SEXUALLY TRANSMITTED DISEASES

please click on any of the following topics for more information
Chlamydia	Gonorrhea	PID	HPV	Herpes	HIV/AIDS
Hepatitis B	Hepatitis C	Trichomonas	Condoms	Bibliography

Today, according to the Institute of Medicine, there are more than 25 STDs, many are viral with no cure. It is estimated that over 15 million new sexually transmitted infections occur every year in the United States. One-fourth of these new infections occur in teens, and two-thirds occur in individuals less than 25 years of age.

Also, according to the Institute of Medicine the STD epidemic is a result of individuals having, on average, more sexual partners in their lifetime and having sex with partners who engage in more risky behaviors than they did a few decades ago. This is important because an individual's lifetime number of sexual partners is one of the most important risk factors for contracting an STD. The younger an individual is when he or she begins sexual activity, the more partners they tend to have. This is especially troubling because adolescent females are more susceptible to some STD's than are adult women. Contracting an STD can have life-altering consequences. Some people die. Most don't, but many live with consequences that change their lives forever.

Chlamydia:
Chlamydia is the most common bacterial infection in humans, which is transmitted through sexual activity. It can also be passed from pregnant women to their newborn infants during childbirth. Typical symptoms include, a vaginal discharge, burning with urination, and pelvic pain. However up to 85% of women who are infected have no symptoms. In approximately 20% to 40% of women who are untreated, the infection will progress into their upper genital tract and can damage their fallopian tubes, causing infertility and ectopic pregnancies. The most serious complication of chlamydial infection is pelvic inflammatory disease (PID). PID can damage the fallopian tubes and result in tubal scarring and infertility. Patients with Chlamydia are diagnosed when the doctor finds the organism in urine and treatment is usually through oral antibiotics.

Gonorrhea:
Gonorrhea is a bacterium that causes genital infection and other infections in humans. About 650,000 Americans become infected with gonorrhea each year. It is spread primarily through sexual intercourse, oral sex and anal sex. A newborn baby can also become infected during the birth process if the mother is infected. The symptoms of gonorrhea infection vary depending on the part of the body that is infected, but a genital infection typically causes discharge from the vagina, and may cause pain with urination. Also abnormal vaginal bleeding ("spotting") is common. In time if untreated this infection can become pelvic inflammatory disease (PID). Uncomplicated gonorrhea is treated with oral or injectable antibiotics.

Pelvic Inflammatory Disease:
PID refers to upper reproductive tract infections in women, which often develop when STDs go untreated or are inadequately treated. Each year, PID and its complications affect more than 750,000 women. PID can cause chronic pelvic pain or harm to the reproductive organs. Permanent damage to the fallopian tubes can result from a single episode of PID and is even more common after a second or third episode. Damage to the fallopian tube is the only preventable cause of infertility.

One potentially fatal complication of PID is ectopic pregnancy, an abnormal condition that occurs when a fertilized egg implants in a location other than inside the woman's uterus - often in a fallopian tube. It is estimated that ectopic pregnancies have increased about five-fold over a twenty year period.

Human papilloma virus:
Human papilloma virus (HPV) is a virus that infects the skin and mucous membranes (tissues that line the mouth, cervix, vagina, urethra and anus). HPV is the most common viral STD with five to six million Americans becoming infected with genital HPV every year. A recent major study that included sexually active 18-22 year old women found that 50% were infected with HPV. Most patients with HPV infection have no symptoms. Approximately 1% of these women will experience genital warts and 14% will experience cervical abnormalities. Genital warts can be very difficult to eradicate. Annually, 2.5 million women experience an abnormal Pap smear in the United States, with a majority of these due to HPV infection. Untreated cervical intraepithelial neoplasia (the "pre-cancer" that typically causes abnormal (Pap smears) can develop into cervical cancer, and 93% of all cervical cancer is caused by HPV. HPV is spread by body fluids and skin-to-skin contact, and the effectiveness in condoms preventing HPV in women has not been demonstrated.

Genital herpes:
Genital herpes infects 20 percent of Americans age 12 and older. Genital herpes is a viral infection spread through sexual contact, once an individual has herpes he or she is infected for life. Genital herpes is probably best known for the sores and blisters it causes. These sores appear around the genitals or lips. In most cases, genital herpes is spread through direct contact with these sores. No one is sure why some people have recurrences of herpes. One trigger seems to be stress, both emotional and physical. Outbreaks may recur when you are under pressure. During pregnancy, there are risks to the baby. Newborns can become infected while they are coming through the mother's birth canal, if the mother has sores at the time of birth.

HIV/AIDS:
HIV/AIDS has caused the deaths of almost 500,000 Americans since the epidemic began. AIDS has no cure. While many HIV-infected people are living longer with modern drug therapy, it is still considered a fatal disease. Most people who are HIV-infected will die of AIDS unless they die of some other cause first. There is no cure or vaccine on the immediate horizon. The possibility of transmitting a fatal disease to a sexual partner should make any HIV-infected individual seriously consider whether or not he or she should be involved in any sexual activity that would put a partner at risk.

Hepatitis B:
It is estimated that approximately 78,000 individuals are newly infected with Hepatitis B in the United States each year. It is also estimated that there are between one million and 1.25 million carriers of Hepatitis B. This occurs because from 2 to 10 percent of individuals with a new Hepatitis B infection are not able to rid themselves of the acute infection. These persons with what is then called "chronic Hepatitis B" usually have no symptoms until they develop liver problems, problems that are very common in this group. Fifteen to 25 percent may die prematurely from either cirrhosis or liver cancer. Approximately 5,000 Americans die annually from these conditions.

Hepatitis C:
An estimated four million individuals in the United States are currently infected with Hepatitis C. Approximately 20 percent of Hepatitis C is sexually transmitted. Oddly, in
long-term monogamous couples in which one partner is infected with Hepatitis C this does not usually happen. It most often occurs when an individual has had multiple partners.)

Trichomonas:
Trichomoniasis is a protozoan parasite and infects the vagina or the urethra in women. This parasite has a tail and moves very much like the human sperm does. The primary and only significant mode of transmission is sexual intercourse. Increased risk of infection is associated with increased numbers of new, different, or casual sex partners. Trichomoniasis vaginalis is one of the most common STD's, in fact, 5-10% of American women are probably infected, with 5 million new cases in the U.S. each year. Women Most women infected with this STD do not know that they are infected. Trichomonas causes vaginitis (inflammation of the vagina and cervicitis (inflammation of the cervix). Routine tests for this STD is not normally done in patients without symptoms, so infected individuals who don't have symptoms are unlikely to be tested. Most trichomonas infections are treated with metronidazole, a drug that is taken by mouth.

Do Condoms keep you safe from Sexually Transmitted Diseases?
· Condoms can break, leak, slip off, or slip down, jeopardizing safety.
· Condoms do not eliminate the risk of acquiring an STD.
· Condoms appear to provide little, if any, protection against HPV, one of the most common STDs in America today and one that causes cervical cancer.
· The data are inconclusive as to whether condoms provide protection against some STDs, such as chlamydia.
· Condoms are not used consistently by most adolescents and young adults.
· Females are at significantly greater risk of acquiring STDs and resulting health complications than males.
· About 15% of couples who rely on condoms to avoid pregnancy will still get pregnant within a year.

BIBLIOGRAPHY
The Medical Institute for Sexual Health, key contributors: J.Thomas Fitch, M.D., Joe S. McIlhaney, Jr., M.D., Mary B. Adam, M.D., W. David Hager, M.C., Joseph R. Zanga, M.D. A monograph on Sex, Condoms and STDs: What We Now Know "Safer sex isn't nearly safe enough.