Cases of gonorrhoea in England have reached record highs, while syphilis cases are at the highest level since just after the Second World War, according to the UK Health Security Agency (UKHSA). Gonorrhoea diagnoses rose to 82,592 in 2022, an increase of 50.3% compared to 2021, while infectious syphilis cases increased to 8,692 in 2022, the largest annual number since 1948. As well as gonorrhoea and syphilis, it’s important to be aware of the risk around all sexually transmitted infections (STIs) including chlamydia, genital herpes, genital warts and HIV. As Dr Hamish Mohammed, consultant epidemiologist at UKHSA, pointed out: “STIs aren’t just an inconvenience – they can have a major impact on your health and that of any sexual partners.” Here, sexual health experts talk through what you need to know about STI prevention, testing and treatment… 1. Anyone can potentially get an STI “Don’t think that because you haven’t caught one in the past – or because you only sleep with people that you don’t think have STIs – that you are immune, because the truth is that no one is,” Sarah Mulindwa, a specialist sexual health nurse who is working with Lovehoney, told PA Media. Regardless of gender, sexual orientation, whether you have lots of partners or you’re in a monogamous relationship, anyone can potentially get an STI. And they affect all age groups, too. “There’s no upper age limit on getting an STI,” Julie Bowring, consultant gynaecologist in sexual and reproductive health at London Gynaecology, added. The number of common STIs caught among the over 65s in the UK increased by 20% from 2017 to 2019, according to the Local Government Association. This may in part be due to differences in health awareness. “When that generation of patients were at school, they didn’t get quite as good and comprehensive sexual health education as we get now,” Bowring said. “And if you look at all the media campaigns for sexual health infections, it’s usually targeted at a younger demographic.” 2. Not all contraceptives protect against all STIs “It’s a common myth that when you’re on regular contraception, you might have protection against STIs,” said Bowring. “I think that can sometimes be missing in information that’s given to patients when they start contraception.” While birth control methods such as the pill, coil or IUD will protect against unintended pregnancy, they won’t protect against STIs. “Condoms [or dental dams] are the only effective method of protecting against STIs if you are sexually active,” said Mulindwa. “And even then, only when you use them correctly: wearing one to cover the whole length of the penis, and using from start to finish of sex, including during oral, anal, or vaginal penetration.” 3. Symptoms can vary greatly With a wide range of symptoms that vary in severity, STIs can sometimes be difficult to spot. “Certain STIs, such as chlamydia for example, might not even present any symptoms in the person that has it,” Mulindwa explained. “If you are experiencing any form of discomfort in and around your genitals, then it is imperative that you get tested right away.” Other signs may include an unusual discharge from the vagina, penis or anus; pain when peeing; lumps or skin growths around the genitals or anus; a rash; unusual vaginal bleeding; itchy genitals or anus; and blisters, sores or warts around these areas. “It can be quite difficult for women to sometimes know when a symptom might be STI related,” added Bowring. “It could be their periods, it could be something non-STI related. If there is a risk of infection and you have noticed a change in either your discharge or your pain, then it is worth getting checked out.” 4. Routine testing is a good idea Because some infections don’t result in any symptoms, routine testing is important. “If you’ve changed partner then it’s a good idea, if you haven’t had STI screening, to attend your local service to get that done,” Bowring advised. Home testing kits are also available with swabs and finger-prick blood tests. “It’s recommended that you screen at least every six months for the most common infections – chlamydia and gonorrhoea – and yearly for blood tests to screen for HIV, syphilis, and hepatitis C,” Mulindwa added. “Depending on your risk factors, you may need to screen more frequently.” 5. Treatments are available STIs are extremely common and there’s no need to feel embarrassed or ashamed if you do catch one, and treatments are available. “The majority of STIs are curable, and even those that aren’t – for example, herpes – have treatments available to manage outbreaks,” said Mulindwa. “Some STIs like chlamydia are treatable with a course of antibiotics, and others require creams and ointments.” 6. Options for people with HIV have come a long way Thanks to scientific breakthroughs, providing they have access to treatment, most people with HIV will not develop any AIDS-related illnesses and can live full lives. “There are now options available that can stop HIV reproducing in the body and prevent you from passing it on, as well as drugs designed to prevent infection if you have been exposed,” said Mulindwa. “People who are HIV positive and are undetectable (which means the level of the virus is very low) are unable to pass it on even when they have unprotected sex.” A relatively new drug called Pre-Exposure Prophylaxis (PrEP) – designed to reduce the chance of contracting HIV – can be helpful for people who may be at increased risk. Health professionals at NHS sexual health clinics can talk you through the options for preventing and managing HIV. 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