The Better2Know Blog

Hepatitis is a growing problem, and the numbers of people with undiagnosed hepatitis is growing. If you are worried that you might be one of them, then this may be a good choice of screen for you. Better2Know launched its hepatitis screen in April 2012, and it is popular with our patients who have a specific worry.

The hepatitis screen needs a blood sample and the results are available the same day as the sample is received in the laboratory.  It is available in any of our STD clinics across the UK.

The screen tests for:

• Hepatitis A
• Hepatitis B
• Hepatitis C

The hepatitis screen can be done 28 days after any incident you are concerned about.

If you have any questions please call the Better2Know booking team on the number above who are waiting for your call 24 hours a day, 7 days a week.

The Chlamydia infection is a sexually transmitted disease (STD) caused by a bacterium called Chlamydia trachomatis. It is transmitted through sexual contact among individuals who have had multiple sexual partners. Chlamydia is a very contagious sexually transmitted disease which accounts for most of the STDs that have been reported. In fact, the occurrence of Chlamydia is three times the incidence of gonorrhea.

Symptoms of Chlamydia are often similar to the symptoms of Gonorrhea, so a definite diagnosis should be made to come up with the right treatment. Some individuals are asymptomatic and may experience manifestations later in the disease when complications arise.

Chlamydia symptoms in women

Half of women with Chlamydia are often asymptomatic. Female Chlamydia symptoms include:

• Mucopurulent discharge from the vagina and urethra
• Clear to white discharges coming out of the rectal area
• Painful urination or dysuria
• Rectal pain
• Edema on the cervix
• Post-coital bleeding
• Bleeding between periods or mid-cycle spotting
• Painful sexual intercourse of dyspareunia
• Abdominal Pain

More advanced disease may lead to salpingitis (inflammation of the fallopian tubes) and liver inflammation.

Complications of Chlamydia in Women

Chlamydia often leads to infertility in women as a result of inflammation in the fallopian tubes which results in constriction of the fallopian tubes. The egg cells are unable to travel through the tubes to meet sperm cells for fertilization. If this is not the case, the egg cell may be fertilized, yet, not able to travel to the uterus for implantation causing ectopic pregnancy.

Chlamydia infection may also be detrimental among pregnant women. The bacteria can lead to infection and cause amnionitis that may affect the growing fetus. However, it is never transmitted through placental perfusion, but may affect the neonate during vaginal delivery leading to eye infections. In cases of Chlamydia infections during pregnancy, an elective cesarean section is usually planned and employed to prevent contact of the neonate with the Chlamydia bacterial infection.

Treatment for Chlamydia usually involves the administration of the antibiotic doxycycline for 7 days or longer depending on the severity of the disease.

If you’re worried that you may have Chlamydia please contact Better2Know on the number above and book a quick and confidential appointment for a Chlamydia Test to put your mind at rest.

Syphilis is a systemic sexually transmitted disease caused by the spirochete Treponema pallidum. The organism enters the body through abraded skin or intact mucous membrane exclusively by direct sexual contact. The transmission happens when there is contact with the syphilitic lesion. After the entry in the reproductive tract, the organism spread through the body by the lymphatic system and blood circulation.

When the spirochete reaches the organs in the body, it usually causes severe complications such as aneurysms.

Syphilis is the third most common STD, but its prevalence has been reduced due to the advent of antibiotics.

The risk factors for syphilis include being an adolescent, young adult, homosexual male or having multiple sexual partners.

Syphilis has four stages. The presence of syphilis symptoms differ at each stage. These include:

1. Primary stage – This stage involves the appearance of chancre and enlargement of the lymph nodes. Chancres are oval ulcers that appear on the genitals, anus or mouth. These sores disappear after 4 to 6 weeks.

2. Secondary Stage – This stage occurs 2 weeks to 8 months after the disappearance of the chancre. This stage involves the appearance of Condylomata lata, a highly contagious, broad based flat papules that develop in the labia, anus or corners of the mouth.

3. Latent Stage – This stage occurs 2 or more years after the appearance of primary lesions. In this stage, there are no symptoms and transmission is not possible through sexual contact. Some patients remain in this stage.

4. Late Stage – This stage of infection involves affectation of the other organs such as joint inflammation, bone disorders, aneurysms, heart valve involvement and CNS disorders. This stage, however, is not infectious.

Syphilis Test

Syphilis testing is important to prevent progress of the disease due to prompt treatment. Syphilis tests involve the collection of blood samples for laboratory testing such as the treponemal and non-treponemal syphilis tests including VDRL tests.

When the diagnosis is ascertained, treatment for syphilis usually includes the administration of antibiotics, specifically penicillins. Early stages of syphilis may only require a single dose of intramuscular penicillin. Late stages may require more frequent administration.

If you’re worried about Syphilis please contact Better2Know on the number above to book your confidential appointment for a Syphilis test today.

In advance of World Hepatitis Day this Saturday 28 July, The Hepatitis C Trust warns that high numbers of people remain unaware of the risks associated with the virus, which if left untreated can cause cirrhosis, liver cancer and even death.

Better2Know is now offering the latest in rapid HIV testing at many of its locations.  This HIV test gives results in just 20 minutes with over 99% accuracy just 26 days post your potential exposure. (The number of days is a minimum – so you can take the test at any time starting at day 26).  This test looks for HIV I and II antibodies as well as the p24 antigen.

This HIV test is available in:

London

Belfast

Cardiff

Cheltenham

Chichester

Edinburgh

Guildford

Liverpool

Manchester

Milton Keynes

Newcastle

Oxford

Portsmouth

Sheffield

Swansea

If you have any questions or want to book, please call us on the number above.

Herpes infection is a sexually transmitted disease caused by the herpes virus. Herpes has two types: Herpes simplex type 1 and herpes simplex type 2. Herpes simplex type 1 is otherwise known as oral herpes while herpes simplex type 2 is genital herpes.

The FDA (Food and Drug Administration) in the United States, has approved the use of a drug called Truvada to prevent HIV.

Home STD testing is now available to diagnose STD’s without going to STD clinics. This is sometimes a more conventional way for STD testing because it saves time and also avoids stigma for the patient that goes for the diagnosis of STD. Patients are usually reluctant to go for tests because they fear being judged by other people. Home STD testing is the solution for the problems of patients who want to be tested for STD and is reliable, cost efficient and confidential.

STD’s vary and can include:

• HIV/AIDS
• Gonorrhea
• Syphilis
• Chlamydia
• Herpes (Herpes simplex Virus type 2)
• Genital warts or Human Papilloma Virus infection
• Hepatitis B
• Hepatitis C
• Ureaplasma
• Mycoplasma
• Candidiasis
• Trichomoniasis
• Non-specific Urethritis

The advantage of the Home STD test is the patient can choose whether to test the presence of most, if not all, of the STD’s or can choose what STD to check, depending on the possible exposure of the individual. Symptoms of STD’s are usually vague and often resemble each other, which makes the Full STD screening advantageous.

STD clinics offer home STD test kits that can be applied online. The home STD test kits are usually mailed to recipients where they collect urine samples and resend it back to STD clinics for testing. In this way, patients don’t have to be present for testing. Results are also reliable and quick and are sent to the recipient again. Results may also be checked online.

Home STD test kits compose of a specimen bottle for urine. These are mailed through posts from the online store or clinic. After which, the container is mailed back using prepaid postage. Results are available after 3 days or more depending on the STD to be checked.

By using the home STD kits, the privacy of the individual is protected. Private STD clinics also allow the use of false or anonymous names to protect the client. In addition, STD clinics also do not share the information to third parties, thereby ensuring confidentiality and maintaining privacy of the client.

Chlamydia is a sexually transmitted disease caused by the bacterium Chlamydia Trachomatis. It infects the reproductive tract and may lead to possible inflammations of the abdominal organs. Chlamydia is the most common sexually transmitted disease with an incidence of 2 million cases per year. Chlamydia is transmitted through intimate sexual intercourse.

A report by the National AIDS Trust has found that police advice on dealing with their own risk of HIV and that of people in custody is outdated and inaccurate.

A study based in four different settings in London found that by testing people (regardless of their risk profile) for HIV.  The HINTS study was conducted between August 2009 and September 2010, in an A and E dept, inpatients dept, a skin conditions clinic, and a large GP practice.

As reported in our blog on 18 May 2012 the FDA in the US has now approved an over the counter HIV test which can provide a result at home in 20 to 40 minutes.  The test uses saliva which does have a higher rate of false positives, but recommends that all positive tests are followed up with a blood test.

The Health Protection Agency (HPA) has called for everyone in the UK to be tested for HIV. The HPA’s Annual Report states that the number of people who are living with HIV in the UK is now just under 100,000, but more than 21,000 (I in 4) of these do not know that they have the virus.  Increasing the number of people who are tested would help early diagnosis, which has two benefits:

• early treatment and medical intervention is key to preventing the disease from progressing
• prevents new infections

Currently, 1 in 5 people attending a GUM clinic refuse an HIV test and are only tested for Chlamydia, gonorrhoea and syphilis.  This is because they are scared to know their status, or do not think it can happen to them. If you think you may be at risk of catching one STD, you cannot tell which one it might be, which is why Better2Know offers a comprehensive screening choice and range of tests.

The HPA also reported that the standard of care in the UK for people with HIV is excellent with excellent access to treatment and lower than expected CD4 counts (a measure of the progress of the infection).

Better2Know offers HIV testing at 10 days after potential exposure (such as unprotected sex) using an advanced technique looking for the actual HIV virus, and then the 28 days after potential exposure test called the H- Duo which looks for both the antibodies and the antigen (the body’s reaction to being infected with the virus).  The Terrence Higgins Trust recommends testing:

• immediately you are worried – to get initial peace of mind, but also help with contact tracing should you later be HIV+
• at 28 days with the H-DUO test
• at 3 months
• at 6 months

Better2Know only uses blood tests (not saliva which is less reliable) to test for HIV.  Instant (up to 20 minutes) tests for HIV are also available in some of our clinics.  HIV tests at 10 and 28 days post potential exposure are available at all our Nationwide clinics.

A new study published by the BMJ shows that the UK’s national screening programme for chlamydia which started in 2000, and aimed to test all 16-24 year olds, has meant a significant decreased in the prevalence of the infection.

The number of new cases of gonorrhoea rose 25% in 2011 from the year before in England.  There are now cases of gonorrhoea (a bacterial infection) in Japan and Europe which so far have failed to respond to antibiotics which are used to cure the Sexually Transmitted Infection (STI).

In a new survey of General Practitioners (GPs) in South East London, where more than 2 in 1,000 of the population is HIV+ (the highest in the UK), Family Doctors reveal why they do not routinely give their patients HIV tests:

The below is the abstract to a report which shows why men as well as women should be tested for Gardnerella.

Although the incidence of Hepatitis C in the UK is relatively low, A study conducted using residual sera collected as part of the HPA Sero-epidemiology programme suggested that around 106,000 individuals became infected with hepatitis C between 1986 and 2001 (HPA 2009 report Hepatitis in the UK).

Primary prevention of hepatitis C infection involves a variety of practical measures, some aimed particularly at risk groups, and other more general measures to ensure that the national blood supply is safe through donor selection and screening. Rates of HCV-related serious liver disease are increasing. Unfortunately, many people living with hepatitis C are unaware of their infection status, resulting in a silent reservoir of infection in society.

An important part of the overall strategy to control hepatitis C is to improve awareness of the infection and encourage testing in risk groups. Once diagnosed, effective treatment can help eliminate a persistent infection, in at least some patients, and so reduce the number of infected individuals. Treatment before the onset of recognisable disease reduces the progression to late complications of infection. Patients who respond to therapy by clearing the virus can avoid the risk of serious liver damage. Among patients who do not respond to therapy, the risk of developing long-term liver damage can be reduced by modifying other risk factors, such as alcohol consumption and avoiding infection with other hepatitis causing viruses.

Having a clear strategy is only the first step in achieving a real impact. Equally important is the delivery of interventions and review of their efficiency.

Progress made to date in the UK varies from country to country, reflecting the different stages of implementation of hepatitis C control programmes and the different approaches taken in the different administrations. A four nations approach will encourage the sharing of good practice and help to identify best practice.

The number of deaths in England due to end-stage liver disease (ESLD) or hepatocellular carcinoma (HCC) with any mention of hepatitis C on the death certificate continues to increase. The number of deaths registered has increased from 81 in 1996 to 230 in 2008. The majority of deaths are in men. The number of deaths in women has remained relatively stable over the last decade.

It is clear from the above facts and report from both the Hepatitis C Trust and the Health Protection Agency, that there is a very considerable health gain from the detection of a Hepatitis C infection. A gain to be enjoyed not only by the individual in whom the infection is detected, where if it had remained undiagnosed, might have lead to cirrhosis, cancer and possibly death, but gains also to society, where infection rates remain on the rise, are recognised by the HPA to be a national health risk, and for which detection of each case can lead to treatment, and the prevention of onward transmission of the disease.

Leaving Hepatitis C undetected can lead to severe complications.

HIV (Human Immunodeficiency Virus) is a retrovirus that can lead to Acquired Immunodeficiency Syndrome (AIDS), a condition in which the immune system begins to fail, leading to life-threatening infections we ordinarily would be able to fight naturally.

You can reduce your chances of catching and/or transmitting an STI or STD by following the suggestions:

A new report published by the National AIDS Trust calls for technology to become a greater part of  helping people newly diagnosed with an STI including HIV to tell their former partners.

New cases of gonorrhoea rose by 25% in the UK in 2011.  A report published by the HPA shows that gonorrhoea is now the second most common sexually transmitted bacterial infection in the UK behind Chlamydia.  There were 20,965 new cases in 2011.

Although bacterial vaginosis can often clear up without treatment, it is advised that all women with BV signs and symptoms be treated to avoid complications. Male partners do not usually require treatment. BV can spread between female sex partners.

It is important to remember that it is usually impossible to have entirely safe sex with another person.

But there are some other things you can do to help protect yourself from catching an STI / STD:

• The HPV vaccine can help protect some people against the HPV virus which causes genital warts and some cancers including cervical cancer.
• The Hepatitis B vaccine can help protect against the Hepatitis B virus.
• Some studies have indicated that Male circumcision can help protect against the transmission of HIV. Note this is NOT to be relied upon and the use of condoms is always highly recommended.
• Regular testing for all STD’s and STI’s has been proven to reduce the overall incidence of infections. Early detection can help in the treatment and outcomes of most infections and diseases.
• Sex with one partner (monogamy) if practiced faithfully is very safe (in regards to STD’s and STI’s). If one partner is unfaithful however, the risk of transmitting an STD or STI increases.
• Good communication is a very important and effective means of determining the risk of catching or transmitting and STD / STI. Partners should openly discuss their sexual habits and history and condoms or other protective barriers should be used. Couples entering into a sexual relationship should both be tested early in their relationship for the full range of STD’s / STI’s.

Other considerations

It is important to remember that most methods of birth control do not protect against STD’s and STI’s.

The birth control pill (The Pill), vasectomy, tubal ligation, contraceptive coils, diaphragms, contraceptive foams and gels, sponges and other contraceptive methods do not offer any protection against contracting and STD or STI. Whilst condoms (both male and female) do provide good protection against pregnancy and STD’s / STI’s) they are never 100% effective.

Pulling out prior to ejaculation (coitus interruptus) when the penis is withdrawn from the vagina, anus or mouth before ejaculation is not safe and does not prevent either pregnancy nor the possible transmission of STD’s / STI’s. Even before ejaculation, the penis can release pre-ejaculate fluid which can carry bacteria, viruses and other disease causing organisms, and it can also carry sperm which can lead to pregnancy.

Alcohol and other drugs

It is important to remember that if you have drunk to much alcohol or have taken drugs, your judgement may be impaired and your ability to resist having unsafe sex may be reduced.

Ureaplasma Urealyticum is a bacterium which occurs naturally in men and women.  Therefore, it is not considered a classic STI, although it can be passed on through sexual contact.  When a colony of Ureaplasma Urealyticum overgrows, it can cause irritation, discharge, inflammation, and red swellings and itching.

If untreated, ureaplasma can cause complications such as infertility and make giving birth much harder.

Ureaplasma is tested with a sample of urine.  You can test for Ureaplasma at Better2Know on its own or as part of our Platinum, Full and Comfort Screens.

Ureaplasma can be treated with a course of antibiotics.

24% of deaths of  HIV positive adults in the UK were due to late diagnosis of their HIV Status. These figures are according to National Audit Data.  One third of newly HIV positive people do not know their status within a year.  This makes them more likely to infect new partners.  HIV is no longer considered to be a life threatening condition, as long as it is detected early, and treatment started.  Knowledge really is power when it comes to managing HIV.

When you are worried that you may have an STD or STI, the idea of waiting for an appointment for an STD test can add to these concerns.