Recently, I have been having quite a few conversations with people about how various STIs are transmitted. Consequently, I have become interested in discordant partners, meaning partners who have different statuses (e.g. one is HIV positive and the other is not). Now, I am a believer in being risk-aware. Life is all about taking risks. If someone is aware of all the risks in a given situation and makes an educated decision as a result, I have nothing but respect for the person, regardless of the decision made. That all being said, this STI 101 post will place a bit more emphasis on how to avoid contracting and spreading an STI in a situation where partners have differing statuses.
The STIs I will discuss in this post are chlamydia, gonorrhea, hepatitis B, herpes, human papillomavirus (HPV) and syphilis. If you are looking for HIV, here is my HIV 101 post. For each STI, I will discuss what is it, how it is transmitted, symptoms, basic testing information, treatment and how to protect yourself and/or how to not spread it to your partners.
Note: Similar to my HIV 101 post, I will not cite my sources throughout my post. I will link my sources at the end.
Chlamydia is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis.
Transmission
Chlamydia is mainly transmitted through vaginal and anal sex. It can also be transmitted from a pregnant mother to her child during birth. The child is most likely to be exposed to chlamydia if the mother contracts it during her pregnancy. Although rare, chlamydia can also be transmitted through oral sex and by touching your eye with your hand that has the bacteria on it. It is estimated that about 2.8 million new infections occur every year. Apparently, people under the age of 25 are the most susceptible to contracting chlamydia.
Symptoms
Most people who contract chlamydia will not experience symptoms. When someone does experience symptoms, they will usually appear about five to ten days after they contracted the STI. Some common symptoms are: abdominal pain, bleeding between periods, abnormal discharge coming from the genitals, painful urination, and genital and anal swelling. If chlamydia has infected the throat, the individual may experience a sore throat and if it has infected the eyes, the individual may experience eye redness, itching and fluid discharge.
If chlamydia is not treated for a long period of time, it can cause pelvic inflammatory disease (PID), which infects the fallopian tubes, ovaries and uterus, and epididymitis, which infects the urethra and testicles. Both of these diseases can lead to infertility.
Testing
A health care provider can determine whether or not someone has chlamydia by taking cell samples from the cervix (Pap Smear), penis, urethra or anus. Also urine can be tested.
Since most people who have chlamydia will not experience symptoms, the only certain way to know if one has contracted chlamydia is to get tested regularly.
Treatment
Chlamydia is treated with antibiotics. If someone has contracted chlamydia, their sex partners should be tested and subsequently treated if they also have chlamydia. Individuals should not have sex (all forms of sex. Yes, oral counts.) until 7 days have passed if they took a single dose antibiotic or after they have finished taking their 7-day course of antibiotics. This is important because not having sex for 7 days will prevent the spread of the STI. Also the CDC (Center for Disease Control) recommends that people should be retested three months after they were treated just to be on the safe side.
Ok, so about sex…
Since chlamydia is mainly spread through unprotected sex, one should use condoms and dental dams to protect oneself from potential infection. I would also suggest using gloves while engaging in manual stimulation (i.e. fingering the vagina and/or anus) to avoid a situation in which a person could infect their eyes by touching it with a potentially contaminated hand.
Gonorrhea
What is it?
Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It is also known as “the clap” or “the drip”.
Transmission
Gonorrhea is transmitted though oral, vaginal and anal sex. Gonorrhea can also be passed from a pregnant woman to her child during childbirth. It is estimated that over 700,000 people become infected with gonorrhea every year.
Symptoms
Like chlamydia, individuals with gonorrhea usually do not experience symptoms. If someone does experience symptoms, they tend to occur one to fourteen days after the initial infection. Some common symptoms include: abdominal pain, bleeding between periods, painful urination, abnormal pain, genital discharge, urinating more than usual, anal discharge and genital swelling. If the throat is infected, one can experience an itchy, sore throat or trouble swallowing.
If a child contracts gonorrhea through the pregnant mother, it can lead to premature birth, stillbirth and infections of the blood, joints and eyes.
If gonorrhea remains untreated it can also cause pelvic inflammatory disease and epididymitis.
Testing
To test for gonorrhea, a health care provider could collect samples of abnormal discharges, cell samples from the cervix, penis, urethra, anus or throat and urine.
Treatment
Gonorrhea can be treated with antibiotics. However, recently, drug-resistant strains are evolving around the world, making treating gonorrhea very difficult. The CDC recommends treating gonorrhea with dual therapy with the use of two drugs to treat the infection. Please make sure to take all the prescribed antibiotics to ensure the infection is gone. Not sticking with the antibiotic regimen for the entire period of time can create more drug-resistant strains.
Ok, so about sex…
Since gonorrhea is spread through unprotected sex, one should use condoms and dental dams to protect themselves.
Hepatitis B
What is it?
Hepatitis is an infection of the liver.
Transmission
The type of hepatitis virus that is most likely to be sexually transmitted is hepatitis B (HBV). HBV is transmitted through vaginal fluids, semen (cum and precum), blood and urine. Infected fluids must come in contact with cuts and tears in the skin and/or through mucous membranes, like the ones in the vagina, anus and mouth. HBV can be spread through unprotected oral, vaginal and anal sex. The friction created in unprotected vaginal and anal sex can cause the canals to tear, giving the virus a way to enter the body. HBV can also be passed from pregnant woman to her child during birth.
HBV can also be spread by sharing intravenous drug needles or using contaminated needles in piercing or tattooing.
Symptoms
Individuals who contract HBV usually do not experience symptoms. When someone does experience symptoms, they usually appear between six weeks and six months after the initial infection. Some common symptoms include: extreme tiredness, abdominal pain/tenderness, loss of appetite, nausea, joint pain, headaches, fever, hives, dark urine, and jaundice.
Testing
A health care provider can conduct a blood test in order to diagnose someone with HBV.
Treatment
A cure for hepatitis does not exist. In most cases, hepatitis B goes away on it’s own in four to eight weeks. However, in some cases, people become carriers and suffer from chronic HBV infection. Carriers can be contagious for the rest of their lives. There are drugs that can help treat chronic HBV, but again, a cure does not exist.
The HBV vaccine is given to prevent an infection, not to cure an already existing one. The vaccine causes the immune system to create antibodies that will fight off the virus.
Ok, so about sex…
One can protect themselves by using condoms and dental dams while having vaginal, anal and oral sex.
Herpes
What is it?
Herpes is an STI caused by two viruses: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Both types can infect the oral and genital areas. However, oral herpes is mostly caused by HSV-1 and genital herpes is mostly caused by HSV-2.
Eight out of ten people in the US have oral herpes and one out of four have genital herpes.
Transmission
Herpes can be spread by touching, kissing and vaginal, anal and oral sex. A pregnant woman can pass herpes to her child during birth. Herpes is the most contagious while the individual has open sores. Cuts in the mouth, cuts in the skin and internal tears due to unprotected sex can make a person more susceptible to contracting herpes.
Symptoms
In many cases, someone with herpes may not experience symptoms for years. Or the symptoms can be so mild that they are not noticed or are not taken seriously.
With oral herpes, cold sores can appear on the lips/mouth and can last for a few weeks and then disappear. Symptoms can reappear weeks, months, or years later. Recurring outbreaks could be caused by: stress, menstruation, other infections, sunburn, sex and skin irritation.
With genital herpes, some symptoms include: clusters of sores on the vagina, cervix, vulva, penis or anus, itching and genital swelling. No one is sure what causes recurring outbreaks in genital herpes.
Initial herpes outbreak symptoms can also include: fever, headache, chills and flu-like symptoms.
Initial symptoms usually go away after two to four weeks and recurring symptoms usually go away after ten to fourteen days.
Testing
A health care provider can conduct a blood test to determine whether or not someone has contracted herpes.
Treatment
A cure for herpes does not exist. However, there are antiviral medications that can suppress recurrent outbreaks while the person takes the medication. Daily suppressive therapy for those who experience symptoms is available in order to reduce the likelihood of transmission to partners.
Ok, so about sex…
During an outbreak, an individual should refrain from having sex and/or kissing (oral herpes). However, it should be noted that even when symptoms are not present, a person could still potentially spread herpes with unprotected sex. Wait until seven days have passed and the outbreak has fully ended before having sex again.
Condoms and dental dams reduce the risk of transmission, but not completely. Contact with sores or fluids, not completely covered by condoms and dental dams, can transmit the virus.
If you are having sex with someone who has herpes, be sure to get tested regularly.
Human Papillomavirus
What is it?
There are over one hundred types of human papillomavirus (HPV). Forty of those can infect the genital area. Genital HPV is very common. Many people have had HPV at one point and many do not know currently they have it.
Transmission
Genital HPV is transmitted through skin-to-skin contact during vaginal, anal and oral sex.
Symptoms
Most people who contract HPV do not experience symptoms.
In many cases, the immune system clears up the virus on its own and the infection will disappear in eight to thirteen months.
However, in the cases, in which the body does not successfully fight off the virus completely, it can cause the body to change. These changes include genital warts and cancer. The strains of HPV that cause genital warts are considered low-risk. High-risk strains of genital herpes can cause cervical, vaginal, anal, penile and throat cancer.
Testing
A common way for someone to find out they have HPV is after receiving abnormal test results from a pap smear. During a pap smear, cell samples are taken from the cervix and tested for abnormalities. Other than a pap smear, there are no other tests for HPV.
Treatment
There is no cure for HPV itself. However, there are treatments for the genital warts and cancers that HPV causes. It is best to diagnose and treat a HPV-related cancer early while it is easily treatable.
There are two vaccines (Cervarix and Gardasil) that help to protect against the strains of HPV that are most responsible for causing cervical cancer. Gardasil also helps to protect against genital warts and other types of HPV-related cancers. Both vaccines are recommended by the CDC to young women between the ages of 11 and 26. Recently, the CDC has recommended that Gardasil should be made available to young men between the ages of 11 and 21. Gardasil is licensed for young men between the ages of 9 and 26.
Ok, so about sex…
Use condoms and dental dams to lower the chances of HPV infection. Barriers (condoms and dental dams) do not completely protect against HPV, but they are much safer than unprotected sex.
Syphilis
What is it?
Syphilis is an STI caused by the bacterium Treponema pallidum.
Transmission
Syphilis is transmitted by contact with open syphilis sores. Contact can happen during vaginal, anal and oral sex. Rarely, syphilis can be spread through kissing if there are sores on the person’s mouth. It can infect the vagina, anus, urethra, penis, lips and mouth. About 36,000 people in the US contract syphilis each year.
Symptoms
Most of the time, a person who has contracted syphilis will either not experience symptoms or the symptoms will be so mild that the person would not really pay attention to them.
There are three stages of syphilis infection:
- Primary Stage – In this stage, painless open sores (known as chancres) appear on the genitals, in the vagina, on the cervix, lips, mouth, breasts, or anus. The sores usually appear about three weeks after infection, but may take up to 90 days. Without treatment, they last 3–6 weeks. Syphilis is especially contagious when sores are present. The liquid that oozes from them is very infectious.
- Secondary Stage – After three to six weeks, other symptoms may appear. These symptoms can disappear and reappear repeatedly for up to two years. These symptoms include: body rashes, mild fever, fatigue, sore throat, hair and weight loss, swollen glands, headache, and muscle pains.
- Late Stage – Long-term untreated syphilis can cause serious damage to the nervous system, heart, brain and other organs and even death.
Syphilis is not usually contagious during the latent stages (hiding period) in the first four years. Untreated syphilis can remain latent for many years or a lifetime. It can still be transmitted from a pregnant woman to her child.
Testing
Like many other STIs, a person who has syphilis will not usually experience symptoms. Regular STI testing will ensure that a syphilis infection is caught early and treated.
Treatment
Syphilis is treated with antibiotics and, in the early stages, syphilis is very easy to treat. Although syphilis is easy to treat, the effects of long-term untreated syphilis are not. A health care provider will test blood or fluid from sores to diagnose someone with syphilis.
Ok, so about sex…
Using condoms and dental dams will reduce the risk of contracting/spreading syphilis.
If there is anything you would like to see added or removed from this post, please let me know (along with the reasons for your request, of course).
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