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He who immerses himself in sexual intercourse will be assailed by premature ageing, his strength will wane, his eyes will weaken, and a bad odour will emit from his mouth and his armpits, his teeth will fall out and many other maladies will afflict him.


Sexually transmitted infections (STIs) are a group of communicable infections, usually transmitted by sexual contact. STIs that have developed a high profile include chlamydia, the most common notifiable disease in Australia and a major cause of pelvic inflammatory disease (PID), HIV infection, syphilis and multi-drug resistant gonorrhoea. Presentations of STIs are summarised in TABLE 109.1; however, most STIs are asymptomatic.

Table 109.1Presentations of STIs and causative organisms1

Key facts and guidelines

  • In Western society most patients with STIs are in the 15–30 years age group.

  • Chlamydia is detected in approximately 1 in 20 young Australians who have screening tests in general practice.2

  • Not all STIs manifest on the genitals.

  • Not all genital lesions are STIs.

  • Chlamydia trachomatis is the commonest cause of urethritis.

  • Up to 50% of men and 75% of women with chlamydia may be asymptomatic.1

  • Gonorrhoea may cause no symptoms, especially in women.

  • STIs such as donovanosis, lymphogranuloma venereum and chancroid occur mainly in tropical countries.

  • HIV infection, which is predominantly sexually transmitted, should be considered in any person at risk of STIs and blood-borne viruses (BBVs). It presents as an acute febrile illness (similar to Epstein–Barr mononucleosis).

  • All sexually active young people aged 15–29 years should be tested annually for chlamydia with a first-pass urine or genital swab.2


  • 3Young people aged 15–29 years

  • Men who have sex with men (MSM), especially:

    • – unprotected anal sex

    • – >10 partners in past 6 months

    • – participate in group sex

    • – use recreational drugs during sex

    • – are HIV-positive

  • Aboriginal and Torres Strait Islander people


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