Sexually Transmitted Infections

You can get chlamydia or gonorrhea by having unprotected oral, vaginal or anal sex or sharing sex toys with a person who has chlamydia or gonorrhea

Babies can get chlamydia or gonorrhea from their mother during birth.

Signs & Symptoms

Most people do not have symptoms for chlamydia or gonorrhea and do not know they are infected. If you have symptoms, they usually appear two days to six weeks after sex with an infected partner, but can take longer to show up. 

The only way to know if you have chlamydia or gonorrhea is to get tested.

Ask your doctor to test for sexually transmitted infections or visit a Sexual Health Clinic for testing if you think you have chlamydia or gonorrhea. A urine sample or a swab of the cervix, penis, throat or rectum is used to test for chlamydia and gonorrhea. Do not urinate for two hours before giving a urine sample.

Chlamydia and gonorrhea are treated with antibiotics. Follow these guidelines to make sure your treatment is successful:

• Finish all of your antibiotics, even if you are feeling better, to make sure the infection is cured.
• Do not have oral, vaginal or anal sex for at least one week or seven days after you and your partner have been treated. Otherwise, you could re-infect each other.
• If you use hormonal contraceptives such as birth control pills, use another kind of birth control such as condoms as a back-up because some antibiotics can decrease the effectiveness of hormonal contraception.
• Tell your doctor if you are pregnant or breastfeeding so you get antibiotics that are safe for your baby.
• If you are pregnant, you need to have a follow-up test to make sure that the infection is cured. This test should be done four weeks after you finish your antibiotics.
• You need to tell all sexual partners from the last two months to get tested for sexually transmitted infections. A public health nurse can help notify them for you. Your name will be kept confidential.

What happens if you are not treated?

If you are not treated for these infections:

• You can give chlamydia and gonorrhea to your sexual partner. 
• Women can get Pelvic Inflammatory Disease or PID, an infection that scars fallopian tubes and causes long-term pelvic pain. Women may have become infertile (unable to have children) when the fallopian tubes are blocked by scar tissue.
• Men can develop epididymitis, a condition that causes swelling or pain in their testicles. Men may become infertile (unable to have children) when the tubes carrying the sperm are blocked by scar tissue.
• Pregnant women with chlamydia or gonorrhea may have problems during their pregnancy and/or the infection can be passed on to a baby at birth.

• Do not have sex. There are many ways to show love besides sex. Kissing, touching and talking feel good and are safe.
• Practise safer sex including using condoms or dental dams from start to finish every time you have sex.
• Limit your number of sexual partners. The chance of getting a sexually transmitted infection goes up with each new sexual partner.

Having a sexually transmitted infection increases your chances of getting other sexually transmitted infections. If you have chlamydia or gonorrhea, get tested for other sexually transmitted infections.

You can get syphilis from:

• Having direct contact with sores, rashes or bodily fluids such as semen, blood or vaginal fluids of a person who has syphilis.  You get syphilis during close skin-to-skin or sexual contact.
• A pregnant woman can give syphilis to her baby before birth.  Syphilis can cause birth defects or death.

You are most likely to spread syphilis to others during the first year after getting the disease.

Signs & Symptoms

Most people who have syphilis have no symptoms. 

Syphilis progresses through different disease stages if it is not treated.  Each stage of syphilis has different symptoms:

A blood test can tell you if you have syphilis. Sometimes a swab is taken from the chancre (if present) and examined under a microscope.

Syphilis can be treated and cured with antibiotics.

• Antibiotics are given by needles or as pills.
• Follow up blood tests are important to make sure the disease is gone.

• Choose not to have sex. 
• Avoid oral, anal and vaginal sex and close contact with the chancre or rash until you or your sexual partner finish treatment and your doctor tells you that you can no longer infect others. You can get re-infected every time you have sex with an untreated partner.
• If you have sex, use a condom or dental dam from start to finish every time.
• Be prepared. Keep condoms with you and be ready to use them.
• Limit your number of partners. The chance of getting a sexually transmitted infection goes up with each new partner.
• Get tested for sexually transmitted infections before having sex with a new partner and ask your partner to get tested too.
• Having syphilis increases your chances of getting another sexually transmitted infection. If you test positive for syphilis, get tested for other sexually transmitted infections too, including HIV.

You can get HIV by:

• Having unprotected vaginal or anal sex with a person who has HIV
• Sharing needles or equipment for drugs

Having unprotected oral sex is a lower risk activity for HIV transmission.  Babies can get HIV from mothers through birth or breastfeeding.

The body fluids that contain HIV are:

• Blood
• Vaginal and rectal fluids
• Semen
• Breast milk

HIV is not spread by hugging, kissing, sharing utensils with or living with a person with HIV.

Signs & Symptoms

The only way to know if you have HIV is to get tested. Symptoms may last a few weeks or you may not have symptoms for HIV.

Get tested for HIV if you:

• Have sex without using condoms
• Share needles or equipment to take drugs
• Have or have had a sexually transmitted infection
• Are pregnant

You need to wait 12 weeks or three months from your last possible exposure to HIV for an accurate test. This is called the window period. If you have HIV, your blood will show antibodies to HIV by the end of the 12-week window period.

You can choose to use your name (nominal) for an HIV test or you can get a code number and have anonymous testing.

You can have nominal or anonymous HIV testing by either an HIV blood test or a Rapid HIV test. A public health nurse will help you decide which option is best for you.

HIV blood test

• involves taking a sample of your blood and sending it to the lab
• test results are ready in two weeks

Rapid HIV testing

• also known as Point of Care
• available for clients that meet certain eligibility criteria
• involves taking a finger prick blood sample
• test results are ready in a few minutes

You can get tested for HIV using your name (nominal) at your doctor's office or walk-in clinics. Sexual Health Clinics provide anonymous testing, testing using your name and rapid HIV testing.

There is no cure for HIV or AIDS, but there are treatments that help control the virus.

• Many people with HIV continue to lead healthy lives for many years, if HIV is found and treated early.
• Prevention is better than treating the virus.
• Talk to an HIV specialist about when to start treatment and what treatment to take; get a referral to an HIV specialist from your doctor.

HIV Testing Clinics

Anonymous and rapid HIV test available. No health card or appointment needed. You must register 15 minutes before clinic closes to be seen.

• Use a condom every time from start to finish for oral, vaginal and anal sex. Keep a condom with you and learn how to use it correctly.
• Do not have sex.
• Talk to your sexual partner about their sexual and drug use history and ask your partner to be tested.
• Get tested for sexually transmitted infections. Your chance of getting HIV goes up if you already have a sexually transmitted infection.
• If you are diagnosed with HIV and are infected with another sexually transmitted infection, you are at a greater risk of passing HIV on to your partner.
• If you inject drugs, use a needle syringe program to get free, sterile needles such as the Van Needle Syringe program.
• Pre Exposure Prophylaxis (PrEP) - is the daily use of oral HIV medications by an HIV-negative person who is at high risk of HIV infection. There is a cost. PrEP can help prevent people getting infected with HIV. Consistent condom use and regular STI testing should be used alongside PrEP. For more information and where to access it in Hamilton, go to Hamilton PrEP Clinic. An online HIV PrEP clinic is also available if you can’t attend a clinic in person at www.prepclinic.ca.
• Post Exposure Prophylaxis (PEP) - Postexposure prophylaxis (PEP) involves 28 days of oral HIV medications starting as soon as possible within 72 hours after an HIV exposure. PEP may be given after an accidental exposure that occurs at work (e.g., health care) or may be given after sexual and injection drug use exposures.  To access PEP in the Hamilton area, go to your nearest hospital emergency room. There is a cost.

What is hepatitis A?

Hepatitis A is a liver infection caused by the hepatitis A virus. Hepatitis A is often spread when someone eats food or drinks water that contains the hepatitis A virus. The food or water becomes contaminated when it comes in contact with the feces from an infected person. This can happen when:

• A person with hepatitis A does not wash their hands properly after using the bathroom 
• Drinking water is contaminated with sewage
• Untreated water is used on crops

Hepatitis A is found in the blood and stool of someone who is infected. It can be spread from person to person by sexual contact, contact with feces, blood transfusions or sharing needles.

There is a vaccine to protect you against hepatitis A.

Most people who get hepatitis A get better on their own and do not have long-term liver damage. But, people with chronic sicknesses like hepatitis C, hepatitis B, or HIV are at risk of getting very sick from hepatitis A. 

How do you get hepatitis A

You are at risk of getting hepatitis A if you:

• Eat or drink unsafe food or water
• Travel internationally to high risk areas.
• Have a sexual partner who has hepatitis A
• Are a man who has sex with men
• Share supplies for using street drugs

Many people who become infected with hepatitis A do not feel sick or have symptoms. If you do get sick with hepatitis A, you may have some or all of these symptoms:

• Yellow skin or eyes
• Upset stomach
• Dark urine or light-coloured stools
• Nausea
• Vomiting
• Fever
• Joint pain
• Feel tired
• Not feel hungry 

Even if you don’t feel sick, you can still have the virus and spread it to others.

How do you prevent hepatitis A?

There is a vaccine for hepatitis A. To learn more about vaccination see the ‘where can I get a hepatitis A vaccine in Hamilton?’ section below.

You can reduce your risk of getting or spreading hepatitis A by:

• Getting a hepatitis A vaccine
• Washing your hands with soap and water for at least 20 seconds or using alcohol-based hand rub with 60-90% alcohol before preparing or eating food and after using the washroom and changing diapers. Please note that 70% alcohol-based hand rub is needed to kill norovirus.
• Not preparing food and beverages for others if you are sick
• Following these tips when travelling to countries where hepatitis A is present
  • Ask for no ice cubes in your drink
  • Peel your own raw fruit and vegetables
  • Drink water from a safe supply (bottled, boiled, etc.)
  • Only eat foods that are well-cooked
• Practicing safer sex
• Never sharing needles or other supplies for using street drugs (cookers, pipes etc..)

Where can I get a hepatitis A vaccine in Hamilton?

You can get the hepatitis A vaccine for FREE in Ontario if you:

• Use injection drugs
• Have a chronic liver disease (hepatitis B or hepatitis C)
• Are a man who has sex with men

Hepatitis A and B are common in many countries. If you are travelling, talk to your doctor about the hepatitis A and B vaccines.  

Ask about getting vaccinated by calling or visiting:

• Your family Doctor
• A travel Clinic
• City of Hamilton’s Sexual Health Clinics at 905-528-5894
• City of Hamilton’s Street Health Clinic

What is hepatitis B?

Hepatitis B is a liver infection caused by the hepatitis B virus. You can have Hepatitis B for a short time (acute) or for a long time (chronic). Chronic hepatitis B can lead to serious liver damage, including liver cancer. 

There is a vaccine to protect you against hepatitis B.

How do you get hepatitis B?

You can get hepatitis B from contact with blood, semen, or vaginal fluid of someone who has the virus.

You may have hepatitis B if you:

• Were born to a person who has hepatitis B
• Lived in or were born in a region where hepatitis B is common  
• Had sex without a condom
• Shared sex toys
• Shared needles and supplies for using street drugs (even once)
• Had tattoos, piercings, manicures, pedicures or medical procedures that were done with poorly cleaned equipment
• Shared personal care items (tooth brushes, nail clippers, razors, etc.).
• Had a blood transfusion in Canada before 1970.

The hepatitis B virus can live for seven days on objects like needles, razors, syringes, or sex toys.

Many people who become infected with hepatitis B do not feel sick or have symptoms. If you do get sick with hepatitis B, you may have some or all of these symptoms:

• Yellow skin or eyes
• Abdominal pain
• Dark urine
• Nausea
• Vomiting
• Joint pain
• Feel tired
• Not feel hungry 

Even if you don’t feel sick, you can still have the virus and spread it to others.

How do you prevent hepatitis B?

You can reduce your risk of getting or spreading hepatitis B by:

• Getting a hepatitis B vaccine
• Not sharing personal care items (razors, scissors, toothbrushes or nail clippers)
• Never sharing needles or other supplies for using street drugs (cookers, pipes etc..)
• Wearing latex gloves when you may come in contact with someone else’s blood
• Getting tattoos or piercings at licensed establishment. If you are unsure if a location is licensed, ask to see their last inspection results. Inspection results are also posted online
• Practicing safer sex
• Covering open sores or breaks in your skin

Where can I get a hepatitis B vaccine in Hamilton?

The hepatitis B vaccine is FREE for people at high risk of getting hepatitis B and for school-aged children in grades 7 and 8.

You can be vaccinated against hepatitis B for FREE if you:

• Have multiple sex partners
• Are a man who has sex with men
• Use intravenous drugs
• Have chronic liver disease, including hepatitis C
• Have a history of a sexually transmitted disease
• Are a household or sexual contact of someone who has hepatitis B
• Are on renal dialysis or have a disease needing blood products       
• Had a needle stick injury in a non-health care setting
• Are waiting for a liver transplant
• Are a child under 7 years old whose family has come from a country where there is a high risk of hepatitis B
• Are an infant born to a hepatitis B positive person

Hepatitis A and B are common in many countries. If you are travelling, talk to your doctor about the hepatitis A and B vaccines.  

If you have been diagnosed with hepatitis B, it is important that you protect your liver from other viral hepatitis infections. People who have viral hepatitis can get FREE vaccines to prevent other diseases like pneumonia or hepatitis A. If you have a hepatitis infection talk to your doctor about what vaccines are right for you.

Ask about getting vaccinated by calling or visiting:

• Your family doctor
• A walk-in clinic
• A travel clinic
• City of Hamilton’s Sexual Health Clinics at 905-528-5894
• City of Hamilton’s Street Health Clinic

Where can I get tested for hepatitis B in Hamilton?

If you think you might have hepatitis B, get tested. It is important to get tested if you were born in, travelled to, or lived in a region that has many hepatitis B infections and do not have a hepatitis B vaccine. Regions that have high numbers of Hepatitis B include:

• Southern and Eastern Europe
• South and Central America
• Africa and the Middle East
• Asia

Ask to be tested for hepatitis B at:

• Your doctor’s office
• A walk-in clinic
• City of Hamilton Street Health Clinics
• The student health facility at your college or university

Where can I get treatment for hepatitis B in Hamilton?

Medicine is available for people who have chronic hepatitis B. Not every person with hepatitis B needs medicine. Medicines to treat hepatitis B cannot cure you, but they can help stop damage to your liver.

If you are at risk for hepatitis B, your doctor may test you for other infections like hepatitis C.

To talk about treatment:

• Call your doctor or nurse who can refer you to a specialist.
• Visit Liver Care Canada, or call Hamilton Public Health at 905-546-2063

Every hour, at least 1 person is infected with hepatitis C in Canada.
Don’t wait. Get tested - It may save your life.

What is hepatitis C?

Hepatitis C is a liver infection caused by the hepatitis C virus. Hepatitis C is very common, and most people do not know they have the virus. You can have hepatitis C for a short time (acute) or for a long time (chronic). Chronic hepatitis C can lead to serious liver damage, including liver cancer.  

How do you get hepatitis C?

You can get hepatitis C from direct blood to blood contact with someone who has the virus.

You may have hepatitis C if you:

• Shared needles or supplies for using street drugs (even once)
• Had tattoos, piercings, manicures, pedicures or medical procedures that were done with poorly cleaned equipment
• Shared personal care items (tooth brushes, nail clippers, razors, etc.)
• Had sex without a condom with a partner infected with hepatitis C
• Were born to a person who had hepatitis C
• Had a blood transfusion in Canada before 1992
• Were born in, travelled to, or lived in a region where hepatitis C infection is common, such as:
  • East Asia and Pacific
  • Eastern Europe and Central Asia
  • Latin America and the Caribbean
  • North Africa and the Middle East
  • Sub-Saharan Africa

The hepatitis C virus can live outside the body for four days on objects like needles, razors, syringes, or nail clippers.

How do you prevent hepatitis C?

There is no vaccine to protect against hepatitis C, and you can get hepatitis C more than once or have more than 1 type of hepatitis C infection.

You can reduce your risk of getting or spreading hepatitis C by:

• Not sharing personal care items (razors, scissors, toothbrushes or nail clippers)
• Never sharing needles or other supplies for using street drugs (cookers, pipes etc..)
• Wearing latex gloves when you may come in contact with someone else’s blood
• Getting tattoos or piercings at licensed establishments. If you are unsure if a location is licensed, ask to see their last inspection results. Inspection results are also posted online
• Practicing safer sex
• Covering open sores or breaks in your skin

If you have been diagnosed with hepatitis C it is important that you protect your liver from other viral hepatitis infections. People who have viral hepatitis can get FREE vaccines for some other types of hepatitis such as hepatitis A or B and vaccines to prevent other diseases like pneumonia. If you have a hepatitis infection talk to your doctor about what vaccines are right for you.

Get tested! It is the only way to know if you have hepatitis C.

Most people with Hepatitis C have no symptoms. If you do get sick with hepatitis C you may have some or all of these symptoms:

• A fever
• Yellow skin or eyes
• Abdominal pain
• Dark urine
• Feel tired
• Not be hungry
• An upset stomach

Even if you don’t feel sick, you can still have the virus and spread it to others.

Where can I get tested for hepatitis C in Hamilton?

If you think you could have come in contact with hepatitis C, get tested. Getting tested early means you can start treatment sooner and stop the damage to your liver.

Ask to be tested for hepatitis C at:

• Your doctor’s office
• A walk-in clinic
• Shelter Health Hep C Team
• City of Hamilton Street Health Clinics
• The student health facility at your college or university

Where can I get treatment for hepatitis C in Hamilton?

Hepatitis C is considered a curable infection. You can get treatment for hepatitis C from a specialist or a clinic that specializes in hepatitis C. Chronic hepatitis C can be cured in 90% of people with medicine prescribed by a doctor. This means the virus won’t continue to damage your liver. Treatment can be as short as 8-12 weeks.

Did you know that most medicine for chronic hepatitis C in Ontario is FREE if you qualify for the Ontario Drug Benefit program? Funding may also be available through your own private insurance or directly from the drug companies. Your hepatitis treatment team will help you with getting the right medicine to treat your infection.

To talk about treatment:

• Call your doctor or nurse who can refer you to a specialist.
• Visit Liver Care Canada, the Shelter Health Hep C Team, or call Hamilton Public Health at 905-546-2063 for help connecting to hepatitis C treatment.

You can get herpes by having direct contact with infected skin, sores or blisters.

• Herpes is passed from the mouth or genitals of a person who has herpes during oral, vaginal or anal sex or fingering.
• The virus is often spread just before or during a herpes outbreak. It can also be spread when an infected person does not have any symptoms.

Signs & Symptoms

Watch your body for changes.  Symptoms usually appear two to 21 days after contact with an infected person.

For some people the symptoms of a herpes outbreak are mild and the person may not know they have herpes. Some signs and symptoms of genital herpes include:

• Itching, tingling or burning skin at the site of the sore
• Painful blisters or sores on or near the genitals, which may last a few days to weeks
• Tender and enlarged lymph nodes

After the first outbreak, further outbreaks are usually less severe and do not last as long. 

If you think that you are having a herpes outbreak, you should see a doctor as soon as possible after your symptoms start. A doctor will:

• Check your sores or blisters
• Take a swab from the blister or sore to send to the lab to confirm if you have herpes

If you want a blood test for herpes, there may be a cost to you.

There is no cure for herpes. You can take antiviral medication each time you have an outbreak to help the sores heal faster.

If you have a lot of outbreaks and the outbreaks interfere with your daily life, talk to your doctor about medication that can prevent outbreaks.

A person who has herpes can pass the virus to you even when they are not having an outbreak. Here are some tips to protect yourself from herpes:

• Choose not to have sex.
• Be aware that herpes can be passed through vaginal, oral or anal sex or any time there is close skin-to-skin contact.
• Use a condom or dental dam from start to finish every time you have sex.  A condom or dental dam only protects the skin covered by the condom.
• Limit the number of sexual partners you have. The chance of getting asexually transmitted infection goes up with each new sexual partner.
• Ask your sexual partner about their history of sexually transmitted infections before having vaginal, anal or oral sex.
• Be aware of the symptoms of herpes and do not have sex or close skin-to-skin contact when herpes sores or other symptoms are present.
• Be aware that herpes can be transmitted even when there are no symptoms.

You can get HPV by having direct contact with the infected skin of a person who has HPV.  HPV is passed through close skin-to-skin contact during vaginal, anal or oral sex. You can also get HPV even if there is no penetration during sex.

Signs & Symptoms

You may not have any visible symptoms of HPV; watch for changes in your body.

• Genital warts are a sign of some types of HPV.
• Warts can be single or clustered, flat or raised, hard or soft, as well as different or the same colour as the surrounding skin.
• Warts can be found on the cervix, vulva, penis, scrotum, anus and/or the thighs of an infected person and on or around the mouth or in your throat.

Some people may not have any signs or symptoms.

There is no test for HPV or warts. If you notice any symptoms that concern you, visit your doctor, a walk-in clinic or a Sexual Health Clinic.

• A doctor can diagnose warts by looking at the genital area.
• If you are having sex, you should have regular physical exams by your doctor.
• Women 21 years of age and older who are or have been sexually active should have Pap tests every three years.  A Pap test can find changes in a woman’s body caused by HPV. 

There is no cure for HPV.

More than 80% of HPV infections clear spontaneously within 18 months. 
There is no way to know who will clear the infection and who will develop cancer or other health problems.

Most genital warts are harmless but can be difficult to treat. Treatment can get rid of the visible warts, but they may come back over time.  Treatment for warts includes:

• Self-applied prescription creams
• Laser removal
• Surgical removal
• Cryotherapy—freezing warts with liquid nitrogen

It may take more than one treatment session or type of treatment to get rid of the warts.

• Choose not to have sex. Any time there is close skin-to-skin contact, there is a risk of getting HPV.
• Be aware that HPV can be passed through vaginal, anal or oral sex any time there is close skin-to-skin contact.
• Practice safer sex – use condoms or dental dams from start to finish every time you have sex. Condom or dental dams only protect the area of skin they cover.
• Use a condom on sex toys and do not share sex toys.
• Limit your number of sexual partners.  The chance of getting a sexually transmitted infection goes up with each new sexual partner.
• Ask your partner about their history of sexually transmitted infections before having vaginal, anal or oral sex.
• Get tested for other sexually transmitted infections with each new sexual partner.
• Get the HPV vaccine through your family doctor or Public Health Services. This protects against some types of HPV.
• Be aware of the symptoms of HPV and do not have close skin-to-skin or sexual contact when your partner has warts.
• Be aware that HPV can be transmitted even when there are no symptoms.

Molluscum contagiosum is spread:

• through skin-to-skin contact; this is the most common way to get it
• through objects such as towels and clothing that come in contact with the lesions on an infected person
• through swimming pools and sharing baths with an infected person 
• by touching a lesion or bump on an infected person and then touching your body

Signs & Symptoms

• Lesions or bumps on thighs, buttocks, groin and lower abdomen
• Lesions or bumps may occasionally appear on external genital and anal areas

Lesions may start as small bumps, which develop over a period of several weeks into larger bumps.

• The lesions can be flesh coloured, gray-white, yellow or pink.
• The lesions can cause itching or tenderness.
• Lesions can last from two weeks to four years, with an average of two years.

People with HIV or others with weakened immune systems may develop more severe outbreaks.

Visit your doctor if you have symptoms that concern you so that a diagnosis can be made. A doctor needs to see you to check what the lesions or bumps look like.

Most lesions clear up on their own, but you can get them treated with a chemical or freezing, or they may be removed surgically by a doctor. 

• Removal of lesions reduces spread to other people and other parts of your body.
• Lesions may come back; it may be a new infection or a recurrence of the same infection.

If you have molluscum contagiousum, avoid touching anything after you touch your lesions without washing your hands to prevent further spread.

• Be aware that molluscum contagiosum can be spread by vaginal, anal or oral sex or any time there is close skin-to-skin contact.
• Practice safer sex - use condoms or dental dams from start to finish every time you have sex. A condom or dental dam only protects the area of skin that they cover.
• Use a condom on sex toys and do not share sex toys.
• Limit your number of sexual partners. The chances of getting a sexually transmitted infection goes up with each new sexual partner.
• Get tested for other sexually transmitted infections with each new sexual partner.
• Be aware of the symptoms of molluscum contagiosum and do not have sex or intimate skin-to-skin contact with a partner when they have molluscum contagiosum symptoms.