Despite most people knowing the risks involved, unprotected sex is still something in which a great many will engage. In a 2012 survey of students of university age, two thirds of those who were sexually active said they had had unprotected sex at least once.
There seems to be a general consensus regarding STIs, especially among younger people, that they aren’t as common as they once were. However, official figures suggest otherwise. While reports from PHE did record a three percent drop in STI diagnoses in England between 2014 and 2015, this was thought to be due to less testing being carried out overall. Cases of syphilis and gonorrhoea during this period actually rose, by 20 percent and 11 percent respectively.
Unprotected sex is undoubtedly a key contributing factor in this trend. Ready access to treatment and more relaxed social attitudes to sex mean that more people are enjoying sex with casual partners and fewer are taking precautionary measures.
The majority of reading material on this subject is preventative in tone: it advises, before the fact, on the potential consequences that could occur if protection isn’t used.
However there isn’t quite as much available addressing the topic of unprotected sex after the fact: namely, what to do if you've had it.
For those looking to prevent the development of STIs and UTIs, reduce the likelihood that they’ll pass on an infection to someone else, and also reduce the chances of unplanned pregnancy, here’s our helpful guide to what you should do in the minutes, days and weeks after a casual encounter:
Go to the toilet.
Urinary tract infections can occur in both sexes, but women tend to be much more susceptible than men, and around 8 in 10 female UTI cases develop within 24 hours of sex. Visiting the toilet a short time after sex to urinate helps to flush out bacteria in the urethra, and reduce this risk.
During the following 24-48 hours...
Think about whether or not you need to take emergency contraception.
Provided you’ve been taking your regular pill regularly without interruption during the weeks beforehand (as well as on the day of unprotected intercourse itself and the days following), then the likelihood of pregnancy is still minimal, and emergency contraception is not likely to be necessary.
However, if you aren’t using any form of hormonal contraception, then the chances of pregnancy obviously increase. In such cases, and provided it is suitable for you, the morning after pill might be advisable.
The efficacy of the emergency pill depends on mostly on how soon after unprotected sex you take it.
Upostelle and Levonelle, which both contain levonorgestrel, need to be taken within 72 hours of intercourse (they should not be used after this). They work best when taken within 12 hours of unprotected sex, and are thought to be 84 percent effective at stopping pregnancy.
EllaOne is a slightly different treatment, and this can be taken within 120 hours of intercourse (and again, no later) and is thought to be 95 percent effective.
See a medical professional immediately if you suspect you’ve been exposed to HIV.
If your partner discloses to you that they have HIV, or have had an encounter with someone else who has the condition, then visit your doctor or local GUM clinic as soon as possible. Those thought to have potentially been exposed to the infection may be issued PEP (post-exposure prophylaxis) within a certain window to prevent it from developing.
Get checked out if you notice unusual symptoms.
We’ve discussed previously how a high proportion of STIs such as gonorrhoea and chlamydia cause no noticeable symptoms, and this is why getting tested is crucial.
However bacterial infections such as these tend to take between a few days and a couple of weeks for symptoms manifest, while those associated with UTIs, BV or fungal infections may develop much sooner. So if you notice anything such as a change in discharge (or in men, any sort of discharge at all), irritation or pain during urination, then these may be signs of an infection, and you should see a doctor.
During the following week…
Get tested for STIs.
As mentioned above, some STIs produce no symptoms at all, so it’s vital to be screened at your local GUM clinic within 7 days of unprotected sex whether you notice symptoms or not.
Where a bacterial infection is found to be present, a practitioner will issue an antibiotic to treat it. Further testing is necessary to ensure that the medication has cleared the infection, and this will typically be undertaken two weeks after treatment has been given.
It’s crucial too to avoid sexual intercourse until you’ve been given the all-clear, so that you don’t risk passing the infection on to someone else.
If you notice any genital lesions, see a doctor.
Herpes doesn’t always produce noticeable symptoms; a high number of those infected with HSV may be carriers but never experience characteristic blisters or sores. The average manifestation time for those who do get symptoms is 5-10 days following exposure. Those who develop herpes can get help from their doctor in the form of antiviral treatment, such as Aciclovir or Valtrex.
Following a missed period...
Get a pregnancy test.
There are new home-testing kits that can detect pregnancy even sooner, but many will advise that you wait until the first day following a missed period to administer it, to get an accurate result. The NHS advises that those who are unsure of when their period is due should wait until at least three weeks after unprotected sex to take the test.
Many home testing kits have a very high degree of accuracy (99 percent in most cases), but those who prefer to be tested by a practitioner to get a definite result can get checked by their GP, or at a local GUM clinic.
3-6 months afterwards...
Get another STI test.
While chlamydia and gonorrhoea may show up on a test within a few days, syphilis and hepatitis B can take up to 6 weeks to develop in the body, and HIV up to 3 months, so it’s important to get tested again following this period to make sure you’re clear.
A word on staying protected
Safe practices are vital for those who are sexually active. Condoms can prevent the transmission of several different types of STIs, limit the risk of UTIs, and significantly reduce the likelihood of unplanned pregnancy: so, particularly if you’re sexually active and engaging in intercourse with more than one sexual partner, their use is a must.
Perhaps the most important thing for couples to keep in mind is to not get swept away in the moment. Take a minute, slow down and think about your options. If either of you has a condom, use it or make sure your partner does. If you or your partner don’t have one, remember that other sexual practices which don’t involve penetration present a much lower risk.