Sexually Transmitted Diseases

Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are infections that you get from having sex with someone who has the infection. The organisms that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids. Some infections - such as gonorrhea, chlamydia, HIV, and syphilis - can also be transmitted nonsexually, such as from mother to infant during pregnancy or childbirth, or through blood transfusions or shared needles.

STDs can be caused by bacteria, parasites, and viruses. There are more than 20 types of STDs; the most common include:

• chlamydia
• gonorrhea
• genital herpes
• HIV/AIDS
• Human papillomavirus (HPV)
• syphilis
• trichomoniasis

Most STDs affect both men and women, but, in many cases, the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby.

If you have an STD caused by bacteria or parasites, your healthcare provider can treat it with antibiotics or other medicines. If you have an STD caused by a virus, there is no cure. Sometimes medicines can keep the disease under control. Correct use of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading STDs.

STDs have a range of signs and symptoms, which is why they may go unnoticed until complications occur or a partner is diagnosed. Signs and symptoms that might indicate an STD include:

• sores or bumps on the genitals or in the oral or rectal area
• painful or burning urination
• discharge from the penis
• unusual or odd-smelling vaginal discharge
• unusual vaginal bleeding
• pain during sex
• sore, swollen lymph nodes, particularly in the groin but sometimes more widespread
• lower abdominal pain
• rash over the trunk, hands, or feet

See a doctor immediately if:

• you are sexually active and you believe you have been exposed to an STD
• you have signs and symptoms of an STD

Make an appointment with a doctor:

• when you consider becoming sexually active or when you are 21, whichever comes first
• before you start having sex with a new partner

STDs can cause long-term health problems, particularly in women and infants. Some of the health complications that arise from STDs include pelvic inflammatory disease, infertility, tubal or ectopic pregnancy, cervical cancer, and perinatal or congenital infections in infants born to infected mothers.

STDs can be caused by:

• bacteria (gonorrhea, syphilis, and chlamydia)
• parasites (trichomoniasis)
• viruses (human papillomavirus, genital herpes, HIV)

Sexual activity plays a role in spreading many other infectious agents, although it is possible to be infected without sexual contact. Examples include the hepatitis A, B, and C viruses, shigella, and Giardia intestinalis.

Anyone who is sexually active has a risk of exposure to an STD. Factors that may increase that risk include:

• having unprotected sex. Vaginal or anal penetration by an infected partner who is not correctly wearing a latex condom significantly increases the risk of getting an STD. Improper or inconsistent use of condoms can also increase your risk.
• having sexual contact with multiple partners. The more people you have sexual contact with, the greater your overall exposure risks. This is true for concurrent partners as well as monogamous consecutive relationships.
• having a history of STDs. Being infected with one STD makes it much easier for you to be infected with another STD.
• anyone forced to have sexual intercourse or sexual activity. Dealing with rape or assault can be difficult, but it is important to be seen as soon as possible. Screening, treatment and emotional support can be offered.
• abusing alcohol or using recreational drugs. Substance abuse can inhibit your judgment, making you more willing to participate in risky behaviors.
• injecting drugs. Needle sharing spreads many serious infections, including HIV, hepatitis B and hepatitis C. If you acquire HIV by injecting drugs, you can transmit it sexually.
• being an adolescent female. In adolescent girls, the immature cervix is made up of constantly changing cells. These unstable cells make the adolescent female cervix more vulnerable to certain sexually transmitted organisms.
• being a man who requests prescriptions for drugs to treat erectile dysfunction. Men who ask their doctors for prescriptions for certain drugs, such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra), have higher rates of STIs. Be sure you are up to date on safe sex practices if you ask your doctor for one of these medications.

If your sexual history and current signs and symptoms suggest that you have an STD, laboratory tests can identify the cause and detect coinfections you might have contracted. Blood tests can confirm the diagnosis of HIV or later stages of syphilis, and urine sampless can confirm several STDs. If you have active genital sores, testing fluid and samples from the sores may be done to diagnose the type of infection. Laboratory tests of material from a genital sore or discharge are used to diagnose the most common bacterial and some viral STDs at an early stage.

It can be traumatic to find out you have an STD. You might be angry if you feel you have been betrayed or ashamed if there is a chance you infected others. You can take steps to help yourself remain healthy.

• Be candid with healthcare workers. Their job is not to judge you, but to stop STDs from spreading. Anything you tell them remains confidential.
• Contact your health department. Although they may not have the staff and funds to offer comprehensive services, local health departments maintain STD programs that provide confidential testing, treatment, and partner services.
• Practice safe sex. Talk to your healthcare provider and your partner about engaging in sex while you have or are being treated for an STD.

STDs caused by bacteria are generally easier to treat than those caused by viruses or parasites. Viral infections can be managed but not always cured. If you are pregnant and have an STD, prompt treatment can prevent or reduce the risk of infection of your baby. Medications can be used to treat some infections.

Antibiotics. Antibiotics, often in a single dose, can cure many sexually transmitted bacterial and parasitic infections, including gonorrhea, syphilis, chlamydia, and trichomoniasis. Typically, you will be treated for gonorrhea and chlamydia at the same time because the two infections often appear together. Once you start antibiotic treatment, you must complete all the medication prescribed to you. If you do not think you will be able to take medication as prescribed, tell your doctor. A shorter, simpler treatment regimen may be available. In addition, it is important to abstain from sex until you have completed treatment and any sores have healed.

Antiviral drugs. You will have fewer herpes recurrences if you take daily suppressive therapy with a prescription antiviral drug; antiviral drugs lessen the risk of infection, but it is still possible to give your partner herpes. Antiviral drugs can keep HIV infection in check for many years, although the virus persists and can still be transmitted. The sooner you start treatment, the more effective it is for any STD. If you have had an STD, ask your doctor how long after treatment you need to be retested. Doing so ensures that the treatment worked and that you have not been reinfected.