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STIs – What are sexually transmitted infections (STIs)?

Sexually transmitted infections (STIs) are infections that can be passed on during sex – through contact with mucous membranes, body fluids, or tiny skin injuries. This can happen during vaginal, anal, or oral sex, but also through sharing sex toys or other objects.

Many STIs cause no noticeable symptoms at first. Still, if left untreated, they can lead to health problems – and be passed on to others. Most STIs are treatable, and some can even be cured completely.An open and informed approach to sexuality and health helps protect yourself and others.

Chlamydien

Chlamydia are bacteria and among the most common STIs worldwide. They can affect the genital area, anus, or throat – depending on sexual practices.

Symptoms

  • Often no noticeable complaints

  • Burning when urinating

  • Discharge from vagina, penis, or anus

  • Pain during sex or in the lower abdomen

  • For people with a vagina: spotting or unusual discharge

  • Anal or throat infections: often without symptoms

If left untreated, chlamydia can cause complications, e.g. infections of the uterus, fallopian tubes, or testes – which may reduce fertility.

Treatment: Chlamydia are easily treated with antibiotics – often with a single dose.

Recommendation

  • Regular testing if you have new or changing partners

  • In Germany, statutory health insurance covers one annual test for people with a vagina under 25

Gonorrhoe ("The clap")

Gonorrhea is a bacterial infection that can affect the genital area, anus, and throat.

Symptoms

  • Yellow-green discharge from penis, vagina, or anus

  • Burning when urinating

  • Pain or itching in the anal area

  • Throat infections often without symptoms – but still transmissible

If untreated, gonorrhea can cause inflammation, infertility, and chronic pain.

Treatment: Antibiotics. Because of resistant strains, therapy is often adjusted individually.

Important

  • Sexual partners should be tested and, if necessary, treated as well

  • A follow-up test is recommended to confirm treatment success

Syphilis

Syphilis is a bacterial STI that progresses in stages – sometimes over months or years.

Symptoms

  • Early stage: painless sore (e.g. on genitals, anus, or mouth)

  • Second stage: rash, flu-like symptoms, swollen lymph nodes

  • Late stage (if untreated): damage to organs, brain, and nerves

Treatment: Syphilis is easily treated with penicillin. If diagnosed early, it can be cured completely.

Recommendation

  • Regular testing, especially if you have multiple or changing partners

  • Particularly important for men who have sex with men, trans*, and non-binary people at higher risk

HIV

HIV is a virus that weakens the immune system. Untreated, it can lead to AIDS. Today, HIV is very well treatable with medications that stop viral replication. People with HIV can live healthy lives and cannot transmit the virus if treatment is effective.

Symptoms

  • Early weeks: flu-like symptoms (fever, night sweats, swollen lymph nodes)

  • Afterwards: often no noticeable signs for a long time

Treatment:
Antiretroviral therapy (ART) suppresses the virus in the body. If successful, HIV becomes undetectable – and untransmittable (U=U).

Protection

  • Condoms

  • PrEP: daily pill for HIV-negative people at higher risk

  • PEP: emergency medication within 48–72 hours after a possible risk

Hepatitis A

Hepatitis A is liver inflammation caused by a virus. It spreads via contaminated food or fecal-oral transmission during sex – e.g. through anal contact.

Symptoms

  • Nausea, vomiting, abdominal pain

  • Fatigue, fever

  • Later sometimes jaundice (yellow skin/eyes)

Treatment:
Hepatitis A usually clears on its own. No special therapy needed.

Protection

  • Vaccination provides reliable protection

  • Especially recommended for anal practices, travel to high-risk regions, or communal settings

Hepatitis B

Hepatitis B is a highly contagious viral liver infection. Transmitted via blood, semen, vaginal fluids, and other body fluids.

Symptoms

  • Fatigue, nausea, abdominal pain

  • Sometimes jaundice

  • Often no noticeable complaints

Treatment

  • Acute infections often clear spontaneously

  • Chronic infections require regular monitoring and possible treatment

Protection

  • Vaccination is widely recommended, including in childhood

  • Especially important for sexually active people with multiple partners

Hepatitis C

Hepatitis C is a viral infection transmitted via blood – historically via contaminated needles, today also through sex, especially anal practices with blood contact.

Symptoms

  • Often no symptoms for a long time

  • Later: fatigue, abdominal pain, liver problems

Treatment:
Hepatitis C can now be cured with modern medication – usually 8–12 weeks of treatment.

Protection

  • Avoid blood contact

  • Use condoms and gloves (e.g. for fisting)

  • Clean shared sex toys thoroughly


Counseling & Testing at SeGe Köln

Many STIs go unnoticed – regular testing is key to sexual health. We offer confidential, open, and non-judgmental counseling. Even if you have no symptoms, you are welcome here.

  • All genders and sexual identities are welcome.

  • We provide information, testing, and treatment – competent, safe, and free of discrimination.

Other sexually transmitted pathogens include:

  • HPV (human papillomavirus): can cause genital warts and cancer

  • Mycoplasma & Ureaplasma: often involved in genital infections

  • Genital herpes (HSV): causes painful blisters around genitals or anus

  • Trichomoniasis: parasites that cause discharge and itching

  • Scabies: mites transmitted through close body contact

  • Condylomas (genital warts): caused by certain HPV strains

Even if your symptoms are unclear or recurring, we are here for you – whether it’s a known STI or something that needs further clarification.


Mycoplasma (M. Gen)

M. Gen is a bacterial STI. Transmission risk is lower than for chlamydia. It is mainly found in the genital tract, less often in the rectum or throat.

Do I need to be tested?

Usually no.

  • In the general population, only 1–2% carry M. Gen.

  • In STI clinics, rates vary between 4–38%.

  • Many people have no symptoms, and the infection can clear on its own.

When is testing useful?

Only if:

  • you have symptoms, and

  • chlamydia and gonorrhea have already been ruled out

Possible symptoms:

  • Burning when urinating

  • Discharge from penis or vagina

  • Lower abdominal pain

  • Spotting or bleeding after sex

Do my partners need testing or treatment?

The incubation period is 1–3 weeks. Testing before that is not useful.
Only regular sexual partners should be treated to avoid reinfection.

Important to know:

  • Treatment options are not always reliable.

  • Overuse of antibiotics can cause resistance.

  • A “test of cure” 6 weeks after treatment is recommended. About 20% may still test positive temporarily.

More information can be found here: