Frequently Asked Questions about Sexually Transmitted Diseases (STDs)
Q. What is the best prevention against contracting a sexually transmitted disease (STD)?
A. The only completely foolproof defense against STDs is to abstain from sex. Failing that, the next surest way to is to limit one's sexual relationship to a single, uninfected partner.
Q. What can a sexually active person do to guard against STDs?
A. If you decide to be sexually active, particularly if you have multiple sex partners, you must take steps to protect yourself. This means being honest and direct with your sexual partner. Ask your partner directly if he or she has an STD, or if they think they have been exposed to someone who has an STD. It may be a little awkward or embarrassing, but it's certainly not as bad as being infected with herpes, gonorrhea or syphilis.
Next, learn the signs and symptoms of STDs, and check your partner for them. Again, this may be a bit awkward at first, but genital warts, molloscum contagiosum and crab lice are even more embarrassing, and will make you ill as well.
Most importantly, do not have sex with anyone who has STD symptoms. Urge that person to get treatment immediately.
Finally, use a condom. Latex condoms have proven to be generally effective at preventing infection if they are put on before starting sex and worn until the penis is withdrawn. Remember that condoms only provide protection for the area they cover; many STDs produce sores or lesions on other parts of the body which can spread infection if they come in contact with a receptive source, such as the mucous membranes of the mouth and eyes, or a break in the skin. Some sources claim diaphragms and spermicides also provide limited protection against infection, but this is questionable. Douching or urinating after sex does not prevent STDs.
Q. What should I do if I think I may have come in contact with an STD?
A. See your urologist, family doctor or ob/gyn at once, even if you're not sure you are infected or if your symptoms seem minor. If your doctor prescribes a course of medication, follow it! Take all medication. Don't stop just because you start feeling better or your symptoms disappear. If the doctor recommends a follow-up examination, schedule one and keep the appointment: it's often the only way to be sure the infection has been completely cured.
Most important of all, abstain from sex until the infection is cured.
Q. Can STDs be transmitted through casual contact?
A. With very few exceptions, no.
Usually direct sexual contact, such as vaginal, oral or anal sex, is required to bring the infection in touch with a receptive surface. Most STDs cannot be spread from person to person through contact with toilet seats, swimming pools, hot tubs, shared clothing, door knobs, eating utensils, etc. There are a few qualified exceptions, however:
- The spirochete bacterium that causes syphilis can be transmitted by direct contact with the open sores which often characterize the disease during its early stages. Kissing can spread the disease under these conditions. Unlike most STDs, primary orsecondary syphilis also can be transmitted by nonsexual contact. For example, if a person with a cut or break in the skin on his hand shakes hands with an infected person who has an open sore on his hand, infection can result. Though this is rare, it points out the extremely infectious nature of the disease at different stages.
- Herpes can invade the body virtually anywhere an open herpes sore comes in to contact with a break in the skin. For example, a person can become infected by kissing someone with a herpes cold sore. Infection also can occur through the eyes, fingers or other parts of the body. Because the virus can survive a few hours outside the body, experts think it possible, though unlikely, for herpes to be spread by contact with objects like toilet seats or hot tubs.
- Trichomonas vaginalis, the parasitic protozoan that causes trichomoniasis ("trich"), is capable of surviving for some hours outside the body in bodily fluids, damp towels or bedding. In rare cases it has been known to be spread by mutual masturbation, when bodily fluids from one partner come in contact with the other partner's genitals.
- Parasitic insects, such as crab lice (Pediculosis pubis) and scabies mites, though typically transmitted through sexual contact, are highly mobile. A person can acquire crab lice from bedding, clothing or toilet seats, and instances of scabies infection through contaminated clothes or bedding have been authenticated.
- Babies can contract many different STDs at birth from their infected mothers.
Q. What is pelvic inflammatory disease? What causes it, and what are its dangers?
A. An estimated 1 million women a year contract pelvic inflammatory disease (PID), an infection of the upper genital tract. It is the most common and most serious complication associated with STDs in women. PID results when infections of the vagina or cervix, particularly gonorrhea and chlamydia, spread upward into the uterus, ovaries, fallopian tubes or adjacent organs. It also can be caused by the insertion of IUDs, an induced abortion, or other procedures where instruments are inserted through the cervix into the uterus.
PID symptoms often include lower abdominal pain, vaginal discharge, fever, pain during intercourse and irregular menstrual bleeding. PID associated with chlamydial infection may produce mild symptoms, however, or no symptoms at all. Untreated, PID can be very dangerous, leading to infertility, tubal (ectopic) pregnancy, chronic pelvic pain and recurrent infection.
A course of antibiotic medication is usually prescribed to treat PID. Severe infections may require hospitalization and intravenous (IV) antibiotic treatment. Sex partners of women with PID should be examined and treated as necessary, even if they have no symptoms, as they may be infected with PID-carrying organisms.