Sexuality and U
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STIs-STDs

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Parasitic STIs-STDs

These STIs are caused by parasites passed from person-to-person during sexual activity. There are 3 in this category: Trichomoniasis, Pubic Lice and Scabies.

Trichomoniasis (Trich)

Trichomoniasis (Female) English

What is trichomoniasis?

Trichomoniasis, or trich (pronounced “trick”), is a common STI that usually has very few symptoms. It is caused by an infection of microscopic parasites called Trichomonas vaginalis. For women, these parasites may infect the vagina, urethra, bladder or cervix. In men, the infection is usually in the urethra, or under the foreskin of uncircumcised men.

How do you get trichomoniasis?

Trichomoniasis is spread through sexual contact with an infected person.

Prevention

The best way to help prevent Trichomoniasis is to use a condom each and every time you have sex.

Symptoms

Many people, particularly men, will not have symptoms of a trich infection. If symptoms do appear, they usually appear within one week of infection, though they can take up to six months. For some people, symptoms may go away and then return later. About half of women will have symptoms of a trich infection. In men, trichomoniasis is rare and most men will not have symptoms.

For women, symptoms may include:

  • Discharge from the vagina
  • Vaginal odour
  • Pain during intercourse or urination
  • Irritation or itchiness of the vagina

For men symptoms may include:

  • mild discharge
  • irritation or redness at the top of the penis
  • burning during urination
  • Men may often become unknowing carriers of trich infections. Treatment is required to ensure that a trich infection is completely gone
Testing

Testing may be done by physical examination or lab testing to detect the parasite.

In some cases, the tiny sores caused by trichomoniasis may be detected during a routine pap test for women; however, pap smears do not specifically test for sexually transmitted infections, and you should never rely on a pap smear to detect trichomoniasis or any other sexually transmitted infections.

Treatment

Typically, trichomoniasis can be treated with a single oral dose of an antibiotic called Metronidazole. However, Trichomonas can be reacquired easily so it is important that you and your partner(s) be treated together. Trichomoniasis may not show symptoms, so even if your partner doesn’t have symptoms, he or she should still be tested.

Impact if not treated

In rare cases, trichomoniasis can cause pelvic inflammatory disease (PID) in women, which can cause infertility, chronic pelvic pain or ectopic pregnancy.

If a pregnant woman is infected with Trichomonas, it may cause premature delivery or low birth weight. Trich can cause small sores and inflammation, which can increase the risk of HIV transmission. Detection and treatment of a Trichomonas infection will help lower your risk of contracting HIV.

What to tell your partner

Trichomoniasis is easily treated, but your partner(s) may not have symptoms. Also, if you’re with a partner who’s infected, they can reinfect you after you’ve had treatment.

Telling a partner about a trichomoniasis infection may be embarrassing, but it’s important to be very honest with your partner(s). Let them know so that they can get tested and treated if necessary.

When can I have sex again?

Ask your health care professional when receiving treatment about when you can have sex again. Do not have sex again if you or your partner(s) have not fully completed treatment, or if you are still displaying symptoms of infection. Remember, you can become reinfected immediately after your infection clears up. As always, it’s a very good idea to use condoms to help prevent sexually transmitted infections and trichomoniasis reinfection.

 

Crabs (A.K.A. Pubic Lice)

Crabs (Public Lice) Female and Male English

  

What are crabs/pubic lice?

Measuring in at about a millimetre tall, pubic lice (phthirus pubis) are tiny crab-like insects that nest in pubic hair.  They bury their heads into the skin and live off human blood, laying their egg sacks (nits) near the base of the pubic hairs.

A substance they secrete into the skin can cause intense itching, and the bites of adult lice turn small patches of skin to a bluish-grey colour.

Unlike head lice, pubic lice have small, wide bodies and arms that resemble crabs. These lice can also be found in chest, armpit and facial hair, eyebrows and eyelashes.

How are crabs/public lice spread?

Pubic lice can be spread during intimate contact. They do this by crawling from one person to another, since they have no wings. Pubic lice also can live for one to two days in bedding, towels and clothing belonging to an infected individual, and these items can be a source of transmission. Lice are not related to poor hygiene. Anyone can get lice, though it’s most common among sexually active people and in situations where individuals are in close contact.

Prevention
  • Avoid sharing towels and clothing that have not been washed.
  • If it can’t be washed, vacuum it.
  • When trying on underwear or a bathing suit at the store always wear something underneath.
Symptoms

Pubic lice and nits are small and can be difficult to spot. Infected individuals may experience:

  • Skin irritation and inflammation accompanied by itchiness and redness.
  • Small blue spots on the skin where lice have bitten.
  • Louse feces , fine black particles, in the infected person’s undergarments.
Testing

Healthcare professionals inspect the area for the crabs and the small greyish-white eggs they lay. Adult lice can easily be identified just by looking at the area with a magnifying glass, or viewing a sample of the area under a microscope.

Treatment
  • Non-prescription shampoo that can be purchased at a pharmacy, clinic or doctor’s office. Usually one wash is all it takes. In cases where a second washing is needed, apply it four days after the first treatment. The pharmacist will be able to help you.
  • A fine-toothed comb or the fingernails can be used to scrape the eggs off the hairs.
  • It’s important to tell recent sex partners so they can be treated at the same time.
  • Clothes, bedding, and other possible contaminated items should be washed in hot water or dry cleaned, or bagged for a week. Items that cannot be washed or bagged should be vacuumed.
  • Shaving may not necessarily get rid of the problem
Impact if not treated
  • It won’t go away on its own.
  • Persistent scratching of irritated skin can cause a secondary bacterial infection.
What to tell your partner

Pubic lice are easily treated, but your partner(s) may not know they have them. Telling a partner about pubic lice may be embarrassing, but it’s important to be very honest with your partner(s). All sexual partners who have had contact with an infected person in the month before diagnosis should be tested and treated to help prevent reinfestation. If you’re with a partner who’s infected, they can reinfect you after you’ve had treatment, so it’s best to get treated at the same time.

When can I have sex again?

Ask your healthcare professional when receiving treatment about when you can have sex again. Do not have sex again if you or your partner(s) have not fully completed treatment, or if you are still displaying symptoms of infection. Remember, you can become reinfected immediately after your infection clears up.

 

Scabies

Scabies (Female and Male) English

What are scabies?

Scabies are parasitic mites that dig holes (burrow) under the surface of the skin and lay eggs. The larvae that hatch move to new areas of the body and spread the infection.
Mites prefer warm areas such as the folds of skin on the elbows, wrists, buttocks, knees, shoulder blades, waist, breasts, and penis, between the fingers, and under the nails.

How are scabies transmitted?

Scabies are spread through close contact with someone who is infected. Scabies can live for three days on clothing, towels and bedding. These can be a source of transmission, but that is much less likely than skin to skin contact.

Mites are not related to poor hygiene. Anyone can get scabies, though it’s most common among sexually active people and in situations where individuals are in close contact.

Prevention
  • Avoid sharing unwashed towels and clothing.
  • If it can’t be washed, vacuum it.
  • If you’re shopping for a bathing suit, wear your underclothes while trying things on in the change room.
What are the symptoms?

Within three to four weeks of infestations an infected person could experience:

  • Intense itchiness, especially at night-time or after bathing. This is caused by an allergic reaction to the mites’ feces.
  • Reddish rash on fingers, wrists, armpits, waist, nipples, or penis.
  • With reoccurrences, the same symptoms occur more rapidly within hours to days of a re-infestation.
  • Severe infections are commonly seen in people with compromised immune systems or HIV. The skin can become scaly or crusty, requiring more complex and aggressive treatment.
Testing and diagnosis

Diagnosing scabies can be difficult and timely, but a healthcare professional examines the area to determine if the patient is infected. A sample may be scraped from the skin and analyzed under a microscope if necessary.

Treatment
  • A special lotion the doctor prescribes is applied to the whole body.
  • Some treatments are available without a prescription, ask your pharmacist
  • Clothes, towels, bedding and other possible contaminated items should be washed with hot water or drycleaned, or bagged for three days to one week. This kills the mites.
  • tems that cannot be cleaned should be vacuumed.
Impact if not treated
  • Persistent scratching or irritated skin can cause a secondary bacterial infection.
What to tell your partner

All household contacts and recent sexual partners within the past month should be treated to prevent re-infestation. Scabies is easily treated, but your partner(s) may not have symptoms. Also, if you’re with a partner who’s infected, they can reinfect you after you’ve had treatment.

Telling a partner about a scabies infection may be embarrassing, but it’s important to be very honest with your partner(s). Let them know so that they can get tested and treated if necessary.

When can I have sex again?

Ask your healthcare professional when receiving treatment about when you can have sex again. Do not have sex again if you or your partner(s) have not fully completed treatment, or if you are still displaying symptoms of infection. Remember, you can become reinfected immediately after your infection clears up.

 

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Did You Know?
In 2006, a study followed 2419 people who had attended an STI clinic. Every three months following their visit to the clinic, the study’s participants were retested for chlamydia, gonorrhea and trichomonas. The study found that about one in four of the women and about one in seven of the men tested positive for at least one new STI within the next year.

Peterman TA et al; RESPECT-2 Study Group (U.S.). High incidence of new sexually transmitted infections in the year following a sexually transmitted infection: a case for rescreening. Ann Intern Med. 2006 Oct 17;145(8):564-72.