Sexual health and blood borne viruses
New sexual partnerships and unprotected intercourse is not uncommon in travellers. With the combination of alcohol and adventure people may embark on casual sexual relationships they would not do at home. The World Health Organization (WHO) estimate 1 million people develop an STI every day. Some are treatable many lead to long-term conditions.
Sexually Transmitted Infection
Risk of infection is dependent on sexual activity and the how prevalence of STIs in the population. 10-20% of travellers are estimated to have a sexual encounter with a new partner, particularly young single travellers.
Transmission can occur during intimate skin-to skin contact or unprotected sexual intercourse including oral, vaginal or anal sex. Contact with contained blood can also result in infection (see below).
More common infections are chlamydia, gonorrhoea, syphilis and trichomoniasis. See here more information on specific STIs. Not all STIs show symptoms immediately, so having protected sex is key. Long term complications could include infertility and pelvic inflammatory disease.
Human immunodeficiency virus (HIV) infection is worldwide and in 2021 there were approximately 38 million living with HIV, the majority in Sub-Saharan Africa. Even with medical management this is a long term condition with life implications. If you think you might be at high risk of HIV get help or speak to someone. Pre Exposure Prophylaxis (PrEP) medication can reduce the risk of transmission.
Prevention
Have protected sex this is key to reduce STI risk.
Take condoms with you even if you are not intending on have sexual intercourse especially single, young travellers. Male condoms may be available locally but may be of a different shape and size or maybe counterfeit or not up to European standards. Female condoms and other products may not be available.
Contraception Plan ahead. Long acting contraceptives may get round the problems of taking the pill in changing tie zones and if you get travellers diarrhoea the pill may not work. Emergency contraception may not be available. See International consortium on Emergency Contraception for overseas clinics.
Know how to get medical advice STIs can cause a wide range of symptoms. Get help if you think you have symptomsand make sure you have travel insurance.Infections have differing signs and symptoms but if you feel you have been exposed or display anything worrying seek medical advice.
Blood borne viruses
All travellers may be at risk of exposure. Viruses including HIV, hepatitis B and C are not just sexually transmitted, but also through exposure to infected blood or bodily fluids. This could be onto broken skin, into the blood or into the eyes, nose or mouth.
Sources of exposure
Medical tourism - see here for more information
Planned or in an emergency medical treatment in countries where there are limited medical facilities.
During a blood transfusion / or in blood products
Sharing of needles or injecting equipment
Tattoos or body piercings with non-sterile contaminated equipment
Non-sterile or re-use of medical, surgical or dental equipment
Contaminated items like barbers razors or items used in medical or beauty treatments eg acupuncture needles
Contact sports
Close contact with locals if they have open wounds or your involved in an accident in close proximity.
Minimising exposure and risk
Do not have piercings / tattoos / acupuncture / shaves unless equipment is single use and sterile.
Do not share needles for drug use
Take first aid kits and some have needles, cannulas and giving sets included (You may need a certificate showing its contents for customs clearance)
Safe sex
Travel insurance
Vaccines for STIs
and
Blood Borne Viruses
Hepatitis B - This can be of benefit to many travellers and there are various brands and schedules.
In adults four doses of vaccine are required. The first with second four weeks later and third 8 weeks after the first with a booster at 12 months. There are accelerated dosing schedules if necessary with second dose after one week, then three weeks after first dose with a booster 12 months afterwards.
Human Papilloma Virus (HPV) - HPV are a group of viruses which cause genital warts and various cancers - cervical, penile, anal, vulval and of the head and neck. It has been given in UK schools to 12-13 year old girls since 2006 and boys since 2018. The vaccine is in two doses given 6 months apart. See here for further information.