"Being gay is a good thing. Don't let anyone tell you that it is a sin to simply be yourself. No one chooses to be gay, it is just the way we are." - Mike Friedman, Two teenagers in 20

Gay and Lesbian Gateway for Young People

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Safer Sex

What is Safer Sex?

Safer sex is any sexual activity that does not allow semen, vaginal fluid or blood to pass from one person into the bloodstream of another person. HIV negative or HIV positive, safe sex is everyone's responsibility.

There are some sexual activities that are safe and do not present a risk for HIV transmission.

• Kissing is safe because it does not involve semen, vaginal fluid or blood. Saliva does not transmit HIV.
• Massage. All forms of sexual enjoyment with only skin contact, such as massage or body stroking, have no risk of HIV transmission.
• Receiving oral sex. The chance of contracting HIV from someone else's mouth is remote.
• Rimming is safe for HIV but many other serious illnesses such as Hepatitis A and B as well as gut bugs are easily passed on this way.
• Mutual Masturbation. Touching and rubbing each other's penis or vagina is safe. However, there are some circumstances under which mutual masturbation can be unsafe:

Cuts or sores on the hands and on the penis or vagina

Using someone else's pre-cum, cum or vaginal fluid as a lubricant

Rubbing the penis underneath the foreskin of another persons penis when cuts are present or if pre-cum or cum are exchanged through the opening of the penis

Rubbing the vagina against another vagina where cuts are present or blood or vaginal fluids are exchanged

What is Unsafe Sex?

Unsafe sex is any sexual activity that allows semen, vaginal fluid or blood to pass from one person into the bloodstream of another person.

Unsafe sexual practices include:

• Intercourse without a condom - Anal or vaginal intercourse without a condom represents a real risk of HIV transmission. Whether you are the insertive or receptive partner, male or female, intercourse is the major way HIV is passed on. Infected blood, pre-cum or semen can enter the bloodstream through the lining of the rectum or the vaginal wall. From the lining of the rectum, the virus can pass through tiny cuts or through the opening of the penis. HIV can also be present in vaginal fluids or blood that enters the penis through tiny cuts or through the opening of the penis. Either partner can get HIV during intercourse. HIV is also found in pre-cum and withdrawing before ejaculation is not safe sex.
• Giving oral sex - Oral sex without ejaculation carries a very small risk for transmitting HIV from the penis or the vagina to the mouth of the receptive partner. Taking blood, semen or vaginal fluids into your mouth will increase the risk. This is especially so if you have any cuts or bleeding caused by flossing and teeth brushing, gum disease, ulcers or other throat infections.

Safe Sex Equipment

Condoms & Lubricant

If used properly, condoms will eliminate the risk of HIV transmission. Choose the right size, check the use by date and Australian Standard mark and take care not to tear the condom when opening the packet. Put the condom on before intercourse starts – make sure the penis is fully erect (if uncircumcised, pull the foreskin back), hold the condom by the teat and roll the condom all the way to the base of the penis. Always use a water-based lubricant as oil-based lubricants can destroy condoms. Hold the condom at the base when withdrawing and only use condoms once. Use a new condom if changing between anus and vagina or partners.

Dams

Dams are thin square pieces of latex which, if used properly, can prevent the transmission of HIV and other STI's through oral sex. Use the dam by completely covering the vagina or anus - adding water-based lubricant on the body side of the dam to increase sensitivity and take care with sharp fingernails. Use only one side of the dam and use a new dam for each person. Use a new dam if changing between anus and vagina.

Gloves

Latex gloves prevents HIV and other STI's entering cuts or sores in the hand when fingering and fisting. Always change gloves when changing partners and use plenty of water-based lubricant on the outside of the glove.

Sex Toys – Use Condoms

If toys, such as vibrators, dildos or buttplugs are shared during sex then semen, vaginal fluid or blood may be passed from person to person. Keep you own toys, use new condoms on them or wash them carefully in hot soapy water after each person uses them.

About Sexually Transmitted Infections (STIs)

What is an STI?

Sexually transmitted infections are caused by a range of Viruses, Parasites, Bacteria and Fungi.

Viruses include HIV/AIDS, Genital Herpes, Genital and Anal Warts, Hepatitis A, B & C and Molluscum Contagiosum.

Parasites include Pubic Lice (crabs) and Scabies.

Bacteria include Gonorrhoea, Chlamydia, syphilis, Gut Infections and Lymphogranuloma Venereum (LGV).

Fungi includes Thrush (candidiasis).

How are STIs transmitted?

STIs are infections that are transmitted through close body contact, usually sexual. Sexual contact includes vaginal/anal sex, oral sex, touching, fingering or kissing / licking a penis or rectum.

How would I know if I have an STI?

Many people with an STI do not have any symptoms. Getting an STI check-up regularly is the only way to detect most STIs.

Signs that may indicate that you have an STI sometimes include:

• smelly, cloudy or yellowish discharge or pus coming from your penis or vagina
• blisters, sores, warts or lumps on your genitals, anus or any of the surrounding skin
• itchiness in the genital area
• if it hurts when you pee
• if it hurts when you have sex
• fever
• swollen glands, especially in the groin
• unexplained weight loss or tiredness

If you have any of these symptoms you should see your doctor or health care worker. If you are sexually active, and especially if you are having sex with different casual partners, you should have regular checkups for STIs even if you do not have any symptoms. Every 6-12 months is a guideline.

Testing for STIs and HIV/AIDS

What does testing for STIs and HIV/AIDS involve?

Testing and treatment are easy and quick. STI check-ups usually involve:

• Talking about your sexual history to find out which parts of your body may have been put at risk for an STI. This helps them decide which sorts of testing are needed.
• A blood sample to check for HIV, syphilis and immunity to hepatitis A and B
• A urine sample to check for chlamydia
• A swab of your cervix, vagina or rectum, tip of the penis or back of the throat to check for chlamydia or gonorrhoea (a swab is like a cotton bud you would use to clean inside your ears)
• A physical examination to check for crabs, scabies, warts and herpes

These tests are recommended as a yearly routine. Even if you don't have any symptoms it is still possible to have an STI and pass on the infection. Testing is the only way to know for sure.

Your doctor or health care worker may suggest other tests like Hepatitis C or genital herpes depending on your sexual history and drug use.

Counselling for HIV tests

Before you are tested for HIV your doctor or health care worker should discuss the test, its meanings and its implications. The doctor or health care worker will gauge your understanding of HIV and discuss how it is transmitted and how to protect yourself. This is known as pre-test counselling.

In this discussion the doctor or health care worker should discuss the implications of a positive and a negative result with you, including what supports you might have available after your result.

You should find out about the "window period" for HIV (the time after infection but before an HIV test will show up positive) and if you need to be re-tested.

You should always be given the results of your HIV test in person – not over the phone. This is so that the doctor or health care worker can also discuss the meaning of the test result with you, including whether you need to be re-tested. This is called post-test counselling.

If you have questions or concerns that haven't been addressed during the discussion, raise them with your doctor or health care worker.

Types of Sexually Transmitted Infections

Lymphogranuloma venereum (LGV)

LGV stands for 'lymphogranuloma venereum'. It's a sexually transmitted infection caused by a certain type of Chlamydia bacteria. It's common in places like Africa, Asia and the Caribbean but is very rare elsewhere. There have now been outbreaks among gay men in some European cities (the Netherlands, Belgium and France) and some gay men in the UK and USA have recently been diagnosed. The first cases in gay men in NSW have recently been confirmed.

How is LGV Transmitted?

The LGV bacteria gets into the body through the warm moist mucus lining of the mouth, penis or inside of the rectum. During sex, friction can cause minute abrasions in mucosal surfaces that allow the bacteria to enter the body. Anal sex without condoms is the easiest way this happens. Using things like dildos in more than one man's rectum without condoms or cleaning can also spread LGV.

How would I know if I have LGV?

As with all STIs, LGV can be asymptomatic and it can be passed on by someone who doesn't know they have it.

The recent LGV infections have occurred mostly within the rectum causing major infection within the area. LGV has 3 stages:

• Stage 1: Three days to three weeks after getting infected there may be a small, painless sore where the bacteria gets into the mouth, penis or inside the rectum. Many people don't get a sore or don't notice it. If infected, a man's penis might get a discharge or pain when urinating. LGV will be able to be passed on to others from this point until treated.
• Stage 2: 10-30 days later (or even longer) glands may become painfully swollen. Feelings of illness and fever may occur. Depending upon the infected site the effects will be different, for example:
  In the rectum - Painful inflammation may occur in the rectum, (called 'proctitis') with blood or pus coming from the area. Shitting may be painful, constipation or painful abscesses/ulcers in the rectum may develop. Feelings of illness and fever will occur.
  In the penis – Discharge may occur, glands in the groin can swell - so much that they might push through the skin and leak fluid.
  In the mouth - If infected through the mouth or throat the neck or armpit glands may swell.
• Stage 3: Over time the bacteria will cause inflammation, scarring and tissue damage that can have disastrous effects on the area around the genitals and inside the anus. Haemorrhoid-like growths can develop in the anus and tissue damage can narrow the rectum. The genitals can swell to a very large size.

Treatment for LGV

As long as it's treated before it gets to the third stage, LGV is quickly cured with antibiotics and leaves no lasting damage.

A routine STI check-up that includes screening for chlamydia in the penis and anus will also pick up penile and anal LGV infection. A negative test means there is no LGV infection.

Chlamydia testing is not routinely performed on the throat so infection in the throat may be missed unless inflammation and swelling of the glands is present.

If LGV is present, samples will test positive for Chlamydia but more tests will be needed to be sure it is LGV and not the more common type of chlamydia. A check-up is crucial if any symptoms of inflammation inside the rectum - or in the penis occur. Sex should be avoided until a STI check has been undertaken.

Prevention against LGV

Using condoms and water-based lube reduce the chances of getting LGV, as does using latex gloves during fisting. When more than two men are having sex a new condom or glove should be used with each man to prevent infection being passed from one to another. Dildos and other sex toys should not be shared or should be covered with a condom that is changed with every new person they are used on or washed between partners. Regular STI testing is recommended. Washing your hands with soap and water immediately after sex can help prevent infection.

Having LGV makes it easier to pick and pass on HIV because of the bleeding and skin damage LGV causes. It also puts you at higher risk of other STIs like syphilis.

For more information on STIs and testing visit whytest.org

Chlamydia

Chlamydia is a bacterium, similar to gonorrhoea, that can infect the genitals, anus or throat.

How is chlamydia transmitted?

Chlamydia is easily transmitted by vaginal or anal sex, oral sex or arse play such as rimming or fingering. Touching an infected area and then touching your own genitals can pass on the infection.

How would I know if I have Chlamydia?

Symptoms may appear between 7 and 21 days after infection but can be mild or in some cases absent. Symptoms can include a discharge from the penis or vagina, pain when urinating or pain during sex. If not treated, Chlamydia may decrease fertility.

Chlamydia can also be detected by a swab collected from the vagina, anus or by a urine sample. It is important not to pass urine for a minimum of 1 hour prior to having this test.

Treatment for Chlamydia

Chlamydia is easily cured with antibiotics.

Prevention against Chlamydia

While using a condom and water based lubricant can help protect against infection, it is not completely safe. Regular testing is recommended. Washing your hands with soap and water immediately after sex can help prevent infection.

Genital Herpes

Herpes Simplex Virus (HSV) is one of the most common sexually transmitted infections in humans. There are two types of Herpes virus. Type one is usually found around the mouth and is commonly known as cold sores. Type two is usually found around the genital or anus areas, however, both can occur in either area.

How is genital herpes transmitted?

Genital herpes is transmitted through close skin to skin contact with an infected person. Usually this occurs during anal or oral sex but HSV can be passed on by non-sexual skin to skin contact as well. HSV can be transmitted by:

• Direct contact with a sore
• Mouth (cold sores) to genitals
• Genital herpes to mouth
• Genital to genital

Genital Herpes can also be transmitted during foreplay when infected areas come into contact with another person. Many people are unaware of infection because they have no symptoms or very minor ones that go unnoticed. HSV can be transmitted when no symptoms are present.

Once a person has HSV, it travels along the nerves that are connected to the affected area and lies dormant at the base of the nerve. The virus can reactivate later and travel along the nerve to the skin surface, causing ongoing outbreaks.

How would I know if I have genital herpes?

The first episode of genital herpes can be particularly severe and last for several weeks. In some cases however, symptoms are very mild.

Symptoms can include itching or tingling feeling around the infected area and outbreaks of painful, fluid filled blisters which later form scabs that eventually heal. Flu-like symptoms may be present. Symptoms may also be very mild or non-existent.

Some people experience tingling, nerve pain and itching before a recurrent episode. Recurrent episodes are usually shorter and less severe and, in some cases, can stop altogether.

When would genital herpes show up?

Genital herpes symptoms usually show up within 2 to 30 days after being exposed, but it may take much longer, even years.

For ongoing outbreaks, it is about 6 or 7 days from initial symptoms to the end of the episode.

Treatment for Genital Herpes

Because the first episode can be so prolonged and severe it is very important that the initial outbreak of genital herpes is treated appropriately. Anti-viral drugs can be used to reduce the severity and duration of the initial outbreak.

There is currently no cure for genital herpes. There are treatments available from your doctor or health care worker that may reduce the severity of symptoms and speed up recovery after an outbreak.

While the possibility of repeated outbreaks varies from person to person, outbreaks may become less frequent or stop all together. There are treatments available that may extend the time between outbreaks. Consult your doctor or health care worker on how these treatments may help you manage herpes.

Keep the area clean and dry. Bath the area in salty water and dry thoroughly once or twice a day. Aspirin or paracetamol may help relieve any discomfort.

Prevention against Genital Herpes

Condoms can reduce the risk of infection but they do not always cover the infected area.

In some cases, 'trigger factors' can be identified that 'trigger' recurrent episodes. 'Trigger factors' can be other illnesses, stress, overwork, drug usage, or anything that compromises your immune system's ability to suppress the virus. Avoidance of these 'trigger factors' can help reduce the likely hood of further outbreaks.

Syphilis

Important Note: Sydney is currently experiencing increasing numbers of syphilis cases.

Syphilis is a bacterium that infects the genitals, throat or anus and then spreads throughout your body via the bloodstream.

How is Syphilis transmitted?

Syphilis is usually contracted by giving or receiving vaginal/ anal or oral sex, or arse play with someone who has the infection. A person can easily transmit the virus while first or second stage symptoms are present. Only areas covered by condoms, gloves or dams are protected from infection. Touching any sore or rash should be avoided.

How would I know if I have syphilis?

It is easy for the symptoms of syphilis to go unnoticed. The symptoms usually progress in three stages.

• Stage 1: A painless sore develops in the area of sexual contact in the early stages of infection (10-90 days). This usually turns into a scab and heals after two to six weeks but the bacterium remains.
• Stage 2: Some people notice a rash on the any part of the body. Second stage symptoms can also include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, muscle aches and tiredness. These symptoms usually occur 7-10 weeks after infection they last up to a few months and then disappear.
• Stage 3: If left untreated, syphilis remains in the body and can lead to third stage syphilis. The bacterium begins to damage the internal organs of the body including the brain, nerves, eyes, heart, liver, bones, joints and blood vessels. third of people with untreated syphilis and usually occurs many years later. This damage may be serious enough to cause death.

To test for syphilis, a swab can be taken from the sore if it is present, otherwise a blood test is required. Once someone has been infected with syphilis, the infection will always show up on a syphilis blood test even though they have been successfully treated.

When would syphilis show up?

• First stage syphilis, the sore, occurs from 10 to 90 days after infection.
• Second stage syphilis, the rash, occurs 7 weeks to 6 months after infection.
• Third stage syphilis occurs after 10 to 25 years if first or second stage syphilis are not treated adequately.

Treatment for syphilis

Syphilis is easily and rapidly cured by antibiotic injections or tablets. The duration of treatment depends on the stage of infection and ranges from between 10 to 30 days.

Prevention against syphilis

Using condoms and water-based lubricant may help reduce the risk of transmission, however, only the area covered by the condom is protected. Contact with any sores or rashes should be avoided.

Thrush

Thrush (also known as candidiasis) is an infection caused by a yeast called candida albicans.

How is thrush transmitted?

It is normal to have small amounts of this yeast in the genital area but a range of factors can cause the yeast to overgrow. These factors can include recent antibiotics, soaps and detergents and tight clothing that promotes excessive sweating.

How would I know if I had thrush?

Thrush can appear on your mouth or your genitals and sometime on your anus. It is not an STI but is sometimes related to sex. Symptoms include redness, rash or itching on the part of the body infected. Thrush is more likely to occur if you are HIV positive. Thrush is diagnosed by a simple genital examination but can be confirmed by swab collected from the infected area.

Treatment for thrush

Thrush is treated with anti-fungal creams or tablets.

Prevention against thrush

To avoid recurrences uncircumcised men should wash (with water only) and dry under their foreskin daily. It may also help to wear light cotton underwear and to avoid tight restrictive clothing.

Scabies

Scabies are tiny mites (smaller that crabs) that burrow under the skin to lay eggs.

How are scabies transmitted?

Scabies are passed on through skin to skin contact, both sexual and non-sexual.

How would I know if I have scabies?

The most common symptom is intense itching which is caused when the mites burrow under the skin. The burrowing causes fine red marks on the skin. The mites like warm areas of skin like the groin and armpits. They are also commonly found in the spaces between the fingers and toes. Itching is usually worse while warm, like in bed.

Scabies are detected by examining itchy areas under a bright light.

When would scabies show up?

Symptoms are usually noticed within four weeks.

Treatment for scabies

Scabies can be easily cured, by using the appropriate scabies lotions available at pharmacies.

Prevention against scabies

All bed linen, clothes, towels and underwear that has come into contact with the infected area should be washed in a hot, soapy wash. Sexual partners and anyone in close physical contact should also be treated to avoid reinfection. It is advisable to repeat the treatment after seven days.

Pubic Lice (crabs)

Pubic Lice or crabs are small parasites that grip onto the hair in the genital area.

How are pubic lice transmitted?

They are most commonly passed on by close body contact with someone who is infested.

As crabs can survive for some time away from the body, it is also possible to catch them by sharing towels, clothes or someone's bed.

How would I know if I have pubic lice?

The most common symptom of pubic lice is itching in the pubic hair. Close inspection should reveal tiny lice clinging to the pubic hair. There may also be nits (eggs) attached to the hair shaft.

Crabs can also be found in beards, armpits, on chest hair and on the eyelashes.

When would Pubic Lice show up?

They usually show up from three days to several weeks.

Treatment for Pubic Lice

Crabs can be easily cured, by using appropriate pubic lice shampoos and creams which are available at pharmacies.

Prevention against Pubic Lice

All bed linen, clothes, towels and underwear that has come into contact with the infected area should be washed in a hot, soapy wash. Sexual partners and anyone in close physical contact should also be treated to avoid reinfection. It is advisable to repeat the treatment after seven days.

Molluscum Contagiosum

Molluscum contagiousum is a pox virus that causes pimple-like lumps on the body.

How is molluscum contagiousum transmitted?

Molluscum contagiousum is transferred by direct skin to skin contact with someone who has the infection. It can be transmitted through sexual and non-sexual contact.

How would I know if I had molluscum contagiousum?

Molluscum contagiousum causes pimple-like lumps that are waxy, firm and painless with a dimple in the middle. They can appear in the genital area as well as on other parts of the body. Molluscum Contagiousum is detected by careful examination of the skin.

When would Molluscum contagiousum show up?

Molluscum contagiousum usually appear within 2 to 7 weeks after contact with someone who has the virus.

Treatment for Molluscum Contagiousum

Molluscum contagiousum is easily treated by freezing the lumps off the body. Alternatively, the core of the lump, which contains the virus can be extracted with a fine needle. The virus stays in the skin for life.

Prevention against Molluscum Contagiousum

While using condoms and water-based lubricant can reduce the risk of infection, only the area covered with a condom, glove or dam is protected from the virus.

Hepatitis A

Hepatitis means inflammation of the liver. Hepatitis A is a virus which causes inflammation of the liver.

How is hepatitis A transmitted?

It is transmitted through small quantities of infected faecal matter entering a person's mouth through activities like arse play, rimming and by not washing your hands properly after sex with an infected person. It can also be passed on by using eating and drinking utensils previously used by an infected person. People are infectious for around three weeks, starting two weeks before they develop symptoms to about a week afterwards.

How would I know if I had hepatitis A?

Symptoms can include a mild flu like illness, vomiting, abdominal pain and jaundice.

When would hepatitis A show up?

It will usually show up within 2 to 4 weeks.

Treatment

People with hepatitis A infection should avoid drugs, alcohol, excessively fatty diets or anything that may affect the liver. If you suspect that you have hepatitis A you should see your doctor or health care worker.

Prevention against Hepatitis A

People who get hepatitis A will recover and develop permanent immunity to the virus.

An effective vaccination against hepatitis A is available. A combination hepatitis A and B vaccination is also available. Gamma Globulin can also be used to provide immediate protection against hepatitis A for people not immunised and at high risk of infection. See your doctor or health care worker for more information.

Hepatitis B

Hepatitis means inflammation of the liver. Hepatitis B is a virus that causes inflammation of the liver. Hepatitis B can occasionally be extremely severe.

Many people with hepatitis B have not symptoms when infected but develop chronic infections that cause liver damage. Hepatitis B can lead to liver cirrhosis, liver failure, liver cancer and death.

How is hepatitis B transmitted?

Hepatitis B is passed on by infected blood or semen entering a person's bloodstream through activities like unsafe sex, sharing injecting equipment, sharing toothbrushes or razors, oral sex, tattooing or body piercing with unsterile equipment.

How would I know if I had hepatitis B?

Symptoms can include loss of appetite, tiredness, nausea, yellowing of the skin and eyes (jaundice) and dark urine. If you suspect that you have hepatitis B you should see your doctor or health care worker.

Many people with hepatitis B have not symptoms when infected but develop chronic infections that cause liver damage.

When would hepatitis B show up?

Symptoms usually show up from 1 to 6 months after exposure.

Treatment

Chronic hepatitis B can now be treated with antiviral drugs and some cases are cured.

Prevention against Hepatitis B

An effective vaccination against hepatitis B is available from your doctor or health care worker. A combination hepatitis A and B vaccination is also available.

Hepatitis C

Hepatitis means inflammation of the liver. Hepatitis C (HCV) is a virus that causes serious damage to the liver. For some people, this can lead to cirrhosis or scarring of the liver.

How is hepatitis C transmitted?

The virus is spread by HCV positive blood entering another person's bloodstream. The most common means of transmission for HCV is through sharing injecting equipment including needles, swabs, tourniquets and so on. Hep C is highly infectious and can be transmitted by microscopic amounts of blood.

Recent studies have shown that Hep C can be, and is being, transmitted sexually. It is thought that this transmission is happening in group sex scenes when toys sexual activity is shared without being cleaned or without changing condoms.

When would hepatitis C show up?

Hepatitis C symptoms can take years after the initial infection to develop.

How would I know if I had Hepatitis C?

In the early stages of hepatitis C symptoms may be absent. Symptoms may include fatigue, nausea, pain under the ribs, sweating and intolerance to fatty diets. Jaundice is not common.

A blood test from your doctor or health care worker can detect hepatitis C.

75% of people infected with hepatitis C may carry the virus in their blood for life. 15% of these people may develop cirrhosis of the liver. A small number of people with cirrhosis may develop liver cancer or liver failure.

Treatment for Hepatitis C

Maintaining a healthy diet, reducing alcohol intake and cutting down on smoking can improve the body's ability to cope with hepatitis C.

There are two approved treatments for hepatitis C - Interferon and ribavirin. See your doctor or health care worker for more information.

Prevention

People who inject drugs and share equipment are at a high risk of contracting HCV. If injecting, do not share any equipment, including spoons and tourniquets.

In group sex scenes washing hands and toys and changing gloves and condoms before moving from one person to the other will prevent the transmission of Hepatitis.

Gonorrhoea

Important Note: Sydney is currently experiencing a gonorrhoea epidemic.

Gonorrhoea is an infection that can infect a person's genitals, anus, throat or eyes.

How is gonorrhoea transmitted?

It can be transmitted through giving or receiving oral sex, vaginal/ anal sex and arse play such as fingering or fisting. Touching an infected person's genitals or anus and then touching your own genitals, anus or eyes can also transmit gonorrhoea.

When would gonorrhoea show up?

Symptoms usually develop within 2 to 10 days.

How would I know if I had gonorrhoea?

Most people who have gonorrhoea will show no symptoms, but for gonorrhoea in the throat the symptoms include a dry sore throat.

If the infection is in the anus, the symptoms include a discharge or pain during bowel movements.

If it is on the genitals, then a clear or yellow discharge from the dick may be present and the person might experience pain or burning when urinating is possible.

The test to detect gonorrhoea is a urine test and/or swabs collected from the genitals, anus or throat. It is important for men not to pass urine for a minimum of one hour prior to having a urine test.

Treatment for Gonorrhoea

Gonorrhoea is easily cured with antibiotics. Sexual contact should be avoided until follow up tests are taken to ensure the infection has cleared, after treatment.

Prevention

Using a condom and water based lubricant can help prevent infection, although safe sex for HIV is not completely safe for gonorrhoea. Washing your hands with soap and water immediately after sex can also help prevent transmission, especially if having sex with multiple partners.

Genital Warts

Genital warts are caused by the Human Papilloma Virus (HPV) that can cause warts on the genitals, anus or surrounding areas. It is one of the most common sexually transmitted infections and many people carry the virus without even knowing it.

It is estimated that 30% of the population is infected with the human papilloma virus, but only a small number infected people develop warts. (Source: NSWHEALTH)

How are Genital Warts transmitted?

The virus can be passed on by any genital skin to genital skin contact with the infected areas of another person, including during foreplay. You don't need to have anal sex to get genital warts.

How would I know if I had Genital Warts?

Symptoms include small bumpy warts around the genitals and anus. Warts can cause discomfort when going to the toilet if the anus is infected but they can also be painless. There may be no symptoms at all.

When would Genital Warts show up?

Generally, warts show up within 2 to 3 months of being infected but it may take much longer.

Treatment

There is currently no cure for genital warts but your doctor, or health care worker, can remove the warts by freezing, burning, laser or by applying liquid wart paints or creams. These treatments do not remove the virus from the skin, so recurrences may happen. Treatment sometimes requires several visits. If you are HIV+ warts are likely to be more severe and difficult to get rid of.

Prevention

While condoms can reduce the risk of transmission, only the area covered by the condom is protected. Warts can be present outside of this area.

Annual Surveillance Report 2007

The 2007 Annual Surveillance Report was released by the National Centre in HIV Epidemiology and Clinical Research (NCHECR) on Wednesday, October 10, 2007.

Below is a summary of the key findings from the report that are of particular importance to the work of ACON.

HIV/AIDS

• Number of new HIV diagnoses in Australia increased by 31% between 2000 and 2006 (763 to 998).
• Number of new HIV diagnoses in NSW decreased from 394 in 2005 to 381 in 2006.
• In NSW, the prevalence rate was 5.9 per 100,000 for 2006, which continues the steady decline that started in 2003.
• Likewise the rate of diagnosis of newly acquired HIV infection in NSW has declined from 2.4 in 2003 to 1.8 in 2006.
• Rates of newly acquired HIV in Victoria have risen by 40% since 2000 and are now at the same level as NSW.
• HIV continued to be transmitted primarily through sexual contact between men. However, between 2005 -2006 the percentage of newly diagnosed HIV infections that occurred through homosexual contact decreased from 72.1% to 68.0%, while the percentage that occurred through heterosexual contact increased from 19.3% to 24.5%.
• The median age of infection for males rose from 37 in 2005 to 38 in 2006, while the median age for women decreased from 32 to 31.
• Between 2000 and 2006 the number infections among men aged 40-49 increased significantly from 133 to 242. Infections for men aged 20-29 in 2006 were at the same levels as 2000 (162 to 166), but had risen in the 30-39 group (280 to 293) and 50-59 (58 to 101).

Gay men/MSM

• In 2006, sexual transmission between men accounted for 85% of newly acquired infections and 67% of newly diagnosed infections. This may represent higher rates of testing among gay/msm.
• The incidence of UAI among gay/msm in Sydney declined from 25.7% in 2001 to 20.8% in 2006 (taken from Periodic survey).

ATSI

• Rate of HIV diagnosis among ATSI decreased from a peak of 7.5 per 100 000 to 4.9 in 2006 (which is comparable with non-ATSI rate of 5.1 in 2006).
• Male homosexual contact accounted for 37% of infections (compared to 65% in) non-ATSI, while heterosexual accounted for 34%. A much higher percentage of infections occurred through IDU among Indigenous than non-Indigenous (18% v 3%) and a higher percentage of infections among women (30% v 11% non-ATSI).

Injecting Drug Users

• Approx. 8% of HIV diagnoses in Australia were in people with a history of injecting drug use, of whom more than half were men who also reported a history of homosexual contact.
• In 2006, 32.3% of homosexually-identifying men who attended NSPs were HIV positive.

Heterosexual

• In the past five years, sixty percent of cases of HIV infection attributed to heterosexual contact were in people from high HIV prevalence countries or their partners.
• The rate of HIV and AIDS diagnosis among people who were born in Sub-saharan Africa was five times higher than people born in Australia.
• Since 2001-2 there has been 0% prevalence of HIV infections among sex-workers presenting at sexual health clinics, regardless of IDU status.

STIs

• The population rate of diagnosis of gonorrhoea increased by 29% from 32.8 in 2002 to 42.2 in 2006.
• The rate of diagnosis of infectious syphilis increased from 3.1 in 2004 to 4.0 in 2006. Both were largely attributed to increases among gay/msm.
• The rate of diagnosis for Chlamydia in 2006 was 232 per 100,000, an increase of 12% from 2005.
• Substantially higher rates of diagnosis of Chlamydia, gonorrhoea, and syphilis were recorded among ATSI people compared with non-Indigenous people.