It is time that we have not only have open communication about sex, but also about STDs. To get you started, I have outlined a quick guide to some of the more commonly asked questions and a break down of information regarding STDs that are most common so that you can be educated about them and make appropriate choices for you and your partner(s).

Lisa S. Lawless, Ph.D., C.E.O. HolisticWisdom.com Founder

What are STDs?

Sexually transmitted diseases (STDs) are the more than 25 diseases that spread through sexual contact.

How common are STDs in America?

STDs are extraordinarily common. For example, over 40 million people are estimated to have chronic genital herpes, and there are an estimated 4 million new chlamydia cases a year.

Are STDs, other than HIV/AIDS, really a serious threat?

Several STDs other than HIV/AIDs (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) are quite serious. Diseases like syphilis, gonorrhea, and chlamydia can have long-term consequences, including pelvic inflammatory disease (PID), which can lead to sterility and chronic pelvic pain. Human papilloma virus (HPV), the virus that causes genital warts, is strongly linked to the development of cervical cancer. STD infection during pregnancy can cause pregnancy complications and, in some cases, lead to illness in the newborn.

Who gets STDs?

STDs know no boundaries. Anyone who is sexually active can contract a sexually transmitted disease. STDs infect men and women of all ages, regions, ethnic backgrounds, and incomes. One in five Americans or approximately 56 million people carries an STD. Teenagers are at the highest risk of getting an STD. This is because of behavioral issues (teenagers are more prone to risk-taking) and biological issues (the teenaged cervix is more susceptible to chlamydia and gonorrhea infections).

Is it true that women are at greater risk for STDs?

Because of differences in anatomy, women are at greater risk of acquiring an STD during male/female intercourse than are men. Women are more likely than men to acquire chlamydia in a single act of unprotected intercourse with an infected partner. These odds are twice as high as a man's risk under the same circumstances. And because the female anatomy often hides early symptoms of disease, women also suffer more severe, long-term effects from STDs, such as pelvic inflammatory disease and infertility. The good news is, women may get tested and treated if they have annual gynecological exams.

Could I have an STD and not even know it?

Yes. The stealthy nature of so many STDs makes them difficult to diagnose. Many people with STDs experience no noticeable symptoms. That doesn't mean that an asymptomatic STD infection won't cause problems down the road. So if you think you have an STD, see your healthcare provider right away.

Can I get herpes or other STDs from a towel or a toilet seat?

Most STDs are spread only through direct sexual contact with an infected person. However, pubic lice and scabies are associated with close body contact, not necessarily sexual contact. It's rare, but possible, to become infected with pubic lice or scabies as a result of contact with infested clothes, sheets, or towels.

Can condoms prevent STDs?

More and more people are using condoms. Research shows that latex condoms, when used correctly, are effective in reducing the transmission of most infectious diseases, including HIV. One of the problems with condoms is that many people use them incorrectly or sporadically. Remember, no method except abstinence is 100% effective. An example of an STD that is not preventable by using a condom is Genital Warts as contact with the skin in any area of the body can transmit it.

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What should I do if I think I have an STD?

If you think you have an STD or have been exposed to one, see a healthcare provider immediately. Timing is everything: beginning treatment early helps minimize the long-term effects of most STDs. You also need to abstain from sexual contact until you're sure that you can't pass the STD on to someone else. That means no sex with anyone until your healthcare provider assures you that you're no longer contagious. You also need to make certain that your partner is tested--to ensure his/her health and also to make sure you don't get reinfected.

Is there any way to be 100% sure that I'm not carrying a STD?

Unfortunately, no. No test for any STD is 100% accurate. Some STDs don't show up right away, even to your healthcare provider. The time it takes for an infection to show up in testing can be anywhere from a couple of days to a few years. If you think you have an STD, get tested. Even if you test negative, you should continue practicing safer sex.

Is there an HPV (the virus that causes genital warts) test for men without symptoms?

Human Papilloma Virus (HPV) is the virus that causes genital warts and cervical dysplasia (abnormal Pap smear). Diagnosing HPV in men without symptoms can be difficult. It is also possible for men to think they have no symptoms when they actually do. A healthcare provider often can see small warts, particularly if they are right inside the opening of the penis. Those warts can be treated, but most men with HPV do not have any symptoms. There is no treatment for asymptomatic HPV.

Just the idea of talking about safer sex and sexually transmitted diseases (STDs) often leaves both men and women speechless.

Is it normal to feel depressed about having an STD?

If you discover that you have an STD, or think you have one, it's normal to feel embarrassed, worried, and even angry. Most people have some kind of emotional reaction. It's important to remember that you're not alone. STDs are very common. Twelve million STD infections occur every year. It's also important to seek help. Confide in your doctor or healthcare provider and begin treatment. Taking control of the situation may help you manage your feelings.

Can I test myself for STDs?

It's not a good idea. While some STDs may present identifiable symptoms, such as discharge or warts, many are not easily identifiable. Even more are asymptomatic (without symptoms). At this point, diagnosing STDs requires clinical training or laboratory tests. Currently there are no home tests for STDs available, although this may change in the future. A home HIV test was recently approved by the FDA and is available.

I'm thinking about getting an AIDS test. What's the difference between "confidential" and "anonymous" testing?

There is an important difference between confidential and anonymous testing for HIV, and the kind of testing you choose may have long-term implications. Confidential testing is a good option for people who need an official copy of their test result with their name on it. Confidential test results become part of your medical records, which can be released only with your written permission. Anonymous testing leaves no paper trail. When you have an anonymous test, you are known only by number, and the only person who learns the results is you.

How can I get more information about STDs?

To find out more about STDs, their symptoms, treatment, and prevention, check out the information below. You also can contact your healthcare provider or local health department, or call the National STD Hotline at 1-800-227-8922.

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Chlamydia

Chlamydia is the number one bacterial sexually transmitted disease (STD) in the United States today. Four million new cases of chlamydia occur each year. It's particularly common among teens and young adults. Pelvic inflammatory disease (PID), which can be caused by chlamydia, is a leading cause of infertility when left untreated.

Symptoms-

Chlamydia is known as the "silent epidemic" because three quarters of the women and half of the men with the disease have no symptoms. Possible symptoms include discharge from the penis or vagina and a burning sensation when urinating. Additional symptoms for women include lower abdominal pain or pain during intercourse and bleeding between menstrual periods. Men may experience burning and itching around the opening of the penis and/or pain and swelling in the testicles.

Testing-

There are two kinds of tests for chlamydia. One involves collecting a small amount of fluid from an infected site (cervix or penis) with a cotton swab. These tests are universally available. New tests, which use only urine samples, will be available soon and will make testing much easier and less painful.

Treatment-

There has been major progress in the treatment of chlamydia with antibiotics over the past few years. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments. (For the U.S. only) Common side effects of these treatments include diarrhea (7%), nausea (5%), abdominal pain (5%), and vomiting (2%).

Prevention-

You can get and spread chlamydia through unprotected vaginal and anal sex. Preventing chlamydia means approaching sexual relationships responsibly: limit the number of your sex partners, use condoms, and if you think you are infected, avoid any sexual contact and visit a local STD clinic, hospital, or your doctor. Be sure your partner is treated to avoid becoming reinfected.

Genital Warts

Genital warts are caused by the Human Papilloma Virus (HPV), one of the most common sexually transmitted diseases (STDs). HPV is the name of a group of viruses that includes more than 60 different types. An estimated 40 million Americans are infected with HPV, with 1 million new cases each year.

Symptoms-

Most HPV infections are subclinical--that means that there are no visible signs. Subclinical HPV infections can cause abnormal cell growth (dysplasia) on the female cervix. Visible signs of the disease include condylomata, which range from soft, pink, cauliflower-like warts to hard, smooth, yellow-gray warts. In women, they may develop inside the vagina, where they are hard to detect. They may also appear on the lips of the vagina or around the anus.

In men, they usually appear on the penis, but are sometimes found on the scrotum (the sac that holds the testicles) or around the anus. If there are visible signs, you will notice them within 3 weeks to 6 months after having sex with someone who is infected. This time period makes it difficult to track the infection as it is passed from partner to partner.

Testing-

Your healthcare provider can check closely to detect warts or other abnormal tissue. For women, the Pap smear is designed to detect precancerous changes in the cervix and may show changes caused by HPV infection. Generally, asymptomatic men with HPV are hard to diagnose and usually aren't treated.

Treatment-

There are several ways to remove visible genital warts, but the underlying HPV infection can't be cured.

The virus that causes genital warts stays in your body and can cause warts to appear in the future. A doctor can get rid of smaller warts by freezing them (cryotherapy) or by burning them off with an acidic chemical such as podophyllin. In severe cases, wart treatment may require laser surgery. All three procedures can typically be done in a doctor's office with local anesthetic.

Prevention-

Genital warts are transmitted when the HPV virus is passed from one person to another during sex. You get genital warts by having sex with someone who is infected. People who have many sexual partners put themselves at higher risk for genital warts. Latex condoms, used properly, provide some protection if they cover the area of infection. Women: be sure to have regular Pap smears.

Gonorrhea

Gonorrhea is a common sexually transmitted disease (STD) which, if not treated early, can cause serious problems, especially for women. About 1 million American men and women contract gonorrhea each year.

Symptoms-

It's possible to have gonorrhea without any symptoms. If symptoms do appear, they may include discharge from the penis or vagina, the need to urinate often, burning or pain when urinating, and in women, bleeding between monthly periods. About half of the women with gonorrhea have no symptoms.

Testing-

The only way to find out whether or not you have gonorrhea is to get tested. The test is simple: the doctor takes a sample of fluid from the penis or vagina and sends it to a lab.

Treatment

Gonorrhea is treated with antibiotics. Common treatments use drugs such as ciprofloxacin, ofloxacin, cefixime, ceftriaxone, and most recently - azithromycin (click here for full prescribing information; download the latest version of Adobe Acrobat Reader free). Azithromycin is a single-dose oral medication. The most common side effects with 2-gram azithromycin include nausea (18%), diarrhea/loose stools (14%), vomiting (7%), abdominal pain (7%), vaginitis (2%), dyspepsia (1%), and dizziness (1%). Ineffective or incomplete treatment can result in serious problems later, such as chronic lower abdominal pain, sterility, tubal pregnancy, and painful joints. In order to avoid reinfection and potential transmission of infection to others, you should stop having sex until both you and your partner are cured.

Prevention

You can get and spread gonorrhea through oral, anal, and vaginal sex. Preventing gonorrhea means approaching sexual relationships responsibly: limit the number of your sex partners, use condoms, and if you think you are infected, avoid any sexual contact and visit a local STD clinic, hospital, or your doctor. Make sure both partners are treated.

Hepatitis B

Hepatitis B is an infection of the liver caused by a virus. It's 100 times more infectious than HIV. About 300,000 Americans get hepatitis B each year. Most people recover, but a few become chronic carriers with increased risk of serious problems later, such as permanent liver disease and cancer of the liver.

Symptoms-

Symptoms usually appear within 2 to 6 weeks after contact. They can include poor appetite; nausea; vomiting; headaches; general malaise; jaundice (yellowing of eyes and skin); dark, tea-colored urine; and light-colored stools. Even without symptoms, you can pass the virus to others. Chronic carriers carry the hepatitis B virus for the rest of their lives and unknowingly pass it to their sex partners.

Testing-

Routine testing is not usually indicated unless the patient is symptomatic from jaundice or has had recent sexual exposure to someone with hepatitis. Sometimes, serological testing is done as part of a hepatitis B vaccination program. However, if you've already had hepatitis B, you don't need to be vaccinated. Remember that 90% to 95% of people who have hepatitis B will fully recover.

Treatment-

For acute hepatitis B, treatment includes rest and diet. There are some new treatments for chronic hepatitis, including interferon. If your sex partner or a member of your household is found to have hepatitis B, you should consult your doctor or healthcare provider and get immunized. Immunization may include hepatitis B immune globulin and hepatitis B vaccination series.

Prevention-

Like acquired immunodeficiency syndrome (AIDS), the hepatitis B virus is spread through contact with infected blood or body fluids. You can get hepatitis B from vaginal, oral, or anal intercourse. It also can be passed from an infected mother to her baby during childbirth. To minimize your risk of contracting hepatitis B, do not share needles or syringes, or instruments used in ear-piercing, tattooing, or hair removal. Do not share toothbrushes or razors. If you have sex, reduce your risk by using condoms. If you are infected, avoid sex and other close contact, such as kissing, until your doctor says it's okay. Hepatitis B is the only sexually transmitted disease (STD) that can be effectively prevented by a vaccine. The Centers for Disease Control (CDC) now recommends vaccination for all newborns in order to prevent infection of hepatitis B later on. The vaccine is highly effective and should be strongly considered. Check with your doctor to find out if you should be vaccinated against it.

Herpes

Genital herpes is a chronic, lifelong viral infection. An estimated 40 million people have it. Each year, about 500,000 new people get symptomatic herpes. There are even more people who have no symptoms.

Symptoms-

Symptoms vary. Most people have no noticeable symptoms. If you do get symptoms, you'll probably notice them 2 to 20 days after having sex with someone who is infected. Early symptoms may include a burning sensation in the genitals, lower back pain, pain when urinating, and flu-like symptoms. A few days later, small red bumps may appear in the genital area. Later, these bumps can develop into painful blisters, which then crust over, form a scab, and heal.

Testing-

Sometimes the diagnosis can be made by physical examination alone. For testing, the doctor will collect a small amount of fluid from the sores and send it to a lab to see if the herpes virus is present. It may take up to 2 weeks to get the results. If no sores are present, testing may be difficult. At present, a blood test for herpes is available only in a few research centers.

Treatment-

Although herpes is a chronic, lifelong viral infection, you can treat the symptoms. Treatment of genital herpes outbreaks, especially when started early, shortens the duration of the outbreak and reduces the symptoms. The drugs used are Acyclovir and, more recently, Valtrex.

Prevention-

You can get and spread herpes through oral, anal and vaginal sex. Preventing the spread of herpes means approaching sexual relationships responsibly: limit the number of your sex partners, use condoms, and if you think you are infected, avoid any sexual contact and visit a local sexually transmitted disease (STD) clinic, hospital, or your doctor. Remember that many genital herpes infections are spread by people with no noticeable symptoms. You also can get the herpes virus from kissing, touching, and caressing infected areas. In cases where people have more than six outbreaks a year, preventative (prophylactic) suppressive therapy is available.

HIV/AIDS

AIDS stands for Acquired Immunodeficiency Syndrome. Sound serious? It is. AIDS is currently the leading cause of death in men between the ages of 25 and 44 in the United States. Think women aren't at risk? Think again. AIDS is the fourth leading cause of death in women in this age group. AIDS is caused by HIV, the Human Immunodeficiency Virus, which attacks the body's immune system. Without immunologic protection, people with AIDS suffer from fatal infections and cancers.

Symptoms-

You can be infected with HIV, the virus that causes AIDS, and have no symptoms at all. On average, it takes about 7 to 9 years for symptoms to develop. Most symptoms of AIDS are not caused directly by the HIV virus, but by an infection or other condition acquired due to the weakened immune system. Symptoms can include severe weight loss, fevers, headaches, drenching night sweats, fatigue, severe diarrhea, shortness of breath, and difficulty swallowing. The symptoms tend to last for weeks or months at a time and do not go away without treatment. Since these symptoms are commonly seen in other diseases, you can't assume any symptom is HIV/AIDS-related until you get laboratory tests. See a doctor if you think you may be at risk or if you have symptoms.

Testing-

The only way to tell if you have been infected with HIV is by taking an HIV blood test. The test can be performed at an AIDS testing site, a doctor's office, or clinic. HIV testing includes pretest counseling and an explanation of the benefits of testing. You may want to seek anonymous testing. When you undergo anonymous testing, you're identified only by number, and you're the only one who finds out the test results. The CDC National AIDS Hotline, 1-800-342-AIDS, can help you find a test site in your area. Home test kits are available.

Treatment-

There is no cure for HIV infection or AIDS. If you have been exposed to HIV, you need to tell your sex partners and anyone with whom you have shared needles and syringes that they too may have been exposed to the virus. They should all be tested for HIV infection. Health departments can help you contact former partners if you don't want to do this yourself. Anti-HIV treatment is usually indicated once the T-cell count goes below 500 (indicating a very weakened immune system).

Therapy for the viral infection, with antiretroviral drugs, uses two classes of drugs: the nucleoside analogs (AZT, ddi, ddc, D4T) and the new protease inhibitors. Treatment is complex and is shown to prolong life. A major focus of HIV treatment is preventing other infections (opportunistic infection prophylaxis). For example, pneumocystis (PCP), tuberculosis, and systemic fungal infections can be effectively prevented, and all of these are big problems in HIV patients. Treatment of pregnant women with AZT has been shown to substantially reduce transmission of HIV to the unborn baby.

Prevention-

HIV is spread in two main ways: through unprotected sexual intercourse with an infected person, or through sharing drug needles or syringes with an infected person. Women infected with HIV also can pass the virus to their babies during pregnancy or birth.

HIV is not passed by everyday social contact. Touching, hugging, and shaking hands with an infected person is safe. Some people think they may get HIV by donating blood. This is not so. A new needle is used for every donor, and you do not come into contact with anyone else's blood. Donated blood is now always screened for HIV, therefore, the risk of getting it from a blood transfusion in the United States is very, very low.

Kissing an infected person on the cheek or with dry lips is not a known risk. No cases of AIDS or of HIV infection due to kissing have ever been reported. Short of avoiding sex entirely, you can protect yourself by having safer sex. Stay with one partner with whom you have discussed AIDS and who is prepared to have safer sex. Latex condoms have been shown to prevent HIV infection and other sexually transmitted diseases. Personal items such as razors and toothbrushes also may be blood-contaminated. Do not share them with an infected person.

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Syphilis

Syphilis is a serious disease that can be debilitating and even result in death if left untreated. You can have syphilis without knowing it and pass it on to others. There are an estimated 120,000 new cases of syphilis in the United States each year.

Symptoms-

Syphilis has three stages. During the first stage, a painless sore may appear at the spot where the bacteria first entered the body (usually from 10 to 90 days after sexual contact with an infected person). This sore may appear around or in the vagina, on the penis, or inside the mouth or anus. Sores inside the vagina or anus are often unnoticed and may disappear on their own if not treated, but the bacterial infection remains. The second stage occurs from 3 weeks to 3 months after the primary stage and includes flu-like symptoms and possible hair loss.

Some people experience a rash on the palms of the hands and soles of the feet, as well as over the entire body. Although extremely rare, tertiary syphilis can appear 3 to 10 years or more after the first and second stages. Symptoms of this stage may include skin lesions, mental deterioration, loss of balance and vision, loss of sensation, shooting pains in the legs, and heart disease.

Testing-

See a doctor immediately if there's a chance you've been exposed to syphilis. A simple blood test can usually determine whether or not you have the disease. However, if you become infected 2 to 3 weeks prior to testing, the blood test might not be sensitive enough to pick it up.

Treatment-

Fortunately, syphilis can be treated with proper antibiotics. The most common treatments are penicillin injections.

Prevention-

You can get and spread syphilis through oral, anal, and vaginal sex. Preventing syphilis means approaching sexual relationships responsibly: limit the number of your sex partners, use condoms, and if you think you are infected, avoid any sexual contact and visit a local sexually transmitted disease (STD) clinic, hospital, or your doctor immediately. Be sure that your partners are tested, as well.

Trichomoniasis

Trichomoniasis ("trich") is a common sexually transmitted disease (STD), attacking 2 to 3 million Americans every year. It is caused by infection with a flagellated protozoan, Trichomonas vaginalis.

Symptoms-

Many people with trichomoniasis experience no symptoms. Women may experience itching, burning, vaginal or vulval redness, unusual vaginal discharge, frequent and/or painful urination, discomfort during intercourse, and abdominal pain. Symptoms tend to worsen after menstruation. Men are usually asymptomatic, but symptoms can include unusual penile discharge, painful urination, and tingling inside the penis.

Testing-

The healthcare provider will collect a sample of secretions from the penis or vagina and send it to a lab to see if trichomonas is present. It may take up to 2 weeks to get the result. Some providers can do a quick office examination of vaginal secretions.

Treatment-

Trichomoniasis can be treated with antibiotics, usually a single dose of metronidazole (Flagyl).

Prevention-

As with other diseases, trichomoniasis is spread through sexual contact. Using condoms (or another barrier method) provides some protection, as does knowing your partner's sexual history. Trichomania can also survive on infected objects such as sheets and towels, and could possibly be transmitted by sharing those objects. It is especially important for the male partner to be treated--even though he is almost always asymptomatic.

In Closing-

I know that it is difficult to even think about STDs let alone study them. If there is one "tip" that I can give you it is to stay empowered with accurate information and make choices that show respect to yourself and others.

With much sincerity,

Lisa

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