Guide to Sexually Transmitted Infections (STIs) and Sexual Health in Thailand

Introduction

The most frequently cited list of threats to the health of expats living in Thailand usually includes factors like air pollution, food poisoning or traffic accidents. But there is another danger you should consider- Sexually Transmitted Infections (STIs) – and you don’t necessarily have to frequent the seedy underbelly of Bangkok’s nightlife to encounter it. If you’re sexually active and want to protect your nether region from looking like a car crash, then postpone logging on to Tinder for a moment and swipe down to keep on reading.

Sexually transmitted diseases (STDs – also known as sexually transmitted infections) are caused by bacteria, viruses or parasites that are most commonly spread through unprotected sex. Anyone who is sexually active is potentially at risk – and prevention is far more convenient than treatment.

With that in mind, let’s untangle some myths and facts on this sensitive issue to help you stay healthy.


MYTH: Online dating is not related to STDs.

FACT: The rise in popularity of dating apps and online dating has been directly linked to a surge in STDs. So make sure you take extra care when getting Thai-friendly online.


General STI symptoms

Depending on the contagion, symptoms can appear within days or weeks (chlamydia, gonorrhoea, genital herpes), or weeks or months (hepatitis B, HIV, syphilis) after the first exposure. This being said, symptoms can often go undetected which is why it is vital to get regular sexual health check-ups.

It’s important to identify and treat STDs as soon as possible. Common symptoms include:

  • Unusual discharge from your genitals or anus;
  • Painful urination;
  • A rash, lumps or skin growths around your genitals or anus;
  • Discomfort, pain, itchiness, blisters or sores around your genitals or anus.

What Happens At a Sexual Health Clinic?

Remember, a general health practitioner probably isn’t an expert and may only test you for the most common infections based on your age or your symptoms, or if you specifically request a particular test. A visit to a sexual health clinic is, therefore, a more sensible option. At the clinic, a doctor or nurse will ask questions about your sex life and may need to examine your genitals or anus.

They will then recommend the most appropriate tests for your situation. If a test reveals you have an STD, it’s important that you tell your sexual partner and any ex-partners so they can get tested and treated too.

You might feel embarrassed, but don’t worry, there’s no need to be – the staff at these clinics see all kinds of infections EVERYDAY. It’s their job and they won’t judge you.

You can go to a sexual health clinic whether you’re male or female, whatever your age, regardless of whether or not you have STI symptoms.

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Staying Safe

You may be proud of yourself for having showing restraint in the throes of passion last night, but that seemingly innocent dry hump also has the potential to attract some unwanted visitors through skin-to-skin contact. Even if you’ve been in a serious relationship for years and both got screened at the beginning, can you say with 100% certainty that neither of you have flirted with temptation?

 

If you are sexually active, getting tested is as important for your health as using protection. Everyone is advised to be screened at least once a year, while sexually active gay, bisexual, and transgender people would benefit from being screened every six months.

Did you know that if detected early, most STI except HIV can be cured with one or two medications?


MYTH: Testing once gives you a clean bill of health.

FACT: Every time you engage in sexual activity, you expose yourself to STD risks.


Sexually Transmitted Infections

Whether you’ve had sexual liaisons with a lady (or gentleman) of the night, or are in a long-term monogamous relationship, here’s a list of common infections you may want to be screened for.

  • Gonorrhoea
  • Chlamydia
  • Hepatitis A, B, and C
  • Genital herpes (HSV)
  • Human Immunodeficiency Virus (HIV)
  • Syphilis

Gonorrhoea

Gonorrhoea first entered public consciousness back in medieval times when it was known as the clap – before we understood what caused it. Nowadays, the bacterium is again becoming more widespread due to an increasing resistance to antibiotics. Gonorrhoea is easily passed through sex without a condom or unclean sex toys, but even wearing protection does not guarantee prevention, due to leakage.

The disease can also be transmitted by oral sex, and less commonly the throat and eyes.  If symptoms appear, they include a thin watery yellow or green discharge and painful urination – usually within a 2 weeks or longer. However, around 1 in 10 infected men and almost half of infected women do not experience any symptoms. If you let gonorrhoea go untested it can result in pelvic inflammatory disease (PID) in women or infertility.

Do you know the funny thing is, you may put of getting tested for so long, but Gonorrhoea is usually treated with a shot of antibiotic and a single antibiotic tablet, followed by a check-up a few weeks later to get the all clear.

Couple STD symptoms Thailand

Chlamydia

Chlamydial infection is one of the most common STDs. Like gonorrhoea, it is easily transmitted through sex without a condom, oral sex, anal sex and can even occur when you and your partner’s genitals come into contact.

Unlike some cases of gonorrhoea, this sneaky little thing often brings no symptoms. If chlamydia does announce itself to its host, the symptoms include pain during urination or a unusual discharge within one to three weeks after being contracted. Often, the symptoms subside until the disease reaches an advanced stage, when it begins to cause inflammation and severe pain which, if not treated quickly, can make the person sterile. If left untreated, not only do you run the risk of being infertile, but you could find yourself some long-term health problems, including PID, epididymo-orchitis (inflammation of the testicles). That is why it’s important to stay on top of your STI screenings.

A simple urine or swab lab test is all your doctor will need to determine whether you’re positive for Chlamydia. If this is the case, a course of antibiotics should be prescribed and you should avoid having sex until you and your current sexual partner have finished the antibiotics.

Sharing isn’t always caring!

Hepatitis A, B, C

Contracting one of the hepatitis triplets can sometimes be as easy as do-re-mi.

Hepatitis A is mainly transmitted through poor sanitation and contaminated food – or sometimes through oral or anal sex. The disease can cause swelling of the liver and, in extreme cases, liver failure. Hep A is usually not a serious illness and most people make a full recovery, however, and you can be protected through a vaccination.

Hepatitis B, on the other hand, is far more serious and is particularly common in Southeast Asia. It is usually contracted by exposure to other people’s bodily fluids, or a cut on your skin, but it is also commonly spread through sex. Many people with hepatitis B will not experience symptoms and may even manage to fight off the infection without realising. However, if symptoms do decide to show up to the party – usually 2 to 3 months after exposure – they include, flu-like symptoms, loss of appetite and yellowing of the skin and eyes.

Infection can result in major liver damage and severely impact your quality of life and life expectancy. The main issue with Hep B is the risk of chronic evolution after the acute phase, which is about 5 to 10% of patients. There is no cure for Hep B, but you can be immunised against it. If you have only been exposed to the virus for a few days, emergency treatment may stop you from becoming infected.

Hep C is endemic in Thailand. It is usually transmitted by sharing contaminated needles in the South East Asian region, and less so through sharing personal care items like razors, or having unprotected sex, although this is rare unless blood is present. Hep C, if left untreated, can lead to cirrhosis of the liver, over time causing the liver to stop working effectively. Be warned: there is no specific preventative medicine or vaccine for Hep C, however it can be treated with medicines that stop the virus from multiplying in the body.

Sexual Health- Insurance Thailand


MYTH: Frequent testing is only for those who engage in risky behaviour, unprotected sex, or who are promiscuous.

FACT: STDs don’t care if you are a courteous lover or if you attend church or temple regularly. They will spread if given the chance, and can also be transmitted in other ways besides sexual intercourse.


Genital Herpes

The symptoms for genital herpes, HSV-2, are small blisters that burst to leave re, open sores on the sexual organs and thighs, which usually take a couple of weeks to heal. The disease can be contracted sexually or orally (as with the HSV-1 virus) and can be prevalent among the general population. In particular instances of genital herpes men and women may mistake the STD for other bacterial or bladder infections and that’s why regular testing and screening is important.

Unfortunately, there is no cure for either of the HSV viruses but symptoms come and go through occasional relapses. It’s during this relapse that a person with herpes is most contagious to others. If symptoms occur doctors can take a swab and test for genital herpes. If you test positive for genital herpes, you should let your previous partners know that they should get tested too. Whilst there is no cure, antiviral medicine can be prescribed to stop the symptoms from getting worse and cream can be administered for the pain.

“How do we protect ourselves from genital herpes?”- Well, using a condom every time you have vaginal, anal or oral sex can help reduce the risk, but herpes can still be passed on if it doesn’t cover the infected area. The sharing of sex toys is not recommended.

HIV and AIDS

HIV is a virus that attacks the immune system and weakens your ability to fight everyday infections and disease. AIDS, the full-blown manifestation of chronic virus HIV, is one of the deadliest diseases to have affected man in recent history. It can be passed from one person to another through sexual contamination.

The first cases of HIV/AIDS were reported in 1984, more than 30 years on the World Health Organization puts the number of deaths from the pandemic at 36 million worldwide. Unfortunately, in Thailand there has been a recent resurgence of HIV among youth, with 23,000 new cases reported in 2012.

The prevalence rate of HIV in Bangkok among men who have sex with men (MSM) is 25% and among female sex workers this stands at 6%.

HIV infection involves 3 phases:

  1. One or two months after incubation, HIV mimics a short-lived flu infection with a high-fever, headaches and cough.
  2. A ‘long silent period’ that has no symptoms and can last anywhere between 2 to 15 years. This can mean victims don’t realise they’re infected with HIV. This delay in diagnosis allows the disease to become more advanced and the virus progressively weakens the immune system by destroying some specific white blood cells.
  3. The resulting condition is AIDS, when the CD4 count reaches lower than 200 cells/mm3  – in which a number of potentially life-threatening infections and illnesses occur. There is currently no cure for HIV, but there are some effective drug treatments that help to suppress the virus and can support a long and healthy life.

HIV can now rapidly be diagnosed with blood and saliva tests within a few weeks or months of contact with an infected individual. It is now recommended by the center for disease control that people have a HIV screening in their annual health check up.

These days treatment is initiated the moment HIV is diagnosed, with a series of antiviral drugs, which are able to prevent up to 80 to 90 per cent of the cases to full-blown AIDS.

STI Health Insurance Thailand


MYTH: There’s no need to worry about HIV these days

FACT: Thailand has one of the highest rates of HIV in Asia (estimated in 2016 at 450,000 out of a population of 70 million), with 1.1% adult HIV prevalence- this highest in the AEC region. HIV mostly affects sex workers, men who have sex with men, transgender people, and people who inject drugs.


Syphilis

Syphilis is a bacterial infection that is usually acquired through close contact such as vaginal, anal or oral sex, or by sharing sex toys with someone who is infected.

Some people with syphilis display no symptoms, but those who do suffer from painless sores or ulcers around the genitals, small skin growths, white patches around the mouth, tiredness and high fever or a blotchy, red rash. In fact syphilis, has so many possible symptoms that it could be mistaken for other diseases.

If you’re worried that you might have syphilis, get yourself down to the clinic to be tested because usually syphilis doesn’t go away on its own. The medicine typically requires a prescription from a doctor and comes in the form of an injection to the buttock or a course of antibiotics.

You should then avoid any sexual contact with another person until at least 2 weeks after your treatment finishes.


Bottom Line

Above all, remember: sex doesn’t need to be dangerous to be good. Staying clean is by far the better solution in the long run. We advocate using protection and having a regular STI Screening.

We also recommend making sure you have comprehensive health coverage, so that you can receive proper medical attention whenever you need it. Contact Luma today to learn about our health insurance options.

Stay Sexy!


Bangkok has resources for HIV/AIDS testing. For testing and consultation, visit:

The Thai Red Cross AIDS Research Centre

Address: 104 Ratchadamri Road, Pathumwan, Bangkok 10330

(5 minutes’ walk from the Rajdamri BTS station and Silom MRT station)

Monday-Friday: 7.30 AM – 3 PM

(Queue system: Testing service closes at 3 PM / Selling medicine service closes at 4 PM)

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