Students – if you have sex, protect yourself

STI Facts

Genital Herpes
Herpes is caused by a virus. There are two types of virus - the first causes sores around the mouth and nose (cold sores) and the second causes sores in the genital area. Both are passed on by oral, vaginal or anal sex with someone who has sores at the time. There is a very small risk of passing the virus on when there are no sores present. Genital herpes infection may facilitate HIV transmission, can cause severe systemic disease in those with impaired immunity, and can be potentially fatal to new born babies. In 2010, 63% of genital herpes diagnosed at Northern Ireland GUM clinics were in females; the highest rates of first infection in both men and women were in the 20–24 years age group and 12% of male first diagnoses occurred in men who have sex with men (MSM).

Gonorrhoea
Gonorrhoea may cause a discharge from the vagina, penis or rectum, pain when passing urine or a sore throat. There may be no signs, especially when infection is in the throat or rectum. Gonorrhoea can enter the bloodstream or spread to the joints, and in women it can cause pelvic inflammatory disease, ectopic pregnancy and infertility. An infected pregnant woman may pass the infection to her baby during delivery. In 2010 84% of new episodes of uncomplicated gonorrhoea diagnosed in Northern Ireland GUM clinics were in males; the highest diagnostic rates in both men and women were in the 20–24 years age groups and 34% of male diagnoses were attributed to MSM.

Genital Warts
Genital warts are caused by human papillomavirus (HPV) and are passed by skin to skin contact. They may appear as little lumps or spots on the skin or may cause an itch. Not all lumps or spots on the genitals are warts. Warts may appear anytime from two weeks to a year after contact with the virus.

The HPV vaccine was introduced as a school-based programme in Northern Ireland in 2008/09. This vaccine protects against the cancer causing types of HPV (types 16 and 18), but not those types causing genital warts.2 A new vaccine which will also protect against genital warts is being introduced from September 2012 onwards. In 2010, Genital warts (first episodes) accounted for 27% of all new STI diagnoses made in Northern Ireland GUM clinics; the highest rates of first infection, for men (37%) and women (36%), were in the 20–24 years age group and 8% of male first diagnoses occurred in MSM

Chlamydia
Chlamydia is the most common bacterial STI diagnosed in Northern Ireland GUM clinics. Often there are no symptoms (in at least 50% of men and 70% of women). If left untreated it can cause chronic pelvic pain and lead to pelvic inflammatory disease (PID), ectopic pregnancy and infertility. Symptoms include a discharge from the vagina or penis or stinging when passing urine.  In 2010 chlamydial infection accounted for 24% of all new STI diagnoses made in Northern Ireland GUM clinics; the highest rates of uncomplicated chlamydia infection in both males (41%) and females (42%) were in the 20–24 years age group and 14% of the total male diagnoses occurred in MSM.

Non Specific Urethritis (NSU)
NSU is an inflammation of a man’s urethra (the tube for passing urine). It can be caused by a number of germs. One of the most common is chlamydia. Symptoms may include a discharge from the tip of the penis or a burning feeling when passing urine.

HIV
Human Immunodeficiency Virus or HIV is found in the blood, semen and vaginal fluids of an infected person. It can be passed on through unprotected penetrative sex, sharing needles to inject drugs and from a mother to her baby before or during birth, or by breastfeeding. All pregnant women in Northern Ireland are now routinely tested antenatally for HIV.

Contact with STIs increases the risk of contracting HIV. A discharge or broken skin around the genital area makes it easier for the virus to pass from an infected person to an uninfected partner. Early diagnosis is important, for a better individual outcome and to reduce transmission of infection to others. During 2010, 79 new first-UK cases of HIV were diagnosed in Northern Ireland, 67% of which occurred in MSM, the largest ever annual number recorded in Northern Ireland. There were also 474 HIV infected Northern Ireland residents receiving care, of those 50% acquired their infection through sexual contact involving MSM and 46% acquired their infection through heterosexual contact

Syphilis
Syphilis is spread during sex, including oral sex. Although half of those infected show no symptoms, painless but infectious sores may appear or a rash may develop later.

Syphilis can be easily diagnosed and treated with antibiotics. This is important as syphilis infection can promote both the acquisition and transmission of HIV. It also has potentially serious or even fatal consequences if left untreated. Late syphilis can cause complications of the cardiovascular and central nervous systems and the skin. Infectious syphilis in pregnant women can cause miscarriage, stillbirth or congenital infection. In 2010 58 people were diagnosed as new episodes of infectious syphilis, 83% of these were diagnosed in MSM; 53% of those diagnosed reported only one sexual partner in the previous three months, but the highest number of reported sexual partners within that time was 30. Diagnosed co-infections included HIV, hepatitis A, chlamydia, gonorrhoea, genital herpes, genital warts and non-specific urethritis (NSU).

Have a check up

• GUM/Sexual Health Clinics: Opening times and operating systems vary – please contact individual centres:

Western area

• APPOINTMENT BASED, week days (Partial booking system 48hrs in advance). Genitourinary Medicine, Anderson House, Glenshane Road, Londonderry. BT47 1SB. Tel: 028 7161 1269
• APPOINTMENT BASED, WEDNESDAY 1.00-6:00pm. Sexual Health Clinic, Outpatients Dept, Tyrone County Hospital, Omagh. BT79 0AP. Tel: 028 8283 3189
• Appointments can also be booked through Altnagelvin GUM on 028 7161 1269 (Mon – Fri)

Northern area

• Walk in and appointments based. Genitourinary Medicine, Outpatients Department 2, Causeway Hospital, 4 Newbridge Road, Coleraine. BT52 1HS. Tel: 028 7034 6028 / 028 7034 7872

Belfast area

• APPOINTMENT BASED: Mon, 9:00am-12:00pm; Tues, 3-7pm; Weds, 9:00am-12:00pm/1:30-4:30pm; Thurs, 9:00am-12:00pm/5:00-7:00pm and Fri, 9:00am-12:00pm/1:30-4:30pm. Genitourinary Medicine, Level 3 Outpatients Department, Royal Group Hospitals Grosvenor Road, Belfast. BT12 6BA. Tel: 028 9063 / 028 9032 2303.

Southern Trust

• Booked slots: Mon 2:00-5:30pm, Weds and Fri, 9:00am-12:30pm. Genitourinary Medicine, John Mitchell Place, Hill Street, Newry. BT34 2BU. Tel: 028 3083 4215
• TUESDAY 9 – 4pm Nurse-Led Clinic, Clinical Zone, Ground Floor, Portadown Health & Care Centre, Tavanagh Avenue, Portadown. BT62 3BE.
• gum@southerntrust.hscni.net

South Eastern Trust

• APPOINTMENT BASED: Mon, 9:00am-12:00pm; weds, 3:30-6:30pm and Fri, 8:30am-12:00pm. Sexual Health Clinic, Outpatients Dept, Downe Hospital, 2 Struell Wells Road, Downpatrick BT30 6RL. Appointments Tel:  028 4483 8133, Nurse Advice Tel: 028 4483 8392
• MONDAY 9:00am-12:00pm Nurse-Led Clinic, Bangor Community Hospital.  Tel028 4483 8133

GUM clinics provide:

• a clinic where you do not need to be referred by another doctor, but in some cases you may need to make an appointment;
• confidential testing and treatment for sexually transmitted infections, including HIV;
• medical, nursing and social support for people with HIV infection;
• vaccination for Hepatitis B;
• confidential advice and counselling on sexual health issues;
• information on contraception;
• safe keeping of your records within the department. No one, including your GP, your partner or insurance company can see them without your permission.