Travel may serve to broaden the mind, but it can also have a profound impact on our sense of good judgment. Surprising recent data shows that many people who practice safe sex at home throw caution out the window while traveling, and that more than 60% of travelers of both sexes choose to engage in casual sex during a holiday abroad, often without the use of a condom or any other form of protection at all. The result of all this lack of restraint can be shocking—World Health Organization figures show that more than one million sexually transmitted infections (STIs) are contracted every day all around the world. So what are the STI risks for travelers?
Most people know that anyone—whether traveling or not—who practices unprotected sex is at risk of catching an STI. This is something that is regularly in evidence at our own medical center, where patients often present with symptoms of STIs, such as urinary discomfort, penile discharge or a genital rash. Even patients who have no symptoms at all tend to turn up at our reception after the glow of an amorous encounter fades—and the reality sinks in about what the consequences may be.
Most cases are seeking to be tested for STIs as soon as possible in order to relieve the anxiety of not knowing their status. While the biggest fear factor for many of these patients is the specter of HIV and AIDS, there are still a large number of other potential infections out there that can be transmitted during unprotected sexual encounters.
Unfortunately, the majority of these infections have no apparent symptoms—or only mild symptoms that may not be recognized as an STI even by a doctor. This can make identifying an STI problematic, especially in cases where a patient is reluctant to reveal their potential risk.
The list of infectious agents known to be transmitted through sexual contact is not short.
There are eight that are linked to the highest incidence of sexually transmitted infections, four of which are treatable:
- Bacterial infection of the genital tract, mouth, eyes, or anus.
- Symptoms usually occur within 10 days after exposure.
- Some people may be infected for months before signs or symptoms occur.
- Signs and symptoms may include thick, cloudy or bloody discharge from the penis or vagina; pain during urination, heavy menstrual bleeding or painful bleeding between periods, swollen testicles, painful bowel movements and anal itching.
- Bacterial infection of the genital tract.
- Symptoms will generally occur (if any show up at all) between 1–3 weeks after exposure.
- Difficult to detect in the early stages.
- Signs and symptoms may be mild and passing, making them easily overlooked. They may include pain during urination, lower abdominal pain, vaginal or penile discharge, pain during sex (in women), bleeding between menstrual periods, and testicular pain.
- Highly contagious bacterial infection (Treponema pallidum).
- Virtually no symptoms beyond sores that can easily be overlooked.
- Increasingly common among gay men.
- Signs and symptoms may include small, painless ulcers around the mouth, genitals, or elsewhere on the body; Rashes on the hands or feet.
- The infection can lie dormant for many years.
- Late stages include severe heart and nerve problems, gigantic open sores, paralysis, blindness, dementia, deafness, and death.
- The disease can spread to unborn children causing birth defects and miscarriage.
- Microscopic, single-celled parasite infection (Trichomonas vaginalis)
- Usually infects the urinary tract in men without symptoms.
- Causes mild to severe vaginal irritation within a week to a month after exposure.
- Signs and symptoms may include clear, white, greenish or yellowish vaginal discharge, discharge from the penis, a strong vaginal odor, vaginal itching or irritation, itching or irritation inside the penis, pain during sex, and pain during urination.
The other four are incurable viral infections:
- A serious liver infection caused by the hepatitis B virus (HBV).
- For some people, the infection becomes chronic, lasting more than six months.
- Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that permanently scars the liver.
- Signs and symptoms may include abdominal pain, dark urine, fever, joint pain, loss of appetite, nausea and vomiting, weakness and fatigue, jaundice.
- A viral infection that typically affects the mouth, genitals, or anal area.
- It is contagious and can cause outbreaks of sores and other symptoms.
- It is a highly prevalent infection globally, with the most common type affecting around 3.7 billion people under the age of 50 years.
- It spreads rapidly through direct contact with a person who carries HSV.
- The majority of people with HSV will not show any symptoms at all, but they can still pass on the virus.
- The symptoms of HSV are typically mild but can cause discomfort.
- Signs and symptoms may include tingling, itching, or burning before blisters appear; painful, fluid-filled blisters on the penis, vagina, buttocks, or anus; flu-like symptoms; Fever; muscle aches; problems urinating.
- Viral infection that impairs immunity
- Can lead to AIDS
- Usually persons contracting HIV develop a flu-like illness within weeks after infection, but this can be overlooked by the patient (or even by the doctor) as the symptoms are not specific. Some people will not develop early symptoms at all.
- Only laboratory testing can establish a person’s HIV status
- Early HIV signs and symptoms may include fever, headache, sore throat, swollen lymph glands, rash, fatigue
- Early signs and symptoms of HIV are short-lived. A person with early symptomatic HIV is highly infectious. Longer-lasting and severe symptoms of HIV may not appear for another ten years, during which time you will remain a carrier of this disease.
- Most sexually active men and women will contract the HPV virus at some point during their lifetime.
- HPV can be spread through oral, vaginal, or anal sex.
- It can result in genital warts and some types of cancer.
- Sometimes, HPV can be transmitted during birth to an infant causing genital or respiratory system infections.
- Safe and effective vaccinations are recommended at the age of 11 to 12 years.
These incurable viral infections can be reduced or modified through treatment.
Prevention and Treatment
How can we prevent spreading STDs? While abstinence remains the only certain method, those who are sexually active should pay attention to some reminders:
- Get vaccinated against Hepatitis A and B before you travel
- If you do have sex, wear good-quality condoms
- Be cautious when having sex after drug or alcohol use—you are more likely to take risks.
If you do think you may have put yourself at risk of contracting an STI, you need to seek medical testing—especially if you’re here short-term and don’t want to carry an infection back home.
Family Medical Practice medical center provides an anonymous testing and treatment service with rapid turnaround of results.
Dr. Serge Gradstein
Infectious Diseases and Sexual Health
A French native with over three decades of experience in medicine, Dr. Serge Gradstein received his MD from the Rene Descartes University Paris 5, and completed his residency in infectious diseases at Soroka Hospital following his work in the largest HIV clinic in the country.
Dr. Christopher Mandani Suazon
General Practitioner, Danang Medical Director
With a great passion for the breadth of experience to be gained by working in general practice, Dr. Christopher Mandani Suazon is FMP’s Danang-based medical director. A self-professed all-rounder, he believes that the diversity of knowledge that comes with this profession is one of his key strengths.