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Overview of Common Sexually Transmitted Infections

Introduction

Sexually transmitted infections (STIs) are infections that are passed from person to person during sexual or intimate contact. This section offers you valuable information about the different types of STIs, symptoms, why they're serious, how to prevent getting them, and what to do if you think you may have an STI.

Important Facts

You should know - There are two kinds of STIs, Bacterial and Viral:

Transmission of STIs

STIs may be transmitted during vaginal, anal and oral sex.

The mechanism of transmission may be through:

STI Poems

These poems were written by real people who have participated in the M.A.R.S. Program.

Gonorrhea
It gets spread many ways
You better be careful when you get laid.
It comes from oral, anal, or vaginal sex.
So what the heck!
You don't be worried till you discharge gray or yella.
If you're a woman or unlucky fella.
Pop some pills till it kills da clap.
If you want no trouble,
Wrap your rascal in a latex bubble.
Fellas, call the doc and talk about STI's
So your girl or guy
Don't get no dribbles in the eye.
-By a student from Monroe High School in Monroe, OR

Chlamydia

Jack and Jill went up the hill to have a little fun.
Jill asked for a condom but Jack said, "I didn't get one."
They didn't care, they did it everywhere.
The next week they looked in their underwear.
Thought it was a dream, went and got screened.
The disease was detected, their parts were infected.
Poor little Jill, had to take a pill.
It hurt when he peed
It made her bleed.
Medicine must be gone, or it will come back on.
-By a student from Monroe High School in Monroe, OR

Chlamydia

What is Chlamydia? It is the most common and most invisible bacterial STI in the U.S. An estimated 3 million Americans are infected with Chlamydia each year. Women are frequently re-infected if their sex partners are not treated.

Transmission: Chlamydia is a bacterial STI that is spread from person to person during vaginal, oral, or anal sex. Chlamydia can also be passed from a mother to her baby during vaginal childbirth.

What are the symptoms of Chlamydia? Chlamydia is often called the "invisible" or "silent" STI because an infected individual may show no symptoms. If symptoms do occur, they most likely will be present within 1 to 3 weeks after exposure.

If transmitted during anal sex, symptoms may include rectal pain, discharge or bleeding. If transmitted during oral sex, symptoms may be found in the throat.

Long term effects or other complications: Many people don't know they have Chlamydia, so they don't get tested or treated. If left untreated it can cause pelvic inflammatory disease (PID) in women. PID causes painful and permanent damage to the pelvic and sex organs and can render women unable to have children in the future. In men, Chlamydia can cause an infection in the epididymis (the tube that caries sperm from the testis), causing pain, fever, and rarely sterility. A mother with Chlamydia can give it to her baby during vaginal childbirth. The baby may have eye or respiratory infections.

Chlamydia increases the risk of acquiring HIV by three to five times.

HIV infected persons who also have Chlamydia are more likely to transmit HIV to a partner because the white blood cells that contain HIV are present in high quantities fighting the Chlamydia bacteria.

Treatment: Chlamydia, once diagnosed, is easily treated with antibiotics. However, it important for the partners of the infected person to also be treated at the same time, even if no symptoms are present. Otherwise, re-infection will likely occur. Individuals with Chlamydia should abstain from sexual activity until they and their partners have completed treatment.

How do you find out if you have Chlamydia? The only way to know for sure if you have Chlamydia is to be tested. Tests for Chlamydia are available through your healthcare provider and through county health clinics. In most clinics, only a urine sample is required to test for Chlamydia.

Reduce Your Risk: Practice abstinence, use condoms or be monogamous with a tested, uninfected partner.

Gonorrhea

What is Gonorrhea? Sometimes it is called "the clap" or "the drip." Gonorrhea is a bacterial infection that occurs 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 bacteria can also grow in the mouth, throat, eyes, and anus. Gonorrhea affects about 700,000 Americans every year.

Transmission: Gonorrhea is a bacterial STI that is spread from person to person during vaginal, anal, and oral sex. A mother may transmit Gonorrhea to her baby during vaginal delivery.

What are the symptoms of Gonorrhea? Often, Gonorrhea has no symptoms. Eighty percent (80%) of women and 10% of men with Gonorrhea show no symptoms. Many people are not aware that they are infected. If they appear, symptoms show up 2 to 21 days after infection.

Men and women may also be infected in the rectum or throat if infection occurred through anal or oral sex. Symptoms of rectal infection, if present, may include discharge, anal itching, soreness, bleeding, or painful bowel movements. Infections in the throat usually show no symptoms, but may cause a sore throat.

Long term effects or complications: Many people don't know they have Gonorrhea, so they don't get tested or treated. If left untreated, it can cause pelvic inflammatory disease (PID) in women. PID causes painful and permanent damage to the pelvic and sex organs and can render women unable to have children in the future. In men, Gonorrhea can cause an infection in the epididymis (the tube that caries sperm from the testis), causing pain, fever, and rarely sterility. Without prompt treatment, Gonorrhea can also affect the prostate and can lead to scarring inside the urethra, making unrination difficult for men. Gonorrhea can spread to the joints or the blood (life-threatening). If passed from an infected mother to her baby during vaginal childbirth, blindness or life threatening joint or blood infections may occur.

Gonorrhea increases the risk of acquiring HIV by three to five times.

HIV infected persons who also have Gonorrhea are more likely to transmit HIV to a partner because the white blood cells that contain HIV are present in high quantities fighting the Gonorrhea bacteria.

Treatment: Antibiotics are prescribed to treat Gonorrhea. However, drug-resistant strains of Gonorrhea are increasing in many areas of the world, including the United States, which makes it more difficult to treat. Antibiotics will end the infection, but will not reverse any damage done by Gonorrhea. Individuals who are diagnosed with Gonorrhea must inform their partners so they also may be treated. Otherwise, it is possible for re-infection to occur.

How do you find out if you have Gonorrhea? The only way to know for sure if you have Gonorrhea is to be tested. Tests for Gonorrhea are available through your healthcare provider and through county health clinics. Testing requires a sample to be taken from the infected area (cervix, urethra, rectum or throat).

Reduce Your Risk: Practice abstinence, use condoms or be monogamous with a tested, uninfected partner.

Human Papillomavirus (HPV) and Genital Warts

What is HPV? HPV is a viral STI and is very common – an estimated 20 million people in the U.S. have HPV. There are over 100 strains of HPV; 30 of these are transmitted sexually. Some strains of HPV are considered "high risk" because they can cause cancer in the cervix, anus or penis. The strains that cause genital warts are considered "low risk" and are not associated with cancer. Genital warts are small, sexually transmitted growths that appear on, around or inside the sex organs of both men and women.

Transmission: They are spread from direct skin to skin contact during vaginal, anal, or oral sex. HPV can shed from infected skin and can be transmitted without the presence of any warts through direct skin contact.

What are the symptoms of HPV? Most people do not know they are infected with HPV because the majority of strains of HPV do not produce genital warts. If infected with a "low risk" strain, genital warts usually develop several weeks to months after infection. If warts do appear, they look like soft, moist, pink or red swellings. Some are round bumps that look like tiny cauliflowers. They are usually painless, but they can itch or burn, especially if they grow larger or spread. On men, most genital warts appear on the outside of the penis, scrotum, groin or thigh. In women, they are found on and around the vulva (lips and opening of the vagina), inside the vagina and on the cervix (opening to the uterus). Men and women can also have genital warts in the throat or anus.

Long term effects or other complications: Most people who have HPV never have symptoms or other problems, though some do. There are several types of HPV, some are high risk and some are low risk.

Treatment: There is no cure for HPV. Treatment for the removal of warts is available, but this does not eliminate the virus from the infected person. Warts may reappear.

How do you find out if you have HPV? Sometimes you can see the warts. You may be able to feel warts that are too small to see. Warts inside the vagina can only be found if a health care provider performs a pap smear (which takes a sample of the cervical tissue). An abnormal pap test could mean you have an HPV infection of your cervix. Presence of HPV may show pre-cancerous changes in the cervix, vulva, anus or penis.

Reduce Your Risk: Practice abstinence, use condoms (though the virus may be shedding in areas not covered by the condom) or be monogamous with a tested, uninfected partner.

In June 2006, a vaccine for HPV was introduced and recommended by the Center for Disease Control (CDC). The vaccine prevents four strains of HPV that are associated with 70% of cervical cancers and 90% of genital warts. Recommendations indicated that all female teens (beginning at age 11 or before they are sexually active) receive the vaccine.

Herpes

What is herpes? Herpes is a viral STI caused by two different, but closely related viruses - herpes simplex virus type 1 (HSV 1) and herpes simplex virus type 2 (HSV 2). Herpes is a very common infection – one out of five people over the age of 12 have herpes (HSV 2) and an estimated 4.5 million people in the U.S. are infected (HSV 2). Both HSV 1 and HSV 2 are easily transmitted. They have similar symptoms. And both can occur on different parts of the body. When the infection is on the mouth, it is called oral herpes. This is commonly cause by HSV 1. Oral herpes can cause "fever blisters" on the lips or mouth, but can also cause genital herpes.

When the infection is on or near the sex organs, it is called genital herpes. Most cases of genital herpes are caused by HSV 2. Herpes can cause blisters on the genitals and rectum. They can rupture, creating sores that can take 2-4 weeks to heal. Additional outbreaks may take place, but even if they don't, the infection can stay in the body for the rest of the affected individual's life. The number of outbreaks tends to decrease over a period of years.

Transmission: Herpes is spread by touching, kissing, and sexual contact, including vaginal, anal, and oral sex. Transmission can occur even when the infected person is not experiencing an outbreak of blisters. HSV 1 can be transmitted during oral-genital contact, as well as genital-genital contact. HSV 2 is transmitted through sexual contact.

You get herpes by direct contact with the virus. Hundreds or thousands of tiny viruses are in each sore. Active herpes virus can be on the skin from the first warning signs (before the sore develops) until the sore is completely gone.

If enough viruses touch an area where the skin is thin (the mouth, genital or eye areas), or where the skin is broken, cut or scratched, the virus enters the body. This is how a herpes infection begins. Even if a condom is used, the virus may be present on areas not covered by the condom, so transmission may occur.

This can happen on your own body if you touch a herpes sore and then touch a skin area that will let the virus in.

What are the symptoms of herpes? Up to 90% of people who have genital herpes are unaware of their infection – in many people the outbreaks are light and may be incorrectly attributed to a rash or insect bite. The first outbreak usually occurs within two weeks after transmission. Outbreaks consist of one or more painful blisters on or around the genitals or rectum. A fever and swollen glands may accompany the first outbreak.

Just before a sore appears there may be a painful, tingling or itching feeling in the area. After it forms, the sore "weeps." Then it develops a scab, heals and goes away.

Sores last 2 to 3 weeks. The number of outbreaks usually decreases over a period of years, but the virus is present in the body indefinitely.

Treatment: There is no cure for herpes. The sores go away, but the virus doesn't. It enters nerve cells close to where the sores were and stays there. There are no signs that it is present. The virus in this stage is "inactive."

The virus can become active again, sometimes due to stress. Then the virus travels down the nerves to the skin. It can stay on the skin without symptoms. Or the sores may appear again.

Anti-viral medications are available that can reduce the symptoms associated with herpes. A suppressive therapy is also available to reduce the chance of transmission to partners.

Long term effects or other complications: Having herpes usually is distressful for the person with the infection.

Genital herpes increases the risk of acquiring HIV by three to six times.

HIV infected persons who also have herpes are more likely to transmit HIV to a partner because the white blood cells that contain HIV are present in high quantities fighting the herpes virus.

How do you find out if you have herpes? Herpes can be diagnosed by a visual inspection of sores by a health care provider. The health care provider may take a sample from the sores to test it in a laboratory. If the individual is not currently experiencing an outbreak of sores, a blood test may help determine if he or she is infected.

Reduce Your Risk: Practice abstinence, use condoms (though the virus may be shedding or sores may be present in areas not covered by the condom) or be monogamous with a tested, uninfected partner. Abstain from sex when sores are present or viral shedding is occurring.

Pelvic Inflammatory Disease (PID)

What is PID? PID is caused by a bacterial infection of a woman's pelvic and sexual organs---the uterus, fallopian tubes and ovaries. Bacteria from STIs can spread upward from her vagina or cervix into her uterus and other organs and cause PID. Chlamydia and Gonorrhea are the two main STIs that can cause PID.

Transmission: STIs, which are transmited through vaginal, anal and oral sex, can cause PID if left untreated. Not all PID is caused by STIs. Rarely, IUDs, douching or some other forms of vaginitis can cause PID.

What are the symptoms of PID?

Long term effects or other complications: Many women don't know they have PID, so they don't get tested. PID can spread and cause painful and permanent damage to the pelvic and sex organs.

One in five women with a history of PID cannot have children. The more times a woman has PID, the more likely that she will not be able to have children. Infertility is caused because the infection results in the build up of scar tissue in the fallopian tubes which prevents the egg from reaching the uterus (or womb).

If a woman who has had PID gets pregnant, the baby may begin to grow in her fallopian tube instead of her uterus. This is because the fertilized egg does not reach the uterus due to the built up scar tissue. This is called tubal or ectopic pregnancy. The growth of the baby in the fallopian tube may cause the tube to rupture and cause severe pain, internal bleeding and possibly death.

PID can also cause painful scarring (lasting months to years) and may require surgery or a hysterectomy.

Treatment: PID can be treated with antibiotics. While these drugs will prevent the spread and further damage by the infection, they will not repair damage or scarring already caused by the infection. Women with PID must make sure that their partner(s) also receive treatment for STIs that may have caused the PID to prevent a recurrence of PID.

How do you find out if you have PID? A visit with a health care provider is important for determining if PID is present. Since symptoms may not be present, or may be mild or non-specific, a physical exam is necessary.

Reduce Your Risk: Practice abstinence, use condoms or be monogamous with a tested, uninfected partner.

Hepatitis B (HBV)

What is Hepatitis B? Hepatitis B (HBV) is a viral STI that causes an infection of the liver. There are an estimated 1.25 million chronically HBV-infected Americans. Most people who acquire Hepatitis B recover on their own within six months of the initial infection. But sometimes Hepatitis B can damage the liver and lead to liver cancer. About 5,000 deaths annually are related to HBV infections.

Transmission: Hepatitis B virus is spread through sexual fluids (semen, vaginal secretions) and blood. This can occur during vaginal, anal or oral sex; sharing of needles used for drugs; and accidental needle sticks. A pregnant mother can pass Hepatitis B to her baby during birth. HBV may be spread through tattoo or body piercing tools. An important thing to note is that the Hepatitis B virus can live up to seven days outside of the body and still cause infection.

What are the symptoms of Hepatitis B? Newly infected individuals typically have no symptoms. When symptoms do occur, they appear between six weeks and six months after infection. Symptoms are more likely to occur in adults than younger individuals.

Long term effects or other complications: Even though about 90-95% of adults who get HBV recover completely, 5-10% of people who get HBV as adults will be "carriers" and have a chronic (long-term) infection. Ninety percent (90%) of infants who get HBV at birth will have a chronic infection unless they receive immediate treatment. Most HBV carriers remain contagious for the rest of their lives. HBV can cause liver cell damage, leading to cirrhosis and liver cancer.

Treatment: There is no cure for Hepatitis B. A vaccine is available that prevents infection for at least 20 years. It is safe for children and adults. If you are exposed to Hepatitis B and have not been vaccinated, you can get a special shot right away to help protect you. You will also be vaccinated at that time. Antiviral medications can help with chronic (long-term) HBV infections.

How do you find out if you have Hepatitis B? A blood test is required to determine if you have Hepatitis B.

Reduce Your Risk: Practice abstinence, use condoms or be monogamous with a tested, uninfected partner. Get vaccinated and clean up spills of infected fluids with household bleach.

Syphilis

What is Syphilis? Syphilis is a bacterial infection. Other names for syphilis are syph, pox or bad blood. Syphyilis is generally less common (roughly 32,000 cases were reported in the U.S. in 2002), however, an increase in cases has been noted recently.

Transmission: Syphilis is transmitted by direct contact with syphilis lesion or infected tissue. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. Transmission of the organism occurs during vaginal, anal, or oral sex. Infected pregnant women can pass it to their baby.

What are the symptoms of syphilis? Syphilis is called the "great imitator" because its signs and symptoms are similar to other diseases. Symptoms on average occur 21 days after infection, but may range from 10-90 days. There are three stages of syphilis – primary, secondary and late stage.

Long term effects or other complications: Even if it's not treated, the syphilis sore will go away after 1 to 8 weeks. But even though the sore goes away, it does not mean you're cured – see the symptoms of the secondary and late stages above.

A mother with syphilis can give it to her baby during pregnancy. Syphilis may cause a miscarriage or the baby may be sick when it is born.

Syphilis increases the risk of acquiring HIV by three to four times – chancres are a site where HIV can enter the body.

HIV infected persons who also have syphilis are more likely to transmit HIV to a partner because the white blood cells that contain HIV are present in high quantities fighting the syphilis bacteria.

Treatment A single injection of penicillin, or another 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. The antibiotics will prevent any further damage done by the disease, but will not repair damage caused prior to treatment. Individuals treated for syphilis must abstain from sexual contact until the syphilis sores are completely healed. It is critical for individuals with syphilis to notify their sex partners so that they also can be tested and receive treatment if necessary.

How do you find out if you have syphilis? Anyone who shows signs of syphilis should visit their health care provider. Syphilis is diagnosed by examining the discharge from a chancre under a microscope, or by performing a blood test.

Reduce Your Risk: Practice abstinence, use condoms (though ulcers may be present in areas not covered by the condom) or be monogamous with a tested, uninfected partner.

HIV (Human Immunodeficiency Virus)

What is HIV (Human Immunodeficiency Virus)? HIV is a sexually transmitted infection that weakens the body's ability to fight disease and can cause AIDS (Acquired Immune Deficiency Syndrom). HIV breaks down the immune system — our body's shield against disease. HIV causes people to become sick with infections that normally wouldn't affect them.

Transmission: HIV is transmitted in blood, semen, vaginal fluids, and breast milk. Transmission can occur through vaginal, anal and oral sex. Transmission can also occur by sharing needles (for drug injection), accidental needle stick, accidental exposure of infected blood to a mucous membrane (e.g. eyes, open cut or nose).

HIV does not survive well in the environment (outside of the body). HIV is not transmitted via kissing, sharing drinking glasses, hugging, or other forms of casual contact.

Individuals who have another sexually transmitted infection are two to five times more likely to contract HIV than individuals who do not have a sexually transmitted infection (if the HIV infection occurs through sexual contact). This is because individuals with another sexually transmitted infection have increased susceptibility. They may have open sores as a result of other STIs which act as an entry site for HIV. STIs that don't produce open sores still increase susceptibility to HIV because they result in an increased concentration of cells in genital secretions that HIV targets.

Individuals who have HIV and another STI are significantly more infectious and are more likely to spread HIV to their partners. This is because the white blood cells that contain HIV are present in high quantities as they fight the other sexually transmitted infection present. They may have up to ten times more HIV present in their genital secretions than someone who is infected with HIV alone. So, there is more HIV present to potentially infect someone else during sexual contact.

What is AIDS (Acquired Immune Deficiency Syndrome)? AIDS is the most advanced stage of HIV disease. AIDS is caused by HIV. There is no cure for AIDS and it is most often fatal. However, some people have lived with AIDS for many years. New treatments and increased knowledge may help many more people live with AIDS even longer.

What are the symptoms of HIV? Some people develop symptoms shortly after being infected. On average, it takes more than 10 years.

There are several stages of HIV disease. The first symptom of HIV disease is often swollen lymph glands in the throat, armpit, or groin. Other early symptoms include slight fever, headaches, fatigue, muscle aches, and swollen glands. They may only last for a few weeks. Then there are usually no symptoms for many years.

Treatment: There is no cure for HIV/AIDS. A variety of treatments — combinations of medicines called "cocktails" — enable people with the virus to live longer with a better quality of life. They are often very expensive and are not available to everyone. They only work for some people and may only work for limited periods of time.

How do you find out if you have HIV? Free rapid HIV testing is offered by the M.A.R.S. Program in Benton County. This test consists of taking an oral sample using a swab and takes approximately 20 minutes to determine the results. You can also have a blood test to determine if you have HIV.

HIV testing identifies the presence of antibodies to the virus. It can take up to three months from the point of infection for the antibodies to be detectable during a test. If you think you may have been exposed to HIV, you should abstain from any sexual contact which may transmit the virus to a partner until you have been tested three months from the time of potential infection.