WDH Mini-Guide on Sexually Transmitted and/or Blood Borne Infections (STBBIs)

STBBI Screening

Getting tested regularly is important for early detection and treatment, preventing transmission to partners, and avoiding serious health complications. Testing is common and is part of a routine health screening for many people. Discuss your sexual history and any symptoms you may have with your healthcare provider so they can recommend the most appropriate tests. Common testing methods include swabs, blood tests, and urine tests.

Many STBBIs have no symptoms (asymptomatic). However, changes such as genital itching, burning when urinating, sores, or abnormal discharge should be investigated if you have risk factors.

Chlamydia and gonorrhea testing are recommended with each new partner, or annually for people under 30 years of age who are sexually active. 

If you have new sexual partners, routinely use alcohol or drugs when having sex, or exchange money, drugs, or a place to sleep for sex, you should consider getting tested every 3 months. STBBIs can be contracted through both same-sex and opposite-sex sexual activity.

Accessing Testing

•  Your primary healthcare provider or sexual health clinic on CAF bases (if available).
• Sexual health clinics in civilian systems (bring your blue cross card).
• Any walk-in clinic in civilian systems (bring your blue cross card).
• Deployed CAF healthcare clinics.
• Self-administered home testing kits (if available in your province/territory or base clinic).

STBBI Treatment

STBBIs can be effectively managed and treated. The treatment aims to eliminate infection, alleviate symptoms, prevent complications, and reduce the risk of transmission to others.

Bacterial STBBIs, such as chlamydia, gonorrhea, and syphilis, are treated with antibiotics.

Viral STBBIs, such as Herpes Simplex Virus (HSV), Human Papillomavirus (HPV), Human Immunodeficiency Virus (HIV), Hepatitis B, and Hepatitis C cannot be cured, but they can be managed with medications (antiviral, antiretroviral), and creams or surgical removal for warts.

Parasites and Fungal STBBIs, such as Trichomoniasis, Pubic Lice (crabs) and Scabies can be treated with medication (some by prescription), creams, and a thorough cleaning of personal items.

STBBI Complications

If left untreated, infections can lead to health-related complications such as infertility, pregnancy loss, birth complications, and constant (chronic) pain. If HIV exposure occurs while another STI is present and untreated, the risk of contracting HIV increases. Certain high-risk strains of HPV can lead to cancers. Regular testing and early treatment help prevent complications.

STBBI Prevention

STBBIs are common and preventable. Regular health screening, consistently using condoms, vaccinations, and medications are options available to reduce risk and prevent transmission.

CONDOMS made from latex or polyurethane are recommended for protection against STBBIs. Lambskin condoms used to prevent pregnancy are NOT recommended for protection against STBBIs because the leather pores are big enough for STBBIs to slip through. Water-based lubrication can be used with condoms, however oil-based lubricants such as petroleum jelly or baby oil should be avoided because they weaken the latex. Condoms must be stored in a safe location between 0 and 38 degrees Celsius to avoid damage and not inside a wallet. Be prepared by storing several condoms for changing before each new sexual act or in case one is damaged or expired.

Vaccines

• Human papillomavirus (HPV) vaccines protect against up to 9 HPV types that can lead to cancers and warts. The vaccine is recommended for all persons aged 9 to 45 years old. Discuss with your healthcare provider if you are older than 45 and have risk factors.
• Hepatitis A and B vaccines often offer lifetime protection against these viruses and are typically given in a series of three doses spread over several months. Alternately, three doses can be given over 21 days, followed by a booster at 12 months, for a total of four doses. Speak to your immunization clinic for more information.
• Meningitis vaccines provide protection against bacteria that causes inflammation of the thin covering (membrane) on the brain and spinal cord. People living in close quarters, such as military dorms, are at higher risk of contracting meningitis because it is spread through respiratory droplets and bodily fluids. Bacterial meningitis progresses quickly (within hours) and has a 10% death rate. Those infected with bacterial meningitis require immediate treatment with antibiotics, and of the survivors, 20% may still have serious health complications. There are several vaccines that offer protection in childhood and in late adulthood. Talk with your immunization clinic about your current level of protection and risk factors.
• Mpox (previously known as monkeypox) vaccination is given in two doses (28 days apart) and is available to those with high risk factors. The Mpox virus belongs in the same viral family as smallpox. It spreads through respiratory droplets and direct contact and usually leads to a painful rash, enlarged lymph nodes and fever. People with Mpox can become very sick, and while most will recover, some are left with long term complications.

Medications

• HIV pre-exposure prophylaxis (PrEP) is a daily medication (antiretroviral) taken by people who do not have HIV but are at a high risk of contracting HIV. When taken as directed, it can reduce the risk of contracting HIV by more than 90% for sexual exposures or 70% for needle exposures. This is very useful for people whose sexual partner is HIV positive (detectable viral load), or for persons who engage in high-risk sexual behaviors. PrEP is available by prescription and requires a full STBBI screening before starting and every 3 months while taking the medication. Before stopping PrEP, discuss with your healthcare provider to assess when your last possible exposure was, and which risk factors were present.
• Post-exposure prophylaxis (PEP) is a short-term daily medication (antiretroviral) taken by people who do not have HIV but are at high risk of contracting HIV after potential exposure. PEP should be started within 72 hours of the potential exposure and continued for four weeks (28 days). When taken as directed, PEP can reduce their risk of getting HIV by more than 80%. PEP is often prescribed after an occupational exposure such as a needlestick injury, or after unprotected sex with a partner of unknown HIV status. The PEP medications may also include antibiotics (such as Doxycycline) to prevent other STBBIs from infecting the exposed individual.
• Herpes simplex virus (HSV) is common, with an estimated one in seven Canadians carrying the virus, often without knowing it. The use of medications (antiviral) for HSV not only manages symptoms but can also reduce transmission. Taking antiviral medications daily as part of suppressive therapy can lower the amount of virus present in the body, decreasing the likelihood of transmitting the virus to others.

Antiviral medications must be taken as soon as symptoms begin (within 72 hours). Outbreaks usually begin with a tingling or burning sensation on the skin or mucous membranes (such as the mouth or groin), followed by the appearance of painful blisters that typically crust over and heal within two weeks. In some cases, severe complications can occur.

For those who experience recurrent episodes, it is recommended to keep a supply of medication (such as valacyclovir, famciclovir, acyclovir) at home for quick use. These are prescription medications, so it's important to consult your healthcare provider before an episode occurs.

For individuals who experience severe outbreaks six or more times per year, suppressive therapy can be considered. This involves taking antiviral medication daily as a long-term treatment. While this approach does not completely prevent recurrences, it significantly reduces the frequency and severity of episodes.

Common Sexually Transmitted and/or Blood Borne Infections