|
Common
Sexually Transmitted Infections:
Frequently Asked Questions
By Andy Craig, MSN, FNP-C
There are several kinds of infections and conditions that can be spread
sexually. Some of the more common ones are:
Human
Immunodeficiency Virus (HIV):
the virus that causes AIDS. It can be fatal. There are
no symptoms when you first contract the virus. It can take up to 6 months after
exposure before a test becomes positive. At-risk persons are advised to have
periodic testing every 6 to 12 months. The virus degrades your body’s immune
system, resulting in unusual and severe infections that your body is unable to
fight off.
Hepatitis B:
this type of liver virus can greatly increase chances of
acquiring cirrhosis or liver cancer. Symptoms include jaundice, a
yellowing of the skin and eyes, nausea, vomiting, and abdominal pain.
Hepatitis B can be prevented by vaccination! Contact the immunizations
department at Student Health Services for details.
Syphilis: a bacterial infection. The first symptom is a painless
ulcer-type sore at the point of entry. This is called primary syphilis.
The sore lasts several weeks whether treated or not. If left untreated, the
disease progresses to the secondary stage, where a generalized rash is
seen—even on the palms and soles. Eventually, this rash goes away as well,
giving the false impression that you are well when in fact, you are still
infected. If still untreated, months to years later tertiary syphilis
develops. The bacteria (which look like little corkscrews) literally start
boring holes in the brain. This can be fatal. Al Capone (the infamous gangster
of the 1920’s) died in prison from tertiary syphilis.
Genital Herpes: a
viral infection that causes periodic outbreaks of painful sores around the
genitals. Herpes simplex virus exists as two different viral types, HSV-1 and
HSV-2. HSV-1 is the virus that causes cold sores. HSV-2 is the virus that
causes genital herpes. It is possible to cross-contaminate and get HSV-2 on the
mouth and/or HSV-1 on the genital areas. Genital herpes can be spread
even when using a condom, because the lesions can be in areas the condom
does not cover. It is also possible to transmit herpes even when you do not
have visible lesions. This is called asymptomatic viral shedding. There is no
cure for genital herpes but medicines can be taken to reduce the number and
severity of outbreaks and lessen the chance of asymptomatic viral shedding. In
between outbreaks, the virus remains dormant in the roots of spinal nerves.
Genital Warts:
caused by the Human Papilloma Virus (HPV). Persons with
this disease have recurring warty growths at the site(s) of infection (penis,
vagina, rectum). There is no cure for this condition. Individual warts can be
treated by freezing with liquid nitrogen. For clusters of warts, a prescription
cream is applied overnight 3 times a week for 3 months. Unfortunately, other
warts eventually come up in their place. Genital warts can be
spread even when using a condom, because the lesions can be in
areas the condom does not cover. Genital warts are also a known cause of
cervical cancer in women. Females can be tested for HPV via the pap smear.
There is no test for HPV for a male. It is diagnosed by clinical exam.
Gonorrhea and Chlamydia: these two STIs are somewhat similar; they are both common and
sometimes occur together.
-
Commonly referred to as “the drip” in
males, gonorrhea manifests as a yellow pus-like discharge from the penis
with burning on urination. In females the symptoms include yellow pus-type
vaginal discharge and lower abdominal pain.
-
Chlamydia has much more subtle symptoms.
Fifty percent (50%) of males and 75% of females have no
symptoms at all. When seen, the symptoms include a thin white or clear
penile discharge with burning on urination in a male. This discharge is
often mistaken for pre-semen or residual urine flow. Often, males believe
they have a urinary tract infection; in fact, this is relatively rare in
males. Often when I see a male patient who suspects they have a urine
infection, they actually wind up having Chlamydia.
-
Both Gonorrhea and Chlamydia are
treatable with two antibiotics given together, but resistant strains do
exist. If untreated, the disease can cause infertility. Females with these
diseases have an increased risk of tubal (ectopic) pregnancy and pelvic
inflammatory disease; males can develop epidydymitis, a condition where the
testicles become swollen and painful.
Trichomonas: this is a small parasite that can be spread through sexual
contact. Eighty percent of males and sixty percent of females are without
symptoms at the time of diagnosis. When present, symptoms include vaginal
discharge, odor, and irritation (females) or penile discharge, burning on
urination, and sometimes painful testicles (males). It is diagnosed by clinical
exam with laboratory examination of a specimen of the discharge. It is treated
with antibiotics.
Body lice, pubic lice, scabies: these are parasitic infections where small insects either attach
and live on your hair (lice) or burrow under your skin (scabies). These are
acquired from either direct contact with an infected person, or indirect contact
via sheets, bedding, towels, hats, clothing, etc. These conditions are very
infectious, but are treatable. Sometimes a topical lotion is prescribed to kill
the mites. An anti-itch medicine may be prescribed since itching can persist
for up to 6 weeks after being successfully treated. To eradicate lice or
scabies, it is also necessary to decontaminate your bedding, clothing and any
durable fabrics (drapes, carpet, etc); either by machine washing in hot water,
placing items in an airtight bag for several weeks, or spraying with a
pediculocide spray (Rid©, Permethrin, etc.).
Testing for STIs:
the following methods are used to test for STIs at Student Health Services:
-
Blood test: a tube of blood is drawn from
your arm using a sterile needle and equipment. This method is used for
testing for HIV, Syphilis, and Herpes.
-
Lesion scraping: The surface of a lesion
(sore, wart, blister, etc.) is scraped open with a sterile blade and then
swabbed for testing. This method is used for testing for Herpes, as well as
some non-sexually transmitted skin lesions.
-
Genital swab: a sterile q-tip is swabbed
inside the vagina or inside the urethra of the penis. This method is used
to test for Gonorrhea and Chlamydia. For males, urinating before the test
can give false-negative results, so don’t urinate within 45 minutes of being
tested.
HIV and Syphilis testing can be
done in one of two ways:
-
Labs can be drawn by SHS staff. Results
will be obtained more quickly this way. The results will go in your medical
record. Depending on your insurance, there may be a fee charged for testing.
-
Labs can be drawn by the Metrolina AIDS
Project (MAP). We partner with MAP and provide them space in our clinic to
perform free, confidential testing. MAP visits once a month, so results may
take longer. Appointments are necessary—call 704-687-4617 and ask for a “MAP
clinic appointment.”
* A note on test results: We do not inform patients of negative results due to time
constraints. If you have a positive result, a member of our staff will contact
you to advise you to make an appointment with a health care provider. Due to
federal privacy laws, we cannot give results over the phone. This is to protect
your confidential medical information.
STI Prevention:
-
The Centers for Disease Control (CDC)
states that the only 100% way to prevent an STI is by not engaging in sexual
activity. This includes oral sex and heavy petting, or any activity where
you may share or exchange bodily fluids. I tell my patients it includes
anything that you would not be comfortable doing in front of your partner’s
parents.
-
The next best way to prevent STIs is to
use a latex condom every single time you engage in sexual activity.
It only takes one exposure to get infected! Put on a condom at the very
start of sexual activity, make sure you put it on correctly, and remove it
and wash yourself thoroughly as soon as you have completed the activity.
This avoids unintended spillage or leaking of body fluids.
-
FREE
condoms are available at Student Health
Services
in the Wellness Promotion office. Ask for a “C.A.R.E. Package” (Condom
Access for Responsible Encounters).
Need more information? Visit the websites below,
or call Student Health Services at 704-687-4617 to schedule an appointment with
a health care provider.
|
Sexually
Transmitted Infections