STI's

Human Immunodeficiency Virus (HIV)

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 fifth leading cause of death for American women and men between 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 U.S. Like many other viruses, HIV remains in the body for life.

Common symptoms

• constant or rapid, unexplained weight loss, diarrhea, lack of appetite
• fatigue, persistent fevers, night sweats, dry cough
• lightheadedness, headaches, mental disorders
• a thick, whitish coating of yeast on the tongue or mouth — "thrush"
• severe or recurring vaginal yeast infections
• chronic PID
• purplish growths on the skin

There may be no symptoms for 10 years or more. In one 20-year-long study, about five percent of men with HIV had not yet developed symptoms.

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 —such as various pneumonias, cancers, and infections that take advantage of weakened immune systems—can be managed to some extent with different treatments. However, at this time, no one has recovered from AIDS. Although people with AIDS are living longer, it is still considered fatal.

Protection

Condoms offer good protection against infection with HIV.

What is chlamydia?

Chlamydia is a sexually 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 spread to the testicles, causing epididymitis, 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 America. At least three million American men and women become infected every year.

Common symptoms

• discharge from the penis or vagina
• pain or burning while urinating, frequent urination
• excessive vaginal bleeding
• painful intercourse for women
• spotting between periods or after intercourse
• abdominal pain, nausea, fever
• inflammation of the rectum or cervix
• swelling or pain in the testicles

Symptoms appear in seven to 21 days — if they appear. If your partner is a man, and he has a urinary tract infection, you may have chlamydia.

Seventy-five percent of women and 50 percent of men with chlamydia have no symptoms. Many women discover they have chlamydia only because their partners are found to be infected. Other women discover that they must have had it for some time when they are treated for the infertility that it can cause.

How chlamydia is spread

• vaginal and anal intercourse
• from the birth canal to the fetus
• rarely, from the hand to the eye
• rarely, during oral sex

Diagnosis

Can be confused with gonorrhea and other conditions. Examination of tissue samples or urine is necessary for correct diagnosis.

Treatment

Both partners can be treated successfully with antibiotics. Follow-up testing may be suggested three to four months after treatment.

Protection

Condoms reduce the risk of infection with chlamydia

Genital Herpes

There are two forms of genital herpes — herpes simplex virus-1 and herpes simplex virus-2. Although herpes-1 is most often associated with cold sores and fever blisters, both forms of herpes may be sexually transmitted. In fact, most adults have herpes simplex virus (HSV), either type 1 or type 2, or both.

During pregnancy, herpes may cause miscarriage or stillbirth. If active herpes infections 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 the 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, the HSV remains in the body for life.

Common 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
• painful ulcerations that occur when blisters break open
• The first outbreak may cause pain and discomfort around the infected area, itching, burning sensations during urination, swollen glands in the groin, fever, headache, and a general run-down feeling.

Symptoms usually appear from two-20 days after infection — but it may be years before an outbreak occurs.

Recurrences are sometimes related to emotional, physical, or health stresses. During recurrences, it is important to observe strict rules of day-to-day hygiene. Wash hands frequently and do not touch the sores. If the sores are touched inadvertently, wash hands immediately. Be particularly careful when handling contact lenses and touching the eyes.

How HSV is spread

• touching, sexual intimacy — including kissing
• vaginal, anal, and oral intercourse

HSV may be passed from one partner to another, or from one part of the body to another, whenever contact is made with an active herpes virus. Oral sex play can pass herpes from the mouth to the genitals or from the genitals to the mouth.

HSV is most contagious from the time the sores are present until they are completely healed and the scabs have fallen off. Some people may be contagious at various times when they have no symptoms. Mucous membranes of the mouth, anus, vagina, penis, and the eyes are especially susceptible to infection.

Diagnosis

Can be confused with syphilis, chancroid, and other sexually transmitted infections. Definitive diagnosis is possible by laboratory culturing of fluid samples taken from the sores or by blood test.

Treatment

No cure. Symptoms can be relieved and the number of recurrences reduced with the drugs valacyclovir, acyclovir, and famciclovir.

Protection

Partners should refrain from sexual intimacy from the time they know the blisters are going to recur until after the scabs have completely fallen off the healed sores. Condoms reduce the risk of transmitting the virus between outbreaks.

Molluscum Contagiosum

Hundreds of thousands of cases of the virus, molluscum contagiosum, are diagnosed every year. It is often transmitted by nonsexual, intimate contact.

Common symptoms

Small, pinkish-white, waxy, round, polyp-like growths in the genital area or on the thighs. There is often a tiny depression in the middle of the growth. Symptoms usually appear between two and 12 weeks after infection — but it can take years.

How molluscum contagiosum is spread

Vaginal, anal, and oral intercourse, as well as other intimate contact. For example, children may become infected through casual contact. In such cases, growths may appear on other parts of the body, especially the abdomen.

Diagnosis

microscopic examination of tissue taken from the sore

Treatment

Growths may be removed with chemicals, electrical current, or freezing.

Protection

Condoms reduce the risk of molluscum contagiosum, but the virus may "shed" beyond the area protected by condoms.

Hepatitis B

Hepatitis B virus (HBV) is a common sexually transmitted infection that can be prevented with vaccination.

About 78,000 Americans get HBV every year because they have not been vaccinated. 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 about five to ten percent of people who get HBV as adults will be "carriers" and have chronic (long-term) infection with HBV. Chronic HBV infection can cause severe liver disease and death. Unless they are treated at birth, 90 percent of the infants born to women with HBV will carry the virus.

Common symptoms

• extreme fatigue, headache, fever, hives
• lack of appetite, nausea, vomiting, tenderness in the lower abdomen

Later symptoms

More abdominal pain, dark urine, clay-colored stool, yellowing of the skin and white of the eye — jaundice

Hepatitis may be invisible during its most contagious phases.

How HBV is spread

In semen, saliva, blood, and urine by:

• intimate and sexual contact, from kissing to vaginal, anal, and oral intercourse
• use of unclean needles to inject drugs
• accidental pricks with contaminated needles in the course of health care
• sharing personal hygiene utensils such as toothbrushes and razors

How HAV is spread

Oral contact with fecal matter through:

• oral/anal sex play
• other kinds of sex play
• sharing needles with intravenous drug use

Hepatitis A and B are very contagious. However, HAV infection is contagious for only a short period of time.

Diagnosis

Blood test

Treatment

In most cases the infection clears within four to eight weeks. Some people, however, remain infected and contagious for the rest of their lives. There are three drugs that can help treat chronic HBV — adefovir dipivoxil, alpha interferon, and lamivudine.

Protection

Condoms may offer limited protection against hepatitis during vaginal, anal, and oral intercourse. Latex or plastic barriers can be used during oral/anal or oral/vulvar contact. But the virus can be passed through kissing and other intimate touching. Children and adults who do not have HBV can get permanent protection with a series of HBV vaccinations. There is also a vaccine for HAV that is recommended for people who may be at risk of infection.