Sexually transmitted diseases (STDs) are still a major health problem in this country. Despite many testing options and treatments, people are still being infected and not getting treated. One of the biggest problems with STDs are that many of them will not initially have symptoms but can still be spread. In this article, I will address many of the major STDs, how to identify them, and how to keep safe. It is up to each person to act responsibly in the prevention of infection.
Infections occur when there is a transmission of blood or bodily fluids. The person most at risk is the receiver of blood or bodily fluids, but any sexual fluid exchange can infect either partner. The type of sexual intercourse, whether vaginal, anal or oral, can affect transmission to some degree but none of them are without risk. While the only way to completely prevent an STD is abstinence, the next safer step is barrier protection with a condom or other latex barrier.
Common STDs include HIV, herpes, gonorrhea, hepatitis, chlamydia, trichomonas, HPV, and syphilis. While bacterial vaginosis is not technically and STD, it can be caused by frequent sexual activity. It will present with a fishy vaginal odor and can be treated with antibiotics. While some of the infections can be cured, others need to be chronically treated. The viruses tend to require long term suppressive therapy while the bacterial infections can usually be cured by antibiotics.
HIV (human immunodeficiency virus) attacks the body’s immune system and allows other infections to become active. The virus can be in the body for as long as 10 years before symptoms appear. Once the immune system has deteriorated, the person can develop AIDS or the acquired immunodeficiency syndrome, which is defined by having HIV infection, certain lab findings, and other opportunistic infections. HIV is a very complex condition and will be discussed in future dedicated articles. The most important point to remember is early detection and frequent testing can lead to early treatment and longer life; but safer sex practices can greatly reduce the spread of the infection.
Gonorrhea and chlamydia are bacteria then tend to transmit together. The most common presenting symptom of gonorrhea is a discharge. Chlamydia can have no symptoms but can lead to severe long term complications, especially for the woman, including infertility and severe infection like pelvic inflammatory disease. Men and women may feel burning and discomfort in the genital area, but often times it is a silent infection. Once again, routine testing is essential.
Hepatitis is a virus that infects the liver and, if left untreated, can lead to liver failure, cirrhosis, cancer and death. A vaccine exists for Hepatitis A (which is transmitted from the food we eat), and Hepatitis B which is transmitted through blood and bodily fluids. While there is no vaccine for Hepatitis C, another blood borne virus, a cure finally exists for this infection. Early infection may present as a common viral syndrome with fever, chills and body aches but can progress to yellowing of the eyes and skin as the liver becomes more inflamed and cannot process bilirubin. This is what causes jaundice, or yellowing of the skin. As with other infections, the initial infection may go without symptoms and this allows for it to be spread, undetected, to many people.
The next infections can sometimes be identified by visual inspection of the genitals and if lesions are present, medical attention should be sought. Syphilis is a particularly nasty bacteria that can be difficult to diagnose. The first stage is a painless chancre or ulceration that occurs at the site of infection. It is possible to transmit the infection by direct contact with this lesion, not necessarily through sexual contact. This lesion, if not treated, will disappear as the infection can then lie dormant before it develops into secondary syphilis, which presents as a full body rash. The final stage is tertiary syphilis and this involves the bacteria invading the neurological system. Early detection and treatment is essential for a good outcome. The lesion is presented in the following picture:
Herpes is a contagious virus that is very difficult to treat and can live inside the body for years. The two type of herpes are 1 and 2. The first is a harmless cold sore while the second is sexually transmitted. The lesion is a painful ulcer or sometimes blister that can appear on any of the mucus membranes. An infected person can spread the virus for 7 days before any lesions appear, which makes it extremely contagious. The infected person may not even feel the outbreak coming but is shedding virus to other people A simple blood test can detect the presences of antibodies to the virus. Medications can be used to put the virus into remission and suppress future outbreaks. It is important to know if herpes is present as infection can have no symptoms for some time before any lesions are present. The following is one example of herpes infection
Human Papilloma Virus, HPV, causes genital warts and cancer. It looks like a cauliflower like lesions on the genitals and is quite contagious. Many types of HPV strains exist and some lead to cancer. Men and women are equally at risk and the virus has been associated with cervical, throat, p enile and anal cancer. It can be spread by direct contact with the lesion. A vaccine exists to prevent the infection and it is best administrated before any sexual activity has started. The following is typical HPV infection
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Trichomonas is a parasite that can have no symptoms or may cause genital redness and swelling with discharge. As with many STDs, it can be detected with lab tests and treated with medications, but may not have any symptoms. Frequent testing is key to early detection and prevention of this disease.
This was a brief overview of the various infections that can occur with sexual activity. It is crucial to remember that many infections are contagious when no signs or symptoms exist. This means people can feel completely healthy but be spreading contagious diseases that can have severe and permanent health problems. Visual recognition of some common lesions is a good warning sign that disease is present. It goes without saying that STD testing should be done before any sexual activity occurs, and no sexual activity should occur if lesions are present. In addition, if the infection is treatable, no sexual activity should occur for at least 7 days after initiation of treatment and clearance of infection is documented. Being responsible before sexual activity and testing regularly can be lifesaving. If there are any concerns, the person should seek medical attention and consult with a physician.
