Article: The Lowdown on STIs (Skipping the ‘Horror Shots’)

If your sex education was anything like mine then sexually transmitted infections were high on the topics list (because who needs to know about sexual orientation, non-‘vanilla’ proclivities, and effective communication, right?). And, if this was the case, then you probably got the same run through of all the main culprits, complete with horrific images and a lacklustre request to protect ourselves, because look – nasty imagery…le gasp.

I’ll concede, for some this shock tactics approach might have worked, but the consensus among my class (and the school gossip train in general) was that it didn’t. Generally, the imagery seemed to have two different effects:

Effect 1: People saw the imagery and immediately felt patronized, shut down, and ignored pretty much everything being discussed (some even skipped the class because they didn’t want to see the images).

Effect 2: The images were so undeniably engaging that any information relating to them was cast to one side and the only thing that stuck in people’s mind was ‘that one rank willy with all the pus ‘n stuff’.

I was in the latter category.

It wasn’t until my own training in Sex Education that I realized I actually knew very little about STIs, their symptoms, and my risk of contracting them. Granted, as someone who had literally only been with one person their entire life the risk was low, but that was no excuse.

Truth be told, I’m still playing catch-up in places, but I’m determined to brush up on my knowledge and to make sure that no one else feels ill-equipped when it comes to their understanding of STIs. So, let’s take a brief look at STIs together, the main culprits, their symptoms, and (importantly) how to reduce the chance of contracting them.

No gory shots needed.

STIs vs. STDs (Just What Is An STI)

Perhaps one of my biggest demonstrations of accidental ignorance is that, for the longest time, I did not know the difference between STDs and STIs: Or, to be more accurate, the fact that there isn’t really a difference.

STDs (sexually transmitted diseases) was the previous term popularly used to describe and medical infections that are contracted prevalently through sexual contact.

But the term sexually transmitted disease implied, in the eyes of medical professionals, an implication that there would always be an obvious sign or symptom for the contracted infection – making them easy to detect and giving them a certain aura of pathological and long-lasting sickness.

But, in reality, the bacteria and viruses that cause infection in people can usually be quite subtle – presenting almost no clear symptoms in some cases, or symptoms that could easily be dismissed as something else – and many of them are treatable (or, at the very least, manageable).

As such, doctors have proposed a move towards the term sexually transmitted infection to describe infections commonly caused by some form of sexual intercourse or exchange. These can involve bacteria, viruses, and parasites (more than 30 different types, as a general count) some of which can be purchased as adorable cuddly toys.

But, before I start gushing over cute venereal diseases, let’s address the most common culprits in detail.


Currently the most common STI in the UK and US, chlamydia is easy to pass on during sexual activities and has very mild symptoms, making it hard to detect (and easier to pass on).

Chlamydia is those with a vulva will typically cause pain when urinating, vaginal discharge, pain in the lower abdomen (especially during or after sex), and bleeding between periods. It can also cause heavier periods. Oh joy of joys.

For those with a penis pain when urinating and discharge is a shared symptom but pain or tenderness in the testicles will also be a possibility.

To check for chlamydia a urine test is taken or a swab. Treatment is nice and simple – antibiotics – but you don’t want to leave this one unchecked. If left untreated it can cause infertility and other long-term issues.

Easy way to reduce the risk of infection? Use a condom or femidom, make sure that you clean your hands between acts that involve un-gloved touching of the genitals (or switch gloves if they’re used), and don’t share toys without washing them. Simples. Oh, and don’t get semen or vaginal fluids in your eye. I know, I know, sexual health can be a spoil sport sometimes.

Genital Herpes

Ah, the familiar herpes simplex virus (HSV): the very same virus that causes cold sores. However, whereas cold sores are commonly caused by HSV type 1 (with 40% of the US estimated to have oral herpes), genital herpes is caused by HSV type 1 or 2, though typically genital herpes will because caused by type 2.

Genital herpes is extremely common, with an estimated 1 in 6 people having it, and 8 out of 10 people are typically unaware they even carry it. This is because herpes can be an incredibly mild STI with few to no initial symptoms. It’s only when the virus is active that an outbreak of genital herpes occurs and then the symptoms kick in.

These symptoms include small blisters that like to burst and leave painful red, open sores, vaginal discharge (where applicable), pain when urinating, and generally feeling pretty under the weather (aches, pain, and flu-like symptoms).

Outbreaks are a bit of a mystery but tend to be linked with stress, too much alcohol, sunbeds, and a weakened immune system.

If you think you’re having a herpes outbreak for the first time then it’s important that you go to your GP and get given an antiviral tablet to help stop the virus from spreading too much. Herpes is one of those STIs that never truly leave your system (remaining dormant, much like a cold sore) and any recurrent outbreak is best treated by keeping the genitals clean, using ice packs, drinking plenty of fluids, and avoiding tight clothing. Basically, you get a few sick days, no one likes them but the pain will pass. Outbreaks are when herpes is most infectious so don’t attempt sexual acts during this time either.

To prevent herpes condom or femidom use is essential, as are all the recommendations given for chlamydia. If you have an outbreak and get diagnosed then it’s important to contact your sexual partners and suggest they get tested for herpes too, just in case.

If you have an outbreak then a swab will probably be used for testing but, outside of this, a urine or blood sample may be taken instead. This will at least be tested for other STIs too, giving you a general diagnosis, so there’s your silver lining.

Genital Warts

Nothing to do with toads at all (thank fuck), genital warts are small growths, bumps, or skin variations that appear on the genital or anal area and are caused by the human papilloma virus (HPV). They are the second most common STI in the UK and has been considered the most common in the US by some reports. In an ironic twist one study of 100 men and women in the US found that 69% were infected with HPV. Aren’t statistics fun?

Typically, genital warts are painless – causing perhaps some itching or redness every now and then, but not often – and don’t really do much except for loiter around being all warty.

They can, however, cause those infected psychological distress, in which case treatment can be pursued. Liquids, creams, or cryotherapy (freezing) may be offered up, depending on the mental and physical impact of the warts.

Most people will only ever have a single episode of genital warts and, like herpes, it can loiter in the body for ages before deciding to make itself known.

HPV can be spread by sexual activity (so use condoms, don’t share toys, etc.), but skin-to-skin contact is also a common way for it to spread, so general caution and common sense is advised when it comes to these lumpy additions to most people’s lives.


Gonorrhea is another often undiagnosed STI – with 50% of women and 10% of men not experiencing any symptoms and, thus, being unaware of their status.

Caused by, you guessed it, unprotected vaginal, oral, or anal sexual activity, or the unprotected sharing of sex toys, gonorrhea can infect the cervix, the urethra, the rectum, and the throat or eyes.

Symptoms (when present) include a thick green or yellow discharge, bleeding between periods (where applicable), pain when passing urine, and tenderness in the lower abdomen or testicles. Inflammation can also occur, especially for those with a penis, and diagnosis and treatment during pregnancy is extremely important because gonorrhea can cause permanent blindness in infected newborns.

Gonorrhea is easily treated with a single antibiotic injection and tablet and will improve after just days of treatment. A follow-up appointment is heavily recommended and a follow-up test taken to check for infection.

The testing process for gonorrhea is usually done through swabbing the discharge produced by the STI or via a urine sample.

As you can probably tell by now, so many STIs have similar symptoms, tests, and treatments that early testing is essential.

Condoms, gloves, general hygiene, good sex toy sense, y’all know the drill for prevention by now.


A bacterial infection that we now typically associate with the nineteenth century, syphilis is currently at its highest case of diagnosis since 1949, with its increase linked to dating apps and, you guessed it, unprotected sexual activity.

Syphilis is bacterial and is caught through sexual intercourse with someone who is infected.

It manifests most commonly through small sores or ulcers on the genitals which are typically painless, a blotchy red rash on the palms of the hands or soles of the feet, skin growths that ca be similar to genital warts, white patches in the mouth, tiredness, headaches, joint pains, a temperature, swollen glands and just about a bajillion other things that could be easily dismissed at first.

This is why, again, testing when you get any symptoms or new growths after sexual contact is very important because, lemmie tell ya, syphilis is a nasty mother fucker.

If left untreated it can spread to the brain or other parts of the body and cause extreme long-term symptoms and it doesn’t got away on its own, so will need treatment.

Testing for syphilis is typically done through a blood test and a swab test, and is treated through an injection of antibiotics (typically into the buttocks, there’s no easy way of breaking that news), usually in a single dose but sometimes in three injections if left untreated for a long time.

A course of antibiotics can be given as an alternative, but it may not always be possible depending on how long you’ve had syphilis. More reason to have protected sex and get tested regularly!


Probably the most politically charged STI of the bunch, HIV is most commonly passed on through unprotected sex (in any instance) or sharing needles with someone who is infected with the virus. It can be spread through semen, vaginal and anal fluids, blood, and breast milk and is fragile, not surviving for long outside of the body (so myths about getting it through sweat, urine, or saliva are all inaccurate).

The symptoms of HIV are short and flu-like for 2–6 weeks after infection and last for 1–2 weeks commonly. After this ends an infected person may not have any more symptoms for months or years after infection, but HIV will ultimately damage the immune system of the infected person weakening the ability to fight off other infections and diseases.

Diagnosis is done through many different methods, including a blood and saliva test for signs of infection. HIV kits can also be purchased now for at-home checks, and pin-prick HIV testing is easy to obtain in many sexual health clinics.

If you suspect (or know) that you’ve had sex with someone with HIV and worry you may have contracted it yourself then getting emergency anti-HIV medication (a PEP) is crucial. It isn’t 100% guaranteed to stop you from getting HIV but it is still a huge prevention booster.

Prevention is done through safer sex practices: condoms/femidoms, dental dams, gloves during other activities, no sharing of sex toys, condoms on sex toys, no sharing of injecting equipment, etc.

If you do get diagnosed with HIV then you will be given antiretroviral medications in the form of a daily tablet, often in a combination to stop HIV from getting used to the treatment. Regular exercise, a healthy, diet, no smoking, and yearly flu jabs are also recommended, but we could all benefit from that advice.

What’s important to recognise is that a HIV diagnosis is not the end of the line and many people with HIV have active sex lives and lives in general.

And That’s All For Now Folks!

Hopefully you’re less befuddled by the world of STIs now and realize that those scary images are kind of irrelevant.

In general, STIs like to all try similar tactics, and prevention, diagnosis, and treatment rely on a lot of the same methods.

In my humble opinion, smart adult performers are far ahead of us when it comes to preventing STIs, by staying diligent with regular testing and using a variety of safer sex items (condoms, femidoms, gloves, and dams) alongside personal guidelines and open exchanges to keep themselves covered. Just sayin’

Practice safer sex, get tested regularly, seek treatment where needed, and keep sexual partners in the know about your current status.

These are the golden rules for any STI and, if you follow them, you’ll be well on your way to a healthier sex life.