Sexually Transmitted Diseases

Part 2: Viral Infections

Maggie Smith

(The Gender Centre advise that this article may not be current and as such certain content, including but not limited to persons, contact details and dates may not apply. Where legal authority or medical related matters are cited, responsibility lies with the reader to obtain the most current relevant legal authority and/or medical publication.)

There are many viral sexually transmissible infections. In this, part 2 of an overview of S.T.I.s, I will discuss some of the main viral S.T.I.s that people may be concerned about. The article on viral S.T.I.s will appear in two parts. In this article I will discuss the viruses tested for with a blood test. These are H.I.V., Hepatitis A and B. I will also briefly discuss Hepatitis C although this is not a sexually transmitted virus, as I will explain later. I am dividing the viral S.T.I.s over two parts as there are many viruses it is possible to pass on during sexual contact and a lot of information to take in.

This article is to be used as a reference. If you have any question or concerns regarding your sexual health please contact your doctor or sexual health clinic.

Human Immunodeficiency Virus (H.I.V.) and Acquired Immune Deficiency Syndrome (AIDS)

Human Immunodeficiency Virus (H.I.V.) is a virus which affects certain immune cells in the body. Acquired Immune Deficiency Syndrome (AIDS) is a group of infections and cancers which occurs as a result of a severely weakened immune system in people who are infected with H.I.V. AIDS usually occurs about ten years after a person becomes infected with H.I.V., or earlier if they have high levels of the virus in their blood. H.I.V. antiretroviral treatments can prevent AIDS in most people.

A person with H.I.V. can pass on the virus to someone else by the exchange of body fluids such as blood, semen, vaginal fluids and breast milk. This can occur by vaginal or anal sexual intercourse without a condom, sharing drug injecting equipment or from an infected mother to her baby during pregnancy, childbirth or breastfeeding.

H.I.V. has never been proven to be transmitted by kissing or cuddling, shaking hands, social contact, sharing knives and forks, cups or glasses, toilet seats or mosquitoes. H.I.V. is not transmitted in urine, faeces, saliva, sweat, tears or phlegm unless there is blood present.

Some people may experience a severe cold or flu, swollen or sore glands and general malaise, (feeling generally tired and unwell), when infected with H.I.V. It is, however, important to note that many people do not know they have been infected with H.I.V., they may have no signs or symptoms of it

What is the test for H.I.V.?

H.I.V. is tested for with a blood test. The window period (the period of time needed to be certain to be certain a person has not been infected) for H.I.V. is three months. Some countries offer "rapid" testing or testing with a saliva test. These tests have not been validated or approved in Australia and are therefore not used or encouraged.

Treatment

There is no cure for H.I.V. H.I.V. management has greatly improved and there are many treatment options to prevent H.I.V. becoming AIDS and maintaining a person's health but it is a virus that infected people will have for the rest of his or their lives.

Hepatitis A and B

Hepatitis is inflammation of the liver caused by any of the hepatitis viruses.

Hepatitis A is passed from one person to another when faeces from an infected person are transferred to another person's mouth. This can occur during anal sex especially during anal/oral contact, such as rimming. Hepatitis A can also be from contaminated food or water (such as water supplies, contaminated with sewerage, used for drinking in some countries.

The average time between exposure to the hepatitis A virus and developing symptoms is about twenty-eight days. Symptoms may begin suddenly or gradually. The most obvious sign of hepatitis is jaundice, when the eyes and/or the skin turn yellow, urine becomes darker and faeces is lighter in colour. Other common signs of hepatitis include fatigue, loss of appetite, nausea, vomiting, abdominal pain and fever.

These symptoms will resolve after a few weeks to several months. It is important at this time to avoid alcohol, paracetamol and recreational drugs.

Infected people can transmit the virus from two weeks before they develop symptoms until approximately one week after they develop jaundice, approximately three to four weeks in total. Following acute hepatitis A and recover, people develop natural immunity. This means they cannot be infected with the hepatitis A virus again. It does not go on to cause possible lifelong infections like Hepatitis B or C.

Hepatitis B

Hepatitis B is a virus which can cause inflammation of the liver. It is more infectious sexually than H.I.V. and more common globally. The Hepatitis B virus is transmitted by vaginal, anal or oral sex without a condom, sharing needles, syringes and other injecting equipment, by an infected woman to her child during birth, sharing toothbrushes, razors or personal items that may lead to the exchange of bodily secretions such as blood and saliva with a person infectious with the virus.

Symptoms usually develop within two to six months after the exposure. Many adults will have no symptoms while others may experience a mild flu-like illness, nausea and vomiting, abdominal pain and jaundice (yellowing of the skin and whites of the eyes).

Most adults who acquire Hepatitis B will recover, and develop lifelong immunity. These people are no longer infectious. About five per cent of adults remain infectious for many years and are called "carriers" of Hepatitis B.

Acute Hepatitis B is occasionally so severe it can be life threatening. Long term H.B.V. carriers may suffer chronic hepatitis which may predispose to cirrhosis (scarring of the liver), liver failure and cancer of the liver.

What are the tests for Hepatitis A and B?

Hepatitis A and B viruses are tested for with a blood test.

Vaccinations

There are vaccinations available for both Hepatitis A and B. A blood test can determine if you have been vaccinated or are immune to hepatitis A and/or B. Vaccinations for these viruses are made from an inactive form of the virus, which means a person cannot get hepatitis from the vaccination. If a person is not immune to either virus a combined vaccination is available if required. It is best to discuss the need for which type of vaccination required with your health practitioner.

Hepatitis C

Hepatitis C is not classed as a sexually transmitted infection.

I will briefly discuss Hepatitis C as it is easy to be confused by the different types of hepatitis. Hepatitis C is transmitted by blood to blood contact. It is not transmitted in other body fluids unless blood is present in these. There have been cases of Hepatitis C being transmitted through sexual contact, however there was most likely blood to blood transmission in these cases (such as sex during menstruation or "rough" sex where bleeding has occurred and cuts or abrasions are present on the other partner. Some "kink" or S&M practices, such as cutting or needle work that cause bleeding increase the chance of Hepatitis C being transmitted. Sharing needles and any kind of injecting equipment for injecting drug use is the biggest risk for transmission of Hepatitis C.

How is it tested?

Hepatitis C is tested for with a blood test. The window period (amount of time needed to be certain a person has not been infected) is six months.

Treatment vaccinations

There are effective treatments for some types of Hepatitis C. If a person has any concerns or questions contact the Hepatitis C Council of N.S.W.

There are no vaccinations for Hepatitis C. Therefore prevention is best. If a person is involved with any sexual practices that may involve blood, gloves should be used. Do not share or re-use any sharp or potentially contaminated equipment. If a person injects drugs, either for recreational use or therapeutic (e.g. injecting hormones), do not share any equipment, needles, tourniquets or even swabs.

In the next article I will discuss other viral S.T.I.s such as genital warts, herpes and molluscum. Please remember that these articles are not about trying to put a person off sex or scare anyone. They are intended as education, so that sex can be both enjoyable and safe.

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