Brandywine Family Medicine Blog

Sexually Transmitted Infections

Published 06.11.2021

You are having sex if you have genital contact with another person. This involves oral sex, anal sex, and vaginal sex. All of these put you at risk for sexually transmitted infections. Condoms every time for every way are your best protection for not getting sexually transmitted infections. If you have a sexually transmitted infection any partner you have should be treated as well. These infections are reported to the state by the testing lab and tracked.

Chlamydia is a bacterial infection that can be cured. It is the most common sexually transmitted infection in the US. You may have chlamydia and have no symptoms so it is recommended that all sexually active young women be screened yearly. If chlamydia is untreated it can spread outside your cervix up into your uterus and fallopian tubes and can lead to pelvic inflammatory disease. Pelvic inflammatory disease can cause tubal pregnancies, chronic pelvic pain, and infertility. Men can have chlamydia and have no symptoms or they can have penile discharge or burning with urination. Symptoms of chlamydia in women can be vaginal discharge or spotting. Both men and women can carry chlamydia for months. Once you have been found to have chlamydia it is recommended to retest you one month and three months later to make sure the infection has cleared and that you didn’t get reinfected.

Gonorrhea is also a bacterial infection that can be cured. Often people who have gonorrhea have chlamydia as well so we always treat for both infections. Both men and women can have no symptoms with infection but if you get symptoms it is usually within three to five days of exposure. Gonorrheal infections can also cause pelvic inflammatory disease and complications of infertility and tubal pregnancies. You can get gonorrhea in your rectum and throat as well. Gonorrhea may be treated by oral antibiotics or by an injection of antibiotic. Again you should be retested to make sure the infection has been cured and that you haven’t gotten reinfected.

Genital herpes is a viral infection that can not be cured but can be controlled with medicine. About 20% of people in the US have herpes but most don’t know they have it. You are most likely to get herpes from another person if they have an outbreak of ulcers but they also can transmit the virus if they have no symptoms. You can have herpes for years and never get an outbreak. There is no way to tell how long you have had herpes or who exposed you. Oral herpes infections are usually with type 1 of the virus and genital infections are usually type 2 of the virus but now that sexual practices are changing we are seeing some oral infections caused by type 2 virus. Condoms are pretty good protection for not getting or spreading the virus but the virus infects all the genital skin not just where there are ulcers so you can still get herpes with a condom. Your risk of transmitting herpes to a partner that doesn’t have it is about 20% during the course of a year. This risk can be decreased to about 4% if you take antiviral medication daily. Herpes is an annoyance but doesn’t have any long term health consequences. Having herpes does increase your risk of other sexually transmitted infections though. Herpes outbreaks are usually painful and last 1-2 weeks but you continue to shed the virus for longer.

Human papillomavirus infections occur in 80% of sexually active women. Most get these infections and clear the virus within a year or two. There are several different types of the virus and some have been found to cause cervical cancer. Starting at age 30 all women are screened for these specific types of HPV. If your body doesn’t clear these infections and the virus stays on your cervix for many years it can lead to cervical cancer. There is nothing you can do to clear the infection but smoking cessation does help if you smoke. The Gardasil vaccine is given to all 12 years old boys and girls now to help prevent these infections. HPV can also infect your throat and lead to cancer. There are about 50,000 deaths a year caused by infections from HPV so getting the Gardasil vaccine is really important.

Syphilis is an infection with a tiny critter called a spirochete. These infections are becoming more common again in the last few years. These infections can last years and come in several stages. With the initial infection there is a circular painless sore at the site of the infection. These are usually about a half an inch in diameter and last for several weeks. A couple of months later a rash develops that appears on the palms of the hands and the soles of the feet associated with general aches and fever. In the final stage of the infection there can be damage to your brain and nervous system or heart. In the initial stages of infection antibiotics can be curative but in the later stages of infection the damage can be permanent.

Hepatitis B and C are viral infections which can be treated and in some cases cured with medication. These are both transmitted by blood and body fluid secretions. These can cause severe liver disease which can be fatal. Most young people have now been immunized against hepatitis B but there is no vaccine for hepatitis C yet.

HIV is a viral infection that can’t be cured but can be controlled with medication if you are compliant with treatment. Condoms are pretty good protection as long as you use them every time, every way. Anyone can have HIV. Don’t assume your partner is negative see the lab report. People are at increased risk for having HIV if they have any history of IV drug use, have multiple partners, or men who have sex with men. Protect your self. If you are having sex with people in high risk groups and want to protect your self you should consider PREP therapy. PREP is taking antiviral medication that can prevent you getting HIV if you come in contact with someone who is positive. It is very expensive and has some side effects. It is not a replacement for using condoms every time.

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