Non-specific urethritis (NSU) is one of the most common sexually transmitted infections (STIs) in men.
It’s also known as non-gonococcal urethritis (NGU) when not caused by gonorrhoea. Urethritis means inflammation of the urethra, which is the tube that urine comes down.
Non-specific means the exact cause of the inflammation isn’t known, but it’s caused by bacteria, parasites or virus (Chlamydia trachomatis, Ureaplasma parvum, Mycoplasma genitalium, Trichomonas vaginalis, herpes simplex virus) picked up from a partner’s mouth, vagina, rectum or penis during sex.
Women can also get NSU but it can be harder to diagnose as it does not cause many symptoms. However, it can lead to pelvic inflammatory disease (PID) if it’s caused by chlamydia and left untreated. PID can be associated with an increased risk of infertility.
There may be no symptoms, but up to three weeks after becoming infected you might notice:
NSU is usually caused by bacteria.They live inside a partner’s mouth, vagina, penis or rectum and can be passed during unprotected oral, vaginal or anal sex.
You might also carry the bacteria on your fingers to your penis or vulva after touching an infected part of your own or someone else’s body.
Using condoms cuts the risk of NSU, which can also be caused by unprotected oral sex. Sometimes NSU is inflammation caused by friction from masturbation and sex.
If you have HIV, having untreated NSU could make it more likely you will pass on HIV during unprotected sex. But if HIV drugs have made your viral load undetectable then NSU and other infections don’t appear to make you more likely to pass on HIV.
There’s a urine test for NSU, or a sample can be taken from the urethra using a swab (a small cotton bud). This might be uncomfortable for a second or two.
A course of antibiotics will cure NSU. Sex should be avoided until the treatment is finished to avoid passing it on. Sexual partners also need to be checked and treated.
The more people you have sex with (especially unprotected sex), the more chance you have of getting infections like NSU. You can have them without knowing, so regular check-ups are a good idea, especially if you’re starting a new relationship and/or you want to stop using condoms with your partner.
If you live with HIV
If diagnosed early, NSU is easily treatable. HIV infection doesn’t affect the treatment regimen.
When you get NSU, it may put your HIV-negative partners at a higher probability of getting HIV from you. This is because STIs often manifest with ulcers, sores, inflammation or broken skin, and they may allow HIV to leave your body and expose your partner more easily. Additionally, people living with HIV having an STI have more HIV in their semen (cum), causing HIV transmission more likely.
If your viral load stays undetectable, you don’t have to worry – there is no risk of sexually transmitting HIV to HIV-negative partners, even if you have STI.
Certain medications for HIV can have unwanted interactions with drugs used for NSU treatment. So, your doctor should be aware of your HIV status and choose the right treatment. You can verify HIV and non-HIV drug interactions at www.hiv-druginteractions.org/checker.
If you don’t live with HIV
If you have NSU, you are more likely to get HIV than someone STI-free. This is because the same types of behaviour and conditions that may put you at risk of getting a sexually transmitted infection STI increase the risk of getting HIV. The presence of STI manifestations such as ulcers, sores, inflammation or broken skin caused by STI may allow HIV to enter your body more easily.
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