STI Testing in Europe

Why?

 Why should I get tested?

Many sexually transmitted infections (STIs) often occur with either few, nonspecific or no symptoms at all. As a result, they often remain undetected for long periods of time and can thus be transmitted unknowingly through (unprotected) sexual contact. Some STIs, if untreated, can lead to grave diseases, permanent damage (e.g. infertility) and even death.

The use of safer sex tools like condoms, internal condoms and dental dams can reduce the risk of transmission for most sexually transmitted infections. We also recommended, prior to any first encounter, to talk to one’s potential sexual partner about their testing habits and risk awareness. Testing habits means when has a person been tested for which STI. Risk awareness includes the questions “How many different people has this person had sexual contact with?”, “Were safer sex tools used?” and “What kind of sexual contact took place?”.

Where?
What?

WHICH STI’S SHOULD I TEST FOR?

Chlamydia, Gonorrhea, Yeast Infections, Hepatitis A+B+C, HIV, Syphilis, Trichomoniasis, & HPV (if exposed). Don’t forget to be tested in the throat (Gonorrhea, Chlamydia, HPV) if you want to have a full test. Be aware that Gonorrea, Chlamydia & HPV don’t show symptoms in up to 60% percent of the cases. 

When choosing your date to get tested be mindful of the incubation windows: https://www.stdcheck.com/blog/how-soon-get-tested-for-stds-unprotected-sex
6 weeks after a risky encounter is a good rule of thumb to test for STIs.

When?

WHEN IS THE RIGHT TIME TO GET TESTED?

If you experience symptoms that for example include discharge, itchiness or damaged skin in your genital area, you should absolutely seek advice from a doctor and testing for STIs.

Even if you are not experiencing any symptoms, it is still important to get tested for STIs before becoming involved with a new sexual partner and suggest them to get tested too.

Additionally, you should get tested if you risked a potential infection (e.g. through unprotected sex with a person that has an STI) or your sexual partner has been diagnosed with an STI.

It is also crucial to keep the waiting period in mind. A transmission of an infection is also possible before a test can even detect the infection. This means that even with a negative test result, you should continue using safer sex methods.

The time period between STI tests depends on various factors such as the number of sexual partners, the risk-promoting behaviour and the incubation times of sexually transmitted infections.

The 7 most common STI's

There are more than 30 sexually transmitted diseases that are induced by bacteria, viruses, fungi or unicellular organisms. Syphilis, gonorrhoea, ulcus molle (chancroid) and lymphogranuloma, are embedded in the Austrian law for sexually transmitted infections and are called the “classical” venereal diseases. Other such infections are for example HIV, trichomoniasis vaginalis, chlamydia, human papillomavirus (HPV), herpes genitalis and scabies. Sexually transmitted infections that affect other organs include hepatitis A, hepatitis B, hepatitis C and cytomegalovirus infection.

According to the World Health Organization (WHO), every day one million people are newly infected with on the four following sexually transmitted infections: chlamydia, gonorrhoea, syphilis or trichomoniasis vaginalis.

The infections often occur with either few, nonspecific or no symptoms at all. As a result, they often remain undetected for long periods of time and can thus be transmitted unknowingly through (unprotected) sexual contact. The use of safer sex tools can reduce the risk of transmission for most sexually transmitted infections.

The indicated information cannot replace neither an examination from a medical professional nor an appropriate treatment.

Trichomoniasis

Trichomoniasis is the most common sexually transmitted disease worldwide and caused by a single-celled parasite. The trichomonads are transmitted from person to person to the genitalia and the lower urinary tract as well as in the prostate and seminal vesicles. They can be the reason for itching, burning urination, or pain during sex. A typical symptom is a yellowish-greenish outflow, which smells very unpleasant. Often, however, no symptoms occur at all. If left untreated, there is a risk of infertility. Antibiotics are used for the treatment of trichomoniasis.

Using internal and external condoms prevents a transmission.

Chlamydia

Chlamydia is one of the most common STIs worldwide. This bacterial infection can cause an inflammation of the eyes, vagina or penis, and can lead to an infection of the fallopian tubes, which may result in a higher risk of extrauterine pregnancies or infertility. Signs of an infection include itching, pain and burning while urinating, as well as vaginal discharge.

Nevertheless, chlamydia usually has no symptoms. Most people don’t know they have it and don’t get treatment. An infection with chlamydia is easily cured with antibiotics

Chlamydia can be transmitted during unprotected oral, anal and genital intercourse.

Using internal and external condoms prevents a transmission.

Gonorrhea

Gonorrhea or the clap is a bacterial infection and can infect the genitals, mouth, rectum, and eyes. It is the second most common STI worldwide. Symptoms can be pain or burning with urination, discharge from the penis or vagina, testicular or pelvic pain, and vaginal bleeding. Infections of the throat and the rectum are most of the time symptomless. Most people who contract gonorrhea are asymptomatic, but left untreated gonorrhea can lead to infertility or pelvic inflammatory disease.

Gonorrhea is treated with a combination of antibiotics but grows more and more resistance to antibiotics which makes it much harder and sometimes impossible to treat.

Using internal and external condoms prevents a transmission.

Syphilis

Syphilis is a bacterial infection that is transmitted almost exclusively via sexual intercourse. The incubation period is two to up to ten weeks. On average, after about three weeks, a small nodule forms at the point of entry of the bacteria, which evolves into a painless ulcer (primary effect) and the lymph nodes swell up. These symptoms usually resolve by themselves. Nine to twelve weeks after the infection, general symptoms such as severe headaches, skin rashes, fever, weight loss, and a marked malaise occur. If the syphilis remains untreated ulcers develop in the whole body in the last phase after years. The organs, skin and nervous system can be damaged, deformations of the skin and painful changes in the nerves may occur. Syphilis can be easily treated with antibiotics at the beginning of the infection.

Using internal and external condoms during vaginal or anal sex as well as oral sex drastically lowers the risk of a syphilis infection.

Scabies

Scabies are small parasites that live in the human skin and trigger a strong itching sensation, especially at night. They are usually transmitted through intense body contact, but can also be transferred through shared clothing, towels, or furniture, especially beds. If a person never had scabies before it can take four to six weeks until symptoms occur. Otherwise symptoms usually appear in one to four days. Scabies is treated with a cream which contains an insecticide. Additionally, an oral antiparasitic treatment can be prescribed.

HIV

The Human Immunodeficiency Virus (HIV) can be transmitted through semen, vaginal secretions, and blood as well as from mother to child during pregnancy, delivery or breastfeeding. HIV triggers attacks and destroys the infection-fighting cells of the immune system. In the acute phase of an infection unspecified symptoms are prevalent which are reminiscent of a flu infection (fever, headache, tiredness). HIV is not curable yet, but medicable. If HIV is left untreated it can lead to the Acquired Immune Deficiency Syndrome (AIDS), which is the most advanced stage of a HIV-infection. Because of the shattered immune system diseases occur which don’t normally occur in people with a healthy immune system. These diseases can be fatale.

U = U (undetectable = untransmittable): If the viral load in the blood of an HIV-positive person is below the detection limit, this person cannot transmit the HI-Virus and is therefore not infectious.

PrEP (pre-exposure prophylaxis): PrEP is a pill which is recommended for situations with a higher infection risks such as having a HIV-positive partner. Most of the times PrEP is taken once a day over a long period of time and prevents a HIV-transmission.

PEP (post-exposure prophylaxis): If an unprotected vaginal or anal intercourse with a HIV-positive person has occurred (such as a ruptured condom), a HIV medication regimen can be started for up to 72 hours later (but the sooner the better) to prevent an HIV-infection.

Using internal and external condoms prevents a transmission.

HPV

The human papillomavirus (HPV) can cause warts (papillomas) on or around the genitals and anus as well as cervical cancer and other anogenital cancers. HPV can also be responsible for warts and cancer in the mouth and throat region.

Approximately 60-80% of humans come in contact with the virus at least once in their lifetime, most of them through sexual contact. In 95% of the cases, there are no symptoms present, the human immune system usually eliminates the virus after a few months.

A vaccination is available that protects against the most common types of viruses. Condoms as well as femidoms only partially protect against HPV, because skin-to-skin transmission is still possible.

Safer sex Toolbox

We recommend using suitable safer sex tools such as external condoms, internal condoms and dental dams for every sexual contact. An open-minded talk about sexually transmitted infections (STIs) helps you take care of your sexual health. We thus advise you to speak with every partner about their attitude towards testing and risk-promoting behaviour. Regarding testing, it is good to clarify when the person has been tested and for which STIs. To evaluate potentially risky behaviour, it is relevant how many people the person in question has been in sexual contact with, whether safer sex barriers were used and what kind of sexual contact occured.

The correct use of safer sex methods and regular check-ups on your sexual health with the help of STI tests reduce the risk of an infection with STIs for you and your partners.

External condom

The external condom is made of latex or another latex-free material and is rolled onto an erect penis or sex toy.

When selecting a condom, pay attention to choose the correct size. The condom should be easy to put on and fit smoothly and comfortably without being loose. If it is loose, you could be risking that is slips off. If it is too tight, your sexual experience will be curbed. When changing between anal and vaginal intercourse, remember to always use a new condom.

Internal condom

The external condom is inserted into the vagina or anus prior to penetration. If you are using an internal condom for anal intercourse, make sure to remove the condom’s inner ring. When inserting the penis or sex toy, it is important not to miss the condom or push it completely inside the opening.

Dental dam

A dental dam is a thin sheet of latex (latex-free alternatives exist) that is used a barrier between mouth and vulva or anus during oral sex. You can use a prefabricated dental dam or make one yourself from a condom.

Gloves

Single-use gloves made of latex, vinyl or nitrile, which are also often used in medicine or gastronomy can be used for sexual play. They protect the mucous membrane of the anus and vagina from being torn by your fingernails and thus reduce the risk of transmitting STIs. They furthermore protect from anal or vaginal residue on fingers (and under fingernails) and promote hygiene. It is advisable to have different colored gloves when playing with multiple people.

Lube

When choosing lubricants there are 3 possibilities.

Water based lubes are especially versatile and are recommended for use with condoms, internal condoms, dental dams, gloves, as well as toys. Since they are based on water they dry out more quickly and have to be re-applied regularly. Moreover they are easily washed off by water which does not make them suitable for play in the shower or similar situations.

Silicon based lubes provide a substantially longer duration of slipperiness when compared to water based ones. They also can be used with various means of protection but shouldn't be brought into contact with silicone toys since they can then be damaged.

Oil based lubes can’t be used with regular latex-barriers like condoms because the oil damages them and will put you at risk of contracting an STI. If you want to use an oil based lube, make sure your condoms and other barriers are latex free.

Generally avoid using household oils like baby oil, massage oil, food oils or vaseline. Just like oil based lubes, they can damage the employed barriers and make them permeable to STIs. Moreover, said products often contain substances that can negatively affect the vaginal flora and leave you more prone to infections.

More Information

Be aware of INCUBATION PERIODs of certain STDs - I usually recommend a 6 weeks minimum waiting period. It should be noted things like HIV and Hepatitis can take 2 to 3 months to be detectable. This is also a reason why regular testing does not free from responsible behaviour. The last test a partner shows you might be negative, but an infection in a risky situation 2 weeks before the test would not be recognized.

Here’s a helpful infographic for this: https://www.stdcheck.com/blog/how-soon-get-tested-for-stds-unprotected-sex

Having no SYMPTOMS does not mean being in the clear. One can carry STDs like Gonorrhea and Chlamydia without showing any symptoms: http://www.self.com/story/stds-you-can-have-without-knowing-it

For those unsure which testing methods are best, here’s a 2016 article on differences between urine and swab testing methods: https://www.verywell.com/urine-testing-for-gonorrhea-and-chlamydia-3132777

Also for urine testing, go test directly after waking up or bring morning urine (better results)

If you have a concrete suspicion / symptoms of having contracted something in your pussy or asshole, a smear test (Abstrich) is recommended, additionally to blood / urine testing.

 

Credits

An initiative from the non-profit Association Sex-Aware

More Infos: www.Sex-Aware.org

Information for Germany and Safer Sex Guide : Marc Seestaedt
Marc’s Article in German