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He who immerses himself in sexual intercourse will be assailed by premature ageing, his strength will wane, his eyes will weaken, and a bad odour will emit from his mouth and his armpits, his teeth will fall out and many other maladies will afflict him.
MOSES BEN MAIMON (1135–1204), MISHNEH TORAH
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Sexually transmitted infections (STIs) are a group of communicable infections, usually transmitted by sexual contact. STIs that have developed a high profile include chlamydia, the most common notifiable disease in Australia and a major cause of pelvic inflammatory disease (PID), HIV infection, syphilis and multi-drug resistant gonorrhoea. Presentations of STIs are summarised in TABLE 109.1; however, most STIs are asymptomatic.
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Key facts and guidelines
In Western society most patients with STIs are in the 15–30 years age group.
Chlamydia is detected in approximately 1 in 20 young Australians who have screening tests in general practice.2
Not all STIs manifest on the genitals.
Not all genital lesions are STIs.
Chlamydia trachomatis is the commonest cause of urethritis.
Up to 50% of men and 75% of women with chlamydia may be asymptomatic.1
Gonorrhoea may cause no symptoms, especially in women.
STIs such as donovanosis, lymphogranuloma venereum and chancroid occur mainly in tropical countries.
HIV infection, which is predominantly sexually transmitted, should be considered in any person at risk of STIs and blood-borne viruses (BBVs). It presents as an acute febrile illness (similar to Epstein–Barr mononucleosis).
All sexually active young people aged 15–29 years should be tested annually for chlamydia with a first-pass urine or genital swab.2
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WHO IS AT RISK OF STIS?
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3Young people aged 15–29 years
Men who have sex with men (MSM), especially:
– unprotected anal sex
– >10 partners in past 6 months
– participate in group sex
– use recreational drugs during sex
– are HIV-positive
Aboriginal and Torres Strait Islander people
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