Sexually Transmitted Diseases

Sexually transmitted infections (STIs) are diseases which are spread by very intimate physical contact. This occurs through intercourse including vaginal, anal, and oral as well as skin-to-skin contact.

Anyone who engages in close, intimate physical contact can get STIs and pass them to another person. Mothers who are infected can transmit them to babies.

Prevention

The most reliable way to avoid transmission of sexually transmitted infections (STIs), is not to have sexual intercourse including oral, vaginal and anal sex.

Another way to lessen the risk for STIs is to be in a long-term, mutually monogamous relationship with an uninfected partner. This means having sex with one uninfected person who has sex only with you. Both partners can be tested for STIs including HIV before starting sexual intercourse.

If a person chooses to have sexual intercourse with a partner whose infection status is unknown or who is infected with HIV or another STI, a new condom should be used consistently and correctly each time.

The male latex condom is effective in preventing the sexual transmission of HIV and can reduce the risk for other STIs including gonorrhea, chlamydia, and trichomonas. Condoms are more effective in preventing infections transmitted by fluids than preventing those transmitted by skin-to-skin contact like herpes or genital warts. This is because the condom does not cover all exposed areas. It does protect the areas that are covered by the condom.

In order to be highly effective in preventing STIs, condoms need to be used consistently and correctly. Use a new condom with each act of sexual intercourse including oral, vaginal, and anal.

Spermicides containing nonoxynol-9 (N-9) are not effective in preventing STIs. Frequent use of spermicides containing N-9 has been associated with genital sores or irritation. This break in the skin can increase risk of HIV transmission.

Limiting the number of sexual partners may also reduce the risk of STIs.

Birth control methods other than condoms do not protect women from STIs including HIV. A male condom or a female condom can reduce the risk of STIs for these women.

Vaccination is a very effective way for preventing certain STIs. Hepatitis B virus is spread commonly through unprotected intercourse. It is recommended for all unvaccinated people being evaluated for STIs to get vaccinated. Hepatitis A vaccination is recommended for intravenous drug users and men who have sex with men. Additional vaccines may be available in the future.

Common Sexually Transmitted Infections (STIs)

1. Bacterial Vaginosis (BV)
2. Chlamydia
3. Genital Herpes
4. Genital Warts
5. Gonorrhea
6. Hepatitis B
7. HIV/AIDS
8. Pubic Lice
9. Scabies
10. Syphilis
11. Trichomonas

1. Bacterial Vaginosis (BV)

BV is a syndrome that results from a change in the natural balance of the vagina. It is the most common cause of vaginal discharge and odor. The cause is not fully understood. BV is associated with having multiple sex partners, douching, and a lack of normal vaginal bacteria. It is unclear if it results from a sexually transmitted germ. You don't have to have sex to get BV. Treating a male sex partner has not been helpful in preventing BV from coming back.

Symptoms:

• Vaginal discharge
• Fishy odor
• It is possible for women to be unaware of symptoms.

How BV is spread:

• The exact cause of BV is unknown.
• Occurs more frequently in women who have new sexual partners
• Occurs in women who have more than one sex partner.
• However, BV is also found in women who are not sexually active.

Diagnosis:

• Examine vaginal discharge.
• Determine vaginal pH.
• Perform a microscopic exam of vaginal discharge.

Treatment:

• Antibacterial pills or creams are used to treat BV.
• Medications are available only by prescription.
• Clinical research trials have not found treatment of sex partners helpful in preventing recurrence of BV. Therefore, routine treatment of partners is not recommended.

Protection:

• Use condoms.
• Avoid douching.
• Avoid perfumed soaps and feminine hygiene sprays.

2. Chlamydia

Chlamydia is one of the most common sexually transmitted infections. It is also one of the most serious. It is caused by bacteria spread from one person to another during sex or from mother to baby during birth. It should be treated at once.

If left untreated, men and women are at risk for becoming sterile. Parts of the reproductive tract may become scarred and lessen a person's ability to have children. It can also cause eye, ear and lung infections in babies.

Symptoms:

• Slight discharge from penis.
• Burning during urination.
• Vaginal discharge.
• Abnormal vaginal bleeding.
• Abdominal pain.
• Pain with intercourse.
• 50% of men and 70% of women don't know they have this STI.

How Chlamydia is spread:

• Vaginal and anal intercourse.
• From mother to baby during delivery.

Diagnosis:

• A urine test can diagnose chlamydia.
• A swab of the cervix, urethra or anus can also diagnose chlamydia.
• You can be tested even if you have no symptoms.

Treatment:

• Prescribed antibiotics
• A person will get chlamydia again unless every sex partner is tested and treated.

Protection:

• You can lower your risk by abstaining from sexual activity.
• Have sex with only one uninfected person who only has sex with you.
  Latex condoms, when used consistently and correctly, can reduce the risk for chlamydia.

3. Genital Herpes

Genital herpes is a recurrent, life-long viral infection. Two types of herpes have been identified: herpes simplex virus-1 and herpes simplex virus-2. HSV-1 causes most oral infections. People call these "cold sores". HSV-2 causes most genital infections. Both types can give you sores in either place. Having one type does not mean that you can't get the other.

Symptoms:

• Most persons infected with genital herpes have mild or unrecognized infections.
• If symptoms occur, they usually appear 2-21 days after contact with a person who has the virus.
• It may be years before an outbreak occurs.
• Fluid-filled sores may appear.
• Itching
• Burning
• Tingling sensation
• Pain
• Flu-like symptoms
• The first outbreak of sores usually lasts 1 to 3 weeks.
• After the sores heal, the virus stays hidden.
• More outbreaks may occur later. This is different for each person.
• Later outbreaks have fewer sores, heal faster and are less painful.

How Genital Herpes is spread:

• Genital herpes is spread by skin-to-skin contact.
• The virus is passed from the part of the skin that has the virus to skin that touches it.
• It can travel in warm body fluids.
• Research indicates that herpes can be spread even if there are no sores.
• More than half of all infections are spread by people who don't know they have them.

Diagnosis:

• Testing the sores when they are new and full of fluid is best.
• Health care providers can examine the sores.
• Blood tests are available but are not recommended for routine screening.

Treatment:

• There is no cure for genital herpes.
• Antiviral medication can treat current outbreaks.

How serious is it? :

• Millions of women with herpes have had healthy babies.
  However, genital herpes can be transmitted to newborns and have serious effects.
• Pregnant women and women of childbearing age who have genital herpes should inform their health care providers in order to prevent transmission to newborns.
• Herpes sores are an easy way for HIV or other sexually transmitted germs to enter a person's body.

Protection:

• You can lower your risk by abstaining from sexual activity.
• Have sex with only one uninfected person who only has sex with you.

• Persons with genital herpes infection should inform their current sex partners and future partners before initiating a sexual relationship.
• Latex condoms, when used consistently and correctly, can reduce the risk for genital herpes when the condom covers the infected areas.
• Abstain from sexual activity when sores are present.

4. Genital Warts

Genital warts is a viral infection that is common among sexually active people. Human Papilloma Virus (HPV) is the name of a group of viruses that cause warts. Certain types of HPV cause warts on the hands or feet, and other types can cause warts on the genitals. Some people never have warts they can see, so many people with HPV do not know they have it. At least half of all people with this infection have no visible warts - yet they can infect others. Very rarely, mothers can pass the virus to babies during birth.

Symptoms:

• Often, people do not know if they have HPV or genital warts.
• Sometimes people do not notice warts because they are inside the vagina or in the anus.
• Warts are often skin colored and do not hurt.
• Warts can be soft, hard, raised, flat, small, large, single or grouped in clusters.
• They may cause itching, pain, or bleeding.
• Subclinical HPV changes can cause a pap smear to be abnormal; this can be the first sign that HPV is present.

How Genital Warts are spread:

• HPV and genital warts are spread by direct, skin-to-skin contact during vaginal, anal or (rarely) oral sex with someone who has the infection.
• People do not get genital warts by coming in contact with warts on the hands or feet.
• Mothers can infect infants during birth but this is rare.
• Warts may appear within several weeks after sex with an infected person; or they may take months or years to appear; or they may never appear.
• Often it is difficult to know exactly when you got the virus.

Diagnosis:

• Health care providers can diagnose warts by physical exam. There must be an outbreak present to be able to diagnose.
• An STD exam and other tests will be done to be sure you do not have syphilis, herpes or other conditions that can look the same as warts.

Treatment:

• The goal of treatment is to remove visible genital warts.
• There are many treatment options: medication applied to warts, freezing, surgical removal, and laser therapy. Discuss with your health care provider which will work best for you.
• Be patient. Most will have to be treated more than once. You may have to try more than one treatment.
• Don't use products intended for warts on your hands and feet. These are not to be used on sensitive genital skin.
• Women with genital warts or female sex partners of patients who have genital warts should have Pap smear screening for cervical cancer on a regular basis.

Protection:

• You can lower your risk by abstaining from sexual activity.
• Have sex with only one uninfected person who only has sex with you.

• Latex condoms, when used consistently and correctly, can reduce the risk for genital warts when the condom covers the infected areas.

5. Gonorrhea

Gonorrhea is one of the most common bacterial sexually transmitted infections. Gonorrhea is passed from one infected person to another through vaginal, anal, or oral sex. It can be transmitted to a baby from an infected mother. If left untreated, gonorrhea can cause arthritis and sterility. It can also cause pelvic inflammatory disease in women.

Symptoms:

• Some experience mild symptoms or no symptoms at all.
• Vaginal discharge
• Burning with urination
• Pus dripping from penis
• Dry, sore scratchy throat
• Rectal discharge, itching, and painful bowel movements

Diagnosis:

• Urine test
• Throat, anal, urethral or cervical culture

Treatment:

• Prescribed antibiotics: shot or pills
• All sex partners need to be tested and most likely treated.

Protection:

• You can lower your risk by abstaining from sexual activity.
• Have sex with only one uninfected person who only has sex with you.

• Latex condoms when used correctly and consistently can reduce the risk of gonorrhea.

6. Hepatitis B

Hepatitis means inflammation of the liver. Hepatitis B can be caused by many things: drugs, toxins, and viruses. Most people recover from the virus, but Hepatitis B may cause very serious liver damage or liver cancer.

A person with a long-term hepatitis B infection is said to be a "carrier." The virus is carried in the blood and can be spread to others. You can get Hepatitis B if you have unprotected sex or share needles with an infected person. Touching an infected person's open sore, sharing a razor, toothbrush or nail clipper can be dangerous. Tiny amounts of blood or other body fluids will spread the virus if direct contact occurs.

Pregnant women who carry this virus can pass it to their babies during childbirth.

Symptoms:

• Yellow color in the skin and eyes
• Loss of appetite
• Nausea
• Vomiting
• Stomach pain
• Joint pain
• Extreme tiredness
• Many people do not have symptoms, yet they have the virus and can infect others.

Hepatitis B is not spread through food, water or casual contact.

Diagnosis:

• Blood test

Treatment:

• There is no cure for Hepatitis B

Prevention:

• There is a vaccine that prevents it.
• It is recommended that babies get vaccinated.
• People whose behavior places them at risk can get vaccinated.

• You can lower your risk by abstaining from sexual activity.
• Have sex with only one uninfected person who only has sex with you.

• Latex condoms when used correctly and consistently can reduce the risk of Hepatitis B.

7. HIV/AIDS

(Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome)

HIV is the virus that causes AIDS. The virus attacks the body's defense known as the immune system. The immune system fights diseases. When it is weakened by HIV, harmful germs can take over. These infections can lead to AIDS which is a late stage of HIV.

Symptoms:

• Most people with HIV have no symptoms for years.
• Fever
• Fatigue
• Loss of appetite
• Severe weight loss
• Sweating at night
• Diarrhea
• Swollen glands
• Cough
• Sores
• Yeast infection

How it is spread:

It is spread by direct contact with infected blood, semen, vaginal secretions and breast milk. A person can get it through unprotected sex and sharing needles. A baby can get it from a mother who has the virus.

HIV can enter another person's body through a break in the skin. Sores and the thin, wet skin near the genitals are easy places for the virus to enter the body.

Diagnosis:

• Blood test
• Saliva test

Treatment:

• There is no cure for HIV or AIDS at this time.
• There are medications that can help the immune system.
• Pregnant women with HIV can take drugs that improve the chances of not passing HIV to the unborn child.

Protection:

• Abstinence
• Having sex with one, uninfected partner.
• Latex condoms, when used consistently and correctly, can reduce the risk for HIV.
• Avoid sharing needles.

8. Pubic Lice

Pubic lice are tiny insects that are also called "crabs" or "cooties." Seen with the naked eye or with a magnifying glass, pubic lice look like tiny crabs. They attach themselves and their eggs to pubic hair, underarm hair, eyelashes, and eyebrows. Their eggs are white and are deposited in small clumps near the hair roots.

Symptoms:

• Intense itching
• Itching can occur as long as 30 days after exposure.
• Visible signs: "moving scab or freckle", white nit at root of hair

How it is spread:

• Direct sexual contact
• Indirect contact: beds, towels or clothing when pubic hairs fall out.

Diagnosis:

• Pubic lice are large enough to be seen without a microscope.
• Self-diagnosis can be made by visual inspection.

Treatment:

• Shampoos, cream rinses and lotions sold at drugstores
• Check with pharmacist because each product has special instructions.
• Sex partners within the last 30 days need treatment.
• If itching continues for more than a week, a second treatment may be necessary.
• Wash clothing and bedding in HOT cycle.
• Dry cleaning or removing items from body contact for 10 days will also kill lice and eggs.

Prevention:

• Limit number of sex partners.

9. Scabies

Scabies is a skin infestation caused by tiny bugs called "mites". These mites burrow between fingers, on wrists, armpits, breast, genitals, skin folds, waist and toes. These are warm moist places they like to live.

Symptoms:

• Intense itching; worse at night
• Small bumps or rashes
• Small curling lines

How Scabies is spread:

• Close contact, including sex, with a person who has these mites
• In adults scabies is often sexually transmitted.
• Scabies in children is usually not sexually transmitted.

Diagnosis:

• Visual exam
• Microscopic exam of a tiny skin scraping.

Treatment:

• Prescribed lotions that kill the mites and their eggs can be used.
• Wash clothing, bedding, and towels in HOT cycle.
• Things that cannot be put in hot water may be wrapped in plastic bags and sealed for 3 or 4 weeks.
• Both sexual and close personal or household contacts within the preceding month should be examined and treated.

Protection:

• Limit the number of sex partners.

10.Syphilis

Syphilis is a very serious disease that can lead to disfigurement, blindness, heart and brain damage, or even death.

Symptoms:

• Primary Stage:
  • A painless, single sore appears in the area where contact was made.
  • It can be on the penis, anus, vagina or mouth.
  • This sore is called a chancre.
  • It is usually hard at the edges and is painless.
  • After 2 to 6 weeks, the sore goes away.
• Secondary Stage:
  • This begins 6 to 8 weeks later.
  • Symptoms include: swelling lymph nodes, rashes and flu-like symptoms.
  • There may be sores or a rash on the palms or soles of the feet
  • These sores can spread the syphilis disease.
• Early Latent Stage:
  • This stage lasts up to one year from time of infection
  • There are no visible signs but damage can be occurring.
• Late Latent Stage:
  • This stage begins after one year.
  • Disease is not spread in this period.
  • Silent damage continues.

How it is spread:

• Skin-to-skin contact with the sores of an infected person.
• Unprotected vaginal, anal, or oral sex.

Diagnosis:

• Blood test
• The sores can also be tested.

Treatment:

• Prescribed antibiotics, given as a shot.
• Both mom and baby can be treated during pregnancy.
• People exposed sexually to anyone who has syphilis in any stage should be evaluated and tested.

Protection:

• You can lower your risk by abstaining from sexual activity.
• Have sex with only one uninfected person who only has sex with you.
• Latex condoms when used correctly and consistently can reduce the risk of syphilis.

11. Trichomonas (Trich)

This is a common STI caused by tiny parasites called protozoa. They live in wet areas of the genitals of infected people.

Symptoms:

• Most men do not have symptoms.
• If there are symptoms, they usually occur 4 to 20 days after exposure.
• Burning with urination.
• Yellow-green Vaginal discharge.
• Vaginal odor.
• Genital itching and irritation.
• Thin, clear or white discharge from penis.

How trich is spread:

• Trich is passed from one person to another during intercourse.

Diagnosis:

• Microscopic exam of vaginal or penile discharge.

Treatment:

• Prescribe antibiotics.

Protection:

• You can lower your risk by abstaining from sexual activity.
• Have sex with only one uninfected person who only has sex with you.
• Latex condoms when used correctly and consistently can reduce the risk of trich.

From : www.co.clark.wa.us/health/clinic