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Sexual health is often referenced to medical and reproductive topics such as sexually transmitted diseases, safe sex practices, and unplanned pregnancies.

However, sexual health also covers aspects such as sexual attitudes, values, sexuality, sexual rights, healthy self-esteem, sexual education, and more.

Being sexually healthy or equipped in your sexual health care is key to achieving health physically, mentally, emotionally, and holistically.

On this resource page, we will share more about the medical aspects of caring for your sexual health.

Sexually Transmitted Infection (STI) is an infection that can be transmitted through sexual intercourse (the methods include vaginal, anal, or oral) or close body contact with another person who is infected with an STI.

Some STIs can also be transmitted from an infected mother to her baby during pregnancy or delivery, through sharing of injection needles or other piercing instruments, contaminated blood transfusions, or sharing of contaminated sex toys.

Are STIs the same as STDs (Sexually Transmitted Diseases)?

While all STDs begin as infections, not all STIs eventually develop into STDs. For example, the Human Papillomavirus (HPV) is most times cleared by the body. However, it may go on to develop diseases such as genital warts and cervical cancer. 

Depending on the type of infection or disease, its symptoms and treatment would vary. It is important to note that many STIs / STDs do not result in obvious symptoms. This means individuals can transmit the virus to others without knowing it. Hence, it is important that these individuals, especially those who are sexually active or who participate in high-risk activities, go for regular screenings to protect themselves and their partners.

Vaccinations also serve as an added protection against certain types or strains of STIs/STDs. Currently, the STI-related vaccines available in Singapore include the Human Papillomavirus (HPV) and Hepatitis B vaccines.

Some of the common STIs or STDs include:

  • Chlamydia
  • Gonorrhoea
  • Syphilis
  • Genital Warts - caused by strains of the Human Papillomavirus (HPV)
  • Genital Herpes - caused by the Herpes Simplex Virus (HSV)
  • HIV / AIDS

Human Papillomavirus (HPV) is a very common virus that can infect both men and women. HPV is transmitted through skin-to-skin contact such as close genital contact during sexual activity.

HPV infections usually do not cause any symptoms.

There are more than 200 different strains of HPV, grouped into high-risk strains that may cause cancer and low-risk strains that do not cause cancer.

High-risk strains are associated with cervical cancer and other cancers such as vaginal, vulvar, oral, anal, and penile cancer.

Other low-risk strains may lead to genital, oral, or other skin warts.

In most cases, the infection can be cleared by the body's immune system. However, sometimes the infection can persist and cause abnormal changes to the cells, which may develop into cancer.

Some risk factors for the development of cancer include the individual’s immune status (those who are immunocompromised are more likely to have persistent HPV infections and an accelerated progression to pre-cancer and cancer) and co-infection with other STI agents.

Regular screenings, coupled with getting the HPV vaccination, are recommended means for the prevention and/or early detection of the HPV infection, alleviating one’s risk of cervical and other HPV-related cancers.

Hepatitis B is an infectious illness caused by the hepatitis B virus which infects the liver. It is transmitted through sexual intercourse (vaginal, anal, or oral), from mother to child (during childbirth), contaminated blood transfusion, sharing of injection needles and other piercing instruments, and contaminated needle stick injury. 

The Hepatitis B virus may not cause any symptoms or may present with severe liver disease upon screening. Individuals with acute Hepatitis B will experience symptoms such as a low-grade fever, nausea, loss of appetite, dark tea-coloured urine, and jaundice.

Chlamydia was reported as the top-occurring STI in Singapore in 2018, affecting both men and women. It is transmitted through sexual intercourse (vaginal or anal) and sometimes can be passed on via oral sex. It often does not cause symptoms, especially in women.

Some of the symptoms include abnormal bleeding or vaginal discharge, pelvic pain, pain when urinating (for women); as well as discharge from the penis, increased frequency of urination, and burning sensation in the penis when urinating (for men).

Possible complications in women include Pelvic Inflammatory Disease (PID), which involves infection in the womb, fallopian tubes, and ovaries. PID can cause infertility and ectopic (abnormal) pregnancy. Chlamydia can increase the risks of premature birth and stillbirth; babies of infected mothers can be infected in the eyes and lungs during delivery.

Possible complications in men include Epididymitis (painful and swollen testicles) and infection in the rectum.

Having chlamydia (or any STI) can also increase one’s risk of contracting HIV.

Gonorrhoea was reported as the second most occurring STI in Singapore in 2018, affecting both men and women. If left untreated, it may spread locally causing health complications. It is transmitted through sexual intercourse (vaginal, anal, or oral), as well as from mother to child during childbirth.

Symptoms include thick white genital discharge and pain when urinating. Possible complications include Pelvic Inflammatory Disease (for women) and Epididymitis (for men).

Syphilis was reported as the third most occurring STI in Singapore in 2018, affecting both men and women. Men who have sex with men are observed to have a higher rate of contracting syphilis.

Syphilis is transmitted through sexual intercourse (vaginal, anal, or oral), from mother to child (trans-placental infection), contaminated blood transfusion, or sharing of injection needles and contaminated needle stick injury.

Many do not have symptoms or may not be aware as symptoms may go unnoticed.

Symptoms of syphilis occur in four stages, as follows:

  • Primary – Painless sores on the genitals and sometimes in the mouth
  • Secondary – Rash on palms and soles, swollen neck and armpit glands, growths on the genitals and anus, patchy hair loss, brain infection
  • Latent – Disease may cause damage to the internal organs
  • Tertiary – Permanent damage occurs to organs

Syphilis can cause an individual to be more susceptible to other STIs.

Human Immunodeficiency Virus (HIV) is an STI that can lead to Acquired Immunodeficiency Syndrome (AIDS). HIV is transmitted through sexual intercourse (vaginal or anal), sharing of injection needles, from mother to child (during pregnancy, at birth, or through breastfeeding), and contaminated blood transfusion.

HIV disrupts an individual’s immune system and weakens the body’s natural defences against even minor infections. AIDS occurs at the end of an HIV infection and can be fatal due to complications.

Most individuals with HIV do not display obvious signs or symptoms, hence, the importance of regular screenings for those who engage in high-risk activities.

Under the National HIV Testing Recommendations, it is recommended that every adult at the age of 21 years and above should get tested for HIV at least once in their lifetime regardless of risk factors, and people at higher risk of HIV infection should be tested more frequently.

Fact #1: STIs or STDs CANNOT be transmitted through sharing of food, utensils, toilet seats, swimming pool, or through handshakes and hugs.

Fact #2: Some STIs can be transmitted through deep, wet kissing, especially when the individual has active symptoms or oral infections. These include syphilis, herpes, oral HPV, chlamydia and gonorrhoea.

Fact #3: Mosquitoes, ticks, or other insects cannot transmit STIs. In the case of mosquito bites, the virus is destroyed in the mosquito’s gut. Mosquitoes also have separate one- way channels for the sucking of blood, and for the inoculating of saliva into the people they bite.

  • Get vaccinated for protection against diseases and infections

    • The vaccines available in Singapore include the HPV and Hepatitis B vaccines. UHC provides both vaccines (more details below).

  • Go for regular screening

    • Many STIs / STDs can go undetected as there may not be symptoms, or the symptoms may not be obvious. Regular screening is the best method for early detection and treatment to prevent future complications. Consult your doctor on the type of screening you should opt for.

  • Observe good personal hygiene

    • This includes washing up before and after any sexual activity and refraining from sharing of towels or undergarments, as well as objects such as razors, needles, or sexual toys.

  • Abstaining from sex or casual sex

    • Practising abstinence from sex or monogamy are some ways to alleviate the chances of contracting an STI / STD.

  • Use barrier contraceptives such as condoms

    • Condoms are often used primarily as a form of contraception. Individuals who practise other forms of contraception may omit the use of condoms, which in turn places them at higher risks of an STI infection. It is important to note that condoms play a key role in the prevention of an STI / STD transmission.

The HPV vaccines approved for use in Singapore are Cevarix and Gardasil 9.

The HPV vaccination offers protection against specific types of HPV infection that may lead to cervical cancer.

Cervarix provides protection against 70% of all cervical cancers.

Gardasil 9 provides protection against 90% of cervical cancers. It also provides protection against other specific cancer- and non-cancer-causing strains of HPV infection. It is clinically effective for both males and females.

The vaccine is most effective if given before the first sexual exposure. It is still beneficial for individuals who are sexually active, as they may not have been exposed to the HPV strains covered by the vaccine.

UHC offers the Gardasil 9 vaccination, which is administered in the form of an injection over three doses in the following intervals (1st dose, 2 months after the 1st dose, and 6 months after the 1st dose).

Always consult a doctor if you are unsure about your vaccination eligibility.

Is the vaccine completely effective for HPV prevention?

  • As with any vaccination, the HPV vaccination does not provide 100% protection. Cervical cancer can be caused by other HPV subtypes which the vaccine does not protect against.
  • The HPV vaccination is not a substitute for routine cervical cancer screening. Women who have received vaccination should continue regular cervical screening according to the local guidelines.

The Hepatitis B vaccination protects against the Hepatitis B virus, which infects the liver.

The Hepatitis B vaccine is effective only for people who have not been infected with the Hepatitis B virus. Individuals who do not have antibodies from a previous Hepatitis B infection and who are not Hepatitis B carriers can receive the vaccination.

UHC offers the Hepatitis B vaccination, which is administered in the form of an injection over three doses in the following intervals (1st dose, 1 month after the 1st dose, and 6 months after the 1st dose).

Always consult a doctor if you are unsure about your vaccination eligibility.

Consult a doctor for advice on appropriate screenings / treatments, or as soon as you notice any signs and symptoms of an STI. Individuals should also avoid any form of sexual activity or high-risk activities to prevent possible further transmission.

Types of STI screening methods include blood tests, swab tests, and urine tests. Test varies for different infections. More information is available here.

Treatment processes also vary for different infections.

For medical advice and support, you can visit UHC or the clinics listed here.

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