Sexually Transmitted Diseases


Venereal Diseases

There are more than 25 STD’s. STD’s are among the most contagious diseases in the United States, about one in four adults has a STD. Every year there are 12 million new cases.

Most STD’s can be cured if treated early. STD’s frequently cause reproductive health problems, making pregnancy difficult or impossible. They can infect newborns. With out proper medical attention STD’s can cause: blindness, cancers, heart disease, and even death.

All STD’s are spread while having sex- vaginal, oral, or anal. An infected person can spread the STD through body fluids, such as, semen, vaginal fluids, and blood. Some diseases, herpes, are spread through direct contact with infected skin. STD’s can be spread from man to woman, vise versa, from man to man, and woman to woman.

Anyone who has sex can get an STD. Wether Male or female, homosexual or heterosexual, young or old, people of all races. Noone is immune.

STD Approximate # affected annually in the US
Chlamydial infections 4 million
Trichomoniasis 3 million
Gonorrhea 1.1 million

STD Approximate # affected annually in the US
Genital Warts 750,000
Genital Herpes 40 million

500,000 each year

Hepatitis B 100,000 - 200,000
Syphilis 120,000
HIV infection 1 million

45,00 per year

Often there are no signs or symptoms.

So if you’ve had sex with someone you think is infected with an STD, a test from the doctor may be the only sure way to tell if you’re infected. It is important to know what to look for in yourself and others. Be alert to body changes in the genital area. These warnings might appear right away or they might come and go. Even if the signs and symptoms do disappear, the disease might still be active. STD’s usually don’t go away on their own. Some signs and symptoms are:

Men and Women:

  • Sores, bumps, or blisters near your sex organs, rectum, or mouth.
  • Burning or pain when you urinate.
  • Swelling or redness in your throat.
  • Swelling in the area around your sexual organs.

Women:

  • Unusual discharge or smell from your vagina.
  • Pain in your pelvic (lower belly) area or deep inside your vagina during sex.
  • Burning or itching around your vagina.
  • Bleeding from your vagina other than your regular menstrual periods.

Men:

  • A drip or discharge from your penis.
  • Pain in your testicles.

Acquired Immune Deficiency Syndrome (AIDS):

Acquired Immune Deficiency Syndrome (AIDS) is the most serious STD because so many people with AIDS have died. There is no cure or vaccine for AIDS. AIDS is to most serious stage of viral infection caused by Human Immunodeficiency Virus (HIV). This virus attacks the body’s immune system and leaves the person with AIDS unable to fight off many kinds of infections and cancers. The U.S. Public Health Services estimates that as many as 1 million are now infected with HIV in this country. Most of them have no symptoms yet, but many will someday develop AIDS. AIDS is different from most other STD’s in several ways.

HIV lives in the blood, semen, and vaginal fluids. If infected blood, semen, or vaginal fluid gets into your body, the virus might infect you, too. Most of the people with AIDS became infected from having sex or sharing needle with an infected person. HIV can be passed from a mother to her baby during pregnancy or at birth. In the past HIV was spread through blood transfusions that had the virus in them. As of March 1985, all blood supplies are screened for the virus, so the risk is very low. The most important thing you need to know about HIV infection is that in most cases there are no symptoms for months or even years. However once infected with the virus, even before any symptoms, individuals can transmit it to others. That means that most people who have the virus are spreading it without even knowing it.

There are no easy clues. HIV makes you vulnerable to all kinds of illnesses, so there are many different symptoms. Some of which have nothing to do with the general region.

You don’t get HIV from touching, kissing, food, coughs, mosquitoes, toilet seats, donating blood, or public swimming pools.

To prevent HIV infection, avoid unprotected sex with infected persons and the sharing of needles or syringes. You can protect yourself from HIV by following the safer sex guidelines used for other STD’s: use condoms regardless of the sexual act, for vaginal sex spermicide be used in addition to condoms. Remember the virus is most easily spread through blood. So anal sex, which causes bleeding, is very risky. So is the sharing of needles to shoot drugs into the bloodstream.

If you think you’ve been exposed to the AIDS virus and have persistent sighs of illness, consult a doctor, or call your local STD clinic run by the health department. For general AIDS information and referrals, call the National AIDS Hotline (1-800-342-AIDS). The call is free and noone will ask your name.

STD’s do not lead to AIDS.

However it has been found that HIV is more easily spread through STD’s that cause genital sores. People with herpes, syphilis, chancroid, or other infections that cause skin breaks. People with an Std should talk to their health care provider about the risk of HIV and the possible need tor an HIV antibody test, which is a special blood test. STD’s usually do not go away without treatment. Instead, they may well get worse. So it’s important to get help from your doctor or from an STD clinic as soon as possible. Tests are safe and private. If you want to learn more about STD’s or want to know where to fo in your area for confidential, free treatment, call the National STD hotline at: 1-800-227-8922.

If you are diagnosed with an STD you should:

  • Inform the person(s) you have had sex with so they know they might be infected and should be tested
  • Avoid having sex while you are being treated.
  • Finish taking all of your medications and get a check-up as many times as your health care provider suggests. The infection can stay active even after symptoms go away.

For more information on STD’s:

  • Contact the STD clinic in your local health department.
  • Check with your own doctor.
  • Call the National STD Hotline (1-800-227-8922). It’s toll free and open to calls from 8:00 am to 11:00 pm Eastern Time, Monday through Friday.
  • Call the National AIDS Hotline ( 1-800-342-AIDS). It’s open to calls 24 hours a day, 7 days a week. Spanish-language callers can dial (1-800-344-SIDA). Deaf callers needing TTY/ TTD service can dial (1-800-AIDS-TTY).

Herpes

What Is Herpes Simplex?:

Herpes simplex is a common virus. It causes sores on or near the mouth (often called “cold sores” or “oral herpes”), and it causes the genital sores known as “genital herpes”. There are two herpes simplex viruses- herpes simplex type 1 (HSV-1) and herpes simplex type 2(HSV-2). These viruses are very similar, and either type can infect the mouth or genitals. Most commonly, however, HSV-1 occurs above the waist, and HSV-2 below.

How Do You Get Genital Herpes?:

Herpes is spread by direct skin-to-skin contact. Unlike a flu virus that you can get through the air, herpes spreads by direct contact-that is, directly from the sight of the infection to the sight of the contact. For example, if you have a cold sore and kiss someone, you can transfer the virus from your mouth to theirs. Similarly, if you have active genital herpes and have vaginal or anal intercourse, you can transfer the virus from your genitals to theirs. Finally, if you have a cold sore and put your mouth on your partner’s genitals (oral sex), you can give your partner genital herpes.

What Happens When You First Get Genital Herpes?:

Symptoms of herpes usually develop within 2 to 20 days after contact with the virus, although it may take far longer. In some people, the herpes virus causes a first attack so mild that it goes unnoticed. In others, the first attack causes visible sores. But in either case the virus eventually retreats into the nervous system and lies dormant there.

What Are The Typical Symptoms Of A First Episode Of Genital Herpes?:

  • In a first episode, the skin often becomes inflamed, and soon afterward on or more blisters or bumps appear. The blisters first open and then heal as new skin tissue forms.
  • Also during a first episode, the area is often painful and may itch, burn, or tingle. Flu-like- symptoms are also common. These include swollen glands, headache, muscle aches, or fever. Herpes might also infect the urethra, and urinating might cause a burning sensation.
  • The first episode might last up to several weeks. When the sores are completely healed, the active phase of the infection is over.
  • Symptoms vary from one person to another. In many people the first infection is so mild that it goes unrecognized. Even so, subsequent recurrences of the disease might cause sores.

When Do Herpes Recur?:

Both oral and genital herpes can recur. Some people have frequent recurrences, while other people have them rarely. Most persons with genital herpes do have recurrences. The average is about four recurrences per year, and for many individuals the number of recurrences decreases as time goes on.
At the beginning of the infection, the herpes virus escapes the immune defenses by entering the nerve endings and traveling to the ganglia, the virus is inactive, and it causes no harm to the body or nerve cells. From time to time, however, the virus can be re-activated. When that happens, it travels back down the nerve to the surface of the skin. There it starts to multiply, causing another out break. Recurrences usually develop near the site of the initial infection, but they can relocate. For example, sometimes a person will experience recurrent herpes on the genitals for a period of months or years and then find the virus relocates to the buttocks.

What Are The Symptoms Of Typical Recurrence?:

During a first episode, the immune system develops antibodies and other weapons against the virus. Therefore, during a recurrence the immune system is prepared to fight off the infection more quickly. As a result, there are usually fewer sores, they heal faster, and the outbreak is less painful. The flu-like symptoms of the first outbreak are seldom present.

What Triggers A Recurrence?:

Herpes infections have different patterns in different people. Many people report that the following factors sometimes-not always- induce an outbreak: surgery, illness. Stress, fatigue, skin irritation (such as sunburn), diet, menstruation, or vigorous sexual intercourse.

When Is Genital Herpes Most Likely To Spread?:

Herpes is most easily spread when sores are present, but it’s often spread at other times too.
Some people notice itching, tingling, or other sensations before they see any changes on their skin. These are called “prodromal symptoms,” and they warn that the virus may be present on the skin. Herpes is most likely to be spread from the time these first symptoms are noticed until the time the area is completely healed and the skin looks normal again.
Sexual contact–oral, vaginal, or anal– poses a very clear risk during this time.
Can Genital Herpes Be Transmitted When There Are No Symptoms?:

Yes. Sometimes small amounts of the virus may be present on the skin without causing any recognizable symptoms. This is called “asymptomatic shedding”. Many genital herpes infections are spread from persons who have no symptoms at a given time but are “shedding” the virus.
Herpes simplex infections also often spread by people who do not know they are infected. These people night have symptoms so mild they don’t notice them at all or else don’t recognize them as herpes.
For those who recognize their symptoms, a sexual contact during asymptomatic periods is less likely to spread the infection than a sexual contact when sores are present. But people tend to have many more contacts when they have no sores, so the risk of asymptomatic transmission is very real. The best way to lower the risk is to use condoms in between recurrent episodes.

What Precautions Reduce The Risk Of Spreading Or Getting The Virus?:

Certain basic principles are important in reducing the risk of getting any sexually transmitted disease, including HIV ( the AIDS virus):

  • You can eliminate your risk of getting any sexually transmitted disease by not having sex with anyone, or by having sex with only a non-infected partner who is only having sex with you.
  • If you are not sure that you and your partner are free of infection, use protection during sex. Condoms (rubbers), used properly from start to finish for each sexual encounter, can be useful protection
  • Spermicidal foams and jellies might off er additional protection.

Why Condoms And Foams?:

Studies have shown that condoms are an effective barrier against many sexually transmitted infections, including genital herpes. When properly used, therefor , condoms are likely to reduce your risk of spreading or getting herpes. But even condoms don’t guarantee your safety. Sometimes herpes sores occur in places not covered by a condom. In these cases, the condom is little if any help. Condoms and foam should not be reapplied upon when herpes sores or symptoms are present.
Contraceptive foams containing the spermicide nonoxynol-9 kill the herpes simplex virus and several other germs that cause STDs. They are recommended for use along with condoms, not in place of condoms.

What Should I Do If I Think I Have Genital Herpes?:

See a doctor while symptoms are still present. The doctor will look at the area, take a sample from the sore(s), and test to see if the herpes virus is present. The test you should request is a specific culture for HPV. The test will not work if the sores have healed and might not work if they’re more than a few days old.

What About Treatment?:

Although there is no cure for herpes, the drug acyclovir has been effective in many cases in reducing the frequency and duration of genital herpes outbreaks. This is a prescription drug that must be ordered by a doctor.
During an outbreak, keep the infected area as clean as possible. This will help your natural healing processes. To prevent chaffing, some people also find it helpful to avoid tight fitting undergarments.
Finally, a healthy immune system may be important in controlling the virus. Don’t ignore the need for proper nutrition, exercise, and rest.

What Else Can I Do After Diagnosis?:
First, get the information you need so you aren’t worrying unnecessarily. Understanding herpes gives you a positive way to deal with your concerns.

Second, seek emotional support when you need it. Keeping your feelings to yourself may do more harm than good.

There is a network of over 90 local support groups in the United States and Canada linked to the Herpes Resource Center. Call the National Herpes Hotline.

Are Complications Possible?:

One kind or complication involves moving of the location of an outbreak to other places on the body by touching the sore(s). The fingers, eyes, and other body areas can accidentally become infected in this way. Preventing self-infection is simple: do not touch the area of an outbreak– especially the first outbreak. If you do, wash your hands as soon as possible. The herpes virus is easily killed with soap and water. Some studies suggest that women with any STD may be at a greater risk of developing cervical cancer than other women. Since early cell changes can be detected by a Pap smear, all women with genital herpes– as with every sexually active woman– should have a Pap smear test at least once a year.
REMEMBER.....
  • You weren’t singled out. In the U.S., an estimated four out of five adults has orofacial herpes, and one in six has genital herpes.
  • If you think you have herpes, see a health care provider or a doctor for diagnosis and treatment.
  • Get more information. The better informed you are about herpes, the easier it will be to manage.
  • Give yourself the best possible chance to limit recurrences by maintaining general good health and keeping stress to a minimum.
  • Take care of the affected skin area– keep the area dry and clean during outbreaks to help healing.
  • Avoid physical contact with the area from the time of the first symptoms– tingeling, itching, burning– until all sores are completely healed (not just scabbed-over).
  • Prevent self-infection to other areas of your body: wash your hands with soap and water if you touch a sore. Better yet don’t touch the sores.
  • Prospective parents: If either mother or father has genital herpes, or the mother’s previous sexual partners had genital herpes, tell your doctor about it.
  • Women with genital herpes: Don’t skip your annual Pap smear.
HPV
 What Is HPV?:
HPV is the name of a group of viruses that includes more than 70 different types. Certain types of HPV causes warts on the hands or feet while others can cause visible genital warts. However, some times HPV infection causes no warts, and many people with genital HPV do not know they have it.
What About HPV That Causes No Visible Warts?:
Some times HPV causes very subtle changes on the skin that can’t be seen with the naked eye. Health care providers can find these “microscopic warts” only with the help of special instruments. In other cases, HPV can live in the skin without causing any warts at all. This is called “clinically inapparent” or “subclinical” HPV infection.
How Would I Know If I Had HPV Or Genital Warts?:
In some cases it’s difficult to know. Sometimes people do not notice the warts because they are inside the vagina, or on the cervix, or in the anus. In addition, they are often flesh-colored and painless. Only rarely do they cause symptoms such as itching, pain, or bleeding. Sometimes warts will be found during a physical exam in men or a pelvic exam in women. For women, an abnormal Pap smear may be the first warning sign that HPV is present, though a Pap smear is not an accurate test for HPV.
You should go to a doctor or clinic if:
  • You notice any unusual growths, bumps, or skin changes on or near your penis, vagina, uvula, or anus.
  • You notice any unusual itching, pain, or bleeding.
  • Your sex partner(s) tells you that he or she has genital HPV or genital warts.

How Are Genital Warts Diagnosed?:

You can check yourself and your partner(s) for warts, but remember: warts sometimes can be very difficult to see. Also, sometimes it’s hard to tell the difference between a wart and other bumps or pimples. If you think you have been exposed to HPV, go to a doctor or clinic. The health care provider will check more closely and may use a magnifying lens to find small warts.
To detect warts or other abnormal tissue, health care providers sometimes put a solution of acetic acid (like vinegar) on the genitals. This causes abnormal tissue to turn white and makes it easier to see, especially if it is viewed through a magnifying lens such as a colposcope. This is not a specific test for HPV but is commonly used in detecting cervical HPV infection.

How Is Subclinical HPV Infection Detected?:

A Pap smear is a test designed to detect precancerous cervical changes- not HPV. However, an abnormal Pap smear often shows changes that can be caused by HPV infection. Women with abnormal Pap smears should be examined further for cervical problems ( usually through a colposcope) or followed closely by a doctor.
There are several new tests that can detect the genetic material of HPV. These are used to find cervical HPV infection in a small number of cases, including research studies.
How Are Genital Warts Treated?:
There are many different opinions about how to treat genital warts. The guidelines of the U.S. Center for Disease Control and Preventions (CDC) include the following treatment information:
  • The goal of treatment should be to remove visible genital warts and get rid of annoying symptoms.
  • Cryotherapy (freezing off the warts with liquid nitrogen) is a relatively inexpensive and effective treatment in many cases.
  • Podofilox and podophyllin are chemical compounds that can be applied to the surface of the wart. Both are relatively inexpensive and effective in a large number of cases. Podofilox can be applied by the patient, while podophyllin is more caustic and must be applied by the health care provider.
  • Trichloracetic acid (TCA) is another chemical applied to the surface of the wart by a physician.
  • Electrocautery (Destroying the infected tissue with electric current) is another option used by some doctors.
  • Laser therapy (using an intense light to destroy the warts ) or surgery (cutting off the warts) is expensive and generally is used only in complicated cases.
  • The antiviral drug interferon is sometimes used, but less expensive therapies work just as well with less discomfort.
Whatever the treatment, here are some important points to remember:
  • Ask your doctor for an explanation of the treatment, including its costs and likely benefits.
  • Avoid treatments which cause bad side effects or scarring.
  • Be sure you understand the follow-up instructions, such as what to do about discomfort and when to came bact to the office or clinic.
  • Be patient–treatment often takes several visits and a variety of approaches.
  • If you are pregnant or thinking you might be, tell your doctor so he or she can choose a treatment that wont be harmful to your or your baby.
  • Don’t use drug store treatments for warts. These are not meant for sensitive genital skin.
  • Some experts suggest avoiding sexual contact with the infected area during treatment. This is partly to protect the treated area of skin from friction and help it heal.
How Is Subclinical HPV Infection Treated?:

While experts disagree on this question, many say there’s no proven benefit to treating subclinical HPV.
It is important, however, that health care providers watch carefully for precancerous changes in the cervix that may be found along with HPV infections.

What About HPV, Genital Warts And Cancer?:

The types of HPV linked to cervical cancer usually are not the types that cause genital warts. But a woman with genital warts, like any other sexually active woman, should get yearly Pap smears.
Some types of HPV that cause “ clinically inapparent” or “subclinical” infection are being studied as “risk factors” for cervical cancer. This means that certain HPV types, along with other factors, may make someone mor likely to develop cancer. These other factors may include first intercourse at an early age, smoking, and the presence of other STDs.
Yearly Pap smears are the best safeguard against cervical cancer. Pap smears detect abnormal cells present on the surface of the cervix. Cancer usually can be prevented through early detection and treatment of abnormal cervical tissue.

How Can I Avoid Getting HPV or Genital Warts?:

Certain ways to lower your risk of getting any sexually transmitted disease also may be effective with HPV or genital warts:
  • You can reduce your risk of getting HPV or genital warts by not having sex with anyone or by having sex only with one uninfected partner who has sex only with you. People who have many partners are at higher risk of getting sexually transmitted infections.
  • Latex condoms (“rubbers”), used properly from start to finish each time you have sex, provide some protection if they cover the area of the HPV infection. Condoms are recommended with all new or casual sexual partners.
  • Spermicidal foams, creams, and jellies are not proven to act against HPV and genital warts, but they are effective against some other SDTs. They are best used along with condoms.

Is It Normal To Feel Emotional Or Upset About Having HPV Or Genital Warts?:

Yes. Some people feel very upset. They feel ashamed or less attractive or less interested in sex. They feel angry at their sexual partner(s), even though it is usually not possible to know exactly when or from whom the virus was spread. They’re afraid that the infection could lead to cancer. It is normal to have all, some, or none of these feelings.
If you are worried about HPV or genital warts, remember:
  • Genital HPV can be managed.
  • Cervical cancer, the most serious problem associated with genital HPV, is easily prevented through regular Pap smears and treatment of precancerous cell changes.
  • Informing yourself about HPV will help you understand and manage the infection.
  • You are not alone. It is estimated that tens of millions of Americans have HPV infection. For most, it is a minor problem.

Where Can I Get More Information?:

For more information on HPV and other SDS:
  • Contact the STD clinic in your local health department.
  • Check with your own health care professional.
  • Call the National STD Hotline, 1-800-227-8922. It’s toll-free and open to calls from 8:00 am to 11:00 pm Eastern Time, Monday through Friday.
ASHA operates a National AIDS Hotline, 1-800-342-AIDS, and National STD Hotline under contract with the U.S. Centers for Disease Control and Prevention

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