Chlamydia, gonorrhea, syphilis

Chlamydia can be spread by all kinds of sex including oral and anal. It can also be spread by activities like fisting and fingering. Touching any part of your (or your partner’s) body that is infected with chlamydia and then touching your partner’s (or your) genitals or butt can spread chlamydia.

Not everyone who has chlamydia will show symptoms, especially if the site of infection is the butt or throat. Symptoms can include a dry or sore throat, itchiness and pain when you poop, pain when you pee, or a clear or yellow discharge from your penis or vagina. Throat infections can also cause discharge, but this is less common. Chlamydia symptoms usually take about a week to show up.

A medical practitioner can diagnose chlamydia by swabbing (collecting specimens from) your throat or butt. Some practitioners also allow you to do your own swabs. Urine tests are usually used to test for chlamydia infection in the urethra. Swabbing the areas you use for sex is important.

At San Francisco AIDS Foundation, we routinely test for chlamydia, but make sure to tell one of our providers if you are experiencing any of the symptoms or if one of your partners was recently diagnosed with an STI.

We can cure a chlamydia infection with antibiotics. If you had sex while you were infected with chlamydia, your sexual partners should also get tested for chlamydia and treated if they are infected.

You can lower the risk of getting chlamydia by using condoms. But condoms sometimes don’t cover all infected areas so there’s a chance of still getting or passing on chlamydia even when condoms are used.

For a person who is HIV-negative, having chlamydia can make it more likely that they will be infected with HIV if they are exposed to the virus. Be sure to get tested every 3 to 6 months as part of maintaining your sexual health.

Gonorrhea typically involves the mucous membranes and can be spread during all types of sex like anal, front hole, vaginal and oral in addition to fingering and fisting. Touching any part of your (or your partner’s) body that is infected with gonorrhea (i.e., eyes, penis, vagina or butt) and then touching your partner’s (or your own) eyes, penis, vagina, front hole or butt can spread gonorrhea.

For instance, if your partner has a gonorrhea infection in their penis and strokes their penis and fingers your butt before anal sex, you can get gonorrhea even if they’re wearing a condom while they’re inside you.

Some people may not have any symptoms of gonorrhea. However, some people may experience:

• Pain or burning when they urinate
• Discharge from the penis or vagina
• Painful or swollen testicles (this is less common)
• Vaginal bleeding between periods
• Anal discharge, soreness, bleeding or itching
• Pain when you poop
• Dry or sore throat, or discharge in your throat (this is less common)

Symptoms can take between two and 10 days to show up.

At San Francisco AIDS Foundation, we routinely test for gonorrhea. Make sure to tell one of our providers if you are experiencing any of the symptoms above or if one of your partners was recently diagnosed with an STI.

We can cure a gonorrhea infection with antibiotics. But you shouldn’t have any sex for seven days after you start your antibiotics to make sure the infection goes away.

There are strains of gonorrhea that are resistant to antibiotics. This means the bacteria are no longer killed by a drug that used to kill them before. The Centers for Disease Control and Prevention recommend that we continuously monitor for antibiotic resistance and encourage the research and development of new drugs for gonorrhea treatment.

Using a condom when you have sex can help prevent you from getting gonorrhea if the area that’s infected is covered. But condoms don’t always cover the entire area that’s infected, so there’s always risk of getting or transmitting gonorrhea. For instance, you can get gonorrhea during oral sex if you touch an infected area and then touch your own penis, vagina, front hole, butt, or eyes.

If you have HIV and get gonorrhea:

• Your symptoms or complications from gonorrhea might be more severe.
• Your HIV disease might progress faster.
• There’s a chance you might develop severe arthritis or keratoconjunctivitis, a severe inflammation of the membrane that covers the eye.

If you don’t have HIV but do get gonorrhea:

• You might be more susceptible to HIV infection during sex.

You can get syphilis by touching a sore caused by syphilis, called an ulcer or chancre, on another person. People who have syphilis usually get ulcers (deep sores) on their genitals or butt or inside their rectum. People can also get ulcers on their lips or in their mouth, which means that it’s possible to get syphilis by kissing someone with syphilis if the person has mouth sores.

Many times, people with syphilis don’t know they have it because they don’t develop any symptoms. When people do experience symptoms, they usually happen in three stages.

Primary Stage:
Three weeks after you’ve been infected, on the part of your body where you were infected (usually on your penis, testicles, vagina, vulva, mouth, throat, rectum or in your butt), you’ll develop an ulcer (deep sore). It is usually not painful, though uncommonly it might be painful. It will scab over, then heal. Even if you don’t do anything about the sore, it will go away on its own but the infection will progress to the next stage.

Secondary Stage:
Two to six months after you were infected, you may develop a rash on the palms of your hands, the soles of your feet, or involving other parts of your body. Often the rash involves the chest, abdomen, and back, though the appearance of the rash may vary. You also might get a fever, have a sore throat, lose your hair in patches, have headaches, have swollen lymph glands, lose weight, be tired or have muscle and joint aches. This can go on for weeks or more without treatment, but without treatment, the infection will progress to the next stage.

Tertiary (Third) Stage:
Without treatment, a syphilis infection will begin to damage your internal organs and other parts of your body such as the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. This kind of damage might not be noticeable for years, and might be serious enough to cause death.

Even when a person with syphilis doesn’t show any symptoms, they are still able to transmit syphilis to others.

Individuals with any stage of syphilis can experience damage to the brain or nervous system, which is called neurosyphilis. If you have syphilis, your provider should ask you about and check you for symptoms or signs of neurosyphilis. Those found to have this kind of neurologic involvement require extended treatment with intravenous (IV) antibiotics, which usually requires admission to the hospital.

Syphilis is diagnosed with a blood test. If you’re having sex, get tested for syphilis, gonorrhea and chlamydia every three months.

Syphilis can be treated and cured with antibiotics like penicillin if the infection is diagnosed early on. Other drugs are used if a person with syphilis is allergic to penicillin.

Prevent syphilis transmission by not touching another person’s syphilis sores or lesions. Condoms, dams or gloves that cover sores or rashes will help prevent infection.

If you’re on treatment for syphilis, wait to have sex with other people until your sores are completely healed or at least 7 days following antibiotic therapy.

People with HIV who get syphilis:

• May be more likely to get an incorrect syphilis test result (e.g., a false positive or negative), although this is rare
• Can experience worse syphilis symptoms (quicker progression and earlier damage to the brain)
• Can experience a faster progression from HIV to AIDS with decreased CD4 counts (a marker of immune health) and increased viral loads