Viral vs Bacterial STI’s

Viral vs Bacterial STI’s v2

While reading an article with this title may sound about as appealing as watching Batman vs Superman (there’s a reason it’s 29% on RottenTomatoes.com), I’m hoping you’ll be pleasantly surprised by the end and will have learned some interesting tidbits along the way that you can casually drop into your next conversation about STIs, microbes or genital rashes.

First, a brief paragraph on the differences between viruses vs bacteria in general. These are two distinct types of organism. One thing that sets them apart is their (in)dependence: viruses can only survive for a limited amount of time independently and need to attach themselves to a living ‘host’ to stay alive. Bacteria are more self-sufficient by nature and can keep on living even when not actively infecting someone. Second, their treatment: a lot of viruses will be beaten by the body’s immune system but when they do need treatment, this is done using antiviral medication (*ahem, yes, when we have antiviral medication that works, thanks for pointing this out, Covid). When a bacterial infection is treated, this is done with antibiotics. Antibiotics don’t work on viruses and antivirals don’t work on bacteria – they’re both a little snobby and elitist like that.

Viral Sexually Transmitted Infections (STIs)

And now, your top three viral infections that can be transmitted sexually:

HIV

Starting off this list with not the most common but arguably one of the most important viruses that can be transmitted sexually. We’ve all heard about HIV and how serious it can be. But did you know that for someone diagnosed today, if their starting CD4 count (a measure of cells that HIV targets) is reasonable, their life span with treatment is the same as someone who’s HIV negative? Unfortunately it’s estimated that almost half of people with HIV don’t know they have it. That’s why getting regularly tested, especially if you are in an at-risk category, is a good idea.

Herpes

Genital herpes is caused by a Herpes Simplex virus – similar to the one that causes cold sores on the mouth, although not exactly the same. While at this point there is no long term curative treatment, antiviral medication can still be very effective for treating individual flares.

Genital Warts

These are generally caused by a type of HPV (Human Papilloma Virus) that is NOT associated with an increased risk of cancer – 9 out of 10 cases of genital warts are caused by HPV 6 or 11. Of all of the types of HPV that can be associated with cancers (the jab that’s offered is against types 16 and 18 as they cause 70% of cervical cancer), types 6 and 11 are safely off the danger list. Lots of warts will eventually resolve on their own but if you do have a new genital skin lesion, it’s usually a good idea to get this checked out.

Bacterial STIs

And your top three bacterial infections that can be sexually transmitted:

Chlamydia

Sneakier than a snake’s surprise party, chlamydia trachomatis often manages to infect people without them even realising. Half of men and 7 out of 10 women don’t get ANY symptoms with a chlamydia infection. Despite not causing symptoms it can definitely cause trouble and mess with future fertility amongst other things. Given that it is *the* most common bacterial STI in the UK, and given that it is super-easy to treat (a single antibiotic tablet in some cases), it’s always worth getting checked for this every time you have a new partner or annually if you’r <25y.

Gonorrhoea

Think of this as the budget version of Chlamydia. It’s not quite as common and not quite as sneaky – it still manages to be present without symptoms in about half of the women it infects, but only 1 in 10 men with it will be caught unawares (unless it is in their rectum or throat). Most men will have a discharge from the tip of the penis +/- burning discomfort when weeing. Similarly, it can also cause trouble and is also easily treatable. It’s kind of like Chlamydias ‘plus one’ as the two often like to go places together – if one is found, there’s a reasonable chance the other may be around as well and worth testing for.

Syphilis

Maybe because ‘venereal’ is so similar to ‘venerable’, or because Syphilis has been postulated to have origins going back to 7000 BC (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956094/), whatever the reason, I have a mental image of syphilis being very aged! And the danger with syphilis is that if it isn’t picked up and treated, it can actually stick around for a very long time and lead to pretty serious complications. Initial symptoms tend to be an ulcer that appears weeks/months after exposure, doesn’t hurt, and goes away after 6 weeks or so.
Weeks/months after this, ‘secondary syphilis’ can occur, which could result in a variety of symptoms such as a rash on the palms, joint pains, swollen glands, warty looking growths around the genitals or back passage, and vague symptoms of feeling unwell.
‘Tertiary syphilis’ happens years or even decades after the initial infection and can cause very serious complications with important parts of your body like the brain, heart, eyes, and nerves.
The plus side? Not that common an infection in the UK, and very much treatable (and curable) with the right antibiotics.

Free advice

Use protection.
Get yourself and your partner tested before you agree to stop using protection (yes this applies to those of you born in the 20th century too – just because this isn’t your first rodeo, doesn’t mean you can’t still get an STI).
If you’ve had a new partner in the last 6 months, get tested.
If you’re in an age group where lots of your peers have STIs (esp if you’re <25yo), get tested regularly. If you’re not sure if you should get a test or not, speak to us (link below) or your local NHS sexual health clinic: https://www.nhs.uk/service-search/other-services/STI-testing-and-treatment/LocationSearch/736

We’ll soon be expanding to be able to offer you STI checks that can be done at home, so watch this space. In the meantime, if you want to talk about anything you’ve read here, download the CheckUp Health app now and book a video or audio call with one of our private GPs, daytime or evening, 7 days/week.

References

BASH (the British Association for Sexual Health and HIV) has some fantastic leaflets (yes, even better written than this article) that cover a bunch of different STIs. Check it out here:
https://www.bashh.org/pils
https://www.thebodypro.com/article/hiv-life-expectancy-in-u-s-matches-general-population-with-some-differences talks about improved life expectancy now for those who have HIV.
https://patient.info/sexual-health/sexually-transmitted-infections-leaflet
https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/

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