Sexually Transmitted Infections (STIs) a.k.a. STDs


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The information provided below is for educational purposes only. Please do not use this information to diagnose yourself. If you have further questions or concerns about this topic or any others, call 621-4967, contact a Campus Health Service provider, or make an appointment by calling 621-9202.


Name of STI
Symptoms
Treatment
Prevention
Extra Information
Bacterial Vaginosis (BV)

BV is an overgrowth of bacteria that are normally in the vagina. 

Bacterial vaginosis is the most common vaginal infection.

Many women do not have any symptoms.

When there are symptoms, they often appear as a form of vaginitis - an irritation of the vagina often associated with a vaginal discharge.

  • Strong, unpleasant vaginal odor
  • Excessive white or gray vaginal discharge with a milk-like consistency that can stain undergarments.
  • Vaginal itching or burning are also sometimes present 
Antibiotics administered orally or intravaginally. 

Products like douches or deodorant sprays that mask vaginal odor should not be used to treat BV.

Non-prescription medications should not be used to treat BV; this can interfere with proper diagnosis. 

Male condoms offer good protection against BV. BV is not always "caught" from another person.  You can develop BV if you are not sexually active, although it is more common in women who are sexually active.

BV is associated with premature delivery, low birth weight, and pelvic inflammatory disease (PID). 

Chlamydia

About 3.5 million Americans are infected each year.

It is estimated that 20 - 40% of all sexually active women have probably been exposed to chlamydia at some time. 

Almost 70% of infected women have no symptoms.

Women

  • Burning or itching in the genital area 
  • Discharge from the vagina 
  • Painful or frequent urination 
  • Pain in the pelvic area 
Men
  • Painful urination 
  • Burning and inflammation of the urethra (tube leading from the bladder to the outside of the body)
  • Discharge from the penis 
If left untreated, chlamydia can cause sterility in both men and women and is the major cause of P.I.D. (Pelvic Inflammatory Disease).  Each year, more than one million women are treated for P.I.D.  Last year P.I.D. caused 11,000 cases of sterility in American women.
Antibiotics 

In most cases these drugs can wipe out the disease in less than 1 week. 

Because risk for gonorrhea is high if you have chlamydia, you may be treated for this infection as well. 

If left untreated, chlamydia can cause sterility in both men and women.  Chlamydia is the major cause of PID. (Pelvic Inflammatory Disease). 

In women, the infection can spread to the uterus and Fallopian tubes causing scarring and a blocked passage for the ova to leave the tubes, resulting in infertility and risk for ectopic pregnancy. 

In men, the infection can lead to epididymitis; a testicular inflammation which can result in sterility
 

If used correctly and consistently, male latex condoms will partially protect against chlamydial infection. The infection may be passed through sexual activity, including oral sex. 

Risk Factors:

  • Young people with more than one sexual partner
  • People infected with or who have had gonorrhea or other sexually transmitted infections
Cytomegalovirus (CMV) There are usually no symptoms with the first infection. 

Reinfection with CMV, or infection with other sexually transmitted organisms such as HIV and hepatitis B, may reactivate the virus and cause illness.

CMV causes 8% of the cases of mononucleosis 

Symptoms include:

  • Swollen glands
  • Fatigue
  • Fever
  • General weakness 
  • Irritations of the digestive tract, nausea, diarrhea 
  • Loss of vision
There is no cure. 

Symptoms may be managed with a variety of intravenous drugs.

Condoms can provide protection against CMV during vaginal, anal, and oral intercourse, but kissing and other intimate touching can spread the virus.  CMV is a virus that is spread in saliva, semen, blood, cervical and vaginal secretions, urine, and breast milk. 

It also can be spread by:

  • Close personal contact
  • Vaginal, anal, and oral intercourse
  • Blood transfusion
  • Sharing IV drug equipment
  • Pregnancy, childbirth, and breast feeding
Genital Warts (Human Papillomavirus, HPV)

HPV is the most common STI in the U.S.

Studies have shown that as many as 50 - 60% of college age women have been exposed to the virus, with most of them and their partners having no symptoms.

HPV usually causes a silent infection that does not have visible symptoms.

Approximately two-thirds of people who have had sexual contact with a partner with genital warts will develop warts, usually within 3 – 8 months of contact.

Women

  • Warts on the outside and inside of the vagina, on the cervix (the opening to the uterus), or around the anus
Men (genital warts are less common)
  • If present, they are flatter and seen on the tip of the penis
  • May also be found on the shaft of the penis, on the scrotum, or around the anus
Rarely, genital warts also can develop in the mouth or throat of a person who has had oral sexual contact with an infected person. 

Genital warts often occur in clusters and can be very tiny or can spread into large masses on genital tissues. 

Left untreated, genital warts often disappear over time. In other cases, they eventually may develop a fleshy, small raised growth with a cauliflower-like appearance.
 

Although treatments can eliminate the warts, none eradicate the virus and warts often reappear after treatment.

Treatment varies depending on size and location of warts

It is particularly important for women who have cervical dysplasia (a premalignant or precancerous change to the cells of your cervix) to have regular Pap smears. This pre-cancerous cervical disease is readily treatable.

The only way to prevent HPV infection is to avoid sexual (direct skin-to-skin) contact with an infected partner (these warts are very contagious).

If warts are visible in the genital area, sexual contact should be avoided until the warts are treated. 

Using a latex condom during sexual intercourse may provide some protection (but warts can affect the area that the condom does not cover).

Scientists have identified more than 100 types of HPV.

About one-third of the HPV types is spread through sexual contact and lives only in genital tissue. 

Low-risk types of HPV (6,11 mainly) cause genital warts, the most recognizable sign of genital HPV infection.

Other high-risk types of HPV (16,18 mainly) cause dysplasia (precancerous changes) and cancer of the cervix, vagina, and vulva. 

Women with HPV who smoke may be at greater risk for cervical dysplasia.

Having multiple sexual partners greatly increases the risk for acquiring HPV.

Gonorrhea 
"The Clap"

The Institute of Medicine estimates that 800,000 cases of gonorrhea occur annually in the United States.

Early symptoms often are mild.  Up to 80% of people with gonorrhea have no symptoms at all.

Symptoms usually appear within 2 – 10 days after sexual contact with an infected partner (although a small percentage of people may be infected for several months without showing symptoms).

Women

  • Painful or burning sensation when urinating
  • Vaginal discharge that is yellow or bloody
More advanced symptoms (which indicate progression to pelvic inflammatory disease):
  • Abdominal pain
  • Bleeding between menstrual periods
  • Vomiting
  • Fever
Men
  • Discharge from the penis
  • Burning sensation during urination
Rectal infection:
  • Discharge
  • Anal itching
  • Sometimes painful bowel movements
Because penicillin-resistant cases of gonorrhea are common, other antibiotics are used to treat most patients with gonococcal infections. 

Gonorrhea can occur together with chlamydial infection, therefore, providers usually prescribe a combination of antibiotics.

All sexual partners of a person with gonorrhea should be tested and treated if infected whether or not they have symptoms of infection.

Proper and consistent use of male condoms may prevent the spread of gonorrhea.

Although in women the cervix usually is the initial site of infection, the infection can spread to and infect the uterus (womb) and fallopian tubes, resulting in pelvic inflammatory disease (PID). 

Rarely it can spread throughout the body, affecting the joints, making the person very sick.

Hepatitis B (HBV)

About 77,000 Americans get HBV every year because they have not been vaccinated. 

There are now about 750,000 people with sexually acquired HBV in the U.S.

HBV may show no symptoms during its most contagious phases. 

If symptoms appear, they appear within 4 weeks.

  • 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
  • Jaundice (yellowing of the skin and white of the eye)
None. In most cases the infection clears within 4 - 8 weeks.  Some people, however, remain contagious for the rest of their lives. Condoms offer some protection against HBV during vaginal, anal, and oral intercourse, but the virus can be passed through kissing and other intimate touching. 

HBV is the only sexually transmitted infection that is preventable with vaccination.

HBV is spread:
  • In semen, saliva, blood, 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
Hepatitis B is very contagious.
Herpes Simplex (HSV)

The virus affects anywhere between 5 and 20 million people, or up to 20% of all sexually active adults in the United States.

There are two types of HSV. 

Most people contract Type 1 – which usually affects the lips, mouth, nose, chin or cheeks during infancy or childhood. 

They usually acquire it from close contact with family members or friends who carry the virus and transmit it to them by touching, kissing, and by the use of common eating utensils and towels. 
 

 

Some people infected with HSV never experience any symptoms and others may have recurrent episodes on average 
4 - 5 times a year

Type 1

  • A rash or cold sores (a.k.a. fever blisters - tiny, clear, fluid-filled blisters) involving the mouth and gums.  They appear shortly after exposure. 
Type 2
  • Usually occurs below the waist, on the buttocks, penis, vagina or cervix, 2 - 20 days after contact with an infected person. 
  • Symptoms of both primary and repeat attacks can include a minor rash or itching, painful sores, fever, achy muscles, and a burning sensation during urination. 
Researchers have confirmed that HSV Type 1 infections can occur in the genital area.  Likewise, HSV Type 2 can occur in locations other than the genital area. 

Symptoms and consequences are the same with either virus type in any location. 
 

There is no cure for oral or genital herpes. 

Medications can be taken to shorten the duration of the outbreak and decrease the pain.

Outbreaks tend to become less frequent and less severe over time.

Two types – both can cause genital herpes through direct skin-to-skin contact

To avoid spread of infection during active phase: 

  • Keep infected area clean and dry 
  • Avoid touching sores
  • Do not share towels,  underclothing, or swimsuits 
  • Wash hands after contact with sores
  • Avoid sexual contact from first appearance of symptoms until sores are completely healed and new skin has formed over the site of the lesions
Between outbreaks, use condoms to reduce risk of transmission.
As many as 80% of people with genital herpes are not aware that they have the disease because they do not develop or recognize the symptoms.

HSV is most dangerous when a woman is pregnant.  Neonatal herpes infection can lead to severe illness and death in an infant.

Human Immunodeficiency Virus (HIV)

HIV is the virus that causes AIDS (Acquired Immunodeficiency Syndrome)

In 2000, 1,688 young people (ages 13 to 24) were reported with AIDS, bringing the cumulative total to 31,293 cases of AIDS in this age group.
 

People infected with HIV can look and feel healthy and may not even know that they are infected. Even though they don't look or feel sick, they can infect others. 

Symptoms vary from person to person. Only a blood test can tell if someone is infected with HIV. Only a provider can diagnose AIDS.

  • Swollen glands
  • Fever
  • Diarrhea
In some women, recurrent, hard-to-treat vaginal yeast infections and cervical cancer may be related to HIV infection.
At this time, HIV cannot be cured. Condoms can provide protection against HIV during vaginal, anal, and oral intercourse.  Sharing "sex toys" can be risky if their use involves contact with another person's blood, semen, or vaginal fluid.

It is possible to become infected from just one sexual experience or one shared needle or syringe with an infected person.  HIV is transmitted by:

  • Having vaginal, oral, or anal sex with someone who is infected with HIV
  • Blood-to-blood contact, such as sharing needles or syringes with someone who is infected with HIV
  • From an infected mother to her baby during pregnancy, childbirth, or breast feeding 
HIV is NOT spread through everyday social activity. It is not spread through casual contact.

Activities like hugging, touching, cuddling, kissing, and massage do not spread HIV, as long as there is no contact with an infected person's blood, semen, vaginal fluid, or breast milk.
 

Molluscum Contagiosum

Hundreds of thousands of cases of this virus are diagnosed every year.

Symptoms usually appear between 2  - 12 weeks after infection — but it can take years.
  • 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. 
Growths may be removed with chemicals, electrical current, or freezing with liquid nitrogen. Condoms may offer some protection, but the virus may "shed" beyond the area protected by the condom (testicles, pubic area). It is often transmitted by nonsexual, intimate contact.

Molluscum Contagiosum is spread by vaginal, anal, and oral intercourse, as well as by other intimate contact. 

Pelvic Inflammatory Disease (PID)

Each year in the U.S. more than one million women experience an episode of acute PID, with the rate of infection highest among teenagers. 

More than 100,000 women become infertile each year as a result of PID, and a large proportion of the 70,000 ectopic (tubal) pregnancies occurring every year are due to the consequences of PID.

PID, particularly when caused by chlamydial infection, may produce only minor symptoms or no symptoms at all, even though it can seriously damage the reproductive organs. 

Many women with PID have sex partners who have no symptoms, although their sex partners may be infected with organisms that can cause PID. 

Symptoms include:

  • Lower abdominal pain
  • Abnormal vaginal discharge
  • Fever
  • Pain in right upper abdomen
  • Painful intercourse
  • Irregular menstrual bleeding
Due to the nature of the infection, the provider will prescribe at least two antibiotics that are effective against a wide range of infectious agents. 

Patients should be re-evaluated by their provider 2 – 3 days after treatment is begun to be sure the antibiotics are working.

Because of the risk of reinfection, however, sexual partners should be treated even if they do not have symptoms. 

Early treatment of gonorrhea and/or chlamydial infections is very important for prevention of PID.

Use male latex condoms correctly and consistently.

 

PID can affect the uterus, ovaries, fallopian tubes, or other related structures. 

Untreated, PID causes scarring and can lead to infertility, tubal pregnancy, chronic pelvic pain, and other serious consequences, including blindness in a baby born to a mother with chlamydia. 

Risk Factors for PID:

  • Women with STIs (especially gonorrhea and chlamydia) 
  • A prior episode of PID 
  • Sexually active teenagers 
  • Having numerous sexual partners 
  • Douching once or twice a month
Pubic Lice 

Every year, millions of people treat themselves for pubic lice. These tiny insects are also called "crabs" or "cooties."

Some people don't itch and don't know they are infested.

Itching usually begins 5 days after infestation begins

  • Intense itching in the genital area or anus 
  • Mild fever 
  • Feeling run down 
  • Irritability 
  • Lice or small egg sacks, nits in pubic hair 
Follow the directions on the package insert of an over-the-counter medication. 

Everyone who may have been exposed to pubic lice should be treated at the same time. 

All bedding, towels, and clothing that may have been exposed should be thoroughly washed in hot water or dry cleaned, and the home should be vacuumed. 

Place items that can not be washed in a plastic bag for two weeks to ensure decontamination. 
 

Limit the number of intimate and sexual contacts. Pubic lice are spread through contact with infected bedding, clothing, upholstered furniture, toilet seats, and through intimate and sexual contact.

They attach themselves and their eggs to pubic hair, underarm hair, eyelashes, and eyebrows. 

Their eggs are white and are deposited in small clumps near the hair roots. 

Scabies Often symptoms are not visible. It may take several weeks for them to develop.
  •  Intense itching - usually at night 
  • Small bumps or rashes that appear in dirty-looking, small curling lines, especially on the penis, between the fingers, on the buttocks, breasts, wrists, thighs, and around the navel.
Several lotions are available to treat scabies. Always follow the directions provided by your provider or the directions on the package insert. 

Everyone who may have been exposed to scabies should be treated at the same time. 

All bedding, towels, and clothing that may have been exposed should be thoroughly washed in hot water or dry cleaned, and the home should be thoroughly vacuumed.
 

Limit the number of intimate and sexual contacts. The scabies mite burrows under the skin. It can hardly be seen with the naked eye. 

Scabies is spread through close personal contact, in bedding and clothing.

Syphilis

There are four stages

In 1999 over 35,600 cases of syphilis were reported in the U.S. 

Syphilis occurred primarily in persons aged 20 to 39, and the reported rate for men was 1.5 times greater than the rate for women. 

The incidence of syphilis was highest in women aged 20 to 29 years and in men 30 to 39.
 

Primary Stage (appearance of an ulcer called a chancre ("shan-ker"): 
  • Appears within 10 days – 3 months after exposure (generally appears within 2 – 6 weeks) 
  • May go unnoticed as can be painless and/or occur inside the body
  • Usually found on the part of the body (penis, vulva, vagina) exposed to the partner's ulcer 
  • Can develop on the cervix, tongue, lips, or other parts of the body 
  • Disappears within a few weeks whether or not a person is treated.  If not treated during the primary stage, about one-third of people will progress to chronic stages 
Secondary Stage
  • Skin rash - characterized by brown sores about the size of a penny
  • Rash (which may cover the whole body; palms of the hands and soles of the feet are almost always involved)
  • Appears anywhere from 3 – 6 weeks after chancre appears 
  • The rash usually heals within several weeks or months 
Other symptoms:
  • Mild fever
  • Fatigue
  • Headache 
  • Sore throat
  • Patchy hair loss
  • Swollen lymph glands throughout the body 
These symptoms may be very mild and, like the chancre of primary syphilis, will disappear without treatment. The signs of secondary syphilis may come and go over the next 1 - 2 years.

Latent Stage

  • No symptoms and STI is not contagious
  • Many untreated people will suffer no further consequences of the disease 
  • Approximately one-third of those who have secondary syphilis, however, go on to develop the complications of late, or tertiary syphilis
Tertiary Stage
  • Bacteria damages the heart, eyes, brain, nervous system, bones, joints, or almost any other part of the body 
  • Can last for years, or even for decades 
  • Can result in mental illness, blindness, other neurologic problems, heart disease, and death
Usually treated with penicillin by injection. 

A person usually can no longer transmit syphilis 24 hours after beginning therapy. 

Some people, however, do not respond to the usual doses of penicillin. Therefore, it is important that people being treated for syphilis have periodic blood tests to check that the infectious agent has been completely destroyed.

In all stages of syphilis, proper treatment will cure the disease, but in late syphilis, damage already done to body organs cannot be reversed.

The open sores of syphilis may be visible and infectious during the active stages of infection. 

Any contact with these infectious sores and other infected tissues and body fluids must be avoided. 

An infected person who has not been treated may infect others during the first two stages, which usually last 1 - 2 years.

As with many other STIs, methods of prevention include using condoms during sexual intercourse.

The bacterium spreads from the initial ulcer of an infected person to the skin or mucous membranes of the genital area, the mouth, the anus, or broken skin anywhere on the body of a sexual partner.
 
Trichomoniasis “Trich”

Affects 2 - 3 million Americans each year.

The infection often persists because the parasite rarely causes symptoms in men; reinfection of women by untreated men is common.

Symptoms (if they occur) appear usually within 4 – 20 days of exposure

Men

  • Thin, whitish discharge from the penis
  • Painful or difficult urination 
Women
  • Heavy, yellow-green or gray frothy vaginal discharge
  • Burning, discomfort during intercourse
  • Vaginal odor
  • Painful urination
  • Irritation and itching of genital area
  • Soreness or redness of the vagina
  • Bleeding after intercourse or between your periods
  • On rare occasions, lower abdominal pain
  • Symptoms may worsen during menstruation
Trichomoniasis can usually be cured with prescription medication. 

Treat both partners

Wash all moist areas (towels, toilet seats, etc) as Trich can live outside of the body

Correct and consistent use of male condoms may prevent the spread of Trich. Most common infection sites:
  • Men - the urethra
  • Women - the vagina 
Trich may cause a woman to deliver a low birth weight or premature infant.
Urinary Tract Infection (UTI) These infections affect women more often than men because a woman's urethra is shorter than a man's and bacteria may get to the bladder more easily.  A woman's urethra is also closer to the anus than a man's.

Symptoms include:

  • Burning pain during urination 
  • The urge to urinate when the bladder is nearly empty
  • Frequent urge to urinate, especially at night 
  • Involuntary loss of urine 
  • Lower abdominal pain or back pain 
  • Blood and pus in urine
  • Fever
Most often a health care provider will prescribe 3 days of antibiotic pills (to be taken as ordered). I f you experience 3 or more UTI's each year you may be placed on preventative antibiotics to reduce the chance of infection. You also may be referred to a urologist. To prevent urinary tract infections or discourage them from returning:
  • Drink eight or more glasses of water a day
  • Avoid soft drinks, which can promote the growth of bacteria
  • Drink unsweetened cranberry juice 
  • Urinate immediately before and after intercourse 
  • Avoid using any sexual position(s) that seem to trigger UTIs 
  • Keep the pubic area clean and dry 
  • Use condoms (male or female) during vaginal or anal intercourse
  • Wipe from front to back after bowel movements to avoid the spread of bacteria to the urethra
Some women who are susceptible to frequent UTIs take antibiotics to prevent infections when they have sexual intercourse.
UTIs are common in women and men who are sexually active.

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 (cystitis)
  • The ureters (the tubes that lead from the bladder to the kidneys)
  • Urethra (the tube that carries urine from the bladder to outside of the body) 
Severe cases, left untreated, may cause kidney infection.

Any kind of sex play that brings fecal material into contact with the vagina and urethra can trasmit the infection. 

Unprotected anal intercourse is a very high-risk behavior for urinary tract infection. 

Some women who use the diaphragm are susceptible to frequent UTIs. 

Adjusting to the bacterial environment caused by having new partners may lead to a bladder infection called "honeymoon cystitis."
 

Vaginitis

Medical term for inflammation of the vagina.

In the U.S., women seek medical attention for vaginitis 10 million times a year.

Some women may not display any symptoms. 

Men have these symptoms less often than women, but both can pass the infection to one another.

Symptoms include:

  • Abnormal discharge 
  • Odor 
  • Itching 
  • Burning pain or irritation with intercourse or urination
Treatment depends on: 
  • The cause 
  • The severity of the symptoms 
  • Pregnancy status 
Each woman has her own pattern of vaginal fluids. Learn your own normal pattern. Then you will notice any changes that may mean you have vaginitis.
  • Keep the area around the genitals as dry as possible 
  • Wear underwear and panty hose with cotton crotches 
  • Avoid wearing jeans, pants, panty girdles, or panty hose that are too tight 
  • Wash your vulva regularly with mild soap and water
  • Rinse well and dry thoroughly after washing
  • Don't share towels 
  • Let towels dry between uses 
  • Avoid sitting around in a wet bathing suit or damp exercise clothes
Try to:
  • Avoid chemicals in perfumed or deodorant soap, detergents, fabric softeners, bubble baths, powder, and vaginal sprays 
  • Always wipe away from the vagina -- front to back -- after bowel movements 
  • Limit number of sexual partners
  • Inspect your partner's penis for sores or discharges 
  • Use a latex condom every time you have vaginal or anal intercourse, unless you and your partner have no infections and have no other sex partners
Vaginitis has little to do with how clean you are. Bathing or douching will not cure vaginitis.
Yeast Infections (Candida)

Second most common type of vaginal infection.

Because outward symptoms may be similar to those of other infections, women are urged to obtain a diagnosis from a healh care provider before  treating themselves with over-the-counter yeast remedies.
  • White, cottage cheese-like discharge that has no odor
  • Vagina and vulva will nearly always become itchy and sometimes red
Yeast infections are usually treated intravaginally with anti-yeast creams or suppositories. Drugs that act against yeast may also be prescribed in oral tablet form. Although yeast infections often cause intense discomfort, prompting most sufferers to seek treatment, they have not been associated with serious health risks.

How safe are condoms?

How do I put on a condom (male)?

How do I put on a condom (female)?

Condom Do's and Dont's
 

If you decide to have sex, you can reduce your risk of infection by:


Talk to your partner.  Find out:


What does NOT protect you:


References:
American College of Obstetrics and Gynecology

Planned Parenthood

National Vaginitis Association

American Social Health Association

American Academy of Dermatology

Centers for Disease Control and Prevention (CDC)

Barnard College

www.familydoctor.org

 

Resources: