Lifestyle

Monogamy does not guarantee protection against STD's, including HIV, unless both partners are definitely not infected and never have sex with anyone else. There is no easy way to be sure about this. If you do decide to have sex, be careful, especially if you have more than one partner. Condoms, if used properly and every time you have sex, are an easy way to protect yourself from STD's. Understanding the basic facts about STD's - the ways in which they are spread, their common symptoms, and how they can be treated - is the first step toward prevention.

It is important to understand at least five key points about all STD's in this country today:

1. STD's affect men and women of all backgrounds and economic levels. They are most prevalent among teenagers and young adults. Nearly two-thirds of all STD's occur in people younger than 25 years of age.
2. The incidence of STD's is rising, in part because in the last few decades, young people have become sexually active earlier yet are marrying later. In addition, divorce is more common. The result being that sexually active people today are more likely to have multiple sex partners during their lives and are potentially at risk for developing STD's.
3. Most of the time, STD's cause no symptoms, particularly in women. When and if symptoms develop, they may be confused with those of other diseases not transmitted through sexual contact. Even when a STD causes no symptoms, however, a person who is infected may be able to pass the disease on to a partner. This is why many doctors recommend periodic testing or screening for people who have more than one sexual partner.
4. Health problems caused by STD's tend to be more severe and more frequent for women than for men, in part because the frequency of infection means that many women do not seek care until serious problems have developed.
   • Some STD's can spread into the uterus (womb) and fallopian tubes to cause pelvic inflammatory disease (PID), which in turn is a major cause of both infertility and ectopic (tubal) pregnancy. The latter can be fatal.
   • STD's in women also may be associated with cervical cancer. One STD, human papillomavirus infection (HPV) causes genital warts and cervical and other genital cancers.
   • STD's can be passed from a mother to her baby before, during, or immediately after birth; some of these infections of the new-born can be cured easily, but others may cause a baby to be permanently disabled or even die.
5. When diagnosed and treated early, many STD's can be treated effectively. Some infections have become resistant to the drugs used to treat them and now require newer types of antibiotics. Experts believe that having STD's other than AIDS increases one's risk for becoming infected with the AIDS virus.

The section below examines the most common STD's prevalent in society today, what they are, symptoms, tests and treatment and complications.

A common sexually transmitted disease caused by bacteria called chlamydia trachomatis. The Family Planning Association suspects that 10% of sexually active teenagers in the UK have this infection, which can cause infertility.

Males:

• A stinging sensation when they urinate
• Discharge from the penis
• Pain or tenderness in the testicles

Females:

• Two thirds will have no symptoms at all
• Stinging when they urinate
• Vaginal discharge
• Pain in the pelvis during sex
• Bleeding between periods

If the infection is caught from anal sex, there can also be pain and discharge from the anus.

A swab is taken at the clinic. The infection is easily treated by a course of antibiotics (tetracycline or erythromycin). The tablets may take a long time to work and it is vital that all the tablets are taken. The infection can get into the eyes so hands must be washed thoroughly after touching the genital area.

If it is left untreated, chlamydia can cause serious damage to your health.

Males:

• Damage to the testicles and possible sterility
• Infection of the prostate gland
• Reiter's Syndrome (arthritis and sore eyes)

Females:

• Infection of the womb and fallopian tubes
• Infertility
• Inflammation around the liver
• Reiter's Syndrome

Babies:

• If a woman has untreated chlamydia, her baby may be infected when it is born. It can cause the baby to have eye damage or pneumonia.

A virus called Herpes simplex (type II), that's usually sexually transmitted. There is no cure for herpes and attacks can come back at any time, but there is now treatment to make it heal up quicker. Doctors think that some people who have never had any symptoms can carry genital herpes.

• The first attack of herpes is usually the worst.
• Within 10 days of catching it, males and females usually have a tingling sensation followed by small watery blisters in the genital or anal areas. These burst to leave painful sores, ulcers or crusts.
• Sometimes a feverish feeling, headache, temperature, swollen glands and aching muscles.
• Sores heal in one to four weeks, but the infection can return at any time.
• Following attacks are less severe, and happen on average about three times a year. During the active phase, the virus is highly infectious.
• Many people who get herpes don't have more attacks after the first one.
• Herpes can become active again if you are run down, stressed, or there is too much friction on the genitals from tight clothes or sex.

There are anti-viral tablets and liquids that stop herpes getting worse, but they must be taken quickly after the start of an attack. It can be agonisingly painful to pass urine, especially for women. Pouring warm water over the area or getting into the bath to pee may help with the pain. Pain and fever is best dealt with by taking paracetamol and having bed rest. Wash the ulcers with salty water then keep them dry so they heal quicker. After touching affected areas, wash hands thoroughly - the virus can easily be spread to the eyes and mouth. If you have active herpes, do not have any kind of sexual contact, even if you usually use condoms.

If a pregnant woman has active herpes when she gives birth, there is a risk that the virus can get into the baby's eyes and damage them.

Sphere
The Herpes Viruses Association
41 North Road
London N7 9DP
Tel: 020 7609 9061

A virus called HPV that is passed on by skin-to-skin contact, mostly during sex. Genital warts are unlikely to spread to other parts of the body.

• Mainly lumps on the skin of the genitals or around the anus that appear one to three months after contact with an infected person
• They can range from white to pink, and often have a cauliflower-like surface
• There can be several warts, or just one, and they vary in size
• Warts are mostly painless, but sometimes they are itchy
• HPV can also cause flat warts or infection that is not visible to the naked eye

• At the clinic, the doctor or nurse can usually tell they are warts by just looking at them
• Sometimes weak vinegar is sprayed onto the area; if the lumps are warts they will turn white
• Warts can be removed by painting them with a solution called Podophyllin
• Warts can also be removed by liquid nitrogen or laser treatment
• Never try to treat genital warts yourself at home
• It can take a long time to get rid of warts, and treatment often has to be repeated several times

Some strains of HPV have been linked to cancer of the cervix, so women who have had warts may need more regular smear tests.

An infection caused by gonococcus bacteria that are passed on during penetrative sex, oral sex and anal sex. The number of young people catching gonorrhoea ('the clap') in the UK is currently rising at an alarming rate.

Symptoms start two to ten days after having sex with an infected person. Males:

• Painful urination
• Yellowish or creamy discharge from the penis
• Tenderness in testicles
• After anal sex - anal itching or discharge
• After oral sex - sore throat and fever
• One third of men have no symptoms

Females:

• Painful urination
• Yellow or greenish smelly vaginal discharge
• After anal sex - anal itching or discharge
• After oral sex - sore throat and fever
• Over half of women have no symptoms

The clinic will take a swab from the affected area and a urine sample. Treatment is normally a single large dose of penicillin (one tablet or an injection).

Symptoms start two to ten days after having sex with an infected person. Males:

• Inflammation of the testicles, possible infertility
• Permanent narrowing of the urethra (urine tube in the penis)

Females:

• Pelvic inflammatory disease - fever, pain, infertility, ectopic pregnancy (the baby begins to grow in the fallopian tubes, not the womb).
• A pregnant woman can infect her baby during the birth, which can blind the baby if it isn't treated.

To understand HIV standing for Human Immuno-Deficiency Virus, you have to know something about the immune system that stops us from getting ill.

Blood plays an important part in our body's defence against illness. It contains millions of cells, about 1% of which are white, and a particularly important type of white cell is called the t-helper cell. One of the jobs of these cells is to fight off infection.

HIV is a virus which attacks the t-helper cells. If it grows inside the t-helper cells and other germs get inside the body, the person will have no way of fighting infection. He or she will become ill and develop what is called Acquired Immune-Deficiency Syndrome, known as AIDS. At the moment it is not clear if everyone who is infected by HIV goes on to develop AIDS.

Let's start with how you don't get it. You don't get HIV from:

• hugging
• kissing, including French kisses
• sharing towels or cutlery
• swimming
• toilet seats
• sharing musical instruments
• giving blood

The virus dies quickly once outside the body. The HIV virus is found in the blood and semen or vaginal fluid of a person. Infection takes place when these fluids pass from an infected person into the bloodstream of someone else.

This can happen in four ways:

• By having unprotected sex with someone who already has the HIV virus when the penis enters the vagina or anus without a condom. The risk of contracting AIDS through unprotected oral sex is thought to be much lower - but transmission is possible if semen, vaginal fluid or menstrual blood comes in contact with bleeding gums or mouth infections. You can protect yourself from HIV infection by using condoms.
• Using or sharing a hypodermic syringe that has already been used by someone infected by HIV, can lead to the exchange of a small amount of infected blood.
• A mother who has HIV can pass it on to her baby whilst she is pregnant.
• People have contracted the HIV virus from receiving contaminated blood in a blood transfusion. However, with routine screening of blood, this is not a problem in most countries.

If you have HIV or AIDS, you are under no obligation to tell your teacher or employer. However the government advises any health care worker who believes themselves to be at risk from infection to seek medical advice immediately. Your employer has a legal duty to treat the information that you are HIV positive as confidential. As a rule, employers are not entitled to tell other workers that an employee is infected with HIV, without his or her permission.

Employers may, if they wish, ask all those who apply for a job to take an HIV test. They cannot insist on existing employees taking a test however, unless it is already in their contract. If you apply for a job and the firm discovers you are HIV positive they are quite within their rights to turn you down. If you lie about it, and they realise you are HlV positive after you have begun work you may be dismissed.

A sexually transmitted infection caused by bacteria called treponema pallidum. It spreads by passing from an ulcer on an infected person to the skin, genitals, mouth or anus of their partner.

Syphilis infection goes through two different stages:
Primary Stage:

• An ulcer appears two to six weeks after being infected
• It is called a chancre (pronounced 'shanker') and is usually painless
• The ulcer appears where the bacteria got into the body
• Many people do not notice that they have a chancre, especially if it's in the anus or inside the vagina
• It disappears several weeks later without treatment - but the disease has NOT gone away, it is gathering forces for stage two.

Secondary Stage:

• A skin rash begins, with brownish sores about the size of a one or two pence piece.
• They are found all over the body, especially on the palms of the hands and the soles of the feet, and are infectious.
• There is sore throat, fever and headache.
• There may be wart-like growths on the genitals

Scrapings are taken from sores and ulcers, and a blood test may be needed. Treatment is easy - a high dose injection of penicillin will kill the bacteria within 24 hours.

If the secondary stage is left untreated, the disease goes into a latent stage. There are no symptoms and the person is not infectious, but it doesn't always go away for good. If the bacteria become active again, the disease goes to the tertiary stage. This final stage of the illness can cause blindness, mental illness, heart disease, damage to the joints, and even death.

A woman can infect her baby during pregnancy, causing a miscarriage or stillbirth.

A highly infectious virus ('hep-B') that can affect the liver. It is spread by contact with body fluids such as semen, blood, vaginal secretions, anal secretions, urine and saliva. It can be caught during any kind of unprotected sex, or from contaminated needles used in drug abuse, tattooing or body piercing.

• Most people who catch this virus have no symptoms and quickly clear it from their body.
• A few infected people can carry the virus without symptoms for years.
• Others develop hepatitis, an inflammation of the liver.
• Hepatitis can cause any of these symptoms: swollen joints in hands and feet, jaundice (yellowing of the skin), skin rash, pain in the abdomen (belly), tiredness, fever, and nausea.
• Symptoms can last just a few days, or several months.

• A blood sample is taken for tests to show whether you have been infected, and if the virus is still in your body.
• An ultrasound scan may be needed too.
• Most patients with hepatitis don't need any treatment apart from several weeks of bed rest at home.
• Alcohol must be avoided, and a low fat diet can help.
• If you have put your partner at risk of infection, they can be immunised, but must seek help quickly.
• If the infection doesn't go away after bed rest, there is only one treatment; an anti-viral drug called interferon, which only helps half of the people who take it.

• Most patients make a complete recovery
• Some become long-term carriers of Hepatitis B virus
• About ten percent of chronic carriers go on to develop cirrhosis of the liver
• Once cirrhosis has developed, there is a risk of liver cancer
• An infected mother can pass the virus on to her unborn baby

You reduce your risk of infection by avoiding unsafe sex, avoiding contaminated needles, and using condoms. If you are in a high-risk group for catching Hepatitis B, you can be immunised against it.

A virus ('hep-C') that can affect the liver. This disease is not fully understood, but it seems to be passed on in several ways. It can be caught during unprotected sex, from contaminated needles, and during blood transfusions (in some countries outside the UK where blood is not tested for the virus).

• A flu-like illness, with nausea, vomiting, and tiredness
• Weight loss
• Diarrhoea
• Itchy skin
• Jaundice (yellowing of the skin), although this is rare.

• A blood test will tell you if you have caught this infection, and a second blood test is needed to see if you are still infectious
• Only about 20% of infected people are able to get rid of this virus from their body
• The other 80% probably become carriers of the disease
• The anti-viral drug interferon may be used to treat Hepatitis C, but it doesn't always work

• Some carriers get repeated attacks of flu-like illness, or chronic fatigue
• Carriers can develop chronic inflammation of the liver, and 50% may develop cirrhosis
• About 20% of these people with cirrhosis will eventually get liver cancer
• The virus has a 1-5% chance of passing from an infected mother to her baby during pregnancy

The most common cause of Hepatitis C infection is by drug users sharing contaminated needles - many drug treatment centres now supply addicts with free clean needles. You can also reduce your risk of infection by avoiding unsafe sex and using condoms.

With all STD's if you think you might have a sexually transmitted infection, sort it out straight away. Go to a genitourinary medicine (GUM) clinic, available at most large hospitals. GUM clinics give free and confidential advice and treatment. Or you can make an appointment to see your GP. You know that the safest way to prevent most sexually transmitted diseases is not to have sex at all -abstinence. However, if you do have sex, practice safer sex. Wearing a latex condom each and every time you have vaginal, oral, or anal intercourse will lower the risk of contracting a STD.

Remember that communication is key. Discuss condom use. Ask about your partner's sexual history. Being open and honest about your and your partner's sexual history shows that you care about one another's health and well being.

More information is available from the following websites:

• Health Discovery
  
• Guide Information
  
• Net Doctor
  
• NHS Direct