STD/STI Education

Disease: Chlamydia

What: Chlamydia is a common sexually transmitted infection (STI) caused by the bacterium, Chlamydia trachomatis, which can damage a woman’s reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur “silently” before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man.

How: Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth.

Any sexually active person can be infected with chlamydia. The greater the number of sex partners, the greater the risk of infection. Because the cervix (opening to the uterus) of teenage girls and young women is not fully matured and is probably more susceptible to infection, they are at particularly high risk for infection if sexually active. Since chlamydia can be transmitted by oral or anal sex, men who have sex with men are also at risk for chlamydial infection.

Symptoms: Chlamydia is known as a “silent” disease because the majority of infected people have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.

In women, the bacteria initially infect the cervix and the urethra (urine canal). Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. If the infection spreads from the cervix to the fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Chlamydial infection of the cervix can spread to the rectum.

Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon.

Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause rectal pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner.

Treatment: Chlamydia can be easily treated and cured with antibiotics. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV negative.

All sex partners should be evaluated, tested, and treated. Persons with chlamydia should abstain from sexual intercourse for 7 days after single dose antibiotics or until completion of a 7-day course of antibiotics, to prevent spreading the infection to partners.

Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple infections increases a woman’s risk of serious reproductive health complications, including infertility. Women and men with chlamydia should be retested about three months after treatment of an initial infection, regardless of whether they believe that their sex partners were treated.

Prevent:

Safest: The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact but, for most people this is unrealistic.

Next Safest: Use condoms of other latex barriers for all sexual contact. Allergic to latex? Use a plastic (polyurethane) condom. Condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.

Avoiding alcohol and drug use may also help prevent transmission of STIs because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STIs so that preventive action can be taken.

CDC recommends yearly chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women. An appropriate sexual risk assessment by a health care provider should always be conducted and may indicate more frequent screening for some women.

Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles could mean an STI. If a woman or man has any of these symptoms, they should stop having sex and consult a health care provider immediately. Treating STIs early in women can prevent PID. Women and men who are told they have an STI and are treated for it should notify all of their recent sex partners (sex partners within the preceding 60 days) so they can see a health care provider and be evaluated for STIs. Sexual activity should not resume until all sex partners have been examined and, if necessary, treated

 

Disease: Gonorrhea


What
: Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can also grow in the mouth, throat, eyes, and anus.

How: Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread from mother to baby during delivery.

People who have had gonorrhea and received treatment may get infected again if they have sexual contact with a person infected with gonorrhea.

Symptoms: Some men with gonorrhea may have no symptoms at all. However, some men have signs or symptoms that appear one to fourteen days after infection. Symptoms and signs include a burning sensation when urinating, or a white, yellow, or green discharge from the penis. Sometimes men with gonorrhea get painful or swollen testicles.

In women, the symptoms of gonorrhea are often mild, but most women who are infected have no symptoms. Even when a woman has symptoms, they can be so non-specific as to be mistaken for a bladder or vaginal infection. The initial symptoms and signs in women include a painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods. Women with gonorrhea are at risk of developing serious complications from the infection, regardless of the presence or severity of symptoms.

Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements. Rectal infection also may cause no symptoms. Infections in the throat may cause a sore throat, but usually causes no symptoms.

Treatment: Antibiotics can successfully cure gonorrhea in adolescents and adults. However, drug-resistant strains of gonorrhea are increasing in many areas of the world, including the United States, and successful treatment of gonorrhea is becoming more difficult. CDC now recommends dual therapy (i.e. using two drugs) for the treatment of gonorrhea. Persons with gonorrhea should be tested for other STIs.

It is important to take all of the medication prescribed to cure gonorrhea.  Although medication will stop the infection, it will not repair any permanent damage done by the disease. People who have had gonorrhea and have been treated can get the disease again if they have sexual contact with persons infected with gonorrhea. If a person’s symptoms continue even after receiving treatment, he or she should return to a doctor to be reevaluated.

Prevent:

Safest: The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact but, for most people this is unrealistic.

Next Safest: Use condoms of other latex barriers for all sexual contact. Allergic to latex? Use a plastic (polyurethane) condom. Condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.

Avoiding alcohol and drug use may also help prevent transmission of STIs because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STIs so that preventive action can be taken.

Any genital symptoms such as discharge or burning during urination or unusual sore or rash should be a signal to stop having sex and to see a doctor immediately. If a person has been diagnosed and treated for gonorrhea, he or she should notify all recent sex partners so they can see a health care provider and be treated. This will reduce the risk that the sex partners will develop serious complications from gonorrhea and will also reduce the person’s risk of becoming re-infected. The person and all of his or her sex partners must avoid sex until they have completed their treatment for gonorrhea and until they and their sex partners no longer have symptoms.

Disease: Hepatitis A, B and C

What: A virus that attacks your liver.

How: Any sexual OR casual contact involving the anus of another person (rimming, anal intercourse, fingering, fisting, etc.) OR something that’s been in contact with the anus of another (sharing sex toys, kissing someone who’s been rimming, oral sex on someone who’s been topping someone else, etc.)
Needle or works sharing. Food prepared by someone infected; contaminated water. Sharing personal items like razors, sex toys etc.

Symptoms:

Hepatitis A (acute):
Symptoms usually begin 2 to 6 weeks after exposure and last 1 to 2 weeks. You’re most infectious in the 2 weeks prior to having symptoms (which means you can spread it easily without knowing it). Many people have no symptoms but can still infect others without knowing it.

Hepatitis B (acute):
Symptoms usually begin 6 weeks to 6 months after exposure and can last weeks, even months.
30-50% of adults have acute symptoms, the rest do not. Either way, you can still spread the virus (usually without knowing it) AND you can still develop chronic symptoms.

Hepatitis C (acute): Three out of four persons who are infected with HCV have no symptoms at first and can infect others without knowing it. Those who do have acute symptoms can get them anywhere from 2 weeks to 6 months after exposure. The symptoms can last weeks, even months.

Treatment: No specific therapy is available for persons with acute hepatitis A or B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect Hepatitis at an early stage.

Prevention:

Safest: The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact but, for most people this is unrealistic.

Next Safest: Get vaccinated. Period. Use condoms of other latex barriers for all sexual contact. Allergic to latex? Use a plastic (polyurethane) condom.Avoid sharing razors, toothbrushes, sex toys etc. Don’t share needles, syringes or works.
Avoiding alcohol and drug use may also help prevent transmission of STIs because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STIs so that preventive action can be taken.

 
Disease: Genital Herpes

 What: is a sexually transmitted infection (STI) caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). Most genital herpes is caused by HSV-2. Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak.  Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.

How: HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to have a sore. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.

HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called “fever blisters.” HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks.

Symptoms: Most people infected with HSV-2 are not aware of their infection. However, if signs and symptoms occur during the first outbreak, they can be quite pronounced. The first outbreak usually occurs within two weeks after the virus is transmitted, and the sores typically heal within two to four weeks. Other signs and symptoms during the primary episode may include a second crop of sores, and flu-like symptoms, including fever and swollen glands. However, most individuals with HSV-2 infection never have sores, or they have very mild signs that they do not even notice or that they mistake for insect bites or another skin condition.

People diagnosed with a first episode of genital herpes can expect to have several (typically four or five) outbreaks (symptomatic recurrences) within a year. Over time these recurrences usually decrease in frequency. It is possible that a person becomes aware of the “first episode” years after the infection is acquired.

Treatment: There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication.  In addition, daily suppressive therapy for symptomatic herpes can reduce transmission to partners.

Prevention:

Safest: The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact but, for most people this is unrealistic.

Next Safest: Use condoms of other latex barriers for all sexual contact. Allergic to latex? Use a plastic (polyurethane) condom.

Avoiding alcohol and drug use may also help prevent transmission of STIs because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STIs so that preventive action can be taken.

Persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk.

 

Disease: Genital HPV Infection

What:  is the most common sexually transmitted infection (STI). There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not even know they have it.

HPV is not the same as herpes or HIV (the virus that causes AIDS). These are all viruses that can be passed on during sex, but they cause different symptoms and health problems.

How: HPV is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.

A person can have HPV even if years have passed since he or she had sexual contact with an infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV.

Symptoms: Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. Health care providers can diagnose warts by looking at the genital area during an office visit. Warts can appear within weeks or months after sexual contact with an infected partner—even if the infected partner has no signs of genital warts. If left untreated, genital warts might go away, remain unchanged, or increase in size or number. They will not turn into cancer.

  • Rarely, warts in the throat — a condition called recurrent respiratory papillomatosis, or RRP.  When this occurs in children it is called juvenile-onset RRP (JORRP).
  • Cervical cancer and other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and oropharynx (back of throat including base of tongue and tonsils).

Prevent:

There are several ways that people can lower their chances of getting HPV:

  • Vaccines can protect males and females against some of the most common types of HPV that can lead to disease and cancer. These vaccines are given in three shots. It is important to get all three doses to get the best protection. The vaccines are most effective when given at 11 or 12 years of age.
    • Girls and women: Two vaccines (Cervarix and Gardasil) are available to protect females against the types of HPV that cause most cervical cancers. One of these vaccines (Gardasil) also protects against most genital warts. Gardasil has also been shown to protect against anal, vaginal and vulvar cancers. Either vaccine is recommended for 11 and 12 year-old girls, and for females 13 through 26 years of age, who did not get any or all of the shots when they were younger. These vaccines can also be given to girls beginning at 9 years of age. It is recommended to get the same vaccine brand for all three doses, whenever possible.
    • Boys and men: One available vaccine (Gardasil) protects males against most genital warts and anal cancers. This vaccine is available for boys and men, 9 through 26 years of age.
  • For those who choose to be sexually active, condoms may lower the risk of HPV. To be most effective, they should be used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom – so condoms may not fully protect against HPV.
  • People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. That’s why the only sure way to prevent HPV is to avoid all sexual activity.

 

Disease: Syphilis

What: Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. It has often been called “the great imitator” because so many of the signs and symptoms are indistinguishable from those of other diseases.

How: Syphilis is passed from person to person through direct contact with a syphilis sore during oral, vaginal or anal sex. Because syphilis sores can be hidden in the vagina, rectum or mouth, it may not be obvious that a sex partner has syphilis. Transmission does not occur after the secondary stage of syphilis. A pregnant woman can also transmit syphilis to her unborn baby (congenital syphilis).

Symptoms: Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated. Although transmission occurs from persons with sores who are in the primary or secondary stage, many of these sores are unrecognized. Thus, transmission may occur from persons who are unaware of their infection.

Primary Stage: The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores. The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days). The chancre is usually firm, round, small, and painless. It appears at the spot where syphilis entered the body. The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to the secondary stage.

Secondary Stage: Skin rash and mucous membrane lesions characterize the secondary stage. This stage typically starts with the development of a rash on one or more areas of the body. The rash usually does not cause itching. Rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed. The characteristic rash of secondary syphilis may appear as rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet. However, rashes with a different appearance may occur on other parts of the body, sometimes resembling rashes caused by other diseases. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent and possibly late stages of disease.

Late and Latent Stages: The latent (hidden) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. This latent stage can last for years.  The late stages of syphilis can develop in about 15% of people who have not been treated for syphilis, and can appear 10–20 years after infection was first acquired. In the late stages of syphilis, the disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

Treatment: Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. There are no home remedies or over-the-counter drugs that will cure syphilis. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.

Because effective treatment is available, it is important that persons be screened for syphilis on an on-going basis if their sexual behaviors put them at risk for STIs.

Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

Prevention:

Safest: The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact but for most people this is unrealistic.

Next Safest: Use condoms of other latex barriers for all sexual contact. Allergic to latex? Use a plastic (polyurethane) condom.

Avoiding alcohol and drug use may also help prevent transmission of syphilis because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STIs so that preventive action can be taken.

Genital ulcer diseases, like syphilis, can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of syphilis, as well as genital herpes and chancroid, only when the infected area or site of potential exposure is protected