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Questions and Answers – STDs and HIV

 

What is a sexually transmitted disease?

There are more than 25 diseases that are spread primarily by sexual activity. These disease are often referred to as sexually transmitted disease (STDs). Some professionals use the term sexually transmitted infection (STI). Today, these terms are used interchangeably.  The Centers for Disease Control and Prevention (CDC) continues to use the term STD and that is what SIECUS uses. Regardless of terminology, these infections have created a significant public health challenge in the United States.  

What are the different types of STDs?

STDs are often divided into two categories—viral and bacterial—based on the type of microorganism that causes the specific disease.

Those STDs caused by bacteria—such as Gonorrhea, Syphilis, and Chlamydia—are curable with antibiotics. Those STDs caused by viruses are not. These include Human Immunodeficiency Virus (HIV), Human Papillomavirus (HPV), Herpes, and Hepatitis B. Medical treatment can, however, alleviate the symptoms of these STDs.

Some STDs are also caused by protozoa (Trichomoniasis) and other organisms (crabs/pubic lice and scabies). These STDs are curable with antibiotics or topical creams/lotions.

What are the symptoms of STDs?

STDs have a range of symptoms, but it’s often hard for people who are infected to determine if they have an STD.  Many STDs have no symptoms, have symptoms that are easily confused with common illnesses, or have latent symptoms that take weeks or years to show up.  

Symptoms of STDs like Chlamydia and gonorrhea can include itching or burning during urination.  Herpes and HPV symptoms sometimes don’t occur for weeks, months, or years and can include sores or a rash (for Herpes) or whitish, raised growths (for HPV).  And HIV-positive individuals usually don’t have any symptoms for years until they begin to experience the opportunistic infections that characterize AIDS.  

There is no way to tell if another person has an STD just by looking at them.  The only way to know for sure is to visit a healthcare provider and get tested.  

What is involved in testing for STDs?  

There are many different ways health care providers screen for STDs. These can include visually examining sores or lesions, collecting fluid from the urethra or cervix with a cotton swab, testing urine or blood, or conducting a biopsy.

Individuals should seek diagnosis and treatment at the first sign of symptoms to avoid serious complications. Because many STDs have no symptoms, individuals should also talk to their health care providers about having a routine STD screening as part of their annual physical or gynecological. Women need to understand that STD screenings are not necessarily part of their annual gynecological exam and that Pap smears do not screen for STDs other than HPV.

Individuals can find an STD clinic in their area by calling 800/CDC-INFO (800-232-4636).

Are condoms effective in preventing STDs?

Condoms provide different levels of risk reduction for different STDs because infections are spread differently—some STDs are spread by contact with bodily fluids while others are spread by skin to skin contact.  In general, research shows that condoms are most effective in preventing those STDs that are spread by bodily fluids, such as HIV.  Condoms can reduce the risk of contracting diseases spread by skin-to-skin contact, such as Herpes, as well. However, they may be less effective because contagious sores and lesions can occur outside of the area covered by the condom.

These are prevention messages recently developed by the CDC:

  • Latex condoms, when used consistently and correctly, are highly effective in preventing the transmission of HIV, the virus that causes AIDS. In addition, correct and consistent use of latex condoms can reduce the risk of other STDs.
  • Latex condoms, when used consistently and correctly, can reduce the risk of transmission of Gonorrhea, Chlamydia, and Trichomoniasis.
  • Latex condoms, when used consistently and correctly, can reduce the risk of Genital Herpes, Syphilis, and HPV only when the infected areas are covered or protected by the condom.

What is Chlamydia?

Chlamydia, which is caused by the bacteria chlamydia trachomatis, targets the cells of mucous membranes including the surfaces of the urethra (male and female), vagina, cervix, and endometrium (the lining of the uterus) as well as the anus and rectum. Although possible, it rarely targets the mouth or throat. If left untreated in women, it can spread to the fallopian tubes and lead to Pelvic Inflammatory Disease (PID), a serious medical condition that can cause infertility.

Chlamydia is transmitted through vaginal or cervical secretions and semen during unprotected anal, oral, or vaginal sex with an infected person. It can also be transmitted from mother to newborn during childbirth.

Chlamydia is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, sitting on public toilets, or touching door knobs.

Chlamydia is curable with oral antibiotics prescribed by a health care provider. All partners should undergo treatment at the same time to avoid passing the infection back and forth. They should also be sure to finish the full course of antibiotics even if symptoms subside.

How common is Chlmydia?  

  • Over 1,030,911 Chlamydia infections were reported to the CDC.
  • The reported rate of Chlamydia among women (515.8 cases per 100,000 females) was almost three times as high as the reported rate among men (173.0 per 100,000 males).
  • Young women ages 15–19 had the highest reported rates of Chlamydia (2,862.7 per 100,000).
  • Chlamydia infections increased from 50.8 to 347.8 per 100,000 between 1987 and 2006.

What is Gonorrhea?  

Gonorrhea, once known as “the clap,” is caused by bacteria called Neisseria gonorrhoea that grow in the warm, moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes in women and the urethra in both women and men. The bacteria can also grow in the mouth, throat, and anus.

Gonorrhea is transmitted through vaginal or cervical secretions and semen during unprotected anal, oral, or vaginal sex with an infected person. It can also be transmitted from mother to newborn during childbirth.

Gonorrhea is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

Gonorrhea is curable with oral antibiotics prescribed by a health care provider. All partners should undergo treatment at the same time to prevent passing the infection back and forth. They should also be sure to finish the full course of antibiotics even if symptoms subside.

How common is Gonorrhea?

  • Over 358,366 cases of Gonorrhea were reported in the United States.
  • For the sixth consecutive year, gonorrhea rates among women (124.3 per 100,000) were slightly higher than among men (116.8 per 100,000).
  • Among women, those ages 15–19 had the highest reported rate of Gonorrhea (647.9 per 100,000).
  • Among men, those ages 20–24 years of age had the highest reported rate of Gonorrhea (454.1 per 100,000).

What is Hepatitis B?

Hepatitis B is a virus that causes chronic infection, cirrhosis (scarring), and cancer of the liver. The virus is present in blood, semen, vaginal secretions, and breast milk.

Hepatitis B is transmitted through unprotected anal, vaginal, and oral sex with an infected person; through contaminated needles or syringes; or from an infected mother to her newborn during childbirth or breast-feeding.

Hepatitis B is one of the only STDs for which a vaccine is available. Individuals must take all three doses of the vaccine to protect themselves against infection. They can obtain the vaccine from their health care provider.

Hepatitis B is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

There is no cure for Hepatitis B. Treatment varies depending on whether the infection is acute (newly acquired) or chronic (persistent).

How Common is Hepatitis B?

  • The number of new Hepatitis B infections per year has declined from an average of 260,000 in the 1980s to approximately 60,000 in 2004.
  • Of an estimated 1.25 million Americans chronically infected with Hepatitis B, 20 to 30 percent were infected during childhood.

What is Herpes?

Herpes is a recurrent skin condition characterized by sores on the mouth or genitals. It is caused by the herpes simplex viruses called HSV-1 and HSV-2. Although HSV-1 most commonly causes “cold sores” or “fever blisters” on the mouth or face and HSV-2 most commonly causes sores on the penis or vulva, the viruses are identical under a microscope and either type can infect the mouth or genitals.

Herpes is transmitted through skin-to-skin contact during unprotected anal, oral, or vaginal sex with an infected person or through kissing. This is possible even when no sores are present.

Herpes is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

There is no cure for Herpes. Antiviral medications can reduce the frequency of outbreaks and speed the healing of the outbreaks

How Common is Herpes?

  •  Nationwide, at least 45 million people ages 12 and older, or one out of five adolescents and adults, have had a genital Herpes infection.
  • Infection with HSV-2 is more common in women (approximately one out of four) than in men (almost one out of five). This may be due to the fact that male-to-female transmission is more efficient than female-to-male transmission.

What Is Human Immunodeficiency Virus (HIV)?

The Human Immunodeficiency Virus (HIV) causes an individual’s immune system to weaken and lose its ability to fight off infections and cancers. After developing a number of these infections or reaching a certain blood count level, an HIV-positive person is diagnosed with Acquired Immunodeficiency Syndrome (AIDS).

HIV is present in blood, semen, vaginal secretions, and breast milk. It is transmitted through unprotected anal, vaginal, and oral sex with an infected person; through contaminated needles or syringes used to inject drugs; or from an infected mother to her newborn during childbirth or breast-feeding.

HIV is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

There is no cure or vaccine for HIV or AIDS. There are, however, a number of drugs and combinations of drugs that allow people with HIV or AIDS to stay healthy for longer periods of time.  

How common is HIV?

  • At the end of 2003, an estimated 1,039,000 to 1,185,000 persons in the United States were living with HIV/AIDS.
  • CDC has estimated that approximately 40,000 persons in the United States become infected with HIV each year.
  • In 2005, almost three quarters (74%) of HIV/AIDS diagnoses were for male adolescents and adults.  
  • In 2005, blacks (including African Americans), who make up approximately 13% of the US population, accounted for almost half (49%) of the estimated number of HIV/AIDS cases diagnosed.  
  • An estimated 4,883 young people received a diagnosis of HIV infection or AIDS in 2004, representing about 13% of the persons given a diagnosis during that year.  

What is Human Papillomavirus (HPV)?

There are over 100 strains of the Human Papillomavirus (HPV). Approximately a third of these strains are sexually transmitted and cause genital HPV. Some types of genital HPV may cause warts that can grow on the cervix, vagina, vulva, penis, scrotum, urethra, and anus. Other strains of genital HPV can cause abnormal cells to grow on the cervix and can lead to cervical cancer.     

Researchers at the pharmaceutical companies Merck and GlaxoSmithKline have developed vaccines that target particular strains of HPV. Merck’s vaccine, Gardasil, targets HPV types 16 and 18, which are associated with 70% of all cervical cancer and types 6 and 11 which are associated with 90% of all genital warts. GlaxoSmithKline’s vaccine only targets HPV types 16 and 18. Both vaccines have been shown to be nearly 100% effective in preventing infection with the HPV strains they target. Merck’s vaccine, Gardasil, was approved by the Food and Drug Administration (FDA) for females ages 9–26 and was recommended for routine use with females ages 11–12. Individuals can obtain the vaccine from their health care provider. GlaxoSmithKline’s has not yet been approved by the FDA.

HPV is transmitted by direct skin-to-skin contact with an infected individual. It can also be transmitted when warts are not present.  It is sometimes transmitted from mother to infant during childbirth.

There is no cure for HPV.  Many HPV infections will resolve on their own without causing any long-term harm.  Others may require treatments to remove warts or abnormal cells.

How common is HPV?   

  • Approximately 6.2 million new cases of HPV infection are reported every year, and, at least 20 million Americans are already infected.
  • Among those individuals ages 15–49, only one in four Americans has not had a genital HPV infection.  
  • Approximately 14,000 women are diagnosed with cervical cancer in the United States each year; over 5,000 die from this disease each year.

What is Syphilis?

Syphilis, which is caused by bacteria called spirochetes, causes sores (chancres) to appear mainly on the external genitals, vagina, anus, or in the rectum. They can also appear on the lips and in the mouth.

There are three stages of syphilis. During the primary stage, which usually occurs within 10 to 90 days after exposure, a sore may appear. During the secondary phase, which usually occurs within 17 days to six-and-a-half months after exposure, a rash may appear on various parts of the body. If left untreated, Syphilis can proceed to the latent stage during which it may have no visible symptoms but can cause irreversible damage to internal organs.

Syphilis is transmitted through direct contact with sores during unprotected anal, oral, or vaginal sex with an infected person. Syphilis can also be transmitted from mother to newborn during childbirth.

Syphilis is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

Syphilis is curable with antibiotics prescribed by a health care provider. Damage to internal organs during the latent stage is irreversible. All partners should undergo treatment at the same time to prevent passing the infection back and forth. They should also be sure to finish the full course of antibiotics even if symptoms subside.

How common is syphilis?

  • Over 9,756 cases of primary and secondary Syphilis cases were reported to the CDC in 2006.
  • The reported rate of primary and secondary Syphilis increased 11.8 percent among men (from 5.1 cases to 5.7 cases per 100,000) between 2005 and 2006. During this time, the rate also increased 11.1 percent among women (from 0.9 to 1.0 cases per 100,000).

What is Trichomoniasis?

Trichomoniasis, or “trich,” is a genital inflammation caused by the protozoa trichomonas vaginalis.

Trichomoniasis is transmitted through skin-to-skin contact during unprotected anal, oral, or vaginal sex with an infected person.

Trichomoniasis is curable with antibiotics prescribed by a health care provider. Both partners must undergo treatment at the same time to prevent passing the infection back and forth. They should also be sure to finish the full course of antibiotics even if symptoms subside.

How common is Trichomoniasis ?

  • Trichomoniasis is the most common curable STD in young, sexually active women.
  • An estimated 7.4 million new cases occur each year in women and men.


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