Health

A Quick Look At Sexually Transmitted Diseases (STDs)


There are a wide variety of STDs (Sexually Transmitted Diseases) out there. They are contracted by many means, have many different symptoms and can cause a variety of health issues to your body from a minor rash to death. Please spend some time reading the different STD’s that can be contracted if you are, or are thinking of becoming sexually active.


AIDS/HIV

AIDS is an acronym for acquired immunodeficiency syndrome.  It is caused by a virus called human immunodeficiency virus (HIV). The disease was first recognized in the United States in homosexual men in the early 1980’s and in the mid 80’s the virus that causes the disease was identified.  Infection by HIV may or may not cause an initial flu like syndrome with rash which generally subsides after a few weeks.  Most people then  become asymptomatic until the virus weakens the immune system enough for them to be afflicted by unusual infections or malignancies (cancer).  HIV is passed from one person to another primarily by 3 main routes:

1.  Sexual contact.  This includes vaginal and anal sex.  Oral sex can also transmit the virus, especially if an individual has small abrasions or cuts in their mouth.

2. Injection of the virus into the blood stream by intravenous drug use, blood transfusion, tattoo needles, piercings, etc.
Intravenous drug use is by far the most likely mode of transmission in this category.  Blood which is transfused in hospitals in this country is relatively safe and is routinely checked for evidence of HIV infection.  You cannot get HIV by donating blood!  Tattoos and piercings will not transmit HIV if clean, sterile needles are used.  Needles should never be re-used for tattoos or piercings.

3. Passage of the virus from a pregnant mother to her baby.  HIV can pass from an infected mother to her baby in the uterus, during the birth of the baby as it moves through the birth canal, or through breast milk.

There are a variety of medications that people infected with HIV can take to delay the virus’s destruction of  their immune system. Unfortunately HIV infection cannot be cured at this time.  Some people can live for years without apparent illness, while others quickly become very sick and die. However, all people infected with HIV may spread the virus to others even if they do not feel ill!
Testing for HIV infection is usually done by detecting the presence of an antibody to the virus.  Because it can take about 6 weeks for a person to develop HIV antibodies, the test is not accurate in very early infections.  Home test kits for HIV have been developed, but have not been shown to be as accurate as the regular blood test performed by doctors, clinics etc.  If you are concerned you may have HIV infection, get a blood test from your doctor, a public health clinic, family planning clinic, etc.

Chancroid

Chancroid is an unusual venereal disease caused by a bacterium called Hemophilus ducreyi.  It produces a draining ulcer which may be up 1 to 2 inches in size.  The ulcer occurs on the penis or the labia (lips of the vagina).  The ulcer which is also called a chancre is usually not particularly painful, but the lymph nodes in the groin are usually very tender and swollen.  About 4000 cases occur in the United States every year.  The disease is much more prevalent in Asia, West Indies, and north Africa.  The disease is transmitted primarily by sexual intercourse especially if there are skin or mucus membrane abrasions.

Chlamydia

About 4 million cases of chlamydia  are diagnosed every year and it is estimated that 1 in 10 teen-age girls are infected with chlamydia.  Unfortunately chlamydia infections are often asymptomatic in females and go untreated leading to chronic infections.  This can result in pelvic inflammatory disease which is inflammation and infection of the upper female reproductive tract including the uterus, fallopian tubes and ovaries.  The infection can lead to scarring and ultimately infertility.  Fortunately, if detected, chlamydia is treatable and curable.  Chlamydia infection in males is usually symptomatic causing pain and burning on urination and forcing men to seek treatment. Therefore chronic infections in males are less common. Female partners of men with chlamydia (also called non-gonococcal urethritis) should always be treated even if they feel fine.

Hepatitis B

Hepatits B is an inflammation of the liver caused by the hepatitis B virus.  Hepatitis B is spread in a similar fashion as the HIV virus.  The 3 main methods of transmission of hepatitis B are:

1.  Injection of the virus into the blood stream by intravenous drug use, blood transfusion, needle sticks, piercings etc.  Blood transfusion is now relatively safe because the donated blood supply is routinely screened for evidence of hepatitis B infection.  You cannot get hepatitis B by donating blood.  Intravenous drug use is the category most likely to spread hepatitis B, however any puncture by a dirty, non-sterile needle can result in infection.

2.  Sexual and intimate contact may transmit hepatitis B because the virus has been shown to reside in vaginal secretions, semen and saliva.

3.  Spread of the virus from pregnant mother to child.  Hepatitis B can be spread to the baby in the uterus or during the birth process.  This route of transmission is very common in Asia and Africa and explains the very high incidence of hepatitis B in these areas of the world.

After a person is exposed to the hepatitis B virus they may not become ill for 1 to 5 months.  Then the infected individual will begin to show symptoms which include fever and jaundice (yellowing of the skin due accumulation of a substance called bilirubin).  This period of symptomatic disease may last weeks to months.  Most adults are able to then clear the virus completely from their bodies.  Unfortunately about 10% of people do not eliminate the virus and become long term carriers of the virus. This occurs more often in children and infants.  These people can continue to spread the virus to others and often suffer continued inflammation of the liver.  Long term carriers of hepatitis B are also at an increased risk of developing cancer of the liver.

Human Papilloma Virus (Warts)

There are many types of  HPV (Human Papilloma Virus) all of which cause warty growths.  Some variants of the virus cause warts on the skin. Other variants cause growths in the throat or nose, and other variants cause warty growths on the penis, female genitalia or anus.  Generally HPV types are specific for certain locations.  For example, viral types that cause warts on the skin do not cause warts on the genitals.

Genital HPV infection is very common and it is frequently without symptoms in both the male and female.   On occasion growths that are visible to the naked eye may be seen on the penis or vulva but this is not the rule.  The danger of HPV infection, especially in females, is its link to cancer of the uterine cervix.  There are certain types of HPV that are particularly prone to cause cancer.  This is why pap smear screening is so important in women and sexually active teen-age girls.

If you are infected with HPV do not panic, because often the infection can be treated by your gynecologist in the office.  Sometimes a person’s own immune system can also rid themselves of the infection.  To protect yourself from cervical cancer the most important thing you can do is get your annual pap smear!

HPV is also linked to penile cancer in the male. However penile cancer is not as common in men as cervical cancer is in women.

Gonorrhea

Gonorrhea is a very common venereal disease caused by a bacterium,  Neisseria gonorrhoeae.  Symptoms usually occur several days after exposure to the bacteria.  The male will often experience burning on urination as well as a discharge from the penis.  Females may have some irritation on urination or a discharge, but are often without symptoms.  If treated promptly with appropriate antibiotics,  the infection is completely cured.  If not treated, males may develop long term inflammation of the male reproductive tract leading to  scarring and infertility.  Similar inflammation of the female reproductive tract called pelvic inflammatory disease may develop in untreated cases likewise leading to infertility. The infection can also spread into the abdominal cavity causing pain and inflammation around the liver.   If the bacteria reaches the blood stream, it may lead to arthritis.

Gonorrhea may also be spread by oral and/or anal sex.  In these situations infection will be manifested by a sore throat or irritated, inflamed anal area

Although gonorrhea is usually readily treated with appropriate antibiotics. Some of the bacteria have begun to show antibiotic resistance

Granuloma Inguinale

This disease is very uncommon in the United States.  It is most prevalent in New Guinea and India and is caused by a tiny bacterium.  For unknown reasons it is more common in men than women.  It causes a large, ulcerating creeping sore on genitalia and adjacent skin.  It can be treated with antibiotics.

Lice (crabs)

Pubic lice may be but are not always spread by sexual contact.  The lice and their eggs cling to pubic hair causing severe itching.  Medicated washes and shampoos are available to treat pubic lice.  Clothing and bedding should also be decontaminated.

Lymphogranuloma Venereum

Lymphogranuloma venereum is unusual in the United States.  Most cases are imported from tropical countries where the disease is much more common.  It begins as a small sore on the genitals, anus or mouth/throat.  Later lymph nodes near the initial site become very swollen and tender.  If left untreated scarring and deformity can occur.

Mites (scabies)

Scabies is caused by a mite ( a type of tiny insect) that burrows into the skin and lays eggs.  It is transmitted by close physical contact among people.  This includes sexual contact or close household contact.  A rash develops with severe itching.  It its treatable with medicated lotions and decontamination of bedding and clothing.  All sexual contacts and household members should be treated.

Syphilis

Syphilis is caused by a bacterium called Treponema pallidum.  Syphilis was once a terrible scourge on mankind because of the severe long term consequences of the infection including insanity and severe heart and vessel disease.  Now syphilis is readily treated with antibiotics if detected.  People infected with syphilis pass through 3 stages of illness:

1.  The primary stage is manifested by a sore that may ulcerate.  It is called a chancre (but is not the same as the chancre of “chancroid”.) The sore may be present on the genitalia, anus, lips etc.   Unfortunately in about 50% of females and 30% of males this primary lesion of early syphilis is not apparent.

2.  In the second stage of syphilis, infected individuals get a rash in the mouth, the palms of the hands and the soles of the feet.  Sometimes the lymph nodes may also be swollen.

3.  The third stage of syphilis (late or tertiary syphilis) is now fortunately very rare because most patients are treated by the time they reach stage 2.  Late syphilis causes inflammation of the largest artery in the body, the aorta.  It also can affect the brain and neurologic system.  It is a very serious disease with debilitating consequences.

Syphilis may be spread sexually but may also be spread from an infected mother to her baby in the womb.  The infected baby may be stillborn or may suffer blindness and severe organ , bone and joint damage.  This disease is called congenital syphilis.

Trichomonas

Trichomonas infection is caused by a parasite, Trichomonas vaginalis.  It sometimes produces a frothy, foul smelling discharge in infected women.  Men are often without symptoms, although occasionally there may be discharge or painful urination.  The infection is treatable with appropriate antibiotics.

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