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UNIVERSITY STUDENT HEALTH SERVICES • Fact Sheet SEXUALLY TRANSMITTED INFECTIONS (STIs) Sexually Transmitted Infections Sexually transmitted infections (STIs) are infections that are passed through sexual contact. Bacteria or viruses can cause infections of the skin, bloodstream, or any orifice of the body where intimate sexual contact has occurred (such as the urethra, vagina, penis, anus, or mouth). The term “STI” is more accurate than “STD” (sexually transmitted disease) since many are curable infections. The term “STI” also avoids the stigma associated with the word “disease.” Some STIs can cause serious infections and permanent damage, while others are not necessarily harmful but annoying and uncomfortable. Any person who is sexually active or is thinking about having sex should be familiar with the symptoms and prevention of these infections. By avoiding risky sexual behavior, seeing your health care provider regularly, and paying attention to signs and signals from your body, many STIs can be avoided or diagnosed early and treated. Facts In most cases, once you have an STI, you do NOT develop immunity. This means that you can be reinfected. There are some STIs that cannot be cured, such as those caused by viruses. These infections often lay dormant in the body but can resurface at any time. You can have more than one infection at a time. In fact, two diseases, gonorrhea and chlamydia, often occur together. Lack of Symptoms Some STIs show few or no symptoms, so an infected person does not know that he or she has it. • 75% of people with chlamydia have no symptoms. • 80% of women and 40% of men with gonorrhea have no symptoms. • Up to 80-90% of women and 99% of men with trichomonas have no symptoms. This is why it is very important to practice safe sex, have regular check-ups, and tell your partner(s) if you have a positive diagnosis. Prevention Remember, if you have sex with more than one partner or if your partner has other partners, then you run a high risk of catching an STI. Listed below are actions you can take to lower your risk of getting an infection: • Limit sexual activity to one partner who only has sex with you. • Always use a latex barrier (eg. condom, dental dam, finger cot) to protect against infection. • • • • • Many brands of condoms contain the spermicide nonoxynol-9. While very effective against pregnancy, frequent use of nonoxynol-9 containing products has been associated with an increased risk of developing genital irritation, which, in turn, may increase the risk of HIV transmission. The CDC does not recommend the use of nonoxynol-9 containing products during anal penetration. Know your status, and talk to your partner about his or her status. Get regular STI screens. Get vaccinated against Hepatitis B. This threepart vaccine is available at Student Health. Also consider vaccination with Gardasil or Cervarix to prevent against infection by certain strains of the HPV virus. These vaccines are also available at Student Health. Treatment Reminders If you are diagnosed with an STI, it is extremely important to: • Take your medication exactly as prescribed. Finish the entire treatment course even if you feel better. • Inform your partner(s) that he or she needs to be tested and treated. • Refrain from sexual activity for at least one week after both you and your partner(s) have completed treatment. Recommended Resources • American Social Health Association STI Resource Center Hotline, 1-919-361-8488, 8am - 8pm EST, Mon. - Fri. www.ashastd.org • CDC National STD Hotline, 1-800-232-4636, available 24/7. www.cdc.gov/std Where to Go For Treatment • University Student Health Services (if you are a student) o Monroe Park Campus 1300 W. Broad St., Suite 2200 (804) 828-8828 o MCV Campus rd 1000 E. Marshall St., 3 Floor (804) 828-9220 • Fan Free Clinic 1010 N. Thompson St. (804) 358-8538 • Planned Parenthood 201 N. Hamilton St. (804) 355-4358 • Richmond City Health Department 400 E. Cary St. (804) 482-5500 or (804) 205-3500 • Private Physicians ■ CHLAMYDIA ■ HEPATITIS B (continued) Cause: Chlamydia trachomatis (bacteria). Statistics: Over 1.3 million cases reported in the US in 2010, but estimates are higher. Transmission: Contact with the penis, vagina, mouth, or anus by bacteria that live in mucous membrane surfaces. Incubation Period: 1-3 weeks. Symptoms: Male: Discharge from the penis, burning with urination, and inguinal lymph node swelling. 30% without symptoms. Female: Vaginal discharge, irregular bleeding, bleeding after intercourse, abdominal pain, fever, and low back pain. Up to 75% without symptoms. Diagnosis: Urethral/cervical swab or urine sample. Treatment: Antibiotics cure the infection. Complications: May increase risk of HIV infection. Male: Epididymitis. Female: PID (pelvic inflammatory disease) which can lead to sterility and ectopic pregnancies. Babies: Eye infection or pneumonia if mother is infected during vaginal delivery. Untreated infections in the mother may lead to premature delivery. Symptoms: Typically undetectable. May mimic the flu (decreased appetite, fatigue) and include nausea, vomiting, dark urine, rash, arthritis, and yellow skin (jaundice). Diagnosis: Blood tests. Treatment: Evaluation by a liver specialist for medication options and/or liver transplant. Complications: Liver failure, death. ■ GONORRHEA Cause: Neisseria gonorrhea (bacteria). Statistics: 309,341 cases reported in the US in 2010, though estimates are much higher. Transmission: Contact with the penis, vagina, mouth, or anus. Incubation Period: 2-10 days (may vary). Symptoms: Male: Discharge from the penis and/or burning with urination. 40-60% without symptoms. Female: Vaginal discharge, pain with urination, irregular bleeding, and abdominal pain. 80% without symptoms. Diagnosis: Urethral/cervical swab or urine sample. Treatment: Antibiotics cure the infection. Complications: Increased risk of HIV infection. Male: Epididymitis, blood infection, and joint infections. Female: PID (pelvic inflammatory disease) which can lead to sterility and ectopic pregnancies. Blood and joint infections. Babies: Eye infection, blindness, joint infection, or life-threatening blood infection if mother is infected during vaginal delivery. ■ HEPATITIS B (Three-part vaccine available for prevention) 100% more infectious than HIV Cause: Hepatitis B virus. Statistics: 38,000 new cases estimated in the US in 2009. Transmission: Contact with blood and sexual fluids. 2/3 of cases transmitted sexually. Also transmitted through blood transfusions, needle-sharing, organ transplantation, tattoos, piercing, and childbirth. No recorded transmission through tears, urine, feces, breast milk, or cerebral spinal fluid. Incubation Period: 2-5 months (average of 90 days). ■ GENITAL HERPES (HSV) Cause: Herpes Simplex virus (HSV), types 1 and 2. Statistics: 16.2% or about one out of six people ages 14-49 have genital HSV-2 infection. Transmission: Genital-to-genital contact or oral-togenital contact (even if there are no visible sores). Incubation Period: 2-20 days or up to years later. Symptoms: Bumps that develop into painful blisters, followed by ulcers and crusting. May be preceded by burning or itching. 80% of infected people are unaware of infection. Recurrent episodes tend to be milder and shorter in length. Diagnosis: Viral culture of lesion. Treatment: Antiviral medications can lessen symptoms, reduce number of future outbreaks, and reduce viral shedding. There is no cure. Complications: Increased risk of HIV infection and transmission. Babies: Can be transmitted to infants if lesions are present during vaginal birth. Infection can cause serious problems that affect the eyes, skin, and brain of the newborn. ■ HUMAN IMMUNODEFICIENCY VIRUS (HIV) Cause: Human Immunodeficiency Virus. Statistics: Estimated 1.2 million people living with HIV in the US, with approximately 50,000 new cases each year. Transmission: Contact with blood and sexual fluids. Also through needle-sharing, childbirth, and breastfeeding. Incubation Period: 25-90 days (rarely up to 6 months). Symptoms: Typically not present but can mimic viral illnesses (fatigue, fever, etc.). Diagnosis: Standard Blood Test: Results take up to 1 week. Rapid Test: Results available in less than 30 minutes. Home Test: FDA-approved and anonymous. Treatment: Antiviral medications. Complications: If treated, many patients will live long, healthy lives. If untreated, half of those infected with HIV will develop AIDS in 10 years. ■ GENITAL HPV (Gardasil and Cervarix vaccines available for prevention) Cause: Human papillomavirus (HPV). Over 40 types affect the genital area. “Low-risk” types cause genital warts. “High-risk” types can cause cervical cancer. Statistics: About 20 million (15%) infected in the US, with 6 million new cases each year. ■ GENITAL HPV (continued) ■ SYPHILIS Transmission: Penile-to-vaginal, penile-to-anal, oral-togenital, and genital-to-genital contact. Hands can serve as a vector, but the virus is site specific. Incubation Period: 1-8 months (up to years). Symptoms: Genital warts: Visible painless bumps on the penis, vulva, and/or anus (often undetectable). Cervical cancer: No symptoms until the cancer is advanced. Regular Pap smears are recommended for cancer screening. Diagnosis: Genital warts: Visual inspection. Cervical cancer: Early pre-cancerous changes and cancer can be detected by Pap smears. DNA typing of HPV is available with Thin Prep Pap. Treatment: Genital warts: Self-applied treatment with podofilox and office-applied cryotherapy (application of chemical treatment). Cervical cancer: Referral to specialist for further evaluation and treatment. Complications: from “high-risk” HPV types Female: Cervical cancer. Vulvar and anal cancers are much less common. Male: Penile, anal, and other male genital cancers are uncommon. Cause: Treponema pallidum (bacteria). Statistics: 13,774 cases of primary and secondary syphilis reported in 2010 (1.6% decrease from 2009). Transmission: Contact with a syphilis sore (known as a chancre) during vaginal, anal, or oral sex. Incubation Period: 10-90 days (average 17-21 days). Symptoms: Primary: A painless sore (chancre) on the external genitalia, anus, rectum, vagina, mouth, or lips. Secondary: Rash, mucous membrane lesions, hair loss, swollen lymph nodes, and flu-like symptoms. Latent: No symptoms. Tertiary: Organ destruction (including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints). Diagnosis: Microscopic evaluation from chancre material. Blood tests. Treatment: Antibiotics kill the syphilis bacteria but will not repair any damage already done in later stages of disease. Complications: Increased risk of HIV infection and transmission. Tertiary: Difficulty coordinating muscle movements, paralysis, numbness, blindness, dementia, and death. Babies: Developmental delay, seizures, and death. ■ PUBIC LICE (CRABS) Cause: Pubic lice (small wingless insect). Transmission: Skin-to-skin contact (rarely from exposure to surfaces, such as toilet seats). Incubation Period: Up to 1 month. Symptoms: Itching or rash in the pubic area. Diagnosis: Visible lice and nits (small whitish-grey eggs) attached to hair shafts. Treatment: Lice-killing shampoos. Washing clothes and linens in hot water. Complications: None. ■ MOLLUSCUM CONTAGIOSUM Cause: Pox virus which affects the skin. Transmission: Skin-to-skin contact, contact with inanimate objects (eg, towels, clothing, or razors), and autoinoculation (touching lesions on yourself and then another part of your body). Incubation Period: 1 week - 6 months (usually 2-6 weeks). Symptoms: Small, painless bumps typically with an umbilicated center. Sometimes itchy and tender. Diagnosis: Visual inspection. Treatment: Office-applied cryotherapy (application of chemical treatment). Usually clears on its own within several months but can persist a few years in a minority of untreated cases. Complications: Extensive disease in some HIV positive patients. ■ TRICHOMONAS Cause: Trichomonas vaginalis (protozoa). Statistics: Estimated 3.7 million people infected in the US. Transmission: Penis-to-vagina or vulva-to-vulva contact. Rarely through wet bathing suits and towels. Incubation Period: 5-28 days. Symptoms: Female: Vaginal burning/itching, discharge, and pain with intercourse. 80-90% without symptoms. Male: 99% without symptoms. Diagnosis: Microscopic evaluation of discharge. Treatment: Antibiotics cure the infection. Complications: Increased risk of HIV infection and transmission. Babies: Premature delivery, low birth weight. _____________________________________________________________________________________________ Published by VCU Division of Student Affairs and Enrollment Services University Student Health Services (804) 828-8828 - Monroe Park Campus clinic (804) 828-9220 - MCV Campus clinic Wellness Resource Center (804) 828-9355 - 815 S. Cathedral Place Revised 7/12