A recent report from the Ministère de la santé et des services sociaux paints a blatant portrait of blood-borne infections and sexually transmitted infections (STIs) in Quebec. The data show an explosion in syphilis cases and the advent of a “new” STI, lymphogranuloma venereum (LGV), which particularly hits the community of men who have sexual relations with men. It also seems that people, mostly young people, are negligent when it comes to protecting themselves.
In 1998, syphilis had all but disappeared in Quebec. Since then however, the number of people infected is on the rise. Experts predict a 56% increase in the number of cases for the current year, compared to 2005. Men having sexual relations with other men are particularly affected. This infection progresses in three stages. The first symptoms are lesions (ulcers) on the genitals. Thereafter, lesions may appear on the skin such as on the torso, hands and feet, as well as on mucous tissues like the mouth, glands and anus. These lesions are accompanied by flu-like symptoms such as fever, fatigue and muscle aches. If syphilis remains untreated with antibiotics, it can later cause neurological, cardiological, digestive, ocular and psychiatric problems.
Lymphogranuloma venereum (LGV) is a relatively new infection in Quebec, although it existed elsewhere in the world. The first case was reported in Montreal in 2003. The second case appeared the following year and a further 26 cases emerged in 2005. The report from the Ministère expects 43 new cases this year alone, principally in men who have sexual relations with men. This infection also progresses in three stages. In the first stage, small painless sores or papules appear where the bacteria entered the body and last only a few days. A few weeks later, the person who is infected may feel feverish, have the chills, malaise, loss of appetite, muscle and joint pains. Painful lymph nodes in the groin area or inflammation of the anus and rectum may appear, along with rectal pain, clear or pussy or bloody discharge from the anus and the constant urge to have bowel movements, with cramps and pain. Finally, if the person has not healed or been treated with antibiotics, the infection can cause serious complications, such as swelling and deformity of the genitals or the rectum.
Although relatively new in our environment, these infections are not the most common STIs. Infections caused by the human papillomavirus (HPV), noticeable by external condylomas or genital warts, genital herpes and chlamydia are the most common STIs in Quebec. An increase in gonorrhea cases has also been reported. A worrisome phenomenon is that the bacterium that causes this infection is increasingly resistant to traditional antibiotics, thereby forcing the medical community to revise optimal treatment choices. Hepatitis C cases are falling. Most infected people are using intravenous drugs. This infection causes severe damage and the treatments are hard as they cause many side effects.
Most STIs do not have blatant symptoms, especially at the beginning of the infection. It is therefore possible to unknowingly transmit an infection. The signs and symptoms can appear and disappear on their own and not all STIs are treatable with antibiotics. Those caused by viruses do not respond to antibiotics. There are antiviral drugs used in their treatment but most of them cannot be cured. Persons infected remain carriers and can transmit it to their sexual partners. Even bacteria-caused infections are not trivial. For women, the infection can reach the uterus and fallopian tubes and cause salpingitis and even lead to sterility. Certain STIs can also increase the risks of contracting other STIs, hepatitis or HIV.
The best protection against STIs remains safe sex practices. Male or female latex condoms are the most efficient protection we have at this moment, even if they are not perfect. Infectious lesions such as herpes or condylomas may be located in other areas that are not covered by the condom. Nevertheless, it is recommended to use a condom with each new sexual partner and to keep using them for the first year of a monogamous relationship. After a year, it is possible to stop using condoms, provided both partners have undergone screening tests for STIs and are not infected. For infections that cannot be healed such as herpes, not only is it a sign of respect to inform any new sexual partner of the condition, but it is essential.
Unfortunately, even though the message of safe sex and prevention is often repeated via the media, schools and other public platforms, it seems that an increasing number of people neglect to protect themselves adequately. As the information campaigns of the Ministère promote “Put a condom on” and “Open your eyes”.
Between you and me, the pleasure is not worth the risk!