Now let's pretend for a moment that my roommate really is a slut . . . um, I mean, well, let's just call him "sexually generous" for the sake of this article. Like a lot of people, he may not even know about the variety of sexually transmitted diseases lurking out there. So this month, let's review some of the most common sexually transmitted diseases.
How serious is gonorrhea? Men can sometimes develop epididymitis, an infection of the testicles (balls), a painful condition that can also cause sterility. Women can also become sterile, develop pelvic inflammatory disease (PID) and manifest damage that can lead to a tubal pregnancy.
Gonorrhea should be treated with antibiotics by a doctor or clinician. Avoid having sex during treatment and for one full week after treatment. Encourage your sex partner(s) to be examined. Gonorrhea can be avoided by using a condom during anal, vaginal or oral sex. Though typically curable, some drug-resistant strains have been discovered.
Syphilis goes through four stages of infection: Incubation -- when you are first infected; no symptoms and it may take up to 90 days for a blood test to show the disease. Primary stage -- painless sores or ulcers show up on the penis, vagina, mouth or anus . . . it may go away on it's own, BUT you are still infected and can spread the disease. Secondary stage -- sores or skin rashes, especially on the hands and feet (they will go away without treatment, but you are still infected and can spread the disease). Latent stage -- no symptoms, but the syphilis bacteria remains in the body and, left untreated, can lead to heart disease, blindness, brain damage or death.
Treatment for syphilis involves antibiotic injections (typically penicillin) to kill the bacteria. You will have to repeat blood tests until cured. Avoid having sex until you are cured. According to the Centers for Disease Control, syphilis is 30 times more likely to affect black Americans than whites due to poverty, lack of access to healthcare and drug use.
Want to avoid syphilis? Use condoms and avoid having sex with partners who have sores or ulcers on the penis, vagina, mouth or butt. Less common than gonorrhea, syphilis affects over 100,000 Americans a year.
The U.S. Preventive Services Task Force recommends that all sexually active women 25 and younger be routinely screened for chlamydia. Current CDC guidelines suggest screening women ages 20 to 24, especially if they have multiple sexual partners or do not use condoms. The American Academy of Family Physicians and the American College of Obstetricians and Gynecologists advise screening only high-risk women ("high-risk" means sexually active in this case). None of these organizations seems particularly concerned about men getting screened, something I find inexcusably backward and sexist. And remember, whether symptoms are present or not, infected individuals remain infected and can pass chlamydia to others. Left untreated, it can cause pelvic inflammatory disease (PID) or sterility in women and infertility in men.
So what's the test and treatment for chlamydia? Diagnosis (I hate this part!) usually involves a cotton swab test taken from the urethra of the penis in men (imagine a Q-Tip in the head of the penis), or from the cervix in women. Fortunately, a urine sample test is being developed. Chlamydia is curable with certain types of antibiotics. Condoms can help prevent transmission.
How serious are genital warts? For most people, they're just ugly and the virus is not dangerous. However, during vaginal intercourse or butt sex they may bleed due to the friction involved. More importantly, the wart virus can cause changes in the anus or in the cells of a woman's cervix. Women should have a yearly Pap smear test even if no warts are visible and men should check regularly for warts.
Lots of treatment options exist for genital warts: topical creams, freezing, burning, laser treatment or surgery. Warts may (but not always) return because the virus remains on the skin. You can remove the warts, but you will always have the virus; there is no cure, but vaccine research is underway.
One last important note about HPV: condoms will only reduce, not eliminate, the risk of getting warts because the virus can be on the skin near the vagina, penis or rectum and not just on the sex organs. Obviously, if warts are visible you should avoid sexual contact until they're treated.
Like other viruses, HSV remains in your body for life. It hibernates in nerve roots when it's not causing symptoms. Those symptoms can include swollen glands, fever and achiness in addition to blisters or open sores. The sores can last 2-3 weeks, weeping a clear secretion, then scabbing over and healing. Herpes outbreaks can happen over and over again. Research indicates that genital herpes outbreaks may be linked to stress, fatigue, lack of sleep, menstruation and genital friction. Tingling and itching of the genital area or pain in the buttocks or legs may signal an outbreak of blisters or sores. Some people will experience yearly outbreaks and others may experience them only from time to time.
Clinicians can swab an active lesion or draw blood to confirm infection with HSV. There is no cure at this point, but several drugs are available to treat genital herpes and the results have been good. Vaccines are also in development. If there are signs of a herpes outbreak or visible sores, you should avoid having sex. Condoms offer some protection, but it's best to avoid the sores until they have completely healed, not just scabbed over.
All of these sexually transmitted diseases are considerably more common than HIV. However, whether bacterial or viral, these are genital diseases with one thing in common: they increase the risk of HIV transmission.