Sexually Transmitted Infections

An infection is when foreign microbes enter the body and begin to spread. When and if those microbes begin to inhibit normal body functions, the infection has become a disease. Sexually transmitted infections and diseases are those which are passed between people through sexual intercourse or related activites. Whether or not an infection progresses to a disease can depend on an individual's biology, so even if you exhibit no outward symptoms of infection, you should take action to protect you and your partner during sexual activities!

Chlamydia

What is Chlamydia?

Chlamydia (cla-MID-ee-ah) is a sexually transmitted infection (STI) caused by a bacteria called Chlamydia trachomatis. It can spread from person to person during sexual intercourse (vaginal and anal) when a person's mucous membranes come into contact with the vaginal secretions or semen of an infected person. It can be transmitted without complete insertion of a penis into the vagina or anus. It is less likely, although possible, to be transmitted to the throat during oral sex. It can also be passed from mother to newborn during childbirth. Chlamydia infections are treatable and curable with antibiotics.

Why worry about Chlamydia?

Untreated chlamydia can lead to severe reproductive health problems for women, including sterility. Pelvic inflammatory disease (PID) is a common result of untreated chlamydia infection. In PID, the bacteria move from the vagina up through the cervix and into the uterus, fallopian tubes and ovaries. Blockage and scarring can damage the tubes, causing women who conceive to be more likely to have "tubal pregnancies." In men, untreated chlamydial infections can lead to prostatitis (inflammation of the prostate gland), urethral scarring, infertility, or epididymitis (inflammation of the cord-like structure at the back of the testes). If you are HIV positive and have chlamydia, inflamed genital tissues contain highly concentrated amounts of the virus, causing 8-10 times more HIV to be shed in your semen or vaginal secretions. If you are HIV negative and have chlamydia, your immune cells are especially susceptible to HIV if your partner is carrying the virus. Rectal chlamydia may increase chances of getting HIV ten to twenty-fold.

What are the symptoms of Chlamydia?

Symptoms usually appear from one to three weeks after infection, but then go away, even if left untreated. Many people infected with chlamydia never have any symptoms at all.

Women may experience pain and itching of the vulva or vagina; vaginal discharge; unusual vaginal or anal bleeding; pain with urination; and/or pain when having sex. 80% of infected women have no symptoms.

Men may experience discharge from the head of the penis or the anus; pain or itching at the head of the penis; and/or pain with urination. 50% of infected men have no symptoms.

What is a Chlamydia test like?

A complete examination for chlamydia includes taking a sexual history, examining any symptoms you might be having and testing a sample of your genital secretions with a swab. In addition, there is a chlamydia test that can be done on a urine sample. The exact test(s) done will depend on where you go for your exam.

Some providers recommend that you get tested for gonorrhea at the same time as your chlamydia test. Talk to your provider about the options available to you when you go to get tested.

How is Chlamydia treated?

Antibiotics cure chlamydia. It is very important to take all the pills you are given even if you feel better, so the bacteria is completely wiped out.

What should I do if I have Chlamydia?

Your sex partner(s) must be examined and treated too, because otherwise they can give the infection back to you and/or infect others. You need to abstain from sex for one week from when the antibiotics were started. If you still have symptoms after you've completed the treatment, it's important to go back to your provider for a check-up.

Once you are treated and cured of chlamydia, you can be re-infected if you're exposed to the bacteria again.

How do I avoid getting Chlamydia?

Abstinence is the only way to completely avoid getting chlamydia or other STIs. If you're sexually active, using condoms consistently and correctly for oral, anal and vaginal sex is your best bet for staying sexually healthy. Since chlamydia can be passed even if the penis or tongue does not completely enter into the vagina or rectum, it's important to use a condom from the very beginning to end of sexual contact.

The risk for chlamydia is directly related to the number of sex partners you have: The more sex partners, the greater the risk of contracting it. Having more sex with fewer partners reduces your risk of getting chlamydia.

If you have a new partner with whom you intend to be monogamous, consider having full STI checkups together before you start having sex. If you're sexually active with more than one monogamous partner, regular STI checkups at least every six months is recommended. Chlamydia and other bacterial STIs are curable with proper diagnosis and treatment.

Gonorrhea

What is Gonorrhea?

Gonorrhea (gon-or-e-uh) is a sexually transmitted disease (STI) caused by a type of bacteria called Neisseria gonorrhoea. Gonorrhea can be transmitted to both male and female partners during vaginal, anal and oral sex from a partner infected in his or her throat, vagina, urethra or anus. Gonorrheal infections are completely curable with antibiotics.

Why worry about Gonorrhea?

If you are HIV+ and have genital inflammation due to gonorrhea, the inflamed tissues contain highly concentrated amounts of the virus. If the gonorrheal infection is in your penis, you can shed 8-10 times more HIV in your semen.

If you are HIV- but have gonorrhea, the disease-fighting cells of your immune system are especially susceptible to HIV if you have unprotected sex with an HIV-infected partner. Rectal gonorrhea increases the risk of contracting HIV by ten to twenty times.

In about 1% of people with untreated gonorrhea, the infection can spread beyond the genital area to the bloodstream, skin, heart or joints. This is called Disseminated Gonococcal Infection (DGI). Symptoms include fever, multiple skin lesions, arthritis, infection of the inner lining of the heart, and meningitis. DGI can be treated with antibiotics.

PID (pelvic inflammatory disease), a serious pelvic infection in women, is a more common result of untreated gonorrhea. In PID, the bacteria move from the vagina up through the cervix and into the uterus, fallopian tubes and ovaries. Blockage and scarring can damage the tubes, making a woman who conceives more likely to have a tubal pregnancy. Left untreated, PID can cause infertility. Untreated gonorrhea can also cause chronic menstrual problems, postpartum endometritis, urinary tract infections, miscarriage, and cervical discharge.

Men with untreated gonorrhea can occasionally develop epididymitis, a painful infection of the testicles. Untreated gonorrheal infections can also cause inflammation of the prostate and urethral scarring, sometimes leading to infertility.

What are the symptoms of Gonorrhea?

Most men develop symptoms of gonorrhea within two to five days after being exposed, with a possible range of one to thirty days. Although most women are asymptomatic (without symptoms), for those who do have symptoms, they usually appear within 10 days after being exposed.

Men who have gonorrhea in the penis or anal area may experience a discharge from the head of the penis or the anus; pain or itching of the head of the penis; swelling of the penis or testicles; pain and/or burning upon urination; frequent urination; anal or rectal itching; white anal discharge; and/or pain during bowel movements.

Women with gonorrhea may have a discharge from the vagina; lower abdominal pain, especially during or after sex; unusual bleeding with cramping; pain or burning with urination.

If you're infected with gonorrhea in the throat, there are usually no symptoms, except possibly a sore throat.

What is a Gonorrhea test like?

There are several different testing options for gonorrhea. Your medical provider will decide which one is best given your situation and the lab facilities available at the clinic or medical practice. Some tests are done on a urine sample, and some on a swab of the secretions from the infected area.

How is Gonorrhea treated?

Your provider will give you antibiotics to kill the gonorrheal bacteria in your body. If you are prescribed antibiotics, take all of the pills, even if you feel better before you finish the dosage. Your sex partner(s) need to be examined and treated also, because if you have unprotected sex again, you can be re-infected. If you're non-monogamous, your partner is also capable of infecting others until he or she gets proper treatment.

What should I do if I have Gonorrhea?

It's important to talk to your partners to maintain your sexual health and that of our community. Also you must abstain from partner sex for one full week from when your antibiotic treatment is started.

How do I avoid getting Gonorrhea?

The risk for gonorrhea is directly related to the number of sex partners you have: The more sex partners, the greater the risk of contracting it. Having more sex with fewer partners reduces your risk of getting gonorrhea.

The only way to be 100% sure of eliminating your risk of contracting gonorrhea or other STIs is to abstain from sex. If you are sexually active, however, using condoms (male or female) for sexual activity is your best bet for protecting yourself. Since gonorrhea can be transmitted during oral sex, primarily mouth-to-penis or penis-to-mouth contact, it would be wise to use a condom when performing oral sex on a man or if you're a man, having oral sex performed on you. Also, we recommend regular STI checkups at least every six months if you're sexually active with more than one monogamous partner. Gonorrhea and other bacterial STIs are curable with proper diagnosis and treatment.

Hepatitis

What is Hepatitis?

Hepatitis is the name for inflammation of the liver caused by several different viruses. The viruses are classified by letters of the alphabet - with types A, B, and C being the most common. Each of these viruses can be transmitted in a number of ways, some sexually. Hepatitis B and C viruses can cause inflammation of the liver, liver failure, liver cancer, and death. Hepatitis B is the most common cause of liver cancer in the world. Chronic Hepatitis C (HCV) is the leading cause for liver transplants.

Why worry about Hepatitus?

HAV usually runs its course without treatment. Once infected, you cannot be re-infected. Both HBV and HCV can attack in acute or chronic forms. The acute forms resemble a bad illness that can last for a few weeks, up to a few months. If the illness turns chronic (long-lasting), both Hepatitis B and C can ultimately lead to liver failure and death

Hepatitis B infection in someone who is HIV+ is more likely to turn into chronic HBV. It is estimated that 5,000 people die each year in the United States due to complications of cirrhosis and liver cancer as a result of HBV.

How is Hepatitis spread?

HAV is highly contagious and is spread from person to person via contaminated food, water or stool. A person is most infectious in the two weeks after exposure, but before symptoms show up - which means people can spread the virus without even knowing they have it.

Poor hand washing and contaminated water supplies can easily transmit HAV, as well as many types of anal sex such as rimming, fisting, fingering, and anal intercourse. Contact with something that's been in contact with the anus of an infected person can also transmit the virus. This means that sharing sex toys, kissing someone who's been rimming, and sucking someone who's just topped someone else can all be risky activities for transmitting HAV.

HBV is the most common sexually-transmitted type of viral hepatitis. People can be infected through anal and vaginal sex by sharing body fluids (blood, semen and vaginal fluids). It is possible, although rare, for Hepatitis B to be transmitted solely via oral sex. People who share or use needles with contaminated blood can be infected. Currently, blood transfusions are rarely the cause of HBV infections in the United States due to the improved screening of blood supplies. Although tattoo, body piercing, and acupuncture needles may transmit HBV, they account for only a small proportion of the total reported cases in the United States.

People who share or use needles or injection drug equipment (works, cotton, cookers, spoons) contaminated with blood can be infected with HCV. Most cases of HCV in the general population today have been the result of blood transfusions in the past. Currently, proper screening for Hepatitis B and C is being done on all blood supplies in the United States.

The risk of transmission via oral and anal sex is unknown, but likely to be very low.

What are the symptoms of Hepatitis?

Within all three types of hepatitis - A, B, C - the severity and type of symptoms vary greatly. Many people do not have symptoms at all. If you do have symptoms, they could include fatigue, stomach pain, yellowing of the skin or eyes (jaundice), dark urine, light colored stool and/or fever.

In Hepatitis A, symptoms usually appear 2-6 weeks after infection. In Hepatitis B, symptoms usually appear 6 weeks to 6 months after exposure, if at all. Hepatitis C symptoms, if any, will show up 2 weeks to 6 months after exposure. Symptoms may be brief or last several weeks.

What is a Hepatitis test like?

Hepatitis is diagnosed via a blood test for hepatitis antibodies. HAV antibodies may be detected as early as the onset of symptoms. HBV usually takes between 3 weeks to 2 months to show up in the blood. The average time it takes for a person infected with Hepatitis C to develop antibodies is 8-9 weeks after exposure.

How is Hepatitis treated?

General treatment for all types of early hepatitis is bed rest and fluid intake. Fluid intake is important to prevent dehydration. Avoidance of alcohol is strongly encouraged to reduce further liver damage. Hepatitis A and acute forms of B and C will eventually run their course, although recovery may take several months.

Chronic HBV can be a fatal disease. There is no cure, although treatments are available to help stop virus replication. Interferon, an antiviral agent, has been 40 percent effective in eliminating chronic HBV infection. It is most effective for people who were infected as adults.

New prescription drugs are now also available including Lamivudine (Epivir) and Adefovir dipivoxil (Hepsera). Talk to your health care provider for more information and to see whether they may be right for you.

HCV is treatable. New studies have shown that up to nearly 50% of people who undergo one year of therapy can be cured. Treatment will differ depending on the stage of illness at the time you seek treatment. Your health care provider can help you make the best decisions about your treatment based on your personal needs and health status.

What should I do if I have Hepatitis?

The most important thing is to avoid alcohol and other drugs like acetaminophen (the active ingredient in Tylenol and Vicodin) because it can further damage your liver. In general, you want to eat healthfully, get plenty of rest, and exercise moderately. You need to see your medical provider on a regular basis to work together on your treatment plan. Don't take any new medications, including herbal or over-the-counter drugs, without talking to your provider first.

If you know you have HBV, you can protect others by using condoms during sexual activity.

If you know you have HCV, you can protect others by not donating blood, body organs, tissue or semen; covering any cuts or sores you have to prevent spreading infectious blood or secretions; not sharing personal hygiene items such as razors or toothbrushes and not sharing needles or any other works. Currently there are no recommendations for condom use with HCV infected partners, however there are many other reasons to use condoms regularly for sexual activity.

How can I avoid getting Hepatitis?

Effective vaccinations are available to protect you against Hepatitis A and B. Both are recommended for those at high-risk of infection including men who have sex with men and health workers. Currently there are no shots to protect you against Hepatitis C.

A new combination vaccine called Twinrix has been approved for protection from both HAV and HBV in people who are 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three.

If you have not yet been vaccinated and you engage in anal sex activities, using condoms for intercourse and cut-up non-lubricated condoms, household plastic wrap or dams (square pieces of latex) for oral-anal sex can significantly reduce your risk of contracting hepatitis. In addition, wash your hands and sex toys as soon as possible after anal contact.

Herpes

What is Herpes?

Genital herpes is a sexually transmitted disease caused by two herpes simplex viruses (HSV type I and type II). Herpes is transmitted from person to person via direct skin-to-skin contact during unprotected oral, anal and vaginal sex. HSV I usually causes fever blisters and cold sores on the mouth, but can also cause sores on the genitals. HSV II usually causes sores on the genitals (vagina, penis, anus) and the skin around those areas but is not usually transmitted to the mouth area. IN college students, most genital herpes is actually caused by HSV-I, transmitted during unprotected oral sex. HSV is different from other common viral infections because once it is introduced into your system, it lives there forever, often with periodic symptoms or without symptoms at all.

Why worry about Herpes?

Genital herpes is seldom a severe or dangerous infection by itself, although it can cause psychological distress because of the nature of the sores and the length of time the virus stays in your system.

The open sores of herpes do play a role in the spread of HIV. A person with a herpes sore is three to five times more likely to acquire HIV if exposed to an HIV-positive sex partner. Also, people with HIV and herpes have an increased amount of HIV fluid in their open herpes sores, which increases the risk of transmitting both diseases to a partner during unprotected sex.

Pregnant women who have a first episode of genital herpes near delivery may transmit herpes to their infant, which could be a serious, even deadly, problem. Fortunately, infection of infants is rare among women with recurrent genital herpes.

What are the symptoms of Herpes?

Many people have genital herpes but don't know it because they have no symptoms. Others have very mild symptoms. For people who do have symptoms, who are symptomatic, the first outbreak is usually the worst. It lasts the longest, is most severe and often very uncomfortable. The initial sores can last five to ten days, first "weeping", then scabbing over, then healing. In addition to blisters or open sores, a person may have swollen glands, fever, and body aches. Women tend to have more severe symptoms than men.

Genital recurrences after the first outbreak seem to be linked to stress, fatigue, lack of sleep, menstruation, and genital friction (new sexual partner after a time of no sex), although more research is definitely needed about this subject. Usually recurrences are more frequent in the first year after the initial outbreak. Some people have tingling or itching at the site of the sores before they appear, which can help them prepare for an upcoming outbreak. For some people, the recurrences are so mild that they have been mistaken for jock itch, razor burns, insect bites, ingrown hairs, and the like. Outbreaks can appear in different locations over time.

What is a Herpes test like?

Even experienced clinicians cannot reliably diagnose an initial herpes outbreak by its appearance alone. There are good viral culture tests available that can tell if herpes is present and which type (HSV I or HSV II). These tests use fluid from an open sore and are most accurate during initial outbreaks and when blisters are present.

There are several new blood tests that are very accurate for diagnosis. These tests also distinguish type (HSV I or HSV II). Speak to your medical provider about these tests if you're interested.

How is Herpes treated?

There is no cure for herpes. However there are currently three FDA-approved antiviral medications available to treat herpes: Zovirax (acyclovir), Famvir (famciclovir) and Valtrex (valacyclovir). Using medication to treat genital herpes can help speed the healing process of an outbreak or be used as a preventative (when taken daily) to help reduce the frequency of future outbreaks.

Valtrex has also been proven effective when taken daily to reduce the risk of herpes transmission to sex partners. The most common short-term side effects of these drugs are nausea and headaches. Thus far, no long-term side effects have been found.

What should I do if I have Herpes?

In order to reduce outbreaks, keep your stress levels low, eat well, exercise regularly and get lots of rest. Learn to recognize the symptoms that occur during the period before the lesions appear. People often describe a tingling or burning feeling during this time. Taking medications in this time period before an outbreak can abort or reduce its duration. In order to avoid transmission of the virus to your sex partners, we advise discussing your herpes diagnosis with a prospective partner before you have sex. A potential partner would need to understand that it's possible for him or her to become infected even if you're using condoms since not all affected areas can be covered by a condom. Most good relationships can weather the news. Your partner may want to gather information and take some time to adjust to the fact that you have herpes. If you're in a serious, long-term relationship, your partner might want to test for herpes as he or she might already be infected, but without symptoms.

How do I avoid getting Herpes?

Condoms provides some, but not complete, protection against transmission of the herpes virus. If you or your partner has herpes, abstain from sexual activities when sores are present. Communication is a wonderful tool to help you and your partner(s) make decisions about what's right for each of you at any given time. However, be aware that herpes can be transmitted to a partner even when there isn't a current outbreak.

HPV

What is HPV?

HPV is the virus that causes genital and anal warts, also sometimes called condyloma. It also causes cervical and anal cancer. There are over 100 types of HPV. The virus may cause wart-like bumps to form on the penis, in and around the vagina, on the cervix (opening to the uterus), and/or around the rectum. The virus is passed via skin-to-skin contact from one person to another during anal or vaginal sex. Warts caused by HPV are not the same warts commonly found on hands and feet, and one type of wart can not be passed from one body part (hands and feet) to another (genital area).

HPV is considered to be the most common STI in the U.S. People who have had unprotected sex with more than two partners in their lifetime have probably been exposed to the virus. It's possible to have been exposed to the wart virus months or years before warts appear, or for symptoms never to appear at all after exposure.

Why worry about HPV?

There are many different types of HPV. Most are harmless - especially the ones which cause the external warts you can see. There are a few types, classified as high risk, which can cause changes in the cells of the cervix (opening to the uterus) or the cells of the anus and could lead to cancer. For this reason, the American College of Obstetricians and Gynecologists recommends that women have their first Pap smear at age 21 and continue over other year until age 30. Women age 30 and over who have had three consecutive negative Pap smears may be screened once every three years. Federal health officials are currently considering recommending yearly anal pap smears for sexually active gay and bisexual men.

What are the symptoms of HPV?

Not everyone who has the wart virus will have visible warts. Warts may appear as wart-like growths or may be flat and only slightly raised from the skin. They may be single or multiple, small or large. They tend to be flesh-colored or whitish in appearance. Warts usually do not cause itching or burning

Sometimes genital warts are so small that they cannot be seen with the naked eye. This is sometimes called "subclinical HPV." This means that a person may not even know he or she has the type or types of HPV that cause genital warts.

What is an HPV test like?

A complete examination for HPV includes taking a sexual history and examining any symptoms you might be having. Sometimes, warts can be very hard to see, even for a trained clinician. Also it can be hard to tell the difference between a wart and normal bumps on the genital area. Your medical provider may use a magnifying lens called a colposcope to see smaller warts. A biopsy is not necessary for diagnosing genital warts. This would only be done if the bump looks unusual or discolored.

Some medical providers put acetic acid (vinegar) on your genital area to check for warts. This would cause any warts present to turn white, making them easier to see, especially if they are viewed through a colposcope. However, the vinegar can sometimes cause normal bumps to be highlighted, so this method of diagnosis is not exact.

There are no blood tests available to diagnose HPV.

How is HPV treated?

Currently, there is no treatment to cure HPV. If you have it, it may live in your body forever. Treating the warts may help reduce the risk of transmission to a partner who has never been exposed to the types of HPV you are carrying.

There are several treatment options available for removing warts. The goal of any treatment should be to get rid of annoying symptoms. No one treatment is best for all cases. When choosing what treatment to use, your health care provider will consider the size, location and number of warts, changes in the warts, your preference, cost of treatment, convenience, adverse effects, and their own experience with the treatments. Some treatments are done in a clinic or doctor's office; others are prescription creams that can be used at home.

Treatments done in the doctor's office include:

  • Cryotherapy: Freezing off the wart with liquid nitrogen.

  • Podophyllin: A chemical compound to get rid of the warts. This is an older treatment and is not widely used today.

  • TCA (trichloracetic acid): Another chemical compound applied to the surface of the wart.

  • Cutting off warts: This has the advantage of getting rid of warts in a single office visit.

  • Electrocautery: Burning off warts with an electrical current.

  • Laser therapy: Using an intense light to destroy warts. This is used for larger or extensive warts, especially those that have not responded well to other treatments. Laser can be very expensive and is not available in all providers' offices.

At-home creams available by doctor's prescription:

  • Imiquimod cream (Aldara): A self-applied treatment for external genital warts. Although expensive, it is safe, effective and easy to use. Aldara boosts the immune system to fight HPV.

  • Podofilox cream or gel (Condylox): A self-applied treatment that destroys the tissue of external genital warts. It is inexpensive, easy to use and safe. The treatment period is about four weeks.

Over-the-counter wart treatments should not be used in the genital area. They will not be effective.

What should I do if I have HPV?

Some people have only one outbreak of warts, while others have recurrences over time. Genital warts are most likely to be transmitted to your sex partners when the warts are actually present, but sometimes warts are too small to see with the naked eye. Very little is known about passing subclinical HPV to sex partners.

How do I avoid getting HPV?

Abstinence is the only way to completely avoid getting HPV and other STIs. If you're sexually active, using condoms consistently and correctly for anal and vaginal sex is your best bet for staying sexually healthy. However, using condoms will only reduce your risk of getting warts from an infected partner because the wart virus can be on the skin near the vagina, rectum or penis - areas not always protected by a latex condom. Some data suggest condoms reduce the risk of cervical cancer in women who have certain types of HPV. Also, condoms can reduce the risk of recurrent HPV in those who already have the virus.

Syphilis

What is Syphilis?

Syphilis is a sexually transmitted disease (STI) caused by a type of bacteria called T. Pallidum. It can spread from person to person by physical contact during vaginal, anal, or oral sex. Syphilis infections are treatable and curable with antibiotics.

Why worry about Syphilis?

Untreated syphilis can lead to organ damage, including brain damage, and in some cases death. In addition, syphilis infection makes HIV easier to catch or to give to sex partners. New data show that for people who have HIV, syphilis can dramatically increase their viral load and cause a drop in CD4 counts. This increase resolves with syphilis treatment.

What are the symptoms of Syphilis?

Syphilis infection occurs in four stages, named primary, secondary, latent, and tertiary.

Primary Syphilis

Symptoms usually show up 2-12 weeks after being exposed. The first sign is often a skin sore called a chancre (shank-er). You may have more than one, or you may have chancres and not notice them because they are inside your anus or vagina. Chancres can also appear on your scrotum, penis, vaginal lips, anus or in your mouth. They are usually not painful. The sores will go away after several weeks without treatment, but you would still be infected.

Secondary Syphilis

Most people who have secondary syphilis notice a skin rash covering their body 4 to 12 weeks after infection. The identifying feature of this rash is that it shows up on the palms of the hands and soles of the feet. Often it is not itchy. Other common symptoms of secondary syphilis are swollen glands in various areas of the body, fever, fatigue, patchy hair loss, weight loss, and headache. Since these symptoms are so similar to those of many other health problems, syphilis has sometimes been called "the great imitator."

Additional symptoms during secondary syphilis that are particularly important are syphilis warts and white patches (condylomata lata and mucous patches, respectively). These warts and patches are highly infectious and can occur in moist areas of the body like the mouth, side of the tongue, anus, etc.

Secondary syphilis symptoms usually last anywhere from 1 to 3 months, but sometimes they last longer, and once in awhile the symptoms come and go over a year or two. But even after the symptoms of secondary syphilis clear up, if left untreated, the infection continues in your body.

Latent Syphilis

Latent syphilis causes no symptoms. The infection can be detected only by a blood test. If not treated, latent syphilis continues for life. Many people with latent syphilis never have serious problems, but some progress to the final stage, called tertiary syphilis.

Tertiary Syphilis

About one-third of untreated people with syphilis experience serious damage to various organs and body systems. Tertiary syphilis can appear any time from a year to 50 years after becoming infected; most cases occur within 20 years. The brain, heart, liver, and bones are the most commonly involved organs. Tertiary syphilis can cause paralysis, mental problems, blindness, deafness, heart failure, and death.

What is a Syphilis test like?

A complete examination for syphilis in a doctor's office or clinic includes taking a sexual history, examining any symptoms you might have (chancres, rash, etc.) and a blood test.

How is Syphilis treated?

Penicillin shots cure syphilis. If you are allergic to penicillin, there are alternative antibiotics. One common alternative is called doxycycline. It is safe and effective.

Even though symptoms will clear up after treatment, sometimes the first treatment doesn't completely cure the infection. It is very important to have several repeat syphilis blood tests to be sure the treatment worked and the infection is completely gone. In most cases this means repeat blood tests one week after treatment, then every few months for the next year.

What should I do if I have Syphilis?

Your sex partner(s) must be examined and treated too. Otherwise they can give the infection back to you and/or infect others. It's important to talk to your partners to maintain the sexual health of our community. At City Clinic, once your treatment is completed, we will give you a card that shows proper treatment was given to cure the infection. At this point, you will no longer be contagious and cannot spread syphilis to others. Until then, you need to abstain from sex or use condoms for anal, oral and/or vaginal sex.

How do I avoid getting Syphilis

The risk for syphilis is directly related to the number of sex partners you have: The more sex partners, the greater the risk on contracting it. Having more sex with fewer partners reduces your risk of getting syphilis.

Abstinence is the only surefire way to avoid getting syphilis or other STIs. If you're sexually active, using condoms consistently and correctly for oral, anal and vaginal sex is your best bet for staying sexually healthy. Also, regular STI checkups at least every six months if you're sexually active with more than one monogamous partner is recommended. Syphilis and other bacterial STIs are curable with proper diagnosis and treatment.

HIV/AIDS

What is HIV/AIDS?

AIDS stands for Acquired Immune Deficiency Syndrome and is a group of health problems caused by a virus called HIV, the Human Immunodeficiency Virus. HIV is transmitted from person to person via exchange of bodily fluids - semen, blood, and vaginal fluids - during anal, vaginal, and possibly oral sex, or when sharing needles during intravenous drug use.

People who test positive for HIV do not necessarily have AIDS. Many people are HIV+ but don't show symptoms of illness for years, if at all. People who do get AIDS can get very ill and die from infectious diseases and cancers that usually don't cause problems for other people. There is currently no cure for AIDS.

Why worry about HIV/AIDS?

People with HIV show signs of AIDS when their immune system is seriously damaged. People with AIDS can suffer from what are called opportunistic infections, such as Kaposi's sarcoma (a skin cancer), PCP (a lung infection), CMV (a virus that infects the eyes), and candida (a fungal infection). AIDS-related diseases also include severe weight loss, brain tumors, and a myriad of other health problems.

AIDS shows up differently in every infected person. Some people die soon after getting infected, while others live fairly normal lives for many years after they are diagnosed with AIDS.

There are now treatments available that can slow down the replication of HIV in your body, along with any immune system damage. The treatment is called anti-retroviral therapy. However, there is currently no cure for AIDS.

What are the symptoms of HIV/AIDS?

You might not know if you are infected with HIV. Some people get flu-like symptoms such as fever, headache, sore muscles and joints, stomach ache, swollen lymph glands, or a skin rash four to six weeks after exposure to the virus. Most people have no symptoms at all.

What is an HIV/AIDS test like?

If you get infected with HIV, your body tries to fight the infection. It makes antibodies, special molecules that are supposed to fight HIV. The most common HIV test is a blood test which looks for these antibodies. If you have them in your blood, it means that you are HIV positive.

If you become infected with HIV, it usually takes between three weeks and two to three months for your immune system to produce antibodies to HIV. If you think you were exposed to HIV, you should get tested. During your visit, speak to your doctor about the possibility of taking post-exposure prophylaxis or PEP.

Newer tests can detect HIV antibodies in saliva, a scraping from inside the cheek, or urine. A rapid HIV test was approved by the FDA in November 2002. Rapid test results are available within a half an hour after a blood sample is taken. The home test kits on the market are designed to help you collect your own blood sample. The sample is then sent to a lab where it is tested for HIV.

Clinics and medical providers will offer either confidential or anonymous HIV testing services. Confidential antibody testing means that you and the health care provider know your results, which may be recorded in your medical file. The health care provider and any other staff in the clinic or office are bound by confidentiality not to disclose the results of your test to anyone without your permission.

How is HIV/AIDS treated?

As mentioned earlier, there is no cure for AIDS. There are anti-retroviral drugs now available that can slow down the virus, and slow down the damage to your immune system. These drugs have also helped reduce the overall rates of opportunistic infections in people with AIDS. The drug regime is severe however - many expensive pills have to be taken regularly on a daily basis - and there can be side effects when the pills are taken for a long period of time. Many people who are able to, though, choose to go on anti-retroviral therapy once they are diagnosed HIV+ to stem any potential illness and keep their quality of life high as long as possible.

What should I do if I have HIV/AIDS?

The best thing you can do is to stay healthy — keep your stress levels low, eat well, exercise regularly, get lots of rest, and if you're sexually active, have protected sex with your partners. You also need to work closely with a medical provider to monitor your health and determine the best course of continued treatment over time. There are resources available to help HIV+ people in the U.S. get treatment and regular medical services, sometimes at low-cost or reduced fees.

In order to avoid transmission of the virus to your sex partners, as well as to protect yourself from getting other bacterial and viral STIs, we advise discussing your HIV status with a prospective partner before having sex. Communication is one of the keys to keeping our community sexually healthy.

How do I avoid getting HIV/AIDS?

The only way to be 100% sure you won't get HIV/AIDS is to abstain from sex and intravenous drug use. If you're sexually active, using condoms correctly each and every time you have anal or vaginal sex provides the best protection against HIV transmission. While there is not enough scientific evidence available yet to be certain, there are many individuals who also state that they have gotten HIV from participating in oral sex (as givers to infected men). It is advisable to consider using condoms for oral sex as well, especially because other STIs like syphilis and gonorrhea, which can increase your risk of getting HIV, can be transmitted via oral sex.

Others

Crabs and Scabies

Crabs are very small bugs that attach themselves to pubic hair and bite the surrounding skin. Scabies are mites (bugs) that dig under the skin where they lay their eggs, often in the genital area. Both cause extreme itching in men and women. Both are usually passed from one person to another during sex, but can also be transmitted by having contact with clothes, bedding, and towels that have been used by an infected person. There are both over-the-counter and prescription creams available to get rid of lice and scabies. Use as directed by your medical provider. You must also wash your clothing, bedding, and towels in hot water to avoid re-infection. Clothes that can't be washed (i.e. leather jackets, etc.), should be stored in a sealed plastic bag for at least 72 hours.

Molluscum Contagiosum

Molluscum or M. contagiosum is a skin affliction caused by a virus that can be passed from one person to another during sex or, more commonly, other close skin-to-skin contact. It is also possible for molluscum to be passed by sharing towels. It's commonly found in people that exercise in gyms. Symptoms include several smooth, firm, rounded bumps with a dip in the center that appear on the thighs, genitals, buttocks, below the waist, and/or in the pubic hair. The bumps may be tan, yellow, grey or pink. Molluscum will go away on its own without any treatment or complications, but if you choose, the bumps can be frozen off by a medical provider with liquid nitrogen.

Non-Gonococcal Urethritis

Also called non-specific urethritis, this is an infection in the male urethra caused by bacteria such as chlamydia, mycoplasma, ureaplasma or trichomoniasis. NGU is passed from one person to another during anal, vaginal and possibly oral sex. Symptoms may include a mild discharge from the head of the penis and pain or burning upon urination. Female partners of men with NGU need to be treated as if they have chlamydia. Antibiotics are used to cure NGU.

Shigella

This is a bacterial infection that causes serious stomach cramps and diarrhea. Shigella can easily be spread from one person to another through rimming (oral-anal contact) and from oral contact with contaminated skin, including skin in the groin area, the testicles and the penis. Shigella can also be spread via fecally contaminated food and water. People with HIV are more likely to have serious complications from shigella infections. Other bugs commonly acquired through oral-anal sex that can case stomach pain and diarrhea are the three parasites: giardia, amebiasis, and cryptosporidium, and the viral Hepatitis A. Shigella can be treated with antibiotics. Very thorough washing of your genitals and hands before and after sex can help prevent shigella and other infections, as well as using a barrier (cut-up condoms, dental dams, or household plastic wrap) for oral-anal sexual activities.

Trichomoniasis

Also known as trich, this is an infection caused by a protozoa that is passed from person to person during vaginal sex. Women have more symptoms than men, most commonly a yellow-green or gray bubbly fluid coming from the vagina that often has an unpleasant odor and is itchy. A prescription drug called metronidazole will cure trichomoniasis. Do not drink alcohol while you are taking this drug as it can cause severe reactions. Your male partner(s) must be treated, too, to prevent your re-infection, even though he probably won't have any symptoms.

Vaginitis

Vaginitis is a name for swelling, itching, burning or infection in the vaginal area that can be caused by several different germs. The most common kinds of vaginitis are bacterial vaginosis (b.v.) and yeast, a fungus. Vaginitis is very common among women and is present when a so-called "bad" bacteria outweighs a "good" bacteria in the vagina. If there are symptoms at all, the primary ones are a gray, yellow or white fishy-smelling discharge from the vagina and itching in the vaginal area. Most of the time, b.v. does not need treatment, but if a woman is pregnant (even if she's considering terminating the pregnancy), it is necessary to take antibiotics so that the bacteria don't spread beyond the vaginal area. There are over-the-counter creams available to treat yeast infections, although if you are getting chronic yeast infections, it is important to see a medical provider as they can be symptomatic of other problems, including HIV infection. To prevent vaginitis, medical providers suggest wearing clean cotton underwear and loose clothing; avoiding douching, vaginal sprays, and scented vaginal products; and eating a balanced diet with moderate amounts of caffeine, alcohol, and sweets, including chocolate.