Sexually Transmitted Diseases (STDs)
	Know before you go!
	Disease profile
	Transmission
	Geographic distribution
	Symptoms
	Treatment
	Vaccination
	Specific STDs  •  Chancroid  •  Chlamydia  •  Genital warts (HPV)  •  Genital herpes (HSV)  •  Gonorrhea  •  Hepatitis B & C  •  HIV/AIDS  •  Intestinal infections  •  Pubic lice & scabies  •  Syphilis  •  Vaginitis
	Prevention & precautions
	Some things to think about

Sexually Transmitted Diseases (STDs)

Updated: January 2001

Know before you go!

Infectious diseases not necessarily common in Canada can occur and may even be widespread in other countries. Standards of hygiene and medical care may differ from those at home. Before departure, you should learn about the health conditions in the country or countries you plan to visit, your own risk of disease and the steps you can take to prevent illness.

The risk is yours
Your risk of acquiring a disease depends on several factors. They include: your age, gender, immunization status and current state of health; your itinerary, duration and style of travel (e.g., first class, adventure) and anticipated travel activities (e.g., animal contact, exposure to fresh water, sexual contact); as well as the local disease situation.

Risk assessment consultation
The Public Health Agency of Canada strongly recommends that your travel plans include contacting a travel medicine clinic or physician 6 to 8 weeks before departure. Based on your individual risk assessment, a health care professional can determine your need for immunizations and/or preventive medication (prophylaxis) and advise you on precautions to avoid disease. We can help you locate a travel medicine clinic closest to your home.

Some facts from the experts
The information below has been developed and is updated in consultation with Public Health Agency of Canada's Committee to Advise on Tropical Medicine and Travel (CATMAT). The recommendations are intended as general advice about the prevention of measles for Canadians travelling internationally.

Sexually transmitted diseases (STDs) are caused by different infectious microorganisms including bacteria, viruses and parasites, which are transmitted through semen, vaginal fluid, blood or other body fluids during sexual activity.

STDs occur worldwide, and range in severity from a nuisance to life-threatening. Some are easily cured, but others, if not treated or if incurable, can have serious effects on your health. Possible consequences include infertility, ectopic pregnancy, cirrhosis of the liver, birth defects in children and cancer. Some STDs, such as HIV/AIDS, can be fatal.

Click here for information about a number of specific STDs, including:

• Chancroid
• Chlamydia
• Genital warts (HPV)
• Genital herpes (HSV)
• Gonorrhea
• Hepatitis B & C
• HIV/AIDS
• Intestinal infections
• Pubic lice & scabies
• Syphilis
• Vaginitis

General information on transmission, symptoms, treatment and prevention of STDs is available below.

Transmission

Some STD infections live in the blood as well as semen and vaginal fluids, and therefore can be spread in several ways. STDs are primarily transmitted through sex-related activities, such as:

• unprotected vaginal, anal or oral sex; and
• close skin-to-skin contact with an infected area anywhere on the body.

Some STDs can be transmitted from mother to child through pregnancy and childbirth (e.g., HIV, gonorrhea, hepatitis B).

Transmission of STDs may occur if an individual has sex with a person who has, or has had, an STD infection. The risk of being exposed to an STD increases if an individual:

• has sex with strangers or commercial sex workers;
• (or his/her partner) has sex with others;
• (or his/her partner) uses injection drugs;
• (or his/her partner) shares needles for body piercing, tattoos or other cosmetic or medical treatments.

At this time, except for hepatitis B, there are no commercially available vaccines to prevent STDs. Moreover, there is no immunity: 'if you get an STD once, you can get it again.'

According to the World Health Organization, an estimated 333 million episodes of curable sexually transmitted diseases (syphilis, gonorrhea, chlamydia and trichomoniasis) occur annually throughout the world. In some parts of the developing world, STDs occur frequently in a large percentage of the population, and many have become resistant to antibiotics, making them far more difficult to treat.

Some people with a STD have few or no symptoms at all; others have obvious symptoms. Be aware of any changes in your health while travelling and after return, such as:

• different or heavier discharge from the vagina;
• discharge from the penis;
• burning feeling when urinating;
• sores, particularly in the genital or anal areas;
• itching feeling around the genitals or anus;
• appearance of a rash;
• swollen glands in the groin;
• sudden onset of flu-like symptoms.

These symptoms might appear alone, or in combination. Refer to Specific STDs (link to new page, Specific STDs) for more details.

Because STDs are caused by various microorganisms, there are a variety of tests that will determine the precise infection. An individual can have more than one STD at a time. Some STDs acquired abroad may be rare in Canada and, as a result, may go undiagnosed.

Many STDs are easily treated, but all can be dangerous if ignored. As well, for most STDs, it is important to ensure that all sex partners receive treatment if an individual is infected. The bacterial infections, such as chancroid, chlamydia, gonorrhea, syphilis, can be treated, but will require different types of medication; that is, no single drug is effective against all bacteria. Furthermore, some bacteria are now showing resistance to standard treatments throughout the world. For viral infections - such as hepatitis B, genital herpes, genital warts and HIV - treatment, when available, may not cure in all cases.

Vaccination

Hepatitis B is the only STD for which a licensed vaccine is available. In Canada, two hepatitis B vaccines and one vaccine for both hepatitis A and B are licensed for use. The vaccines are usually given as a series of three injection doses over six months, and are considered safe and effective.

The anonymity of travel, the sense of isolation brought on by unfamiliar surroundings, and a desire for unique experiences tend to encourage travellers to shed their social and sexual inhibitions.

When travelling, if you have unprotected sex outside of stable monogamous relationship - especially if you are sexually active with overseas nationals - you may be at an increased risk for a variety of STDs. Many STDs have symptom - less periods of some duration when you can spread the infection to others. Therefore, an infected individual may not know he/she is at risk of transmitting disease. Having sex with commercial sex workers can put you at a much greater risk for STDs as these workers are: known to have multiple partners; may have sex with injection drug users or be injection drug users themselves; and may not have access to good medical care.

Recommendations

The Public Health Agency of Canada strongly recommends that travellers practice the following personal precautions to prevent the transmission of STDs:

• Don't have sex (vaginal, oral or anal) with strangers or commercial sex workers, and avoid casual sexual contacts.
• If you are going to have sex with a new partner, use latex (or if allergic, use polyurethane) condoms consistently and correctly for every sexual contact. Before departure, pack your own supply of high-quality latex condoms.

Vaccination against hepatitis B
Hepatitis B vaccination is recommended for travellers who may engage in high-risk sexual activity.

While travelling or after your return, if you think you may have a STD (i.e., you have symptoms), or you have engaged in activities that may have placed you at risk for a STD (i.e., you have no symptoms), seek medical attention.

Sexual violence while travelling
The occurrence of sexual violence varies around the world. Sexual assault and rape can be traumatic and bewildering for the victim, particularly when travelling overseas. If you are raped or assaulted, seek medical attention immediately so that STD counselling can be provided. Travellers should be aware that some medical services overseas may not be up to Canadian standards. The Consular Services of the nearest Canadian Diplomatic or Consular Mission can assist you with medical and emergency services.

1. People tend to shed their normal social and sexual inhibitions when they travel.
2. They often feel anonymous, isolated and adventurous.
3. Sexually transmitted diseases occur worldwide, and some are fatal.

Your behaviour can determine your risk of acquiring STDs. Discuss your planned activities and itinerary, along with your risk of sexually transmitted diseases, with a travel medicine physician before departure.

For more information...

• More details on specific STDs, click here.
• More HIV/AIDS information, click here.
• General information about immunizations recommended for travel outside of Canada, click here
• More Know before you go! information, click here.