STIs Sexually Transmitted Infections

WHAT ARE STIs?
Sexually Transmitted Infections (STIs) are infections passed from one person to another during sexual activity. STIs can be serious, painful and may have long term effects, especially if left undetected and untreated.  They infect your sexual and reproductive organs.  The most common STIs on college campuses identified in young adults include: chlamydia, genital herpes and genital warts (HPV). Bacterial STIs, like gonorrhea, chlamydia and syphilis, are relatively easy to cure with antibiotics if detected and treated early. Genital herpes, genital warts, Hepatitis B and HIV are viral infections that cannot be cured, but the symptoms can be treated. Sometimes you can have an STI with no signs or symptoms.  Other times, the symptoms spontaneously go away, but you still have the infection.

HOW ARE STIs SPREAD?
STIs can be spread during vaginal, oral and anal sexual contact with an infected person.

YOU CAN PROTECT YOURSELF FROM STIs
Anyone who is sexually active can get or transmit an STI, so it's important to reduce your risk.

Abstain from sexual contact to eliminate all risk; or engage in behaviors that don’t involved skin to skin contact, or contact with the bodily fluids of your partner(s) like: fantasy, massage and mutual masturbation.  If you decide to engage in other sexual behaviors consider the following:

• Use a condom!  While not 100% effective, condoms provide the best protection now available.  For oral sex, use a condom or latex square.
• Think about your alcohol and drug use.  Alcohol and drugs are often factors when people have risky sex.
• Talk with/examine your partner.  Share sexual histories and past diagnosis of infections.  Look closely at your partner for any signs of STIs - a rash, a sore, redness or discharge in the genital area.  If you see anything you're worried about, don't have sex!
• Don't share vibrators or other sex toys.
• Know the signs and symptoms of STIs.  If you notice a symptom that worries you, get it checked.
• Be checked for STIs every time you have a health exam.  This is very important since many people are infected but have no signs of an STI.  If you or your partner has more than one partner, you may need an STI checkup every six months, or after an act of unprotected sex that may have caused an STI.
• Get a Hepatitis B immunization.  The vaccine is safe and effective.  Hepatitis B is a serious and sometimes fatal disease.  A series of three vaccinations is required to obtain protection.
• Request that your sexual partner(s) be tested for STIs before you engage in sexual activities with them!  Screening tests for STIs usually include tests for chlamydia, gonorrhea, syphilis, hepatitis B and HIV. If a partner was infected with one of these infections recently, the tests may be negative.
• There is no routine screening test for human papilloma virus (HPV) or genital herpes.  The diagnosis for warts is made by visual check or biopsy.  Testing for active herpes is done on a sample taken from an open sore. A blood test to screen for herpes simplex type 2 can sometimes assist the clinician in diagnosing herpes in individuals who have unexplained genital ulcers. Routine blood screening for herpes is not indicated in low risk populations (those without a history of genital ulcers).

WHAT TO DO
It's normal to feel guilty, ashamed or embarrassed if you think you have an STI.  But if you do have these feelings, don't let them prevent you from getting tested.

HOW CAN I TALK TO MY PARTNER ABOUT STIs?

Before I become infected:
The key to prevention is to limit your risk.  It can be difficult to bring up the topic with a prospective sexual partner.  Keep in mind that if your partner cares about you and you about him/her, you will want to keep each other safe from any diseases.  Below are some tips to help communication before you have sex.

• Think about how you will bring up condom use with your sexual partners. Develop statements that you feel comfortable with to introduce the topic.
• Bring up the topic of sex, sexual histories and STI testing outside of the bedroom - during dinner, on a walk, etc.  This helps both you and your partner stay focused and not get lost in the moment of passion.
• Suggest that BOTH of you get tested for STI's, including HIV.  Remember, being tested does not mean you are worried that either you or your partner is infected. Make testing something you do together, for each other.
• Let each dimension of your relationship develop at the same pace.  Allowing the intellectual, mental, spiritual and emotional aspects grow, along with the physical, usually results in more open communication, healthier relationships and increased levels of trust because you and your partner have gotten to know each other better. Many people find that allowing a relationship to develop in this way makes sex better!

After I am diagnosed with an STI
It can be scary and shocking to be diagnosed with an STI, especially if it is viral and not curable (like herpes or HPV).  However, many couples face these diagnoses together and learn ways to enjoy a fully satisfying sexual life.  If you're not currently in a relationship, you can still enjoy dating and sexual activities with a new partner, as long as precautions are taken to reduce the likelihood of transmission.

• Tell your partner you have been diagnosed.  It may be recommended that he or she get tested also.
• Discuss the information you have received from your health care provider with your partner - he or she will have questions too.  Seek more information (books, videos, Web sites), if needed.
• Remember that your partner may feel angry and defensive and have the same questions and thoughts you do.  Allow your partner time to absorb the information and to process their reactions.  In order to work through a diagnosis, repeated discussions may be necessary, as trust needs to be rebuilt into the relationship (if you decide to stay in the relationship).
• Make an appointment together to talk with a counselor or the sexual health educator at McKinley to discuss ways to alter your sex life to decrease possible exposure, or for tips on how to talk to your partner.
• People with STIs often feel angry and isolated. Keeping those feelings inside can do more harm than good.  Consider sharing your feelings with someone you trust: a friend, family member or counselor.  Remember you're not alone.

Most bacterial STIs are treated with a high dose of antibiotics.  It is important to do exactly what your provider recommends, and be sure to use all of your medicine.  You should also consider telling your past and present sexual partner(s).  If they aren't treated, they can spread the STI - they can even give it to you again.  Ask your provider when you can resume sexual activity.

WHERE TO GO

• McKinley Health Center: To make an appointment for a medical evaluation call: McKinley Health Center/Dial-A-Nurse 333-2700
• If you have questions or concerns about STIs or other sexuality issues, call: Sexual Health Educator (Health Education Unit) 333-2714
• If you would like information on the Hepatitis B vaccine, call: Immunization and Travel Clinic 333-2702
• If you want to get condoms and spermicide, visit either of these locations or call:
  -  Health Resource Center, McKinley – Main Lobby – Information/HRC Counter 333-6000
  -  Health Resource Center, Illini Union, Room 40 at the OASIS (lower level) 244-5994

OTHER RESOURCES

• STD/STI Hotline 1-800-227-8922
• National AIDS Hotline 1-800-342-AIDS
• C-U Public Health District STD/STI Clinic 352-7961
• Planned Parenthood 359-8022

BACTERIAL STIs (CURABLE)

STI - Chlamydia Diagnosis: Men - Urethral swab or urine specimen/Women - Vaginal/cervical swab or urine specimen. When to be tested: 2-3 weeks after exposure
What to watch for:	Symptoms may appear 7-21 days after infection. Many women and some men have no symptoms. Women Unusual discharge from the vagina. Bleeding from the vagina between periods. Burning or pain when you urinate. Pain in abdomen, sometimes fever and nausea. Men Watery or white discharge from the penis. Burning or pain when you urinate. Pain or swelling in the testicles.
How do you get this STI?	Vaginal, anal and sometimes oral sex with someone who has chlamydia.
What can happen?	Can be cured if tested and treated. YOU CAN GIVE CHLAMYDIA TO YOUR SEXUAL PARTNER(S). Can lead to a more serious infection. Reproductive organs can be damaged. Fertility may be affected for both men and women. May be transmitted to newborn during childbirth.

 

STI - Gonorrhea Diagnosis: Men - Urethral, oral or anal swab or urine specimen/Women - Cervical, oral or anal swab or urine specimen. When to be tested: 2-3 weeks after exposure
What to watch for:	Symptoms may appear 7-21 days after infection. Many women and some men have no symptoms. Women Unusual discharge from the vagina. Bleeding from the vagina between periods. Burning or pain when you urinate. Pain in the abdomen, sometimes fever and nausea. Men Watery or white discharge from the penis. Burning or pain when you urinate. Pain or swelling in the testicles.
How do you get this STI?	Vaginal, oral or anal sex with someone who has gonorrhea.
What can happen?	Can be cured if tested and treated; drug resistant cases are growing nationwide. YOU CAN GIVE GONORRHEA TO YOUR SEXUAL PARTNER(S). Can lead to more serious infection. Reproductive organs can be damaged. Fertility may be affected for both men and women. May be transmitted to newborn during childbirth.

 

STI - Syphilis Diagnosis: Men - Blood draw/Women - Blood draw When to be tested: 12 weeks (3 months) after exposure
What to watch for:	1st Stage Symptoms usually appear 1-2 weeks after infection. A painless, reddish-brown sore/chancre on the mouth or genitals. Chancre lasts 1-5 weeks. Chancre heals. 2nd Stage Symptoms usually appear 2-6 weeks after chancre disappears. A rash appears on the body. Flu-like feelings. Rash and flu-like feelings go away, but you still have syphilis.
How do you get this STI?	Vaginal, oral or anal sex with someone who has syphilis.
What can happen?	Can be cured if tested and treated. YOU CAN GIVE SYPHILIS TO YOUR SEXUAL PARTNER(S). A pregnant woman with syphilis can pass it to her baby (in the uterus). Can cause heart disease, brain damage, blindness and death if left untreated.

 

STI - NGU - Men - (Nongonococcal or nonspecific Urethritis, NSU) Women - Cervicitis Diagnosis: Non specific diagnosis - Men - Urethral swab or urine sample/Women - Cervical swab When to be tested: 2-3 weeks after exposure
What to watch for:	Symptoms usually appear 7-21 days after infection. Most women and some men have no symptoms. Discharge or burning in the vagina. Burning or pain when you urinate. Yellow or white discharge from the penis.
How do you get this STI?	Vaginal or anal sex with someone who has a NGU infection.
What can happen?	Can be cured if tested and treated. YOU CAN GIVE NGU INFECTIONS TO YOUR SEXUAL PARTNER(S). Can lead to more serious infection. Reproductive organs can be damaged. Fertility may be affected for both men and women, if left untreated. A woman with NGU infection can give it to her baby during childbirth.

 

STI - Trichomoniasis (Trich) Diagnosis: Men - Urine test/Women - Vaginal swab When to be tested: 2-3 weeks after exposure
What to watch for:	Symptoms usually appear 4-20 days after infection. Some women and most men have no symptoms. Women Heavy, yellow or grey discharge from the vagina. Itching and swelling around the genitals. Men Thin, white discharge from the penis. Burning or pain when you urinate.
How do you get this STI?	Vaginal sex with someone who has trichomoniasis. Sometimes passed by sharing moist objects - such as towels, washcloths, bathing suits and sex toys.
What can happen?	Can be cured if tested and treated. YOU CAN GIVE TRICHOMONIASIS TO YOUR SEXUAL PARTNER(S). Uncomfortable symptoms will continue.

VIRAL STI'S (TREATABLE, NOT CURABLE)

STI - Genital Herpes Diagnosis: Made by taking a swab sample from active sores/lesions. Blood tests may assist diagnosis in patients with history of unexplained ulcerative disease. When to be tested: When sores are present. Blood test when sores are not present, at least eight weeks post-exposure. When not to be tested: Positive predictive value of blood test reduced in low risk populations (those without a history of genital ulcers).
What to watch for:	Symptoms usually appear 2-30 days after infection with the virus. Some people have mild or no symptoms. Flu-like symptoms. Small, painful blisters on the genitals (or mouth). Itching or burning before blisters appear.
How do you get this STI?	Vaginal, oral or anal sex - or skin to skin contact with someone who has herpes. Oral herpes can be transmitted to the genitals during oral sex. Asymptomatic transmission can occur (when no blisters are visible).
What can happen?	YOU CAN GIVE HERPES TO YOUR SEXUAL PARTNER(S). Herpes symptoms can be treated, but an infected person will always have the virus. May be transmitted to newborn during childbirth.

 

STI - Hepatitis B Diagnosis: Men and Women - blood draw When to be tested: 12 weeks after exposure (three months)
What to watch for:	Symptoms usually appear 2-6 months after infection. Fatigue and weakness. Anorexia (loss of appetite). Jaundice and darkened urine. Fever and abdominal pain. Majority of those infected have no symptoms.
How do you get this STI?	Vaginal, oral or anal sex with someone who has the virus (it is 100 times more infectious than HIV). Sharing needles (to inject drugs) with someone who is infected. Close, frequent contact with infected blood, semen, vaginal secretions, saliva or someone with whom you share a needle.
What can happen?	YOU CAN GIVE HEPATITIS B TO YOUR SEXUAL PARTNER(S). You can develop a lifelong infection (carrier state), chronic liver disease or hepatoma (liver cancer). You can infect future children if you become a carrier. Vaccination can prevent Hepatitis B.

 

STI - HPV (Human Papilloma Virus, Genital Warts) Diagnosis: Men - visual exam/Women - Visual exam; sometimes detected on pap smear. When to be tested: 12 weeks after exposure (three months)
What to watch for:	This is the most common STI in college populations! Symptoms usually appear within 3-6 months after infection with the virus. In some cases, symptoms may not appear for years. Small, bumpy growths on the genitals and anus. Most warts do not go away without treatment. Itching and burning around the genitals.
How do you get this STI?	Vaginal, oral or anal sex or skin to skin contact with someone who has the virus. Asymptomatic transmission (no visible warts) can occur.
What can happen?	Vaccination is available to prevent the most serious strains of HPV. YOU CAN GIVE HPV TO YOUR SEXUAL PARTNER(S). Viral load in young healthy individuals can be cleared to non-detectable levels in an average of 8-24 months. More warts may appear; transmission is possible without visible lesions/warts. May lead to abnormal Pap smear (for women).

 

STI - HIV/AIDS Diagnosis: Men and Women - Blood draw When to be tested: 12 weeks after exposure (three months)
What to watch for:	Symptoms appear several months to several years after infection with the virus. Unexplained weight loss. Persistent diarrhea. Swollen lymph glands. Purple bumps on the skin and inside the mouth, nose and rectum. Recurrent yeast infections.
How do you get this STI?	Vaginal, anal and possibly oral sex with someone who is infected with the virus. Sharing needles (to inject drugs) with someone who is infected with the virus.
What can happen?	YOU CAN GIVE HIV TO YOUR SEXUAL PARTNER(S) OR SOMEONE WITH WHOM YOU SHARE A NEEDLE. HIV cannot be cured. Most people die from a disease linked to HIV infection. A pregnant woman can pass the virus to her baby.

Remember: you can be infected without symptoms if you have been exposed to an STI.

Symptoms should be taken seriously. Even if symptoms "go away" on their own, you may still be infected.

Source
Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. MMWR 2002; 51 (No. RR-6)

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