scrotum can swell massively with blocked fluid.
Treatment
As long as it’s treated quickly LGV can be cured in three weeks of starting antibiotics and leaves no lasting damage. Because of the bleeding and skin damage LGV causes it makes it easier to pick up or pass on HIV, hepatitis C, syphilis and other STI’s, so It’s likely you will be tested for these when attending a sexual health service.

 

NON-SPECIFIC URETHRITIS (NSU)

Non-specific urethritis (NSU) is a condition where the tube that pee passes through becomes inflamed, usually due to infection. The term “non-specific urethritis” is used when the cause is not yet known (Gonorrhoea is an STI that can also cause urethritis and tends to be more serious than NSU). NSU can have a number of possible causes, but it is thought that chlamydia is responsible for 75% of all cases.
Symptoms
Symptoms tend to range from mild to a stinging sensation in the piss tube and this can usually pass within a few months, this needs to be checked out.
Treatment
You should always have any unusual stinging sensations checked out with your GP or sexual health service because of possible causes, and treatment will be required to prevent the spread of infection. Antibiotics are usually used to treat cases of NSU. Untreated NSU can lead to swelling of the small tubes in the balls (epididymitis).

 

PUBIC LICE

Pubic lice (phthirus pubis), also known as ‘crabs’, are tiny blood-sucking insects. They live in coarse human body hair, most commonly pubic hair, and cause itching and red spots. The lice can also be found in the eyelashes or eyebrows, hair on the abdomen or back, and facial hair, such as beards or moustaches if left untreated. Adult pubic lice are about 2mm long and are grey-brown in colour. They are caught through close contact with someone who has them. The most common way is during sex. There is not enough evidence to say whether pubic lice can be passed through items such as bedding or towels, although some experts think that it might be possible. Only humans get pubic lice, you can get them at any age but they are seen most in young adults.
Symptoms
Pubic lice can cause itching to the infested area and lay egg sacks at the base of pubic hair which have a silver or shiny appearance.
Treatment
Pubic lice can usually be successfully treated with insecticide medicines available over-the-counter in most chemists, or from a GP or sexual health service. You should tell any current sexual partners and any partners from the past three months as they may need to be treated. If pubic lice are caught through sex, it is best that tests for STI’s also be done.

 

SCABIES

Scabies is a skin condition caused by tiny insects called Sarcoptes scabiei, which burrow into the skin. It can be spread through prolonged skin-to-skin contact (such as sleeping) with someone who is infected and sexual contact with someone. Scabies can also be passed on through sharing clothing, towels and bedding with someone who is infected. However, this is less likely than getting the infection through skin-to-skin contact. They feed using their mouthparts and front legs to dig into the outer layer of the skin. They eat tissue and fluids as they burrow. As they feed within the skin layer, they burrow at a rate of about 0.5mm a day. The females lay two to three eggs a day inside the burrow. After three to four days, the baby insects (larvae) hatch from the eggs and travel to the surface of the skin where they lie in shallow pockets before becoming adult insects. Scabies like warm places on the skin, such as skin folds, between the fingers, under fingernails or around the buttock or breast creases. They can also hide under watchstraps or bracelets, and in the skin on the finger under rings. Crusted scabies is when there are insects that have had lots of babies that have spread; this can affect older people and those with a lowered immune system (the body’s natural defence against illness and infection).
Symptoms
Scabies is not usually a serious condition, but the itching can be unpleasant and leave you feeling low or depressed. Visible signs can be small ‘silver’ threads that you may see that run across the skin. It can take up to eight weeks before you have any symptoms.
Treatment
Itching that is caused by scabies can usually be effectively treated using specialist skin creams, some of these need to be re-applied over 24 hours and may need to be put on the body again a few days later. The itching can persist for several days after treatment. Scabies can lead to another skin infection if the skin becomes irritated and inflamed through excessive itching and scratching. If this happens you need to see a GP or visit a sexual health clinic.

 

SYPHILIS

Syphilis is a bacterial infection that is usually passed on through sex. Three stages of disease Syphilis may not always be seen in its three stages, not everyone will have symptoms and if syphilis is up the bum changes may not be noticed.
Stage 1 (primary syphilis).
Symptoms of syphilis can be painful and highly infectious, they can range from one to lots of look-alike sores on the genitals or sometimes on the mouth/tongue/cheek/gums. If somebody else comes into close contact with the sore, for example during sex such as oral sex or anal sex, they can also become infected. The sore lasts two to six weeks before disappearing.
Stage 2 (secondary syphilis).
Secondary symptoms, such as a rash on the palms of the hands/soles of the feet, then develop. These symptoms may disappear within a few weeks, after which you experience a hidden (latent) phase with no symptoms, which can last for years. Due to being in the body untreated for years, syphilis can then progress to its third, most dangerous stage.
Stage 3 (tertiary syphilis).
At this stage, it can cause serious damage to the body.
Symptoms
The first and second stages are when you can most easily pass it to infect other people. Symptoms can include: swelling in your lymph glands (small organs found throughout the body, such as in the neck, groin or armpit), a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet, tiredness and headaches. Less common symptoms include: fever, weight loss, patchy hair loss and joint pains. In the middle (latent) phase (and usually around two years after becoming infected), syphilis cannot be passed onto others but you can still get symptoms.
Treatment
If found early, syphilis can be easily treated with antibiotics, usually penicillin injections. If it is not treated, syphilis can progress to a more dangerous form of the disease and cause serious conditions such as stroke, paralysis, blindness or even death.

 

SHIGELLA

Shigella causes severe diarrhoea and is often mistaken for food poisoning. It’s caught from bacteria in shit getting into your mouth during sex. Gay and bisexual men are particularly at risk.
Symptoms
You will get diarrhoea lasting more than 48 hours (often with blood in it), normally with stomach cramps and fever. Symptoms usually start within four days of getting infected.
It is spread very easily – all it takes is for a tiny amount of bacteria to get into your mouth.
Treatment
Shigella infection is easily cured with antibiotics. Visit your doctor or a sexual health clinic to get tested, explaining you may have picked up a gut infection from sex, possibly Shigella. The doctor needs to know this so you get the right tests and treatment. A full sexual health check-up is a good idea.
Anyone with a bad case of diarrhoea should:

• Drink fluids to stop losing too much water.
• Not go back to work until Shigella infection has been ruled out by a doctor, if work involves handling food or contact with patients.
Get tested – and if you have Shigella:
• Wait for 48 hours after the symptoms stop before going back to work.
• You can not go back to work until given the all clear by a public health official if your work involves handling food or contact with patients.

A person with Shigella can be infectious for up to a month.
During that time if you have Shigella (or any severe diarrhoea):
Wash your hands frequently! Do this after using the toilet and before eating or preparing food. Use warm water and soap. Avoid preparing food for other people while you’re ill or until a week after symptoms stop.
And avoid:

• Sex – until a week after symptoms stop.
• Sharing towels – use separate towels at home, and clean all taps, door handles, toilet handles, levers and seats with hot soapy water frequently.
• Spas/jacuzzis/hot tubs – you might contaminate the water and infect others.

There is a leaflet available HERE!

 

Some STI’s have no symptoms –
it is important to have regular check ups.

Download our Sexual Health Booklet HERE!

 

STI’s and Condoms

To prevent HIV transmission, you should always use condoms and water-based lubricant for anal sex.
We recommend Durex Extra, Natural Skins and the Boys Own brand. If you want to buy condoms, we recommend you try your nearest branch of Boots or Superdrug. You can also get free condoms & lube packs (MEnvelopes) from gay bars in Newcastle and loose condoms from local gay saunas and by calling in and collecting a supply from MESMAC.

The lubricant you use should always be water-based, because lube with oil seriously weakens the rubber in the condom. Some popular brands include KY jelly, Boots’ own brand lubricant, TLC and ID Glide. Once again, you can get free lube (along with condoms in the MEnvelope packs) from gay bars or MESMAC. You may have heard of a new polyurethane condom called Avanti, which is thinner than rubber condoms, supposed to be stronger, and which can also be used with oil-based lube. Some research has been done which suggests that these condoms are actually not as reliable as latex (rubber) condoms. At the moment we don’t recommend them for anal sex.
For more information on condoms, check our CONDOM page.