Why we need to talk about safe sex
Sex should be fun. For everyone involved. But it should also be safe. At work, I am often impressed by how thoughtful patients are when it comes to the issue of safe sex – regularly coming in and requesting a check-up, even when they have no symptoms.
Studies show that young people especially are doing far better when it comes to protecting themselves and their partners than older generations – the 40- to 50-year-old age group being poorly informed about the risk of sexually transmitted infections, and less likely to use condoms.
If you haven’t already been for a check-up, you’re in a new relationship, or you or your partner have sex with more than one person, here are some things you need to know: ❚ Anyone can get a sexually transmitted infection (STI). Your age, ethnicity, or gender are not protective – but a condom is! Condoms are available free from sexual health clinics, or on prescription from your doctor – a mere $5 fee will get you 144 of them, so don’t be put off by cost. ❚ The most commonly reported STI in New Zealand is chlamydia, followed by gonorrhoea. Rates of other infections such as Human Papilloma Virus (which causes genital warts), and herpes are not well understood, as they often remain asymptomatic for long periods. ❚ In recent years there has been a surge of cases of syphilis in New Zealand. This potentially serious infection is easily treated, but if left undetected can lead to permanent damage to the brain, nerves, and bones. Syphilis is detected via a blood test. ❚ HIV is actually relatively uncommon in New Zealand, except among certain high-risk groups, but rates of sexually transmitted hepatitis B are much higher. ❚ Ask your doctor about immunising yourself against HPV and hepatitis B. These vaccines are safe and highly effective. ❚ STIs can be transmitted through all types of sex – oral sex, for example, can be a way of transmitting syphilis, gonorrhoea, and herpes. ❚ You are more likely to be infected with an STI if you have any broken skin or sores on your mouth or genital area. It is thought that shaving your pubic area may slightly increase your risk of getting an STI, as the hair creates a barrier, protecting against infection. ❚ Many STIs do not cause symptoms, but can lead to quite serious complications if left untreated. Chlamydia for example can lead to pelvic infection and infertility if left untreated. Getting screening tests done, even when you don’t have symptoms, may be the only way to tell whether you have an STI or not. ❚ Although having multiple sexual partners makes an STI more likely, you only need to have sex with one person ever to potentially have been exposed to an infection. ❚ The following symptoms may all indicate a sexually transmitted infection: abnormal discharge in the genital area; abnormal bleeding in the genital area; pain when passing urine or having sex; ulcers or wart-like growths; itching.
There are behaviours which lead to a higher chance of getting an STI: ❚ Multiple or frequent change of sexual contacts. ❚ Absent or inconsistent use of condoms. ❚ Early onset of sexual activity. ❚ Use of alcohol or drugs.
However, if you don’t fall into one of those ‘‘at risk’’ groups, it certainly doesn’t mean you are immune to an STI. I would encourage everyone who has had a new partner over the previous year, or has multiple sexual contacts, to get tested.
If you don’t have symptoms, the ideal time is a minimum of two weeks from your last potential exposure – if you get tested earlier than this the result may be a false negative, and you may miss out on important treatment.
Testing is incredibly easy. For women, you will be able to do ‘‘self swabs’’. This means that you go to the bathroom, and take the swabs from the lower vaginal area yourself. These swabs check for the two commonest STIs (chlamydia and gonorrhoea). Many opt for this as a quick and easy method of getting checked.
For men, the process is even simpler – if you are asymptomatic, testing for chlamydia and gonorrhoea can be done on a simple urine sample, although swabs and blood tests may be required for more extensive testing. Results are available within 2-3 days. ❚ For more information, talk to your doctor, Family Planning, a Sexual Health Clinic or visit the fantastic justthefacts.co.nz ❚ Cathy Stephenson is a GP and medical examiner.