smithSEX.ED - Sexually Transmitted Infections

Sexually Transmitted Infections (STIs)

Bacterial Vaginosis***Chlamydia***Cytomegalovirus***Gonorrhea
Hepatitis B***Herpes***HIV***HPV***Molluscum Contagiosum
Pelvic Inflammatory Disease***Pubic Lice ("Crabs")***Scabies
Syphilis***Trichomoniasis***Urinary Tract Infections

Bacterial Vaginosis
Bacterial Vaginosis (BV) is a condition caused by a change in the balance of different kinds of bacteria in the vagina. Most women will get BV at some point in their reproductive years. When there are symptoms, they often appear as a form of vaginitis – an irritation of the vagina often associated with a vaginal discharge. BV is not always due to sexual contact. However, women who are sexually active run a high risk of developing the condition. It can develop when an external factor, such as sexual contact, disrupts the balance between bacteria that protect the vagina from infection and those bacteria that don’t.

BV is associated with premature delivery, low birth weight, and pelvic inflammatory disease. It can also increase the risk for HIV infection. Pregnant women with BV run higher risks of miscarriage, especially in the first trimester.

What to know:

Symptoms: strong, unpleasant vaginal odor; vaginal discharge.
Many women do not have symptoms
Spread via vaginal intercourse
Treatment: antimicrobial creams
Protection: condoms may reduce the risk of developing BV

Chlamydia (cla-MIH-dee-ah)
Chlamydia is a sexual transmitted bacterium. It can cause sterility in women and men. In women, it infects the cervix and can spread to the urethra, fallopian tubes, and ovaries. It can cause bladder infections and serious pelvic inflammatory disease, ectopic pregnancy, and sterility. In men, Chlamydia infects the urethra and may also spread to the testicles, causing epididimitis, which can cause sterility.
Chlamydia can also lead to reactive arthritis – especially in young men. One in three men who develop reactive arthritis become permanently disabled. In infants, Chlamydia can cause pneumonia, eye infections and blindness. Chlamydia is the most common and most invisible sexually transmitted bacterial infection in the US. At least three million American women and men become infected every year.

What to know:

Symptoms: discharge; pain or burning during urination; vaginal bleeding; painful intercourse; nausea and fever, inflammation of the rectum, cervix, or testicles.
75% of women and 50% of men have no symptoms
Spread via vaginal and anal intercourse and rarely from the hand to the eye
Treatment: anti-biotics
Condoms reduce the risk of infection with Chlamydia

Cytomegalovirus (CMV; sigh-tow-MEG-a-low-VI-rus)
CMV is a virus that is transmitted through many body fluids. It is also sexually transmitted. Every year, CMV causes permanent diability, including hearing loss and mental retardation, for 4,000 to 7,000 babies. It is the most common infection in the US that is spread from a woman to a developing fetus – from 10 to 20 percent of infants born to women with CMV become infected. CMV is also very dangerous for people with weakened immune systems. It can cause blindness and mental disorders. Like many other viruses, CMV can remain in the body for life.

What to know:

Symptoms usually do not appear with first infection. Reinfection, or infection with other STIs, may reactivate the virus and cause illness
Symptoms: Swollen glands, fatigue, fever, general weakness – CMV causes 8 percent of cases of mono
Spread via saliva, semen, blood, cervical and vaginal secretions, urine, and breast milk.
No cure. Symptoms can usually be controlled with a variety of intravenous drugs.
Condoms and dams may reduce the risk of infection with CMV during vaginal, anal and oral intercourse, but kissing and other intimate touching can spread the virus

Genital Warts (See Human Papilloma Virus)

Gonorrhea
Gonorrhea is a bacterium that can cause sterility, arthritis, and heart problems. In women, gonorrhea can cause pelvic inflammatory disease, which can result in ectopic pregnancy or sterility. During preganacy, gonorrhea infections can cause premature labor and stillbirth. To prevent serious eye infections that can be caused by gonorrhea, drops of antibiotics are routinely put into the eyes of newborn babies immediately after delivery. About 650,000 new cases of gonorrhea are reported every year in the US.

What to know:

Symptoms: frequent burning urination; menstrual irregularities; pelvic of lower abdominal pain; yellowish or green discharge from the vagina; swelling or tenderness of the vulva; in men, pus like discharge from the urethra
80% of women and 10% of men with gonorrhea have no symptoms.
Spread via anal, vaginal, and oral intercourse
Treatment: anti-biotics
Condoms reduce the risk of infection with gonorrhea

Hepatitis
Hepatitis B (HBV) is a common sexually transmitted infection that can be prevented with vaccination. About 120,000 Americans get HBV every year because they have not been vaccinated. There are now about 417,000 people with sexually acquired HBV in the US. Sexual transmission of the Hepatitis A virus (HAV) is less common. Unlike most sexually transmitted infections, a person with HAV also develops immunity against reinfection. Sex play has a limited role in the transmission of hepatitis C virus (HCV).

Although 90-95 percent of adults with HBV recover completely, the virus can cause severe liver disease and death. Unless they are treated within an hour of birth, 90 percent of babies born to women with HBV will carry the virus. Pregnant women who may have been exposed to HBV should consider being tested before giving birth so that their babies can be vaccinated at birth or treated if they become ill. Like many other viruses, HBV remains in the body for life.

What to know:

Symptoms include fatigue, headache, fever, hives, nausea, vomiting, dark urine
Hepatitis may be invisible during its most contagious phases
Spread via semen, saliva, blood and urine, or oral contact with fecal matter (HAV)
Treatment: none. In most cases the infection clears within four to eight weeks. Some people remain contagious for life.
Protection: Condoms and dams offer some protection against hepatits during vaginal, anal, and oral intercourse. The virus can still be passed through kissing and other intimate touching. Children and adults who do not have HBV can be protected by a series of vaccinations

Herpes
There are two forms of genital herpes – herpes simplex virus-1 and herpes simplex virus-2. Although HSV-1 is most often associated with cold sores and fever blisters, both forms of herpes may be sexually transmitted. In fact, most adults have HSV, either type 1 or type 2, or both. During pregnancy, herpes may cause miscarriage or stillbirth. If active herpes sores are present during childbirth, newborn infants may suffer serious health damage, including developmental disabilities and, rarely, death. Transmission to a newborn is more common during the first episode of herpes infection and less common during recurrent herpes outbreaks. More than 45 million Americans have been diagnosed with genital herpes. At least one million new cases are diagnosed every year. Like many other viruses, HSV remains in the body for life.

What to know:

Symptoms: a recurring rash with clusters of itchy or painful blistery sores appearing on the vagina, cervix, penis, mouth, anus, buttocks, or elsewhere on the body
Spread via contact with herpes sores (from partner to partner or from one part of the body to another). It is also possible to spread herpes when no sores are present.
Treatment: no cure. Symptoms can be relieved and the number of recurrences reduced with prescription drugs.
Protection: Because blisters often appear outside of the areas covered by condoms and dams, partners should refrain from sexual intimacy from the time they know the blisters are going to recur until the scabs have healed and fallen off. Condoms and dams offer some protection against infection with HSV between outbreaks.

Human Immunodeficiency Virus (HIV – im-MU-noh-dee-FISH-en-see)
HIV infections weaken the body’s ability to fight infection and can cause Acquired Immune Deficiency Syndrome (AIDS) – the most advanced stage of HIV disease. HIV is the most dangerous sexually transmitted infection, and it affects people of all ages. It is now the 5th leading cause of death for American women and men between the ages of 25 and 44 years old. It is believed that at least 40,000 Americans become infected each year. There have already been more than 700,000 cases reported in the US. Like many other viruses, HIV remains in the body for life.

Common Symptoms:

Constant or rapid unexplained weightloss
Diarrhea, lack of appetite
Fatigue, persistent fevers, night sweats, dry cough
Lightheadedness, headaches, mental disorders
Thrush (oral yeast infection)
Severe or recurring vaginal yeast infections
Chronic PID
Purplish growths on the skin
There may be no symptoms for 10 years or more.

How HIV is spread: In blood, semen, vaginal fluids and breast milk by

Anal and Vaginal intercourse – less commonly transmitted through oral sex
Sharing contaminated needles for injecting IV drugs
Transfusion of contaminated blood products
Childbirth
Breast feeding
Accidental pricks with contaminated needles in the course of health care

Diagnosis:
There are blood, urine and saliva tests to detect HIV antibodies. Diagnosis of AIDS is based on the presence of one or more of a variety of conditions and “opportunistic” infections related to HIV infection.

Treatment:
No cure or vaccine. HIV infection and many AIDS-related conditions can be managed to some extent with different treatments. Although people with AIDS are living longer, it is still considered fatal.

Protection:
Condoms offer good protection against infection with HIV.

Human Papilloma Virus
There are more than 100 different HPVs. They cause a variety of warts and other conditions and can remain in the system for life. Studies suggest that as many as three-quarters of adults in the US have been infected with at least one type of HPV. Thirty of these HPVs are genital and affect the sexual and reproductive organs. A few cause genital warts, but most genital HPV infections are not visible and have no symptoms. Some of these cause cancer of the cervix, vulva or penis. Every year, more than five million Americans are newly infected with genital HPVs – about 20 million men and women are now infected.

What to know:

Symptoms: warts appear on the genitals, in the urethra, in the anus, or in the throat. Warts are soft to the touch and often itch.
Spread via vaginal, anal, and oral intercourse
Treatment: No cure. Though they may recur, genital warts can be treated in a number of ways.
Condoms reduce the risk of genital warts and cervical cancer, but the viruses may be shed beyond the area protected by condoms and dams.

Molluscum Contagiosum
Hundreds of thousands of cases of this virus are diagnosed every year. It is often transmitted by non-sexual intimate contact.
What to know:

Small, pinkish white, waxy, round, polyp-like growths in the genital area or on the inner thighs
Spread via vaginal, anal, and oral intercourse, as well as other intimate contact.
Treatment: growths can be removed with chemicals, electrical current, or freezing
Condoms and dams reduce the risk of Molluscum Contagiosum, but the virus may be “shed” beyond the area protected by condoms and dams.

Pelvic Inflammatory Disease (PID)
PID is a progressive infection that harms a woman’s reproductive system. PID occurs throughout the pelvic area, in the fallopian tubes, the uterus, the lining of the uterus, and the ovaries. Treated or untreated, PID can lead to sterility, ectopic pregnancy, and chronic pain. The more episodes of PID a woman has, the greater are her chances of becoming infertile. PID is not always the result of a sexually transmitted infection, but in most cases it is. The sexually transmitted infections that most often cause PID are Gonorrhea and Chlamydia. More than 1,000,000 US women have an acute episode of PID every year. It is believed that millions of other cases go undiscovered.

What to know:

Symptoms: unusually long or painful periods; unusual vaginal discharge; spotting and pain between periods or during urination; pain in the lower abdomen and back; fever or chills; nausea and vomiting
Treatment: antibiotics, bed rest, and sexual abstinence. Surgery may be required to remove abscesses or scar tissue, or to repair or remove reproductive organs.
Condoms reduce the risk of infections commonly associated with PID.

Pubic Lice
Every year, millions of people treat themselves for pubic lice. These tiny insects are also called “crabs”.
What to know:

Symptoms: intense itching of the genitals or anus; mild fever; feeling rundown; irritability; lice or small egg sacks in pubic hair
Spread via contact with infected bedding, clothing, upholstered furniture and toilet seats, and intimate sexual contact
Treatment: follow the directions on the package insert of an over the counter medication like RID or A-200. Stronger prescription lotions are also available. All clothing, bedding, or towels that may have been infected should be thoroughly washed or dry cleaned, and the home should be vacuumed.
Protection: limit the number of intimate and sexual contacts

Scabies
The Scabies mite burrows under the skin. It can hardly be seen with the naked eye. It belongs to the same family as the spider. It is usually sexually transmitted. However, school children often pass it to one another through casual contact.

What to know:

Symptoms include intense itching and burning, usually at night; small bumps or rashes that appear in dirty looking, small curling lines, especially on the penis, between the fingers, on buttocks, breasts, wrists, thighs, or around the navel. Often symptoms are not visible.
Spread via close personal contact and contact with bedding and clothing
Follow the directions on the package insert of a prescription medication such as Kwell or Scabene. All bedding, towels and clothing that may have been infected should be washed thoroughly or dry cleaned, and the home should be thoroughly vacuumed.
Protection: limit the number of intimate and sexual contacts

Syphilis
Untreated, the Syphilis organism can remain in the body for life and lead to disfigurement, neurologic disorder, or death. There are 70,000 new cases in the US each year.

Syphilis has several phases that may overlap one another. They do not always follow in the same sequence. Symptoms vary with each phase, but there are no symptoms most of the time.

Primary Phase: Painless sores or open, wet ulcers – chancres – often appear from three weeks to 90 days after infection. They last three to six weeks. They appear on the genitals, in the vagina, on the cervix, lips, mouth, breasts or anus. Swollen glands may also occur during the primary phase.
Secondary Phase: Other symptoms often appear from three to six weeks after the sores appear. They may come and go for up to two years. They include body rashes that last from two to six weeks – often on the palms of the hands and the soles of the feet. There are many other symptoms, including mild fever, fatigue, sore throat, hair loss, weight loss, swollen glands, headache, and muscle pains.
Latent Phase: No symptoms. Latent phases occur between other phases.
Late Phase: One third of untreated people with syphilis suffer serious damage to the nervous system, heart, brain, or other organs, and death may result.
Spread via vaginal, anal, and oral intercourse and kissing. Especially contagious when sores are present early in the disease.
Treatment: antibiotics, although damage caused by the disease in its later phases cannot be undone.
Condoms reduce the risk of infection with syphilis during vaginal, anal, and oral intercourse.

Trichomoniasis
“Trich” is a condition caused by a protozoan – a microscopic, one-cell animal. It is a common cause of vaginal infection. Up to five million Americans develop trich each year.

What to know:

Symptoms include frothy, unpleasant smelling vaginal discharge; itching in and around the vagins; swelling in the groin; frequent painful urination. Men rarely have symptoms, and sometimes women have no symptoms.
Spread via vaginal intercourse, mutual masturbation, and the passing of fluids from one partner’s genitals to the other.
Treatment: Drugs called 5-notroimidazoles are successful for both partners
Condoms reduce the risk on infection with trich.

Urinary Tract Infections
UTIs are caused by bacteria that have spread from the rectum to the vagina or penis and then to the urethra and bladder. They may be sexually transmitted. UTIs include infections of the bladder, the ureters (the tubes that lead from the kidneys to the bladder), and the urethra. Severe cases, left untreated, may cause kidney infection.

What to know:

Symptoms include burning pain during urination; the urge to urinate when the bladder is nearly empty; frequent urge to urinate; lower back or abdominal pain; fever; and blood or pus in urine.

UTIs are common in women and men who are sexually active. They affect women more often than men because a woman’s urethra is shorter and bacteria may get to the bladder more easily. A woman’s urethra is also closer to the anus than a man’s.
Spread via any kind of sex play that brings fecal matter into contact with the vagina and urethra. Also, adjusting to the new bacterial environment cause by having new partners may lead to a bladder infection called “honeymoon cyctitis.”
Treatment: antibiotics. Pyridium may relieve symptoms but will not cure the infection.
Protection: Drink lots of water and unsweetened cranberry juice. Avoid caffeine. Urinate immediately before and after sex. Avoid sexual positions that seem to trigger UTIs. Use latex condoms during vaginal and anal intercourse. Always use a new condom for each instance of intercourse.

***NOTE: Adapted from Planned Parenthood’s Sexually Transmitted Infections: The Facts

Written by Amanda Hanley '06
Last Updated: 1-29-06