STDs/HIV

Sexually transmitted diseases (STDs) are infections that pass from one person to another through sexual contact (e.g., vaginal, anal, and oral sex, and genital-to-genital contact).

Seventy-five percent of STDs are acquired in persons who range in age from 15 to 24 years old.

Common STDs in the U.S. are: Chlamydia; genital herpes; gonorrhea; hepatitis B; HIV/AIDS; human papillomavirus (HPV), the cause of genital warts; and trichomoniasis. The most common ones among college students are chlamydia and HPV.

Cases of syphillis, another STD, have reached an all time low. For information on this STD, access www.cdc.gov.

More than 1 STD can be present at the same time. Some can be present without symptoms. If you are sexually active or have ever had sex without adequate “barrier” protection (e.g. latex or polyurethane condom), you could have an STD and not even know it.

Signs, Symptoms & Causes

Chlamydia

Chlamydia is caused by different strains of the bacterium chlamydia trachomatis.

About 25 percent of males have few or no symptoms, but can still transmit the disease. Symptoms may show up 2 to 4 weeks after infection and include: Watery, mucous discharge from the penis; burning or discomfort when urinating; and pain in the scrotum.

Seventy-five percent of females have few or no symptoms, but can still transmit the disease. When present, symptoms show up 2 to 4 weeks after infection and include: Slight yellowish-green vaginal discharge; vaginal irritation or pain or burning feeling when urinating; abdominal pain; and abnormal vaginal bleeding. In females, chlamydia can cause pelvic inflammatory disease (PID), which can cause infertility. (See "Pelvic Inflammatory Disease" (PID))

Genital Herpes

The Herpes simplex virus (type 1 or type 2) causes genital herpes. Type 1 often affects the oral area, showing up as cold sores, but can affect the genital area, too. Type 2 usually affects the genital area, upper thighs, and area near the anus, but can also affect the oral area. The virus is spread by direct skin-to-skin contact from the site of infection to the contact site, but can also be spread during periods where there are no noticeable symptoms. Oral sex can spread herpes from the mouth to the genital area and from the genital area to the mouth.

Signs and symptoms (which may appear as early as 2 to 20 days after contact) include:

	Itching, irritation, and tingling in the genital area 1 to 2 days before the blisters appear
	Painful blisters and/or sores on the genital area, anus, and thighs and/or buttocks
	After a few days, the blisters break open and leave painful, shallow ulcers, which can last from 5 days to 3 weeks.

With outbreaks, especially the first one, there may be flu-like symptoms (swollen glands, fever, body aches). Subsequent outbreaks are usually milder and shorter. Stress, fatigue, illnesses, vigorous sexual intercourse, sunburn, etc. may trigger outbreaks.

Using a latex or polyurethane barrier (condom, dental dam, etc.) when you have sex or skin-to-skin contact may help prevent transmission, but this is not guaranteed.

The sores may be located on skin areas not covered by the latex or polyurethane barrier. The virus can also be transmitted when sores are not present. This is known as "viral shedding."

Gonorrhea

Gonorrhea is also called "the clap," "dose," or "drip." It is caused by a specific bacterial infection. If not treated, it can spread to joints, tendons, or the heart. In females, it can cause pelvic inflammatory disease (PID), which is directly linked to infertility in females. (See "PID".)

Sixty to 80% of females have no symptoms. If symptoms are present, they appear 2 to 10 days after infection and include: Mild vaginal itching and burning; thick, yellow-green vaginal discharge; abnormal vaginal bleeding; burning when urinating; and severe pain in lower abdomen.

In males, signs and symptoms include: Pain at the tip of the penis; pain and burning during urination; and a thick, yellow, cloudy, penile discharge that gradually increases.

Hepatitis B

Hepatitis B is a virus that causes liver inflammation. The virus can be contracted from contact with infected blood or bodily fluids (e.g., having sex and/or sharing drug needles with an infected person, exposure to infected blood through cuts, open sores, and unsterilized instruments used for body piercing).

Sharing razors with an infected person and exposure to an infected person’s saliva may transmit the virus. Hepatitis B is not spread through food or water or by casual contact.

Three doses of Hepatitis B vaccine can prevent getting this virus. Consult your health care provider if you have not yet received this vaccine.

Some persons have no symptoms. When symptoms first occur, they are flu-like (fatigue, fever, appetite loss, nausea and vomiting, and joint pain).

Later, symptoms include jaundice, dark urine, and pale, clay-colored stools.

HIV/AIDS

HIV stands for human immunodeficiency virus. AIDS, acquired immune deficiency syndrome, is caused by HIV. HIV destroys the body’s immune system leaving a person unable to fight off diseases. The virus also attacks the central nervous system causing mental and neurological problems. HIV is spread when body fluids, such as semen and blood, pass from an infected person to another person. Usually, the virus is spread by sexual contact or by sharing drug needles. It can also be passed from an infected female to her baby during childbirth or breast-feeding. You cannot get HIV from donating blood, touching, hugging, or social (dry) kissing a person with HIV. You cannot get HIV from a cough, a sneeze, tears, sweat, or from using a hot tub, telephone, or restroom.

You cannot get HIV from hugging a person with HIV

Early symptoms of HIV/AIDS:

	Fatigue
	Loss of appetite
	Chronic diarrhea
	Weight loss
	Persistent dry cough
	Fever
	Night sweats
	Swollen lymph nodes

Persons with AIDS are susceptible to many diseases, such as skin infections, fungal infections, tuberculosis, pneumonia, and cancer. These “opportunistic” infections are what lead to death in an AIDS victim. When HIV invades the brain, it leads to forgetfulness, impaired speech, trembling, and seizures.

Human Papillomavirus (HPV) - Genital Warts

About 25 types of HPV can infect the genital area. Only a few types cause genital warts. Other types increase the risk for cervical cancer.

Often, there are no clearly visible signs or symptoms. Genital warts are often skin-colored, do not hurt, and may be located inside the vagina or the head of the penis, or in the anus. This makes them hard to see. To find out if you have genital warts, a health care provider can put a solution of acetic acid (vinegar) on the genitals.

HPV is spread by direct skin-to-skin contact during vaginal, anal, or (rarely) oral sex with an infected partner. You don’t get genital warts from touching warts on other parts of the body, such as the feet or hands.

Genital warts can appear several weeks after being infected or may not show up for months or even years. It is difficult, then, to know when the virus was contracted and which partner was the carrier.

Certain types of HPV have been associated almost exclusively with the precancerous form of cervical cancer and the cancer itself.

To lower your risk for getting HPV, use latex or polyurethane condoms, which are most likely to cover potentially affected areas of the body. (A diaphragm will not prevent transmission.)

Trichomoniasis

Trichomoniasis is caused by a parasite, not by bacteria or a virus.

In females, the protozoan can be present in the vagina for years without causing symptoms. If they do occur, typical symptoms include:

	Vaginal itching and burning
	A yellow-green or grey vaginal discharge with an odor
	Burning or pain when urinating
	Painful sexual intercourse

In males, symptoms are not usually present. Males may infect their sexual partners and not know it. When present, symptoms include:

	Discomfort when urinating
	Pain during intercourse
	Irritation and itching of the penis

Treatment

Call your health care provider, your school’s Health Service, or the National STD Hotline (800.342.8922) to find out how to get tested for STDs. Testing may be free at your college’s Health Service. Treatment depends on proper diagnosis. For Chlamydia: Oral antibiotics for the infected person and his or her partner(s) Avoiding sex until treatment is completed in the infected person and his or her partner(s) For Genital Herpes: There is no cure. Symptoms occur, though, only during flare-ups. Oral antiviral medicines (e.g. acyclovir, valacyclovir). These are used to shorten the duration of outbreaks and to prevent them. Self-care measures listed below

Follow your health care provider's advise.

For Gonorrhea:

	Antibiotics
	Pain relievers
	Treating sexual partner(s) to avoid reinfection
	Follow-up cultures to determine if the treatment was effective

For Hepatitis B:

	Self-care measures below
	Medication may be prescribed for chronic cases.

While most people with this type recover, up to 10% can become chronic. (The person can spread the infection even though he or she has no symptoms.) This type can lead to cirrhosis of the liver and liver failure in some persons.

For HIV/AIDS:

	Medications. These drugs are often used in multidrug combinations.
	Treating infections, such as pneumonia

For HPV (Genital Warts):

	The warts can be treated with topical creams or a gel prescribed by a doctor. You apply these yourself.
	The warts can be removed medically by cryosurgery (freezing them); an acidic chemical that burns them; or laser surgery.
	Females who've had HPV need a Pap test as often as advised by their health care providers to check for cervical cancer. They should also not smoke.

For Trichomoniasis:

	The oral medication metronidazole (Flagyl). {Note: Don’t drink alcohol for 24 hours before, during, and 24 hours after taking metronidazole. The combination causes vomiting, dizziness, and headaches.}
	Treating sexual partners to prevent reinfection and spreading the infection further

Questions to Ask

Do you test positive for HIV or do you have signs and symptoms of any STD listed in this topic?
Do you already have a diagnosis of genital herpes and do you have severe pain and blistering and/or are you having frequent outbreaks?
Are you symptom-free, but worried about having contracted an STD from someone you suspect may be infected?
Do you want to rule out an STD because you have had multiple sex partners and you are considering a new sexual relationship, planning to get married or pregnant?
Do genital sores appear only after a recently prescribed medicine?

Self-Care

Sexually transmitted diseases need medical care, not self-care alone. Along with medical care, do the following:

For Genital Herpes:

	If prescribed an antiviral medicine (e.g., acyclovir, valacyclovir), take it as directed.
	Bathe the affected area twice a day with mild soap and water. Pat dry with a towel or use a hair dryer set on warm. Using a colloidal oatmeal soap or bath may be soothing.
	Use a sitz bath to soak the affected area. Get a sitz bath basin from a medical supply or drug store.
	Apply ice packs on the affected genital area for 5 to 10 minutes to relieve itching and swelling.
	Wear loose fitting pants or skirts. Don’t wear pantyhose. Wear cotton (not nylon) underwear.
	If pain is made worse when you urinate, squirt tepid water near the urinary opening while urinating or urinate while using a sitz bath.
	Take a mild pain reliever.
	Ask your doctor about using a local anesthetic ointment, such as lidocaine, during the most painful part of an outbreak.
	Wash your hands if you touch the blisters or sores. To avoid spreading the virus to your eyes, don’t touch your eyes during an outbreak.
	To avoid spreading the virus to others, use latex barriers during sex and skin-to-skin contact.

For Hepatitis B:

	Rest. Drink at least 8 glasses of fluids a day.
	Avoid alcohol and any drugs or medicines that affect the liver, such as acetaminophen.
	Follow a healthy diet. Take vitamin and mineral supplements as advised by your health care provider.
	Use latex condoms during sexual intercourse to avoid spread of the virus.

For HIV/AIDS:

Medical care, not self-care alone, is needed to treat HIV/AIDS. Self-care measures include:

Taking steps to reduce the risk of getting infections and diseases: Get adequate rest and proper nutrition. Take vitamin supplements as advised by your doctor. Get emotional support. Join a support group. Also ask your family and friends for support.

For Information, Contact

CDCNational AIDS Hotline (NAH)
800.342.AIDS (342.2437)  –  English
800.344.7432  –  Spanish

American Social Health Association (ASHA)
www.ashastd.org

CDC National Prevention Information Network (NPIN)
800.458.5231
www.cdcnpin.org

CDC National STD Hotline
800.342.8922  –  English
800.344.7432  –  Spanish