STDs

How to Prevent STDs

Sexually transmitted infections (STIs) are infections that are spread by sexual contact. STIs are very common and easily spread. Some STIs can be treated and cured, but others cannot be cured. By knowing the facts, you can take steps to protect your health.
You Need to Know
• signs and symptoms of infections
• who is at highest risk of infection
• how to prevent infections

OVERVIEW OF SEXUALLY TRANSMITTED INFECTIONS

Anyone who has sexual contact with another person is at risk of getting an STI.
Some STIs cause symptoms and others do not. A person with an STI can pass it to others through contact with skin, genitals, mouth, rectum, or body fluids. This includes contact through vaginal sex, anal sex, or oral sex. Even if there are no symptoms, your health can be affected.

What are the symptoms of an STI?
Symptoms can range from vaginal discharge and mild irritation to severe pain.
Often, symptoms occur only if the infection has gone on for a while. In most cases, long-term health problems can be avoided with early treatment.

What causes STIs?
STIs are caused by infections with bacteria or viruses. STIs caused by bacteria are treated with antibiotics. STIs caused by viruses cannot be cured, but symptoms can be treated. Even if there are no symptoms, tests can be done to diagnose infection. Testing will help you know if you have an STI so you can take steps to prevent passing it to others.

Who is at highest risk of STIs?
People are at high risk of getting STIs if they
• have or have had more than one sexual partner
• have a partner who has or has had more than one sexual partner
• have sex with someone who has an STI
• have a history of STIs
• inject drugs or have a partner who injects drugs

GONORRHEA AND CHLAMYDIA

Gonorrhea and chlamydia are caused by bacteria. These infections often have no symptoms but still can have long-term effects on fertility. When symptoms occur, they may appear 2 to 21 days after contact with an infected person. These infections can occur at the same time.

What are the symptoms of gonorrhea and chlamydia?

Discharge from the vagina or penis
Painful urination or the need to go more often
Pain in the pelvis or abdomen
Burning or itching in the vaginal area
Redness or swelling of the vulva
Bleeding between menstrual periods
Sore throat with or without fever
Swollen or enlarged lymph nodes

What is the treatment for gonorrhea and chlamydia?
Gonorrhea is typically treated with an antibiotic shot followed by antibiotic pills. Doctors often recommend follow-up testing to make sure the infection is gone.
Chlamydia is treated with antibiotic pills.

Should my partner be treated?
All of your sex partners within the last 60 days should be treated. If your partner cannot see their own health care professional, you may be able to get a prescription for your partner from your health care professional.

Why is treatment for gonorrhea and chlamydia important?
Untreated gonorrhea or chlamydia can cause pelvic inflammatory disease (PID).
PID is an infection of the uterus, fallopian tubes, and ovaries. Symptoms of PID are fever, nausea and vomiting, and pain in the abdomen. PID can lead to infertility and long-term pelvic pain.

HUMAN PAPILLOMAVIRUS

Human papillomavirus (HPV) is one of the most common STIs in the United States. Some HPV types are spread through sexual contact.

HPV is a virus. Like all viruses, HPV causes infection by entering cells. Once inside a cell, HPV takes control of the cell's internal machinery and uses it to make copies of itself. These copies then infect other nearby cells. HPV infection is a slow process. In most people, the immune system clears the body of HPV before it causes disease.

Certain types of HPV can cause abnormal changes in the cervix that may lead to cancer. HPV is also linked to cancer of the anus, vulva, vagina, penis, head, and neck.

How is genital HPV passed from person to person?
There are about 40 types of HPV that typically infect the genitals. These HPV types are spread by skin-to-skin contact during vaginal, anal, or oral sex. You can get a genital HPV infection even if you do not have sexual intercourse.

What are the symptoms of HPV infection?
HPV infection generally has no symptoms. People with HPV infection usually do not know they have it. This is one reason why HPV spreads easily.

But a few types of HPV can cause genital warts. Warts can appear anywhere in the genital area.

What is the treatment for HPV warts?
Sometimes warts go away on their own. If they do not, there are treatments available.
Even after the warts have cleared up, HPV can remain in the body for weeks or years without symptoms.

Can HPV infection be prevented?
A vaccine is available that can significantly reduce the risk of getting cancer, precancer, and genital warts caused by HPV infection.
The vaccine is safe and effective but does not protect against all types of HPV. This means that you should follow cervical cancer screening guidelines even if you were vaccinated.

HPV and Genital Warts
Genital warts are growths that can appear on the outside or inside of the vagina or on the penis. Warts can also spread to nearby skin and can grow around the anus, on the vulva, or on the cervix.

What types of HPV cause genital warts?
Some types of HPV cause genital warts. These types are called "low-risk types" because they do not turn into cancer. Most cases of genital warts are caused by just two low-risk types of HPV: type 6 and type 11.

Are genital warts painful?
Warts may cause itching or pain, or they may not cause any symptoms.

How are genital warts treated?
Warts can be removed with medication or surgery. Talk with your health care professional about treatment. Wart removers found in the pharmacy should not be used on genital warts.

HPV and Cancer
The immune system fights most HPV infections and clears them from the body, usually within 2 years. But sometimes HPV infections can last longer. A longer infection with a "high-risk" HPV type can turn into cancer. It usually takes years for this to happen.

What types of HPV cause cancer?
There are at least 13 types of HPV linked to cancer of the cervix, anus, vagina, penis, mouth, and throat. Most cases of HPV-related cancer are caused by just two high-risk types of HPV: type 16 and type 18.

How long does it take for cervical cancer develop?
It can take 3 to 7 years for certain changes in the cells on the cervix to become cancer.
The purpose of cervical cancer screening is to detect these changes while they are still easily treated.
If you have severe or moderate changes, you can get treatment to have the cells removed from the cervix. The HPV vaccine may be given to help with treatment in some cases (read "The HPV Vaccine After Infection" below). If you have mild changes, you can be tested over time to see if the cells go back to normal.

Preventing Infection With the HPV Vaccine
One way to protect against HPV infection is by getting the HPV vaccine. The vaccine is safe and effective and protects against the HPV types that are the most common causes of genital warts and cancer.

Millions of people around the world have gotten the HPV vaccine without serious side effects. The vaccine does not contain live viruses, so it cannot cause an IIPV infection.

How effective is the HPV vaccine?
The HPV vaccine is highly effective when given before a person has sex. The vaccine can reduce the risk of HPV-related genital warts and cancer by up to 99 percent when all recommended shots have been given. It is one of the most effective vaccines you can get.

When should people get the HPV vaccine?
Vaccination works best when it is done before a person is sexually active and exposed to HPV. But vaccination can still reduce the risk of getting HPV for people who have already been sexually active.
The ideal age for HPV vaccination of girls and boys is 11 or 12. But anyone can get it starting at age 9 and through age 26.

What if I am older than 26 and want the HPV vaccine?
If you are older than 26, have not been vaccinated, and are at risk of a new HPV infection, you and your health care professional can talk about whether you need the HPV vaccine. The vaccine is approved for people through age 45.

How is the HPV vaccine given?
The HPV vaccine is given as a series of shots:

For those age 9 to 14, two shots of vaccine are recommended. The second shot should be given 6 to 12 months after the first one.
For those age 15 through 26, three shots of vaccine are recommended.

The second shot should be given 1 to 2 months after the first one. The third shot should be given 6 months after the first shot.
The three-dose schedule is also recommended for anyone age 27 through 45 who decides to start the vaccine series after talking with their health care professional.

What happens if my child misses a shot?
Children who have not had all of the shots do not have to start over. Your child can get the next shot that is due even if the time between them is longer than recommended. This is also true for you if you have not completed the number of recommended shots. Talk with your health care professional if you have questions about getting any shots you missed.

What are the side effects of the HPV vaccine?
The most common side effect of the HPV vaccine is soreness and redness where the shot is given. There have been no reports of severe side effects or bad reactions to the vaccine.

Can I get the shot if I have already had sex?
Yes. If you have had sex, you may already be infected with one or more types of HPV.
But the vaccine may still protect you against HPV types you do not have yet.

Do I still need cervical cancer screening if I have had the HPV vaccine?
Yes, you still need to have regular cervical cancer screening. Talk with your health care professional about when and how often you should be screened.

How is cervical cancer screening done?
Cervical cancer screening includes the Pap test, an HPV test, or both (called co-testing). Both tests use cells taken from the cervix.

Pap test: This test can detect abnormal changes in cells of the cervix. If testing shows cell changes that could lead to cancer, treatment can be given before cancer develops.
HPV test: This test can identify most of the cancer-causing types of HPV even before there are visible changes in the cervical cells.

You should start having screening at age 21, regardless of when you first start having sex. How often you should have screening and which tests you should have depend on your age and health history.
Talk with your health care professional about the screening schedule that is recommended for you.

In addition to the HPV vaccine, how else can I protect myself against HPV infection?
Although the HPV vaccine protects against the most common causes of genital warts and cancer, it does not protect against all HIPV types. If you are sexually active, using a condom or dental dam every time you have vaginal, anal, or oral sex can help reduce the risk of HPV infection. Look for condoms and dental dams made of latex or polyurethane.

The HPV Vaccine After Infection
Remember that HPV infection can lead to changes in the cells on the cervix. These changes are called cervical intraepithelial neoplasia (CIN) or cervical dysplasia. When CIN is moderate or severe (known as CIN 2 or CIN 3), treatment involves removing or destroying the abnormal cells. The HPV vaccine may help prevent abnormal cells from coming back after treatment.

Who may get the HPV vaccine to help with treatment for CIN?
You may get the HPV vaccine to help with treatment for CIN if the following applies to you:

You are getting treatment for moderate or severe CIN (CIN 2 or CIN 3).
You are age 27 to 45 and have not previously gotten the HPV vaccine.
You have a healthy immune system.

Anyone age 9 to 26 should get the HPV vaccine as usually recommended regardless of whether you are getting treatment for CIN.

SYPHILIS

Syphilis is caused by bacteria. The bacteria that cause syphilis enter the body through a cut in the skin or through contact with a partner's syphilis sore.
Because this sore commonly occurs on the vulva, vagina, anus, or penis, syphilis most often is spread through sexual contact. If not treated, syphilis can cause long-term health problems.

What are the symptoms of syphilis?
Symptoms of syphilis differ by stage:

Primary stage - Syphilis first appears as a painless sore. This sore goes away without treatment in 3 to 6 weeks.
Secondary stage - If syphilis is not treated, the next stage begins as the sore is healing or several weeks after the sore has disappeared. Symptoms at this stage may include rash on the soles of the feet and palms of the hands, flat warts on the vulva, and flu-like symptoms.
Latent infection - In some people, the rash and other symptoms may go away in a few weeks or months but the infection is still in the body. This is called latent infection.

How is syphilis treated?
Syphilis is treated with antibiotics. The length of treatment depends on how long you have had the infection. You may have blood tests over time to see if the treatment is working. Avoid sexual contact during treatment. If you are diagnosed with syphilis, you should also be tested for HIV. Your sex partners should be treated for syphilis too.

Why is treatment for syphilis important?
Without treatment, the symptoms of syphilis may go away, but the disease will remain. Years later, it can return in its most severe form and cause heart problems, nervous system problems, paralysis, and blindness.

GENITAL HERPES

At least 50 million people in the United States, about 1 in 6 adults, are infected with the virus that causes genital herpes.
Herpes infection can cause painful sores, but sometimes there are no sores. It is possible to have herpes and not know it.

What are the symptoms of herpes?
When first infected, a person with herpes may have flu-like symptoms. Sores may appear as small, fluid-filled blisters on the genitals, buttocks, or other areas. The sores are often grouped in clusters, and the area around the sores may be swollen and tender. When a person has symptoms, they appear about 2 to 10 days after the virus enters the body.

What happens to the herpes virus in the body?
After a person is first infected, the virus travels to nerve cells near the spine and stays there. When there is a trigger, the virus can become active again. Triggers can include illness, stress, and hormonal changes.
When the virus is active again, it travels along the nerves, back to where it first entered the body, and causes a new outbreak of sores and blisters. This is called a recurrence. The virus can be passed to others more easily during a recurrence.

What is the treatment for genital herpes?
There is no cure for herpes, but the infection can be managed. Antiviral medications taken during outbreaks can make them shorter and less severe.
When taken on a daily basis, antiviral medications can reduce the number of outbreaks. This is called suppressive therapy. In some cases, suppressive therapy can prevent outbreaks for a long time. This therapy also reduces the risk of giving herpes to someone else.

HUMAN IMMUNODEFICIENCY VIRUS

Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). HIV is passed from person to person through contact with infected body fluids, such as semen, vaginal fluid, or blood.
Once HIV is in your body, it attacks the immune system. As the immune system weakens, it is less able to resist disease and infections. AIDS is diagnosed when a person with HIV develops diseases that the immune system normally would fight off, such as pneumonia, certain types of cancer, and infections.

What are the symptoms of HIV infection?
Some people may have flu-like symptoms within 2 to 4 weeks of getting the virus.
But other people may not feel sick until the infection is more serious. The only way to know if you have HIV is to get tested.

What is the treatment for HIV?
There is no cure for HIV infection, but it can be treated. Medications are available that can help people with HIV stay healthy for a long time. The earlier treatment is started, the better for your long-term health. Early treatment also reduces your risk of giving the virus to your sex partners.

How can HIV be prevented?
If you are not infected with HIV but are at high risk of getting it, you can take medication to help prevent infection. This is called pre-exposure prophylaxis (PrEP). PrEP involves taking a daily pill or getting injections every 2 months. Along with other preventive measures, such as using condoms, PrEP may reduce your risk of getting HIV.

TRICHOMONIASIS

Trichomoniasis is an infection caused by a microscopic parasite that is spread through sex. It can be cured with treatment.
Many people have no symptoms of trichomoniasis. When symptoms do occur, they include discharge from the vagina and vaginal itching and redness.

HEPATITIS

Hepatitis is a serious infection of the liver caused by a virus. Two types of hepatitis, B and C, can be sexually transmitted. They can be spread by direct contact with the blood, semen, vaginal fluids, and saliva of an infected person.
There is a vaccine to prevent infection with hepatitis B. There is no vaccine to prevent hepatitis C infection.
Many people infected with hepatitis B or hepatitis C recover completely. But some people develop chronic liver infections, which can lead to long-term health problems.

How to Protect Yourself From STIs
There are many ways you can reduce your risk of getting an STI:

Know your sexual partners-The more partners you or your partners have, the higher your risk of getting an STI.
Use a latex or polyurethane condom- Using a latex or polyurethane condom every time you have vaginal, oral, or anal sex reduces the risk of infection.
Know that some sex practices increase the risk-Sexual acts that tear or break the skin carry a higher risk of STIs. Anal sex poses a high risk because tissues in the rectum break easily. Body fluids can also carry STIs. Having any unprotected sexual contact with an infected person poses a high risk of getting an STI.
Get vaccines-Vaccines are available to help protect against hepatitis B and HPV.

YOUR TAKEAWAYS...

General

Sexually transmitted infections are very common and easily spread.
Some STIs can be treated and cured, but others cannot be cured.
Knowing the risk factors can help you protect yourself from STIs.
See your health care professional for testing and treatment if you have signs of an STI.

HPV

Most people who have sex will get an HPV infection at some point in their lives.
HPV infections can lead to genital warts and cancer.
HPV vaccination is a safe and effective way to protect yourself and your children against HPV-related diseases.
Even if you have gotten the HPV vaccine, continue regular cervical cancer screening and use condoms or dental dams to reduce the risk of getting HPV types not covered by the vaccine.
The HPV vaccine may be given to help with treatment for abnormal cell changes caused by HPV infection in some cases.