STDs & HIV Infection
Studies have shown that other sexually transmitted diseases, also called sexually transmitted infections (STIs), increase the risk for HIV infection. Safer sex is important for preventing the transmission of all STDs, including HIV, and for reducing the risk for HIV infection.
The higher risk associated with STDs, especially conditions that damage the genital mucosa and expose areas where HIV can contact lymphocytes, suggests that treating or preventing STDs can help prevent AIDS. Studies are being conducted to evaluate the impact of aggressive STD prevention programs on HIV transmission.
Genital herpes, also known as herpes simplex virus (HSV), causes painful sores on the labia, the inside of the vaginal canal, and the cervix in women, and on the penis and scrotum in men. Genital herpes is caused by the same virus that causes oral herpes. When the outbreaks recur, the sores always appear in the same place. Patients who have been infected more than once develop recurring sores in more than one place.
In some cases, patients feel itching and soreness before the actual herpes outbreak. Women who have genital herpes should be especially aware of these early symptoms since treatment is much more effective if it is started early in the course of the outbreak.
Treatment for genital herpes is the same as for oral herpes. Several oral medicines, including famcyclovir (Famvir), valacyclovir (Valtrex) and acyclovir (Zovirax), can be effective, especially when started at the earliest sign of an outbreak. Alternatively, topical creams and ointments can be used to treat outbreaks, although they usually are not as effective as pills. Patients who experience frequent outbreaks may take continual small doses of famcyclovir, valacyclovir, or acyclovir to help prevent recurrences.
Genital herpes can be transmitted through sexual contact when the infected partner has open sores or is feeling the itching, burning, or tingling sensations that occur before the sores appear. People who have herpes and have open sores or pre-outbreak itchiness should not have sex. Not only can they transmit the disease, but they also can spread their own infection to a larger area.
Patients who may have herpes or may have been exposed to herpes should see a physician or other health care provider promptly. The infection is much easier to diagnose when the sores are present.
Gonorrhea is a sexually transmitted bacterial infection that causes pus-like discharge, lower abdominal pain, and fever in women. Early infection may not cause symptoms. If left untreated in women, gonorrhea can progress to a serious, life-threatening infection known as pelvic inflammatory disease (PID). PID involves the uterus and fallopian tubes. Men experience thick, off-white penile discharge and painful urination, although early infection may not cause symptoms.
Gonorrhea can spread between sex partners during oral sex, intercourse, or the sharing of sex toys. Patients who have HIV and may have gonorrhea or may have been exposed to gonorrhea should immediately see their physician or other health care provider. Antibiotics are used to treat gonorrhea.
Syphilis is a sexually transmitted bacterial infection that usually starts as a large open sore, or chancre, on the vagina or penis. If the bacteria are transmitted through oral or anal sex, the chancre may appear on the mouth or anus. If left untreated, syphilis progresses through 3 stages:
- Primary syphilis is the period during which the initial open sore appears. The chancre is painless and may be as big as 1/4 inch across or larger. After the chancre heals, many people think that the infection is gone. But actually, this indicates that the infection has spread into the bloodstream, which is known as secondary syphilis.
- During secondary syphilis, the patient may feel ill and develop a fever and an unusual rash on the palms of the hands and the soles of the feet. Widespread lesions and swollen lymph nodes also may occur.
- Tertiary syphilis, the third phase, is the spread of the infection into various organs and tissues, including the brain and heart. At this stage of infection, the bacteria cause long-term damage.
Syphilis is readily curable when treated with high dose penicillin or another antibiotic. There is some evidence that patients who have syphilis and HIV require higher doses and longer courses of antibiotics.
Patients who may have syphilis or may have been exposed to syphilis should see their physician or other health care provider as soon as possible. Syphilis can be diagnosed at any time during the infection, and earlier treatment can prevent complications.
Chlamydia is a sexually transmitted bacterial infection that can affect the cervix and pelvic organs in women and the penis in men. Symptoms may include discharge and a burning sensation during urination. In some cases, early infection does not cause symptoms.
If left untreated in women, chlamydia can progress to a serious and life-threatening infection (pelvic inflammatory disease) that involves the uterus and fallopian tubes. Later in the course of the infection, symptoms may include lower abdominal pain, pain during intercourse, low-grade fever, and bleeding between periods (in women).
Chlamydia can spread between sex partners during oral sex, intercourse, or the sharing of sex toys. Patients who are infected with HIV and may have chlamydia or may have been exposed to chlamydia should contact their physician or health care provider immediately. A number of antibiotics can be used to treat chlamydia.
Molluscum contagiosum, also known simply as molluscum, is a virus that usually is transmitted through skin-to-skin contact. It causes small, pimple-like, flesh-colored bumps on the face or in the groin or genital area. The lesions usually do not hurt, and they are not open like genital herpes lesions. Molluscum is treated by freezing the bumps with liquid nitrogen, surgically removing them, or applying toxic liquids such as podophyllum.