SAMPLE. How Are STDs Caught?

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2 Could You Have an STD? STD stands for sexually transmitted disease. This means the disease is spread during sex. (An STD can also be called STI for sexually transmitted infection.) If you have an STD, you re not alone. STDs are common, and serious. The good news is that STDs can be treated and many can be cured. Better yet, all STDs can be prevented. Read on to learn how you can protect yourself. How Are STDs Caught? You can catch an STD if you have sex with someone who has an STD. Any sex that involves the penis, vagina, anus, or mouth can spread disease. Some STDs spread through body fluids such as semen, vaginal fluid, or blood. Others spread through contact with affected skin. 2 This booklet is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem. 2003, 2007, 2011, 2013 Krames StayWell, LLC All rights reserved. Made in the USA.

3 Who Is At Risk? It doesn t matter if you re straight or gay, male or female, young or old. Any person who has sex can get an STD. Your risk increases if: partners you have, the greater your risk. ner is exposed to an STD, you could be, too. people in the past. Either of you might be carrying an STD from an earlier partner. or other health problems that increase your vulnerability to new infections. Your risk will stay high unless you change the behaviors that put you at risk of the current infection. EXIT Get Checked Now Are you at risk of an STD? If you think you may be, go to a clinic or to your doctor. Get checked. Don t delay! The sooner you seek treatment, the better your chances of avoiding major health problems. If you find you have an STD, be sure your partner gets treatment, too. If not, his or her health is at risk. And left untreated, your partner could pass the STD back to you, or on to others. Prevent Future Problems Left untreated, certain STDs can lead to cancer or even death. Some can harm unborn babies whose mothers are infected. Others can cause sterility (not being able to have children). You can prevent these problems with safer sex, regular checkups, and early treatment. Always use a latex condom when you have sex. Get tested if you re at risk. And get treated early if you have an STD. Talk with your healthcare provider about vaccines that are available to help prevent HPV and hepatitis A and B. 3

4 4 Choose the Right Condom Condoms made of latex prevent disease best. If you re allergic to latex, use polyurethane condoms instead. Male condoms fit over the penis. Female condoms line the vagina. Before buying a condom, read the label to be sure it prevents disease. Some novelty condoms don t. The Right Lubricant Helps Buy lubricated condoms or use lubricant. This provides greater comfort and reduces the risk of condom breakage. Use only water-based lubricants such as K-Y or Astroglide. Don t use oil, lotion, or petroleum jelly. They can weaken the condom, causing breakage. Also, you may want to choose lubricants without nonoxynol-9. It s now known that this spermicide does not prevent disease and may cause irritation. Playing It Safe When it comes to sex, nothing is risk-free. Any sexual contact with the penis, vagina, anus, or mouth can spread an STD. The only sure way to prevent STDs is abstinence (not having sex). But there are ways to make sex safer. Use a latex condom each time you have sex. And choose your partner wisely. Condoms only work if you use one each time you have sex. Use Condoms for Safer Sex If you have sex, latex condoms provide the best protection against STDs. Latex condoms stop the exchange of body fluids that carry certain STDs. They also limit contact with affected skin. Be aware though, a condom doesn t cover all skin. So affected skin that is not covered can still transfer disease. But you re safer with a condom than without one. Use a condom even if you use other birth control. While birth control methods like the pill or IUD help prevent pregnancy, they do not protect against STDs. Use Condoms Correctly For condoms to work, they must be used the right way. Keep these tips in mind. sex. Slip the condom on the penis before any contact is made. condom as the penis pulls out. This prevents the condom from slipping off. a condom. hot, such as a car or a wallet that is carried in a back pocket.

5 Talk openly with your partner before you decide to have sex. Stay in control of your decisions. Limit the amount of alcohol you drink. Get to Know Your Partner Safer sex begins well before the condom wrapper comes off. Safer sex is a process. It involves getting to know your partner and making informed choices. Ask each other how many partners you have had in the past, and how many you have now. Find out if either of you has an STD. If you decide to have sex, use a condom each time. Don t stop using condoms unless you re sure neither of you has other partners and you ve both been tested to confirm you don t have STDs. Then stay free of disease by having sex only with each other (monogamy). Keep Your Cool For safer sex to work, plan ahead and stick to your plan. Don t let alcohol or drugs cloud your judgment. They could lead you to have sex with someone you wouldn t have chosen if you were sober. Or, you might forget to use a condom. If you do plan to have sex, keep a latex condom with you. Don t wait until you re in the heat of passion to try to find one. Consider Abstinence The only way to be sure you won t get an STD is to abstain from sex. Abstinence is a choice that many people make at some point in their lives. Maybe you want to wait until you are sure you re ready before you have sex. Maybe you d like a break from the responsibilities of sex for a while. Or maybe you just want to know your partner better before taking the next step. Abstinence is a choice you can make now to protect your future. 5

6 6 Your History and Exam Getting Checked The only sure way to know if you have an STD is to get checked by a healthcare provider. If you notice a change in how your body looks or feels, have it checked out. But keep in mind, STDs don t always show symptoms. So if you re at risk of STDs, get checked regularly. Fallopian tube Uterus Cervix Prostate Urethra Testicle STDs can harm the reproductive organs, the rectum, and the mouth. Common Symptoms Be alert to any changes in your body and your partner s body. Symptoms may appear in or near the vagina, penis, rectum, mouth, or throat. They include: or painless or rectum Even If You Don t Have Symptoms You may have an STD, even if you don t have symptoms. If you think you are at risk, get checked. Go to a clinic or to your doctor. If your partner has an STD, you need to be tested too, even if you feel fine. You will be asked about your sex habits and health history. You may also be asked about drug use. Give honest answers. Your healthcare provider will then check your body for signs of STDs. He or she also may perform one or more of the following tests: also may be taken from the vagina, penis, mouth, or rectum. The samples are then tested for STDs. They are checked for viruses or bacteria that cause STDs. cervix (where the vagina and uterus meet) are checked for signs of cancer. This is called a Pap test. If cell changes are found, a magnifying scope may be used to take a closer look (colposcopy). Even if you have no STD symptoms, have a Pap test at age 21, and every 2 years after.

7 Follow Your Treatment Plan Treatment depends on the type of STD you have. Common treatments include injections and oral pills or liquids. Creams and gels can be applied to sores caused by certain STDs. Follow the tips below: STD. Use medications as directed. do so by your doctor or clinic. Getting Treated Treating STDs early limits the problems they can cause. If you have an STD, get treated right away. Ask your partner to be tested, too. Then avoid sex until you ve finished treatment and your healthcare provider says it s okay to have sex again. Ask your healthcare provider any questions you have about your treatment. Talk to Your Partner If you have an STD, it s your duty to tell all your recent partners so they can be tested and treated. This is one important way to prevent the disease from being spread. Telling a partner that you have an STD can be hard. You may be embarrassed, angry, or afraid. It s often unclear who had the STD first. So try not to place blame. Your healthcare provider may offer some advice on how to begin. Choose a quiet place to talk with your partner about STDs. Then focus on sharing information. Prevent Future Problems Even after you ve been treated, you can still be infected again. This is a common problem. It happens when a partner passes the STD back to you. To avoid this, your partner must be tested. He or she may also need treatment. After treatment, go to any scheduled follow-up visits. Then prevent future problems with safer sex. Limit your number of partners and always use a latex condom. 7

8 Chlamydia Chlamydia is a bacterial disease. It spreads when infected fluid from the sex organs or rectum contacts the penis, vagina, mouth, or anus. Chlamydia often shows no early symptoms. But over time, it can scar reproductive organs. Chlamydia can be cured. But any damage from scarring remains. Chlamydia often has no symptoms, so many people don t know they have it. PID (pelvic inflammatory disease) begins when bacteria infect the uterus and fallopian tubes. PID may have mild to severe symptoms, or none at all. Symptoms can include abdominal or low back pain, fever, nausea, pain during sex, and bleeding between periods. Scarring from PID can cause sterility. It can also cause tubal pregnancy (the baby begins to grow in a fallopian tube, where it can t survive). Resulting rupture and bleeding can put the mother s life at risk. Early Symptoms When chlamydia shows early symptoms, they can include discharge, burning with urination, or burning or itching around the sex organs. The rectum may be painful if the disease was caught through anal sex. Treatment and Prevention Chlamydia can be cured with antibiotics. Get treated early to limit lasting damage. Your partner must be treated too, even if no symptoms are present. Don t have sex until you have taken all your medication and your healthcare provider says it s okay. Then, practice safer sex. Always use a latex condom. And limit your number of partners. Left Untreated... Men: Chlamydia first attacks the urethra. The disease can then spread to the testicles and prostate. This can cause pain, swelling, and fever. With time, scarring occurs. Women: Infection begins in the cervix. It can spread to the uterus and fallopian tubes, causing PID and related problems. Left untreated, chlamydia can pass from a mother to her baby during birth. This can cause eye, lung, or other health problems in the baby. 8

9 Condoms help protect you from gonorrhea by preventing contact with infected body fluids. Gonorrhea Like chlamydia, gonorrhea is a bacterial disease. It spreads when infected fluid from the sex organs or rectum contacts the penis, vagina, mouth, or anus. Gonorrhea may not show early symptoms. But left untreated, the infection can scar reproductive organs. Gonorrhea can be cured. But any damage from scarring remains. Early Symptoms When present, early symptoms can include discharge, burning with urination, or burning or itching around the sex organs. The rectum may hurt if the disease was caught through anal sex. If the disease was caught through oral sex, a sore throat can result. Treatment and Prevention Gonorrhea can be cured with antibiotics. Early treatment limits lasting damage. Your partner must be treated too, even if he or she shows no symptoms. Don t have sex until you have finished taking your medications and your healthcare provider says it s okay. Then, practice safer sex. Limit your number of partners. And always use a latex condom. Left Untreated... Men: Gonorrhea first infects the urethra. It can then spread to the testicles and prostate. This causes pain, swelling, and scarring. Women: The disease first infects the cervix. It can then spread to the uterus and fallopian tubes, causing PID and related problems (see page 8). Left untreated, gonorrhea can pass from a mother to her baby during birth. This can cause blindness or infected blood and joints in the baby. Men and women: The disease can infect the blood, joints, and skin (disseminated gonorrhea). This can be serious and even life-threatening. 9

10 Signs and Symptoms Herpes Herpes is a virus that causes outbreaks of sores around the sex organs or mouth. It is spread through contact with affected skin during sex, kissing, or intimate touching. Herpes outbreaks tend to decrease over time. Although herpes can be treated, the virus stays in the body. When an outbreak occurs, painful blisters appear on or near the penis, vagina, rectum, or mouth. After a few days, the blisters break, leaving tender sores. The first outbreak may take weeks to clear. It may also cause fever and swollen glands. Later outbreaks don t cause these flu-like symptoms and tend to heal faster. Medications reduce herpes outbreaks and help speed healing. Blister Fluid inside the blister holds the herpes virus. Even after the blister heals, the virus remains in the body. Treatment and Prevention There is no cure for herpes. But medications can limit outbreaks and speed healing. To help sores heal faster, keep them clean and dry. And don t scratch them. To avoid spreading the virus, don t have sex during an outbreak in the sex organs. Also, don t kiss or have oral sex when you have a sore on your mouth. Even after sores heal, the herpes virus can still be spread. So always use a latex condom. These condoms help limit the spread of herpes by reducing skin contact. But keep in mind, herpes can still be passed through contact with affected skin that a condom doesn t cover. Left Untreated... The herpes virus can be passed from a mother to her baby during birth. This can happen if the mother has an outbreak in the sex organs near the time of delivery. In such a case, a surgical delivery (cesarean, also called C-section) may be performed to protect the baby. If you re pregnant, tell your healthcare provider if you or your partner has herpes. 10

11 Syphilis Syphilis is a bacterial disease. It spreads through contact with affected skin. Syphilis progresses in three stages. Symptoms and health complications become more severe with each stage. Syphilis can be cured. But certain types of damage caused by the disease cannot be reversed. Early Symptoms During the first stage of syphilis, a painless sore can appear. The sore may not be noticed, and will go away on its own. After the sore heals, the disease stays in the body. The effects of syphilis are often not seen or felt at first. But silent damage continues. Sore (chancre) The first stage of syphilis can produce a painless sore called a chancre. Syphilis is usually treated with an injection. antibiotic Treatment and Prevention Syphilis is most often treated with an antibiotic injection. Antibiotics clear the bacteria from the body. But they can t reverse complications, such as nerve damage, that are caused by the disease. Any complications must be treated, too. As with all STDs, don t have sex until you have finished treatment and your healthcare provider says it s okay. Then, practice safer sex. Limit your number of partners. And always use a latex condom. Left Untreated... Over time, syphilis progresses to the second stage. This stage can produce a rash on the body that can spread to the palms and feet. It can also cause swollen glands, fever, sore throat, and headache. Patchy hair loss, weight loss, or tiredness can also occur. If syphilis remains untreated, it enters the third stage. Damage to the brain, nerves, blood vessels, and heart may occur. This can lead to blindness and even death. In a pregnant woman, untreated syphilis at any stage can cause organ and brain damage to her unborn baby. 11

12 Signs HPV and Genital Warts HPV is a family of viruses that spread through skin contact. Some forms of HPV cause genital warts (also called condyloma). Other types put women at higher risk of cervical cancer. HPV can t be cured. But there are treatments to remove warts. There are also tests to help spot warning signs of cervical cancer. Warts are a sign of HPV. They can grow in, on, or near the penis, vagina, cervix, rectum, and throat. Warts may be bumpy or cauliflowershaped. Sometimes they are flat and hard to see. Some types of HPV never produce warts. Instead, these types cause abnormal cell changes in a woman s cervix. Pap tests help catch cell changes in the cervix (dysplasia) early, when treatment is most effective. Warts Warts caused by HPV can be domeshaped or have ridges. Some are flat and hard to see. Treatment and Prevention Warts can be removed using chemicals, heat, freezing, or lasers. More than one treatment may be needed. If you are pregnant, tell your healthcare provider. Certain treatments should not be used while pregnant. Keep in mind: Removing warts does not cure the virus. HPV can still be spread and new warts can appear later. Reduce the spread of HPV by limiting your number of partners. Keep using latex condoms. But be aware that HPV can be passed through contact with affected skin that a condom doesn t cover. A vaccine is available for women and men. It protects against infection with certain types of HPV that cause genital warts and cervical cancer in women. Ask your healthcare provider whether this vaccine is right for you. Left Untreated... Certain types of HPV can lead to cancer of the cervix in women. To protect your health, have a Pap test at age 21 and every 2 years after. Doing so helps ensure that cervical changes are found before they progress to cancer. In rare cases, HPV can pass from a pregnant woman to her baby during birth. 12

13 Vaginitis Vaginitis is a group of infections that inflame the vagina. Not all types of vaginitis are STDs. But having sex can make some types of vaginitis more likely. Depending on the type of vaginitis, both partners may need treatment. This is because men can carry and spread the infection. All forms of vaginitis can be cured. Cotton or cotton-crotch underwear lets air through. This makes it harder for yeast to grow. Problems and Symptoms Trichomoniasis (trich) is an STD. It produces frothy yellow discharge that can have an odor. The vagina can itch or burn. Yeast infection produces discharge that can look like cottage cheese. It can cause an intense itch. Bacterial vaginosis (BV) produces grayishwhite, watery discharge. The discharge has a strong, fishy odor. Treatment and Prevention Prescription medications can treat and cure each type of vaginitis. Because trich is a true STD, all partners must be treated. Partners are also treated for yeast infection in certain cases. Over-the-counter creams or suppositories are available for yeast infections. Use these only if you re sure you have a yeast infection. If you could have something else, check with your healthcare provider. If yeast is an ongoing problem, wear cotton underwear, wash with mild soap, and avoid douching. To reduce the risk of vaginitis, practice safer sex. Limit your number of partners. And always use a latex condom. Left Untreated... Without treatment, burning, itching, and discharge can persist. If your partner is not treated for trich when you are, he or she can infect you again. Untreated BV can lead to PID and related problems (see page 8). In pregnant women, trich and BV may cause early rupture of membranes or preterm birth. 13

14 14 Early Symptoms Hepatitis Hepatitis is a virus that damages the liver. Hepatitis A is spread through infected feces. Contact can occur by eating infected food or through sex. Hepatitis B and C spread through the exchange of body fluids during sex or drug use. They also spread through contact with infected blood. Hepatitis often stays in the body. Over time, serious health problems can result. In many cases, hepatitis does not show any symptoms. When it does, early symptoms can include muscle aches, fever, yellow skin and eyes (jaundice), itchy skin, nausea, dark urine, or diarrhea. Symptoms may last days or months. Vaccines are available for hepatitis A and B. Ask your healthcare provider if vaccination is right for you. Liver Hepatitis B and C can cause scar tissue in the liver. This makes it hard for the liver to function. Treatment and Prevention At first, the goal of hepatitis treatment will be to relieve any symptoms. need further treatment. to a specialist. He or she will test for liver damage and provide treatment if needed. Treatment may include medications. You may be asked to avoid alcohol and certain medications that can damage the liver. If you re at risk, being vaccinated for hepatitis A and B is the best way to protect yourself. To prevent spreading any form of the disease, practice safer sex. Limit your number of partners. Always use a latex condom. And never share drug, tattooing, or piercing needles. Left Untreated... Hepatitis A tends to go away without treatment. Hepatitis B may go away on its own. Hepatitis C almost always stays in the body. When hepatitis B and C remain, they can continue to be passed to others. With time, they can cause liver damage. Over many years, scarring of the liver can lead to liver failure or liver cancer. As a result, a liver transplant may be needed.

15 Early Symptoms HIV and AIDS HIV is a virus. It weakens the immune system so the body can t defend itself against infection. HIV spreads through the exchange of body fluids during sex or drug use. It also spreads through contact with infected blood. There is no cure for HIV. But treatment is effective in helping people to feel better and live longer. At first, HIV may not cause symptoms. Or, it may cause flu-like symptoms. These include swollen glands, fever, night sweats, extreme tiredness, weight loss, headache, rash, or body aches. Symptoms often go away after a few weeks or months. Then many people are free of symptoms for years. HIV can t be cured, but medications can help suppress the virus and prevent infections. HIV/AIDS virus HIV stays in the blood. It prevents the body from being able to fight infection. Treatment and Prevention If you re at risk of STDs, get tested for HIV. That way you can begin treatment if needed. The type of treatment depends on your blood test results. You and your healthcare provider will work closely to form a treatment plan that is best for you. Ongoing follow-up visits are key to staying healthy. Antibiotics and antiviral medications can help you resist infections. To prevent the spread of HIV, limit your number of partners. Always use a latex condom. And never share drug, tattooing, or piercing needles. A medication is available to help prevent HIV in high-risk persons. To be eligible for the medication, you must test negative for HIV and be in the high-risk group. You must also continue using condoms and other safer sex practices. Talk to your healthcare provider to learn more. Left Untreated... When you have HIV, you are more likely to get other infections. Over time, HIV can progress to AIDS as the body s immune system weakens. Infections such as thrush (a fungus causing white spots in the mouth), pneumonia (lung infection), and meningitis (brain infection) can occur. Complications from AIDS can lead to death. Untreated, HIV is likely to be passed to a baby during pregnancy. 15

16 Learning More To better protect yourself, learn more about STDs. The Public Health Department can be a useful resource. Look for a listing in your local phone book. Other helpful resources include: CDC-INFO American Sexual Health Association Consultant: Kim S. Erlich, MD, Infectious Diseases With contributions by: Joseph Engelman, MD, Public Health James R. Fishman, MD, Urology Mindy Goldman, MD, OB/GYN, Associate Clinical Professor Sam Stebbins, MD, MPH, Family Practice and Public Health Susan A. Tweed, MS, RN Protecting Your Future Stay in control of your future by practicing safer sex. Limit your number of partners and always use a latex condom. Also, get checked for STDs regularly if you re at risk or if you notice any changes in your body. Be sure your partner is tested, too. Finding STDs early helps you control them before problems become severe. That way, you can look forward to a healthy future