Many students have questions about sexual health and how to remain healthy while sexually active or are seeking information on how to avoid pressures to become sexually active.

The Wellness Center can provide unbiased scientific information about sexually transmitted diseases (STDs), contraception (including barrier methods of contraception and hormonal / non-hormonal contraception), abortion, alternatives to abortion, waiting for sex, and sexual decision-making.

STD Overview

Both Bacterial infections – Chlamydia, Gonorrhea, Syphilis – and Parasitic infections – Trichomoniasis – can be cured by a round of antibiotics once detected. Early detection is key for these because, if left untreated, these infections can cause some serious, permanent damage.

Viral infections however, which we remember by the H's – Herpes, Hepatitis, HPV and HIV – once acquired, the symptoms can be suppressed with medication, but can never be cured.

STDs don't discriminate: According to the American Social Health Association, STDs affect people of all ages, genders, ethnicities, social backgrounds, and from all walks of life - in the U.S. alone there are approximately 19 million new cases each year, about half of which occur among youth ages 15-24 years.

It is important to remember that most of these infections, whether bacterial or viral, DO NOT SHOW SYMPTOMS, or can lie dormant for years before showing symptoms. This is why it is so vital to get tested before engaging in a sexual relationship with a new partner.

Talk about testing and your STD status with a potential new partner. Getting tested before engaging in sex with a new partner and seeing your partner's test results is the only way to ensure that you are both STD free.

Bacterial infections

Chlamydia

Chlamydia is the most prevalent bacterial STD in the U.S. – over 1 million cases reported per year.

• The highest rates of infection occur between the ages of 18-24.

Transmission

• Can be transmitted by oral sex as well as by other forms of sexual intercourse (vaginal, anal).

Symptoms

• Will appear 7-28 days after sex with an infected partner
• Most women and many men infected with Chlamydia have NO symptoms.
• • Women: some or all of the following - discharge from the vagina, bleeding between menstrual periods, burning or pain when urinating, more frequent urination.
  • Men: some or all of the following - a watery, white drip from the penis, burning or pain when urinating, more frequent urination, swollen or tender testicles.

Testing

• Testing recommended yearly for those under 25 and sexually active
• Urine sample and/or fluid sample

Treatment

• The infected person and their partner are given antibiotics, which can cure infection in one dose.
• • If left untreated, can also lead to infertility in men, although not as often as in women.

Pelvic Inflammatory Disease (PID)

PID is a serious infection that harms the female reproductive organs. It develops when an infection spreads up from the vagina and cervix into the fallopian tubes, uterus, and ovaries.

• Usually caused by untreated Chlamydia or gonorrhea, but may be caused by other infections

Symptoms

• Unusually long or painful periods, and unusual vaginal discharge, spotting and pain between menstrual periods or during urination, pain in the lower abdomen and back, fever, chills, nausea, vomiting, pain during vaginal intercourse.

Testing

• No definitive test
• • Can test for gonorrhea and Chlamydia
  • Pelvic ultrasound

Treatment

• Treated by antibiotics and abstaining from vaginal intercourse for a short period of time.
• If PID is not treated, it can cause serious problems, such as infertility, problematic pregnancy, and chronic pain. The more times a woman has PID, the greater are her chances of becoming infertile.    

Gonorrhea

Gonorrhea is caused by a bacterium that flourishes in mucus membranes including the moist linings of the mouth, throat, vagina, cervix, urethra, and anal canal.

Being infected with gonorrhea increases susceptibility to HIV transmission.

Transmission

• Penile-vaginal, penile-anal or oral contact
• Gonorrhea causes infection of the throat or rectum of people who engage in oral or anal sex.

Symptoms

• Will appear 2-21 days after sex with an infected partner
• Most females are asymptomatic.
• Up to 50% of males have very minor symptoms or none at all.
• Women: some or all of the following: thick yellow/gray discharge from the vagina, burning/pain during urination or bowel movement, abnormal/bleeding between periods, abdominal pain.
• Men: some or all of the following: thick yellow or greenish discharge, burning or pain when urinating or during a bowel movement, more frequent urination, swollen or tender testicles.

Testing

• Urine sample
• Fluid sample - Urethra, cervix, rectum, throat

Treatment

• There are a variety of relatively inexpensive antibiotics available to cure gonorrhea.
• If left untreated, it can cause PID in women and both urethritis and epididymitis (the epididymis is the coiled tube at the back of the testicle that stores and carries sperm) in men. 

Syphilis

The bacterial pathogen passes through any break or opening in the skin or mucus membrane.

Syphilis progresses in 3 stages:

1. Primary syphilis- is characterized by an ulcer called a chancre
2. • Chancre – firm, painless lesion on genitals, anus or in mout
   • Typically appears 10-90 days after exposure.
3. Secondary syphilis- flu-like symptoms and a skin rash on palms and feet
4. • Typically appears 3-6 weeks after the chancre.
5. Tertiary (late stage) syphilis- can damage many organs of the body, possibly causing severe dementia, cardiovascular damage, blindness and death.

Symptoms

• Can be asymptomatic, or may only exhibit symptoms of later stages
• Chancres are usually found at the site where the organism entered the body. When a chancre is present, the disease is highly contagious.
• • Some people only develop one sore, some develop many
  • • Chancres can appear and disappear quickly, but syphilis is still contagious with or without their presence
  • The sores associated with syphilis dramatically increase the risk of acquiring HIV or transmitting it to someone else.

Testing

• Examining material from a chancre
• Blood sample

Treatment

• All stages can be treated with antibiotics
• • However, damage from late syphilis can be permanent
    

Viral Infections

Herpes (HSV 1 and 2)

Herpes is one of the most frequently diagnosed STIs.

• Herpes Simplex Virus (HSV) 1 is oral herpes
• • So common that 50-80% of U.S. adults have HSV 1 antibodies.
• Herpes Simplex Virus (HSV) 2 is genital herpes
• • About 1 in 5 college students in the US have genital herpes!!!

Prevention

• Condom use reduces the likelihood of transmitting the virus but Herpes can be transmitted skin to skin in areas, which are not protected by condoms.
• Herpes does make one more susceptible to contracting or transmitting HIV.
• You are just as likely to contract Herpes through oral sex as any form of other sexual contact, so a dental dam or other form of protection should be used during all oral sexual activity.

Transmission

• Oral-labial herpes is usually caused by HSV 1 and genital herpes is usually caused by HSV 2, but both viruses can cause either.
• Herpes is generally life-long and can stay dormant in nerve cells and reactivate at any time.

Symptoms

• Most (up to 90%) people do not exhibit symptoms.
• Genital herpes symptoms include small, painful blisters on the sex organs or mouth, itching or burning before the blisters appear, flu-like feelings. Blisters last 1 -3 weeks.
• Those that do develop symptoms often notice them within 1-30 days of having sex with an infected partner.
• • Outbreaks
  • • It is not unusual to have an outbreak months or even years after exposure.
    • The initial outbreak, referred to as the "primary outbreak," frequently causes flu-like symptoms in addition to lesions.
    • Herpes outbreaks can be triggered by stress, illness, fatigue, sun exposure, sexual intercourse, and menstruation.

Testing

• Visual inspection if the outbreak
• Taking a sample from the sore(s) and testing it in a laboratory
• HSV infections can be diagnosed between outbreaks by the use of a blood test.
• • Blood tests detect antibodies to HSV-1 or HSV-2 infection

Treatment

• There is no cure for herpes, once infected the person carries the virus for life. 

Human Papillomavirus (HPV)

Genital HPV infection is very contagious

• Roughly 5.5 million new cases per year (accounting for 33% of STDs annually)
• The most common STD to be diagnosed and treated in student health services nationally
• • However, in 90% of cases, HPV is cleared by the body within 2 years
• HPV is correlated with development of cervical cancer, especially if left untreated
• Warts are not a precursor and do not lead to cancer

Prevention

• Condoms and other barrier methods reduce the risk of HPV, but DO NOT provide complete protection. HPV is transmitted via skin-to-skin contact, and can be spread to areas not protected by condoms.
• Gardasil vaccine Protects against 4 strains of HPV, two of which cause warts (6 and 11), two of which are highly correlated with cervical cancer (16 and 18)
• 3-shot series over 6 monthsRecommended for everyone, males and females, under 26 years old
• Available at the Health Center

Transmission

• Penile-vaginal, penile-anal intercourse, oral sex
• • Men are often carriers, but do not experience symptoms and can pass HPV to their partner during unprotected sex
• The HPV incubation period ranges from 1 month to 2 years from time of contact

Symptoms

• Most people do not know they are infected, i.e. do not exhibit visible symptoms (warts)
• Small bumpy warts on the genitals or anus, itching or burning around the genitals

Testing

• Women: Pap smear during annual exam can detect the abnormal call development that is correlated with cervical cancer
• Men: no available test to detect carrier status

Treatment

• Warts: Medication and removal of warts by surgery
• • However, HPV continues to infect healthy tissue nearby so that even after treatment, a person can still transmit HPV to someone else

Hepatitis B

Hepatitis B is a virus that causes inflammation of the liver.

It is estimated that approximately 5,000 people die in the United States each year due to liver complications resulting from Hepatitis B infection.

Transmission

• Hepatitis B is spread during vaginal, anal, or oral sex. It is also spread by sharing needles or contact with infected blood.

Symptoms

• Many people have no symptoms or mild symptoms.
• Symptoms generally show up 1 – 9 months after contact with the virus.
• • Include tiredness, flu-like feelings that don't go away, jaundice (yellow skin), dark urine, and light-colored bowel movements.

Testing

• Blood sample

Treatment

• Acute infection (newly acquired) often leads to simple recovery without treatment, but they can still give Hepatitis B to others.
• Chronic infection (persistent infection) can be treated with several drugs, however they are only about 40% effective in eliminating Hepatitis B.
• Other patients may experience liver cirrhosisor liver cancer that can result in death.

Human Immunodeficiency Virus (HIV)

AIDS (Acquired Immune Deficiency Syndrome) is caused by the virus, HIV.

• Not all HIV cases progress to AIDS

Transmission

• Blood, semen (including pre-ejaculatory fluid), vaginal fluids, breast milk
• 4% of HIV infection has been transmitted through oral sex
• • Higher susceptibility if already diagnosed with another STI

Symptoms

• May not occur for 10-15 years.
• Include: unexplained weight loss or tiredness, flu-like feelings that will not go away, frequent diarrhea, and white spots in the mouth.
• • Women often experience recurrent yeast infection

Testing

• OraQuick, an oral swab test, gives results in 20 minutes
• • The Student Health Center offers free/reduced cost OraQuick tests
• Blood sample, which is a more comprehensive test

Treatment

• There is no cure for HIV/AIDS, however a variety of treatments and medications, generally referred to as ARTs (antiretroviral therapy) exist to fortify an HIV patient's immune system

Parasitic Infection

Trichomoniasis ("Trich")

An estimated 7.4 million new cases occur each year in women and men.

Trichomoniasis is caused by the single-celled protozoan parasite, Trichomonas vaginalis.

Transmission

• The parasite is sexually transmitted through penile-vaginal intercourse or vulva-to-vulva (the genital area outside the vagina) contact with an infected partner
• The vagina is the most common site of infection in women, and the urethra is the most common site of infection in men

Symptoms

• Men: most do not have signs or symptoms; some may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.
• Women: a frothy, yellow-green vaginal discharge with a strong odor, discomfort during intercourse and urination, irritation and itching of the female genital area.
• • In rare cases, lower abdominal pain can occur. Symptoms usually appear in women within 5 to 28 days of exposure.

Testing

• Men: The parasite is harder to detect in men; physical exam, no definitive test
• Women: a pelvic exam and fluid sample

Treatment

• Can be cured with antibiotics
• Partner(s) must be treated