Could You Have an STI?

Could  You Have an STI?

 An important part of becoming sexually active with another person is learning how to take care of your and your partner’s health. Any unprotected sexual act that includes vaginal, anal, or oral sex can result in the transmission of a sexually transmitted infection (STI) if one or both partners is infected. In the United States alone, approximately 19.7 million new infections occur per year; approximately half of all new STI cases involve young people between the of ages 15 to 24.1 Being aware of your body, as well as attending regular doctor’s appointments, is vital to ensuring good physical health. Noticing possible symptoms, such as unusual changes in penile or vaginal discharge, the onset of rashes or growth or genital itchiness or discomfort, can aid in the early detection of several STIs. Diagnosing STIs as soon as possible can reduce the risk of physical complications that may arise from postponing treatment, such as sterilization in both males and females.  Males may have an advantage in STI detection because they have external genitalia that is easily visible and can be examined by the individual for certain symptoms (e.g., chancres or sores).  However, many of the most common STIs are often asymptomatic, meaning that they do not present any visible physical changes or signs of infection. Certain STIs may exhibit symptoms several weeks or months after the initial infection, which can lead to health complications and transmission to others if the carrier (person infected) is engaging in unprotected sex.

 I Am Noticing Symptoms, Does This Mean I have an STI?

Various STIs share the same symptoms as non-STIs. If you are experiencing certain symptoms, such as painful urination, yellow discharge, unpleasant genital odor, pelvic pain, or genital growths, these may be symptoms of non-STIs (e.g., urinary tract infections, yeast infections, bacterial vaginosis, pearly penile papules and Fordyce spots).  STIs are generally divided into three categories that are dependent on the pathological nature of the disease: parasitic infections, bacterial infections, and viral infections. The following are medical facts and symptoms associated with certain STIs. If you present any of these symptoms, visit your medical practitioner immediately for official medical diagnosis.

Parasitic Infections:

                                

Parasitic infections: The image on the far left are scabies mites and the image in the far right are pubic lice

.The most common parasitic infections are pubic lice (also known as “crabs”) and scabies. They can be transmitted through non-sexual contact (e.g., sharing towels, sharing clothing, sleeping in infested beds, or close physical contact) but are usually transmitted via sexual activity. Pubic lice and nits are generally smaller than head lice but are still visible on genital skin. They can also be found on eyelashes and facial hair, but this is rare. Pubic lice infestation is usually accompanied by itching.  Scabies are microscopic burrowing mites that are not visible with the naked eye. They usually appear as small red bumps on the skin and are commonly found on genital, buttock, armpit, umbilical, elbow, and hand regions.2 They cause excessive itchiness, particularly at night and secondary infections can arise from excessive scratching. Both parasitic infections are treated with topical creams or oral medications. Further actions, such as washing infested bedsheets and clothing are also required.

Bacterial Infections:

Bacterial infections are some of the most common STIs in the United States, and they include chlamydia, gonorrhea, and syphilis. Chlamydia is the most commonly reported STI in the United States and is primarily spread through vaginal sex, anal sex, and childbirth (from mother to child). Chlamydia is very common because it is typically asymptomatic; only 25% of females and 50% of males acquiring symptoms. STIs are more likely to spread when the carrier is not aware of his/her condition.3 Symptoms associated with chlamydia include painful urination, lower abdominal pain, unusual white discharge, painful sex, and unusual discharge odor. Gonorrhea has similar symptoms as chlamydia, but most males show symptoms while only 20% of females do. Syphilis has four stages: It first appears as a chancre (red bump) at the site of infection; transitions into a painless rash that can be accompanied by fever; swollen lymph nodes, sore throat, and muscle pain; then into a latent stage during which there are no apparent symptoms, and finally into the fourth stage where large ulcers may appear on the skin or internal organs, potentially causing organ damage. All three of these STIs can be treated with oral or subcutaneous (under the skin) antibiotics.

            

From left to right: Chlamydia bacteria and discharge on male penis, gonorrheal discharge on male and female genitalia, syphilis chancre during the first stage

Viral Infections:

Human papillomavirus (HPV), Herpes, and human immunodeficiency virus (HIV) are the three most common viral STIs, and unfortunately, none are truly curable. HPV has over 100 different strains and approximately 40 of those strains cause certain STIs. Strains 6 and 11 are responsible for 90% of genital warts, which are soft pink bumps or cauliflower-like growths that can appear on the genitals or anus; these growths can be removed, but the virus will remain.4 HPV can also lead to anal cancer in both genders and cervical cancer in women. In both cases, men and women tend to be asymptomatic in the early stages of HPV. Preventative measures may be taken to reduce the likelihood of becoming infected with certain strains of HPV, which dramatically decreases the likelihood of developing cervical cancer in females. The vaccine, marketed as Gardasil® or Silgard®, is designed to prevent the acquisition of strains 6, 11, 16, and 18 of HPV and can be administered to both females and males. Preferably, they should receive the vaccination before they become sexually active. 5

 Herpes can be found on both the mouth and genitals of those infected, manifesting itself as blisters that may or may not be painful; simultaneous fever and swelling of the lymph nodes may occur.  Herpes is a lifelong condition and its outbreaks vary in terms of frequency, severity, and duration.  Medications are available to mitigate symptoms, but even with their usage, the carrier is contagious and must take extra precautions, such as refraining from sex during outbreaks or using barrier methods, even when there are no visible symptoms.

HIV can be acquired through sexual contact, the sharing of infected needles, and childbirth (from mother to child).  During the initial stages of HIV, there are no clear indications of infection, making it much more likely that the carrier will transmit the virus. If /When the virus progresses to full-blown AIDS, the immune system is severely compromised, and allows infection by opportunistic diseases, which are then usually the final cause of death in the victim. Fortunately, there are now regimens of anti-retroviral drugs available that, if taken correctly, greatly improve chances of survival and quality of life. Commonly known as HAART (highly active antiretroviral therapy), these drugs have raised the life expectancy after diagnosis from about 10 years to about 20.

When Should I Seek Medical Care?

We strongly encourage regular STI screenings every six months, which involves being tested for STIs without having any physical symptoms, especially for those who are at risk of contracting an STI. At-risk populations include those who are sexually active, involved in sexual relations with people who have been diagnosed with incurable STIs, habitual intravenous drug users, and those who engage in riskier sexual behaviors (e.g., unprotected sex with multiple partner, sexual contact with sex workers, and anal sex).6 We recommend talking to your physician about your sexual history so that he/she can devise best STI screening schedule that is most tailored to your sexual practices.

  The ideal testing scenario involves both parties getting tested before engaging in any type of sexual activity, whether it is protected or unprotected, as barrier methods (e.g., condoms) may break or slip off. If you have recently engaged in unprotected sex and are worried about the possibility of having contracted an STI, most medical facilities advise waiting a certain amount of time before getting tested in order to avoid false negatives. There are no screening tests for herpes as tests are generally only conducted when visible outbreaks are present. The general waiting periods are as follows:

  • 2 weeks for gonorrhea and chlamydia
  • 1 week to 3 months for syphilis
  • 6 weeks to 3 months for HIV, hepatitis C and B7

An official medical diagnosis is required for the treatment of any STI; diagnostic exams include pelvic exams, genital swabs, urine analysis, and blood analysis and are the only definite way to know if a person is or is not infected. Rapid at-home HIV tests are now available for over-the-counter purchase, but confirmation of one’s HIV status by a physician is recommended, as drug therapy options for alleviating HIV symptoms still require an official medical diagnosis. As always, your health and well-being should be the top priority in any sexual relationship you develop.

Last Updated: 23 April 2015.

References

1."Statistics - American Sexual Health Association." American Sexual Health Association. N.p., n.d. Web. 20 Oct. 2015.

2. Center for Disease Control and Prevention. N.p., 02 Nov. 2010. Web. 20 Oct. 2015. <http://www.cdc.gov/parasites/scabies/gen_info/faqs.html>.

3."Chlamydia - CDC Fact Sheet (Detailed)." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 24 Sept. 2015. Web. 20 Oct. 2015. <http://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm>.

4."Information About Human Papillomavirus (HPV)." WebMD. WebMD, n.d. Web. 20 Oct. 2015. <http://www.webmd.com/sexual-conditions/hpv-genital-warts/hpv-virus-infor....

5. Feature, Julie EdgarWebMD. "HPV Vaccine for Children: Gardasil and Cervarix Pros and Cons, Side Effects." WebMD. WebMD, n.d. Web. 20 Oct. 2015. <http://www.webmd.com/children/vaccines/features/should-your-child-       get-hpv-vaccine>.

6. "HIV Prevalence in Sub-populations with High-risk Behavior." - MEASURE Evaluation. N.p., n.d. Web. 20 Oct. 2015. <http://www.cpc.unc.edu/measure/prh/rh_indicators/specific/stis-hiv-aids/....

7."STD Screening: The Basics." Health Tips and Medical Advice from San Francisco NYC DC Boston and Chicago Doctors One Medical Group STD Screening The Basics Comments. N.p., n.d. Web. 20 Oct. 2015. <http://www.onemedical.com/blog/live-well/std-screening/>.

 

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