STI information

Many STIs have similar symptoms to other illnesses (such as thrush or a urinary tract infection), so it’s always important to visit your GP or a sexual health clinic if anything unusual is happening in your genital or anal regions.

If you are experiencing any of the following symptoms, you should visit your GP or sexual health clinic as soon as possible:

• Stinging or burning sensation when you urinate
• Unusual discharge from the penis, vagina or anus
• Smelly discharge from the penis, vagina, or anus
• A rash on or around the penis, vagina, or anus
• Sore, tender or inflamed genitals
• Testicle ache or pain
• Abdominal ache or pain
• Bleeding between periods or after sex
• Itching, blisters or sores in the genital region or the mouth.
• Pain during or after sex

Chlamydia is a bacterial STI and is very, very common amongst young people.

If untreated, it may cause infertility, ectopic pregnancy (when a fertilised egg implants and starts growing outside of the uterus) or pelvic inflammatory disease.

Symptoms, when they do appear, include a cloudy white discharge from the penis or vagina, and a burning or tingling sensation when you pee. However, many people who have Chlamydia do not know they are infected, so it’s really important to test regularly. The only way to know if you have Chlamydia is to do a Chlamydia test.

Chlamydia can be cured using tablet antibiotics.

Bacterial vaginosis (BV) is a common cause of unusual vaginal discharge. BV is not a sexually transmitted infection (STI), but it can increase your risk of getting an STI such as chlamydia.

Genital herpes is a common sexually transmitted infection (STI). It is caused by a virus called Herpes simplex, closely related to the one that causes cold sores around the mouth.

Like genital warts, treatments are available for the sores which are caused by herpes, though there is no treatment for the virus itself. A person who becomes infected with herpes may only ever have one outbreak of sores, or they may have multiple outbreaks throughout their lives.

The herpes virus can be passed on even if before any sores are visible, so it’s very important to always use a condom as it drastically reduces the likelihood of transmission.

Genital warts are the most common viral sexually transmitted infection (STI) in the UK. They are caused by the human papilloma virus (HPV) which can be passed on during sexual contact and can affect both the genital and rectal areas, as well as the mouth and throat.

There is currently no cure for HPV, although treatment is available to get rid of the warts.

If you contract the strains of HPV which lead to genital warts, you may get only one outbreak of warts or you may get multiple outbreaks throughout your lifetime.

Gonorrhoea another common bacterial STI that is caused by bacteria and can affect the urethra (the tube urine is passes through), rectum (back-passage), throat and, in women, the cervix and fallopian tubes.

Gonorrhoea may cause pelvic inflammatory disease in women and infection of the prostate gland in men.

Symptoms are similar to chlamydia but only appear in about 40% of cases, meaning that like Chlamydia, many people do not know when they have Gonorrhoea.

Gonorrhoea can be cured using tablet antibiotics and an antibiotic injection.

HIV is a viral sexually transmitted infection which attacks and weakens one’s immune system, making them susceptible to illness, infections, cancers, and other serious health issues.

While there is still no cure for HIV, there are many treatments available today, and people living with HIV in the UK can usually live normal lives and have safe sexual relationships.

People who are diagnosed with HIV soon after they become infected have the best chance of living long, healthy lives, so it’s really important that you test regularly for HIV if you have unprotected sexual contact.

Hepatitis means 'inflammation of the liver'. There are three main viral strains (A, B, C)

Hep A is passed through ingestion of faecal matter, and, while the least serious, can still make you very ill.

Hep B is passed through blood, semen, vaginal fluid and saliva and can cause serious harm to the liver. Treatments are available, though success rates vary.

Hep C is the most dangerous (in certain cases even fatal) and is usually passed through sharing needles or, sometimes, through unprotected sexual intercourse.

What is Hepatitis A?
Hepatitis A is a viral liver infection. If you're worried about Hepatitis A, please speak to your GP as GUM services are not able to treat you! 

How do you catch Hep A?
It’s passed on through tiny particles of infected faeces entering the mouth. Faeces can get into the mouth when rimming, or onto your hands during various sex acts including scat, fingering, fisting, engaging in anal play or handling contaminated objects such as dildos or used condoms.

From your hands, it’s really easy to transfer the infection to your mouth through eating food, having a cigarette, touching your mouth or any number of other ways. It can also be passed on by using eating/drinking utensils or drug-smoking equipment previously used by someone with Hep A. People are contagious for around three weeks, starting two weeks before they develop symptoms to about a week afterwards.

How will I know?
Flu-like symptoms are common, alongside; nausea, vomiting, abdominal cramps, muscle and joint pain and jaundice. As with most STIs, some people will only get some symptoms and they can range in severity depending on the individual. Symptoms will normally appear within 2-7 weeks of infection. People with Hepatitis A should avoid drugs, alcohol, excessively fatty diets, or anything that may affect the liver.

Testing and treatment
Like the flu – there is no specific treatment just plenty of fluids and bed rest. Symptoms can last for up to a month and most people will be able to clear Hep A by themselves. In most cases people will develop antibodies against HEP A after having it, meaning that they will be immune to any further attacks.

Protecting myself
Wash your hands after using the toilet, before and after sex (especially any anal play), and use dams for rimming. If you think you are at high risk, you can get yourself vaccinated against Hep A: it is normally 2 separate injections. 

HIV-positive guys and Hep A
If you are living with HIV, getting immunised for Hep A is a good idea. Many of the drugs used to treat HIV will need to pass through your liver and can not be tolerated during acute hepatitis infection.

What is Hepatitis B?
Hepatitis means inflammation of the liver. Hep B is a virus that affects the liver and can result in liver disease.

How do you catch Hep B?
Hep B is caused by infected blood, semen or vaginal fluid entering a person’s bloodstream mainly through unprotected sex and sharing injecting equipment. It can also be transmitted through sharing drug snorting equipment, crack pipes, toothbrushes, razors, also oral sex and tattooing or body piercing with unsterile equipment.

How will I know?
Flu-like symptoms are common, alongside; nausea, vomiting, abdominal cramps, muscle and joint pain, jaundice and dark yellow urine. As with most STIs, symptoms can vary from person-to-person and range from mild to severe depending on the individual. Symptoms will normally appear within 1-6 months after infection. Hep B can become a chronic infection lasting for more than 6 months. Most people will be able to clear it eventually but for some, it can lead to cirrhosis and liver cancer.

Testing and treatment
A blood test will be able to determine if you have contracted Hep B. There is no cure, in some cases people will be able to clear the virus naturally and will develop antibodies against it, meaning that they will most likely be immune to any further attacks. However, in the cases where someone can not clear the virus, close ongoing monitoring of the liver function is required. For those people with liver damage as a result of chronic Hep B, your doctor may suggest some treatment options with specialised anti-viral medications.

Protecting myself
To reduce the risks of catching Hep B get vaccinated or avoid coming into contact with another person's bodily fluid, especially blood and semen.

Always use condoms and water-based lube when having sex, if fisting use gloves and lube, and keep sex toys and dildos covered. Be sure to use new condoms, new gloves and clean, covered toys between different partners.

Always wash your hands and any sex toys thoroughly before and after sex (also during – if you are having an extended session).

Avoid sharing drug-taking equipment and personal toiletries, especially: needles, crack pipes, snorting straws/notes, razors, toothbrushes, nail clippers etc….

It is a good idea to get yourself vaccinated against Hep B, it is usually 3 separate injections over a period of time.

HIV-positive guys and Hep B
If you are HIV positive and sexually active, it is strongly recommended to get immunised against Hep B and have your Hep B levels checked at least once a year. Co-infection with both HIV and Hepatitis B may lead to more rapid progression of Hepatitis B to liver cancer. Many of the drugs used to treat HIV will need to pass through your liver and can not be tolerated during acute hepatitis infection.

What is Hepatitis C?
Hepatitis means inflammation of the liver. Hep C may result in liver disease. For some people, this can lead to cirrhosis, or scarring of the liver, and eventually liver failure and death after many years.

How do you catch Hep C?
Hep C is caused by infected blood entering a person’s bloodstream, mainly through unprotected sex and sharing injecting equipment. It can also be transmitted through sharing drug-snorting equipment, crack pipes, toothbrushes, razors, also oral sex and tattooing or body piercing with unsterile equipment.

Strictly speaking, Hep C isn’t considered an STI, however, there is now definitive evidence that it is being passed on during sex – and especially during group sex if the play is particularly rough. It can be transmitted when tiny amounts of blood are present on fingers, fists, toys or dicks which are moved from one arse to the next without being cleaned.

Sex without condoms is the main risk for sexual transmission and this risk is amplified with any sort of anal play that affects the inner lining the anus. This means fisting, unprotected anal sex, rough sex, unwashed sex toys, prolonged sex sessions – especially chemsex and group sex all significantly amplify the risk of contracting Hep C. All of these acts involve the possibility of broken skin and blood, making it an easy entry point for Hep C to get inside your bloodstream.

How will I know?
Symptoms for Hep C may be absent and can take years after the initial infection to show up. If they are present, symptoms may include fatigue, nausea, pain under the ribs, sweating and intolerance of fatty diets.

75% of people infected with Hep C may carry the virus in their blood for life 15% of these people may develop cirrhosis of the liver. A small number of people with cirrhosis may develop liver cancer or liver failure.

Testing and treatment
Hep C can be detected with a blood test.

It’s wise for sexually active guys to test regularly for HEP C, at least once every year, but more so if you are having lots of sex, any unprotected sex, chemsex or group sex. For HIV-positive people, it is also advised to test more regularly.

There is no vaccination against Hep C. If you have had Hep C and cleared it, you will retain antibodies in your blood, however, it is possible to catch it again. People that are not able to clear Hep C, will need to be regularly monitored with blood tests to check liver function.

There are treatments available to help clear Hep C and to help stop the progression of liver damage, cirrhosis (liver scarring), liver cancer or liver failure. These treatments may not be suitable for all people and this can depend on a range of different issues. 

The earlier you detect Hep C in your body, the better, as you can take steps to reduce the risk of passing it on, and also be assessed by a liver specialist who can decide whether or not you would benefit from treatment. As with all STIs the longer you leave it, the worse it will get.

Speak to your doctor about treatment options.

Protecting myself
To reduce the risks of catching Hep C avoid coming into contact with another person’s blood.

Always use condoms and water-based lube when having sex, if fisting use gloves and lube and keep sex toys like dildos covered. If you are sharing the love around be sure to use new condoms, new gloves and clean, covered toys between different partners.

Always wash your hands and any sex toys thoroughly before and after sex (particularly if you are having a prolonged session).

Avoid sharing drug-taking equipment and personal toiletries, especially: needles, crack pipes, snorting straws/notes, razors, toothbrushes, nail clippers etc…

HIV-positive guys and Hep C
This is a common, yet serious, combination of viruses to have. Living with HIV can increase the amount of Hep C in the bloodstream meaning that the risk of passing on Hep C increases.

For guys who are dealing with both HIV and Hep C, treatment for both is possible, however, treatment for HIV will take priority and this is because untreated HIV will increase the levels of Hep C in the system. Some people will need treatment for both especially if the liver is showing signs of liver damage.

The problem here is that some HIV medications will also cause inflammation of the liver and for this reason, starting treatment for both HIV and Hep C at the same time is generally not recommended. Starting HIV treatment has also been may also briefly reactivate Hep C symptoms. People who have both Hep C and HIV will need to closely monitor their liver function and avoid antiviral (anti-HIV) medications associated with liver problems.

Where can I test?
At a GUM clinic. Find your nearest one.

What is LGV?
LGV is Chlamydia's sibling, it's a particularly hostile form of the Chlamydia bacteria that has 3 different stages of its attack

How do you catch LGV?
LGV gets inside the body through the mucus lining of the mouth, penis or inside of the rectum. Anal sex without condoms is the easiest way this happens, sharing dildos/toys and fisting in more than one guys anus without cleaning or using gloves can also spread LGV.

How will I know?
The 3 stages:

Stage 1: 3 days to 3 weeks after infection a small painless sore on the penis, mouth or anus can appear at the site of the original contact. This sore often goes unnoticed. If this was in the penis, it may also hurt when you pee or you may have a discharge.

Stage 2: A few weeks after the first sore has appeared the glands in your groin may swell up or hurt like hell. The symptoms are different for the different sites of infection.

In the anus – Painful inflammation with blood or pus coming from the area. Shitting may be painful, and constipation or painful abscesses/ulcers inside the anus may develop.

In the penis –Discharge and swelling of the glands, so much that can they push through the skin and leak fluid.

In the mouth –swelling of the glands in the neck and armpits.

Stage 3: Over time the bacteria will cause inflammation/elephantitis of the genitals (no, this is not a good thing). Scarring and tissue damage can occur on the area around the genitals and inside the anus. Haemorrhoid-like growths can develop in the anus and tissue damage can narrow the rectum. 

Testing and treatment
If you test positive for rectal Chlamydia further tests will need to be done to check if it is LGV. If you catch LGV before it reaches stage 3, it is easily treated with antibiotics.

Protecting myself
Using condoms with guys for sex/dildos use and making sure these are changed between guys will help protect you, as will using fresh gloves for anal play and a dam for rimming. Washing your hands with soap and water immediately after sex can also help prevent transmission, especially if having sex with multiple partners.

HIV positive guys and LGV
For HIV positive guys the sores may be more severe, this is due to a weaker immune system. LGV can also increase your viral load, making it easier to pass HIV on to partners.

If you test positive for rectal Chlamydia your clinic should do further tests to make sure it is not LGV.

Where can I test?
If you test positive for rectal chlamydia, you may also be required to do further tests to check if it is LGV. Find your nearest GUM clinic to find out more. 

While not an STI, Mpox is a virus which is spread through close physical contact. 

As of August (2024) there has been a surge of a new Mpox strain (Clade 1b) primarily in the Democratic Republic of Congo. As of 31/10/2024, one case of Clade 1b was confirmed in the UK. The risk remains low, however men who have sex with men are encouraged to receive the vaccination if they have not already.

How is Mpox transmitted? 

• Close physical contact including sex acts, kissing, cuddling or holding hands 
• Touching clothing, bedding, towels or surfaces previously used by someone with Mpox
• Very close respiratory contact 

What are the symptoms of Mpox? 

• A high temperature
• A headache
• Muscle aches
• Backache
• Swollen glands
• Shivering/chills
• Exhaustion 
• A rash
  • usually appears 1-5 days after the first symptoms 
  • usually starts on the face, genitals or anus, but can appear anywhere on the body
  • begins as raised spots, gradually turns to small blisters which eventually scab and fall off. 

What to do if you believe you may have Mpox

• Contact your local sexual health clinic. Make sure to call before going to any healthcare settings.
• Find a sexual health clinic: www.nhs.uk/service-search/sexual-health/find-a-sexual-health-clinic
• Symptoms can last for 2-4 weeks, therefore, if confirmed to have Monkeypox it is advised to isolate, however, more specific advice may be given by health professionals. 

Vaccination

• As Mpox is caused by a similar virus to smallpox, the smallpox vaccine offers a good level of protection. Protecting you from monkeypox: information on the smallpox vaccination - GOV.UK (www.gov.uk)
• The NHS has a list of clinics currently offering the Mpox vaccine:  www.nhs.uk/conditions/monkeypox/find-a-monkeypox-vaccination-site/
• Please do not attend any appointments if you are currently experiencing symptoms of Mpox.

What is NSU/NGU?
NSU/NGU (Non-Specific or Non-Gonococcal Urethritis) is an inflammation of the urethra (the tube in your penis that carries the urine)

How do you catch NSU/NGU?
Inflammation of the urethra can be caused by many different factors, most commonly the Chlamydia bacteria but can also be the result of any number of sexually transmitted bacteria. It may sound a bit peculiar, but sometimes NSU is called non-gonococcal urethritis (NGU) because the inflammation is not caused by gonorrhoea.

In some situations, the inflammation/irritation can be the result of hygiene products such as shower gels and deodorants. NSU/NGU can also be the result of damage to the urethra (which could be the result of extended or rigorous sexual activity).

How will I know?
Symptoms may not always be present but may include; a burning/irritation or tickle inside the urethra, often worse when urinating. Some other guys may get a discharge or fluid from the end of the penis which can be yellow, green or clear in colour.

Testing and treatment
Testing usually entails taking a small swab of the site, along with a urine sample. NSU/NGU is usually treated with antibiotics, make sure you also get your partners treated and refrain from any sex for 1 week after taking the medication to prevent reinfection.

Protecting myself
Using condoms and water-based lube can reduce the risk of transmitting the infections that cause NSU/NGU.

Where can I test?
If you think you have symptoms of NSU/NGU get it checked out at a GUM Clinic.

Pubic lice (also known as crabs due to their appearance) are tiny parasites that live on coarse human body hair (such as pubic hair) and spread through close body contact.

Symptoms include itching and inflammation in the affected areas, black powder in your underwear and/or tiny blood spots on your clothing or skin.

Scabies is caused by tiny parasitic mites that burrow into the skin and lay eggs.

It is usually transmitted through direct skin contact or, less frequently, through sharing bedding or towels.

Shigella is a group of bacteria that cause bowel infections often passed through infected faeces.

How do you catch shigella?

It’s passed on through tiny particles of infected faeces entering the mouth. Faeces can get into the mouth when rimming, or onto your hands during a variety of sex acts including scat play, fingering, fisting, engaging in anal play or by handling contaminated objects such as dildos or used condoms.

From your hands it’s really easy to transfer the infection to your mouth through eating food, having a cigarette, touching your mouth or any number of ways.

How will I know?

Symptoms can include diarrhoea, stomach cramps, nausea and fever. These can show up as soon as several hours after exposure.

Testing and treatment

Testing for Shigella is by providing a stool sample.  Anti-diarrhoea treatments are often enough to treat gut infections, but antibiotics can also be used. Drink plenty of fluids as dehydration is a common side effect.

Protecting yourself

Wash your hands thoroughly after sex and handling any used condoms or dildos.  Use gloves for anal play and a dam for rimming.  Douching will not help limit the spread of Shigella as it brings the bacteria to the surface of the rectum. Be aware that faeces can enter your mouth after sex through biting your nails, having a cigarette cupping water in your hand to drink from the tap, and touching food or eating utensils.

If you think you may have Shigella and work as a waiter or in a food service industry it is advised not to return to work until 7 days after the symptoms have stopped.

If you think you have Shigella make an appointment with your GP

Where can I test?

If you think you have shigella make an appointment with your GP or visit a GUM clinic

Syphilis is a serious bacterial STI which can be transmitted through sexual activity and direct skin contact.

Symptoms may (but do not always) include sores around the genital or anal area, a painless rash and general flu-like symptoms.

It is important that you get tested as the infection can, if left untreated, cause irreversible damage to your body.

There are a number of genital infections that are not transmitted through sexual contact, yet have similar symptoms. It is important to undergo a full sexual health check to ensure that you get the correct treatment. Unlike thrush and BV, STIs will not go away by themselves.

Trichomonas vaginalis (shortened to TV) is a tiny parasite which causes an infection in the vaginal canal or the urethra (in both men and women).

It is easily passed through sexual contact and symptoms (if there are any) can often be confused with chlamydia. Testing is therefore strongly recommended.

Urethritis is when the tube that carries pee from the bladder out of the body (urethra) becomes swollen and sore. It's often caused by a sexually transmitted infection (STI). It's important to get it treated to avoid it spreading to other people.

Gonococcal urethritis is when the infection is caused by gonorrhoea.

Non-gonococcal urethritis (NGU) or non-specific urethritis is more common. This is when the infection is caused by something other than gonorrhoea, such as chlamydia.