ABC Guide to Travel Health - Vaccines, Vaccinations

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Sexually transmitted infections (STIs)

Common STIs include: syphilis, gonorrhea, Chlamydia infections, trichomoniasis, chancroid, genital herpes, human papillomavirus, genital warts, HIV/AIDS and hepatitis B.47 Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. STIs are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, untreated disease (with or without obvious lesions) increases the risk of HIV infection and transmission.47

Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilised instruments used for acupuncture, piercing and tattooing.

Geographic Distribution47
Worldwide. An estimated 340 million episodes of curable sexually transmitted infections (i.e. chlamydial infections, gonorrhea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers47
Lack of information about risk and preventative measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to STIs. In some developed countries, a large proportion of STIs now occur as a result of unprotected sexual intercourse during international travel.

Precautions and prevention47

  • Sexual abstinence or sexual intercourse between mutually faithful uninfected partners can eliminate STI risk.
  • Vaccination against hepatitis B. No prophylaxis is currently available for any of the other sexually transmitted diseases.
  • Male or female condoms, when properly used, have proved to be effective in preventing the transmission of many, but not all sexually transmitted infections.
  • As hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments should be avoided. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor’s authorisation for their use.
  • Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home.

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