Sexually transmitted infections

Also called STIs, Chlamydia, Gonorrhoea, Syphilis, Trichomoniasis

Mostly symptomless, which is why testing rather than symptoms is the point. Free, confidential, and available by post.

What it is

Infections passed on through sexual contact. The common ones in the UK are chlamydia, gonorrhoea, syphilis, trichomoniasis, genital herpes, genital warts and HIV.

The single most important fact is that most are symptomless most of the time. The majority of people with chlamydia have no symptoms at all, which is why waiting for something to appear is not a strategy and why routine testing exists.

Untreated, the consequences are real: chlamydia and gonorrhoea cause pelvic inflammatory disease, which causes chronic pain, ectopic pregnancy and infertility. Syphilis, which has risen sharply in the UK, damages the heart and nervous system years later and causes serious harm in pregnancy.

Gonorrhoea is becoming resistant to antibiotics, which is why treatment is given in specialist services and why a test of cure is often needed.

Testing is free and confidential on the NHS at sexual health clinics, and postal self-sampling kits are available in most of England. Under-16s can access confidential services.

HIV is now a manageable long-term condition, and someone on effective treatment with an undetectable viral load cannot pass it on. PrEP is available free and prevents HIV.

Signs you might notice

Often nothing at all.

When present: unusual discharge from the vagina, penis or anus; pain or burning on passing urine; pain during sex; bleeding between periods or after sex; sores, blisters, lumps or warts around the genitals or anus; itching; and lower abdominal pain.

Syphilis: a painless sore that heals by itself, followed weeks later by a rash often involving the palms and soles.

Urgent: severe lower abdominal pain with fever, which may be pelvic inflammatory disease; testicular pain and swelling; or a painful red eye alongside genital symptoms.

Test after any unprotected sex with a new partner, whether or not there are symptoms, and repeat according to the window period the clinic advises.

How it can affect day-to-day life

Shame is the barrier, not access. Services are free, confidential and used by enormous numbers of people, and saying that plainly changes behaviour more than any warning.

Partner notification is part of treatment, not an optional extra, and clinics can do it anonymously. Untreated partners cause reinfection.

Adults with a learning disability have the same rights to sexual health services and are routinely assumed not to need them, which leaves them unprotected and unscreened.

Sexual health is also a safeguarding surface. An STI in a child, or a pattern suggesting exploitation or coercion, must be raised through the proper route.

Older people are having sex and are not being tested; STI rates in the over-45s have risen and services rarely reach them.

Supporting someone well

Test rather than wait for symptoms. Order a postal kit or book a clinic.

Use condoms, which remain the only contraception that reduces STI transmission.

Complete treatment, avoid sex for the period advised, and go back for a test of cure where asked.

Tell partners, or let the clinic do it anonymously.

Ask about PrEP if at risk of HIV; it is free and highly effective.

Get vaccinated: HPV vaccination is offered at school for all genders, and hepatitis A and B vaccination is offered to some groups.

Ask about sexual health support for anyone with a learning disability rather than assuming it is not relevant.

Raise safeguarding concerns through the proper route.

Where to get help

A sexual health clinic, free and confidential, with no GP referral needed. Postal testing kits are available in most areas.

A GP practice, though clinics are usually faster and better equipped.

Terrence Higgins Trust for HIV and sexual health information and support.

Brook for under-25s.