Sexually Transmitted Diseases: Human Papillomavirus, Chlamydia, Gonorrhea, Syphilis, HIV, Genital herpes

Sexually Transmitted Diseases: Human Papillomavirus, Chlamydia, Gonorrhea, Syphilis, HIV, Genital herpes

sexually transmitted diseases in adolescence

According to studies by the Centers for Disease Control and Prevention (CDC)

  • 47.4 percent of high school students have had sex.
  • 39.8 percent did not use a condom.
  • Nearly half of the 19 million incidents of STDs per year occur in the ages 15 to 24.

So this is a very important subject for young people to know about.

A Study Showed That:

  • 40 percent of women ages 14 to 19 who have had sex have at least one STDs, with the most common one being HPV or Human
    Papilloma Virus.
  • Other STDs include chlamydia, gonorrhea, trichomonas and
    herpes.
  • There’s a high rate of reinfection once you’ve had an infection of this sort even if you’ve been treated. About 40% are reinfected within few months.
  • Repeated STD infections are a risk factor for HIV infection.

Talking to Your Parents

We encourage you to talk to your parents or another trusted adult about these sensitive issues. They can usually give you good advice.

1. Human Papillomavirus

How do you get HPV
How do you get HPV
  • Most common sexually transmitted disease.
  • Many different strains.
  1. High-risk HPV strains which include 16, 18, 31 and 33 and these are associated with cervical cancer.
  2. Low-risk HPV strains which include 6 and 11 and these are associated with genital warts.

If you have one strain or the other, it doesn’t predispose you to develop other diseases. For instance, if you have a low-risk strain, you’re not at high risk of cervical cancer and if you have a high restraint, you’re not at risk of genital warts unless you’re infected with the other spring as well.

HPV Genital Warts
HPV Genital Warts
  • Pap smear – Checks the cells of the cervix for cervical changes which include cancer or pre-cancer. Can also do an HPV test at that time.
  • No pap smear is needed until age 21 for most patients, regardless of sexual activity and this is because young people clear the virus quite quickly and even if there are changes in the cervix these usually go back to normal without any further treatment.

HPV can cause changes in cervical cells over time from Normal Cells to Pre-Cancer cells and then Cancer Cells which look very different from the normal cells.

HPV Prevention

  • Gardisil vaccine which is approved for ages 9 to 26.
  1. It protects against strains 6 and 11 which cause genital warts and strains 16 and 18 which are the most common to cause cervical cancer.
  2. Three shots over six months.
  3. Available for boys and girls.
  • Condom use can also help prevent HPV but it’s not 100% effective.

2. Chlamydia-Most Common Bacterial Sexually Transmitted Disease

  • Chlamydia is the most common bacterial sexually transmitted disease.
    It’s frequently asymptomatic, which means you have no symptoms and there is a recommendation that we should screen sexually active women ages 25 or less universally.
  • Women can develop an infection of the cervix or the urethra,
    which is the tube where the urine comes out of the bladder. Women can also develop pelvic inflammatory disease which can cause infertility in the future. So it’s very important to diagnose this infection if you have it and have it treated. So that you don’t have issues with fertility in the future.
  • For men, they can develop a Urethritis which is a discharge of the penis, Epididymitis which is an infection of the testicles or Prostatitis which is an infection of the prostate.
  • The test for chlamydia is a swab of the cervix or a
    urine test for men.

Prevention and Treatment of Chlamydia

  • Prevention is linked to education.
  1. Delay age of first intercourse is key to preventing sexually transmitted
    diseases including chlamydia.
  2. Use condoms
  3. Reduce the number of sexual partners.
  • Treatment

Treatment includes antibiotics such as azithromycin or doxycycline and these are taken by mouth.

3. Gonorrhea

  • Gonorrhea is the second most common bacterial sexually transmitted disease.
  • Women are usually asymptomatic but the men are not.
  • In men, it can cause Urethritis, Prostatitis or Epididymitis. Women
    can develop a Cervicitis which would give you a usual vaginal discharge or Pelvic inflammatory disease which can lead to infertility.
  • Gonorrhea can also give you a throat infection related to oral sex and you can have symptoms of a sore throat from gonorrhea.
  • Ocular transmission is also possible.

Gonorrhea Diagnosis, Treatment and Prevention

Testing involves using a swab of the cervix or the throat if we suspect a throat infection or a urine test.

Treatment

Treatment includes Ceftriaxone which is actually an intramuscular injection plus Azithromycin or doxycycline and this is because there is increasing the resistance of Neisseria gonorrhea to antibiotics. So it’s a recent recommendation try to use two antibiotics to treat this infection.

Prevention is Linked to Education

  1. Delay age of first intercourse.
  2. Use condoms.
  3. Reduce the number of sexual partners.

Expedited Partner Therapy

If you have been diagnosed with an infection particularly Chlamydia, you can get a prescription for your partner as well, without having evaluated your partner and this is in order to prevent reinfection of the patient. It’s not appropriate for Gonorrhea because part of the treatment for gonorrhea is an injection and for that, the partner must come in to see the provider.
Another issue with Expedited Partner Therapy is that the partner is never
evaluated for all the other sexually transmitted diseases so there is a risk of
missing some infections.

It is recommended avoiding sex for seven days after initiating treatment.

4. Genital herpes

  • Genital herpes is caused by Herpes Simplex Virus Type 1 or
    Type 2.
  • Can be transmitted by vaginal sex, anal sex and by oral sex.
  • There’s a high rate of carriers for herpes virus in general whether it be oral or genital.
  • Primary Infection
  1. Flu-like symptoms- fever, headaches, fatigue, body aches.
  2. Painful genital ulcers which will cause burning with urination and enlarged lymph nodes in the groin.
  • Recurrence– This infection is a permanent infection. Your body will always harbor the virus and you will be at risk for recurrence. The recurrence is however, can be less painful and of shorter duration.

You will have painful ulcers with the recurrences.

  • Your body will always have the virus and you can transmit it even without any ulcers or symptoms(shedding).

Herpes Diagnosis, Prevention and Therapy

  • Diagnosed by viral culture of the ulcer.
  • Blood testing is less sensitive.
  • Prevention: Condom use can help reduce transmission by about 50%. Because condoms don’t cover the entirety of skin that is exposed to your partner, it’s definitely possible with skin-to-skin contact to still have transmission despite the condom.
  • Treatment: Treat this infection with acyclovir, Famciclovir or Valaciclovir which can help improve the symptoms but does not cure the virus.
  • If frequent recurrence of ulcers, you can take medication every day to prevent ulcers.
  • During pregnancy, this can be a dangerous condition because if babies are born through the birth canal when there is shedding of the virus, the babies can actually get very sick from this and for that reason prophylactic antibiotics are given towards the end of pregnancy in order to reduce the occurrence of ulcers or shedding.

5. HIV

STD Prevention Use Condom
Always Use Condom
  • HIV is caused by a virus which attacks your immune system.
  • Primary infection symptoms are mono-like or none at all
  1. If you have a mono like reaction, you will have fevers, body aches, sore throat, fatigue, enlarged lymph nodes, rash.
  2. Diagnosis can be missed because so many people may think that they just have the flu or mono and never think that this is a primary HIV infection.
  • The diagnosis is usually made once the patient develops opportunistic infections. What this means is that because your immune system is lower, you’re more susceptible to infections that people with a good immune system would normally not get. If you have one of these rare infections then HIV is suspected and tested for.
  • Transmission of HIV can be by sex (oral, vaginal or anal), IV drug use and rarely blood transfusions.
  • Blood test for HIV diagnosis.
  • Universal screening is recommended for ages 13 to 64 because it may be asymptomatic or maybe the symptoms were passed off as the flu.
  • Prevention: Condom use and treatment of an HIV partner to reduce their viral levels and help reduce transmission.
  • Treatment– Complex multidrug regimens called HAART or Highly Active Antiretroviral Therapy.
  • Can never be cured but only controlled with medications.
  • Death is caused by opportunistic infections in most cases.
  • AIDS is a late-stage HIV infection where t-cell count drops to less than 500.
  • In pregnancy, it is possible to transmit HIV from mother to a child called vertical transmission.

6. Syphilis

  • Syphilis is caused by bacteria.
  • Different stages of syphilis which cause different symptoms
  1. Primary syphilis infection which occurs two to three weeks after exposure. You’ll notice a raised red bump than a sore where the infection occurred and is usually painless.
  2. Secondary syphilis infection can occur weeks to months after infection and only 25% of people will actually have these symptoms which include a rash and flu-like symptoms.
  3. Latent syphilis is when you have no symptoms at all.
  4. Tertiary syphilis is a very serious condition where you can have damage to the heart, brain, eyes and other organs.

Syphilis Diagnosis, Treatment and Prevention

  • Syphilis is diagnosed with a screening blood test and then a confirmatory blood test
  • Treatment
  1. Penicillin shots
  2. Doxycycline
  • Prevention
  1. Use condoms
  2. Limiting the number of sexual partners

Take care of yourself and your partner

Get tested for STDs prior to having sex with a new partner
Get tested for STDs prior to having sex with a new partner
  • Disclose any sexually transmitted diseases and any treatments.
  • Get tested for STDs prior to having sex with a new partner.
  • You can get tested at various clinics like Planned Parenthood or free clinics if you can’t see a regular doctor.

Frequently Asked Questions

If you have come into contact with herpes but never show symptoms are you a carrier? Can you still pass it on?

It’s definitely possible to be infected with herpes but to not actually have the primary outbreak and it is possible in that case to still be shedding.

How can I prevent spreading a sexually transmitted disease?

It depends on which disease it is. Condoms are effective for the prevention of sexually transmitted diseases in most cases. However, in skin-to-skin contact, diseases such as herpes or genital warts, it can be less effective.
The other key to prevention is education, delaying the age of first intercourse, reducing the number of partners that can definitely help with reducing the incidence of sexually transmitted diseases.

How should I talk to my kids about sexually transmitted diseases?

It can be uncomfortable for parents to talk about sex and these diseases with their children. However, it’s very important to maintain open lines of communication and having a frank discussion with your children is a very good idea. You may want to do it over possibly a meal or at a time when you and your child are feeling relaxed. Where you can just open up the discussion about what may be going on with your child, with their friends and give good advice to your children. They are looking for advice from whomever they can find and I think parental support and guidance is very important in this situation.

Does viagra protect against sexually transmitted diseases?

I have not seen any research related to that so my understanding is that it does not protect against any STDs.

As a teen where can I get tested for sexually transmitted diseases?

You can go to your own pediatrician or doctor to get tested and treated and it is confidential and your parents don’t have to know about it.

Can PILL protect me from sexually transmitted diseases?

Birth control pills will protect you against pregnancy but they will not
protect you against sexually transmitted diseases so if you’re still concerned
about STDs, you should use condoms.

How can I get a sexually transmitted disease if I’m still a virgin?

First, we should define a virgin. If you’ve had oral sex or anal sex you may still consider yourself a virgin however you have had sex that can expose you to sexually transmitted diseases. So it’s not just vaginal sex that leads to sexually transmitted diseases but oral and anal as well. If you’re a virgin yet and you’re engaging in oral or anal sex, you can definitely contract STDs that way. Other than that as a virgin, if you’ve no sexual contact whatsoever it would be very difficult to be infected with a sexually transmitted disease.

How often should I be screened for
sexually transmitted diseases?

Anytime you change partners you should be screened for sexually transmitted diseases and at least once a year. You should request screening if your doctor doesn’t initiate that discussion. It is very important because so many of these diseases can be asymptomatic to be screened on a regular basis.

How do Human Papilloma Virus vaccines?

What a vaccine does is it actually exposes you to the antigens of the virus, so that your body can build an immune response to the actual virus strains and by doing that you actually form antibodies which will then fight off any
sort of initial exposure to the virus itself.

How do I protect myself from HPV while engaging in oral sex?

Condom use can definitely help with this but if there’s skin-to-skin contact there’s always a possibility of transmission.

Are there any genetic or hereditary risks associated with CIN and HPV?

HPV can cause CIN- Cervical Intraepithelial Neoplasia which is a precancerous change in cervical cells. In terms of genetic or hereditary risks, some people can be predisposed to developing changes in their cervix more easily with the HPV infection than other people. So some people are infected with HPV and they never develop any sort of precancerous changes whereas other people do. It’s usually related to your immune system, for instance, if you’re a smoker or if you have an HIV infection,
if you’re on steroids or other immunosuppressive medications then you’re at increased risk of having cervical cancer or precancerous changes from the human papillomavirus. in terms of genetic or hereditary risks not so much.

If you have unprotected sex while using an IUD for birth control, Does that increase the chance of getting an STD?

Many years ago, there was a concern that if you have an IUD and you contract a sexually transmitted disease like gonorrhea or chlamydia, you are at higher risk for pelvic inflammatory disease. The current day IUDs, particularly the Mirena IUD which has a little bit of a progesterone hormone called levonorgestrel, you actually develop thicker cervical mucus which actually prevents pelvic inflammatory disease. If you are using an IUD for birth control it does not increase your chance of developing an STD and in fact, it could be protective against pelvic inflammatory disease. An IUD is an excellent form of contraception so highly recommended.