Are STIs transmitted through sharing of food, utensils, toilet seats or through handshakes?

No. STIs cannot be transmitted through sharing of food, eating utensils, toilet seats or swimming pools or through shaking hands. The organisms causing STIs usually cannot survive outside the human body.

Can STIs be contracted through kissing?

Dry kissing is generally safe. Some STIs can be transmitted through deep, wet kissing. Syphilis, gonorrhoea, chlamydia and herpes may be present in the mouth/throat of infected persons. However, STIs are not commonly transmitted through kissing.

Can a person be infected with more than one STI?

Yes, this is possible and not uncommon. This is why it is always important to be tested for other STIs if you have already been diagnosed with one.

Can someone inherit an STI from his or her parents, i.e. is it a genetic disease?

STIs are acquired infections; they are not inherited. However, mothers with STIs can pass on their infection to the baby during pregnancy, delivery or breastfeeding. Early treatment of an infected pregnant mother can prevent infection in her baby.

What are the common symptoms and signs of STIs?

STIs may present in a number of ways. The common symptoms of STIs are:

• Genital discharge (from the urethra or the vagina)

• Dysuria (pain on passing urine)

• Genital sores or ulcers (these may be painful or painless)

• Blisters on genitals

• Growths on genitals

• Swelling of lymph glands (in the groin)

• Rash on genitals and other parts of the body

Sometimes an infection can present in the absence of any symptoms or signs. This is called an asymptomatic infection.

Do these signs and symptoms occur only in STIs?

Not necessarily. Rashes and growths on genitals may be signs of conditions that are not sexually-transmitted. Similarly not all discharges and dysuria are due to STIs. You should consult your doctor if you develop these signs and symptoms.

How long does it take for the signs and symptoms of STIs to appear after infection?

The incubation period is the period of time from infection to the appearance of signs and symptoms; it can vary among the different types of STIs. Some infections such as gonorrhoea, non-gonococcal urethritis (NGU) and genital herpes have short incubation periods, ranging from 2 days to 3 weeks. The incubation period of other STIs such as syphilis may range from 2 weeks to many months, and that for HIV infections may be several years.

What must you do if you suspect that you have contracted an STI?

See a doctor immediately. Avoid sex as you may pass on the infection. Do not self-medicate.

How soon should you see a doctor after having sex with a stranger?

You should see a doctor as soon as you notice any of the signs and symptoms of an STI. If none of the signs or symptoms occurs, blood tests for syphilis and HIV should be carried out after 4 weeks. Your doctor should be able to provide further advice or order other tests. Do refrain from sexual intercourse until the doctor has given you the all clear. Do not self-medicate as this is usually ineffective and may lead to complications.

What will happen to the signs and symptoms of various STIs if you do not seek treatment?

In some cases, the signs and symptoms of an STI may disappear even without treatment. This does not mean that the infection is cured. Even if you do not show any sign or symptom, the infection may still be present and may spread to the other parts of the body. The infection may begin to invade the internal organs and cause irreversible damage.

Can a person with an STI not show any sign or symptom?

Certainly. All STIs are symptomless during the incubation period. More than 10% of males, and more than half of females with gonorrhoea and chlamydia infection do not show any sign or symptom. Asymptomatic STIs are also more common in individuals who are incorrectly treated i.e. who have self-medicated with antibiotics or those who did not follow prescribed antibiotic treatment. Individuals with an asymptomatic STI can still pass on the infection to their sexual partners.

Are all STIs curable? Why do I need to seek early treatment for STIs?

Bacterial STIs are curable if treated early. Early treatment of an STI prevents transmission to others and also prevents complications. Most viral STIs however are not curable.

Can all STIs be diagnosed or confirmed by blood tests?

Blood tests are useful only for a few STIs. These include syphilis, hepatitis B infection and AIDS/HIV infection. For the other STIs, examination of specimens from the discharge and samples from the skin and mucous membranes are used to confirm diagnosis.

How are STIs treated?

Different STIs are treated differently. Those caused by bacteria are treated with antibiotics; those caused by viruses are treated with antiviral drugs; and those caused by parasites are treated with with antiparasitic drugs. There is no single medication that can treat and cure all STIs. It is therefore important to identify the type(s) of STI before treatment.

Can a person take antibiotics before sex to prevent STIs?

No. Oral antibiotics before or after sex are not useful. Different STIs require different antimicrobial medications. Antimicrobials taken before sex as a preventive measure may actually mask the signs and symptoms of infection in an infected person, if he or she is still carrying the infection. Preventive antimicrobials will also promote the development of resistant organisms. STIs caused by resistant organisms are more difficult to cure. The only recommended prophylaxis against STI before sex is a condom.

Can a person be immunised against STIs? Does a person develop immunity to an STI once he is cured of the infection?

Vaccines are available to prevent hepatitis B infection and human papillomavirus.

​And with the exception of hepatitis B infection, a person can be re-infected despite having been cured of an STI.​​​​

Please note that this article is only for your information and you should always see your doctor if you have developed any symptoms and are uncertain if you have an STI.

Genital Rashes – Non-STI Related

The external genitalia are a common site for rashes, itching, and minor infections. The various possible causes can be discussed under the following categories: (1) Red (inflammatory patches) (2) White patches (3) Skin coloured lumps and bumps.

Endogenous eczema ('sensitive skin')

Red Patches

Patients may already have a history of eczema or 'sensitive skin', or they could initially experience itch that may be caused by a yeast infection, heat, moisture, or any irritant.

Repeated scratching can cause breaks in the skin and secondary infection. Over the scrotum, the skin can become very thickened, and can sometimes resemble 'elephant skin'. This is a process called 'lichenification'.

Treatment consists of topical corticosteroids, antihistamines and avoidance of irritants. Secondary infection of excoriated skin may require a course of antibiotics.

Contact dermatitis

This can occur as a result of irritation or from an allergic reaction to something applied.

The most common irritants are soaps, topical medicaments, urine, faeces and infected or copious vaginal secretions. Irritant contact dermatitis of the genitalia presents with redness and itching.

Lichen planus

This is a disease where the cause is unknown. It can affect the skin, mouth, nails and genitalia. It is usually itchy and causes pinkish or purplish small bumps to appear, sometimes with a lacy white streak on the surface. You should see your doctor if you suspect you have lichen planus. Topical corticosteroids are used for treatment.

Psoriasis

There are usually manifestations of psoriasis elsewhere on the body. Psoriasis is a chronic skin disorder that also affects the scalp and nails. It causes pinkish spots or small patches to appear on the genitalia, and may be itchy and scaly.

Fungal infection

Tinea cruris (jock itch) is caused by a ringworm type of fungus. It affects the groins. Candida is a type of yeast infection that causes vaginal discharge and rash, and also balanitis – an inflammation of the penis. If you have severe or recurrent candidal infections, you should see a doctor and conduct investigations to exclude diabetes.

Plasma cell (Zoon's) Mucositis

This presents as a balanitis in males. It appears as a moist, shiny, erythematous, well-demarcated plaque on the glans penis. It is benign and can be treated with a topical corticosteroid. However, a biopsy is often required to differentiate it from erythroplasia of Queyrat, which is a type of cancer occurring on the penis. Nearly all cases occur in uncircumcised males. Cause of this condition is unknown.

White Patches

Lichen sclerosus et atrophicus

Lichen sclerosus et atrophicus (LSA) and its male counterpart, balanitis xerotica obliterans (BXO) presents as ivory or porcelain-white, smooth and atrophic areas on the genitalia.

The cause is unknown, and it may be present for years before detection.

Treatment is difficult and usually includes the use of potent topical or intralesional corticosteroids, as well as topical testosterone propionate ointment. Circumcision may relieve symptoms in males.

Postinflammatory hypopigmentation

This can follow any inflammatory disorder and does not require any specific treatment.

Vitiligo

These are sharply demarcated areas of depigmentation. Pigment is lacking in these areas.

Skin Coloured Bumps

Pearly penile papules

These present as two or three rows of uniform, flesh-coloured papules running circumferentially around the corona. Onset is typically noted in the 20s and 30s. These things are not infectious and no treatment is required. They are often mistaken for warts.

Vestibular papillomatosis

These are also normal anatomical variants that occur on the mucous membrane of the introitus and labia minora and are often mistaken for warts. They are usually uniformly and symmetrically distributed, and are asymptomatic and require no treatment.

Ectopic sebaceous glands (Fordyce spots)

These are uniformly distributed, 1-2 mm flesh-coloured or yellowish papules that occur on the penile shaft as well as the labial surfaces. No treatment is required.