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STDs on Campus: Symptoms, Treatment, and Prevention

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Sexually transmitted diseases (STD) have become increasingly common among college students in the United States. One in five teens gets a sexually transmitted disease each year in the United States. Chlamydia, gonorrhea, genital herpes, and genital warts (human papillomavirus or HPV) are the most common STDs on college campuses. HPV infects 5.5 million people, while Chlamydia infects 3 million people a year.

Chlamydia is the most frequently reported STD in the United States. It is caused by the bacterium, Chlamydia trachomatis. Symptoms of Chlamydia are usually mild or absent. This mean that serious complications that cause irreversible damage (including infertility) can occur “silently” before a woman ever suspects a problem. Three quarters of infected women and about half of infected men have no symptoms. In men, the most seen symptoms of Chlamydia are a discharge from the penis, a burning sensation when urinating, or burning and itching around the opening of the penis. For women, the bacteria initially infect the cervix and the urethra. Symptoms during this stage include an abnormal vaginal discharge, a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes, some women might have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Women are frequently re-infected if their partners are not treated for the disease. If symptoms do occur, they usually appear within 1-3 weeks after exposure. Chlamydia can be transmitted during vaginal, anal, or oral sex. It can also be passed from an infected mother to her baby during vaginal childbirth. Men or women who are the receivers of anal sex may acquire the infection in the rectum, which can cause rectal pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner. If Chlamydia is not treated in women, it can cause pelvic inflammatory disease (PID). In rare cases, a Chlamydia infection can cause arthritis accompanied by skin lesions or eye and urethra inflammation (Reiter’s syndrome). Chlamydia can be easily treated and cured with antibiotics. All sex partners should be evaluated, tested, and treated if need be. To avoid re-infection, abstain from sex until treatment has been completed.

Gonorrhea is a sexually transmitted disease (STD) caused by the bacterium, Neisseria gonorrhoeae. This type of bacteria multiplies easily in the warm, moist areas of the reproductive tract. The bacteria can also grow in the mouth, throat, eyes, and anus. Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted. It can be transmitted from mother to child during childbirth. Most people who are infected do not experience any symptoms. If symptoms do occur, they can take as long as 30 days to appear. For men, symptoms of gonorrhea include a burning sensation when urinating, a white, yellow, or green discharge from the penis, and swollen or painful testicles. In women, the symptoms are often mild. They include a painful or burning sensation when urinating, increased vaginal discharge, or bleeding between periods. Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements. Infections in the throat may cause a sore throat but usually there are no symptoms. Untreated gonorrhea can cause serious and permanent health problems in both women and men. In women, gonorrhea is a common cause of pelvic inflammatory disease (PID). PID can lead to internal abscesses and long-lasting, chronic pelvic pain. PID can cause damage to the fallopian tubes, increase the risk of eptopic pregnancy, and cause infertility. In men, gonorrhea can cause epididymitis, a painful condition of the testicles that can lead to infertility if not treated. Gonorrhea can spread to the blood and joints. This can be a life threatening condition. People with gonorrhea can more easily contract HIV, while HIV-infected people with gonorrhea are more likely to transmit the virus to someone else. Generally, antibiotics are used to cure gonorrhea. However, drug-resistant strains of gonorrhea are increasing in many areas of the world, including the United States. This makes successful treatment of gonorrhea more difficult. It is important to take all of the medication prescribed for gonorrhea. Medication stops the infection, but it will not repair any permanent damage done by the disease.

Genital herpes is an STD caused by the herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2). Most genital herpes is caused by HSV-2. Many people have no signs or only minimal signs or symptoms from an HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters burst, leaving tender sores (ulcers) that may take two – four weeks to heal. Typically, there is another outbreak weeks or months after the first. It is usually less severe and shorter than the first outbreak. Although the infection stays in the body indefinitely, the number of outbreaks tends to decrease. Genital HSV-2 infection is more common in women (1 out of 4) than in men (1 out of 5) Male-to-female transmissions are more likely than female-to-male transmission. HSV-1 and HSV-2 are released from the sores that the viruses cause, but they can also be released between outbreaks from skin that does not appear to have a sore or be broken. Generally, a person can only get an HSV-2 infection during a sexual contact with someone who already has a genital HSV-2 infection. HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips (aka “cold sores” or “fever blisters”) HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has an HSV-1 infection. Genital HSV-1 outbreaks recur less often than genital HSV-2 outbreaks. Most people infected with HSV-2 are not aware they have it. If signs and symptoms occur during the first outbreak, they can be quite pronounced. The first outbreak usually occurs within two weeks after the virus is transmitted, and the sores usually heal within two -four weeks. Other signs and symptoms may include a second crop of sores and flu-like symptoms. Most individuals with HSV-2 infection never have sores, have very mild signs that they do not even notice, or that they mistake the sores for insect bites or another skin condition. Most people diagnosed with genital herpes can expect to have several (4 or 5 on average) outbreaks within a year. Over time, recurrences usually decrease in frequency. Genital herpes can cause psychological distress in people who know they are infected. Genital HSV can cause potentially fatal infections in babies. It is essential to avoid contracting herpes during pregnancy. Herpes can make people more susceptible to an HIV infection and can make HIV-infected individuals more infectious. There is no treatment that can cure herpes. Antiviral medications can prevent and shorten the duration of outbreaks during the time the medication is taken. Daily suppressive therapy for symptomatic herpes can reduce transmission to others.

Genital HPV infection is an STD that is caused by human papillomavirus (HPV). Human papillomavirus is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted. Most people who become infected with HPV will not have any symptoms and the infection will clear up on its own. Some of these viruses may lead to cancer of the cervix, vulva, vagina, anus, or penis. Some cause abnormal Pap tests in women and genital warts. Genital warts are single or multiple growths (cauliflower shaped) or bumps that appear in the genital area. Approximately 20 million people are currently infected with HPV. At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percent of women will have acquired genital HPV infection. About 6.2 million Americans get a new genital HPV infection each year. The types of HPV that infect the genital area are spread primarily through genital contact. Most HPV infections have no signs or symptoms. Most people that are infected are unaware they are infected and continue to transmit it to others unknowingly. A pregnant woman can pass HPV to her baby during vaginal delivery. The virus lives in the skin or mucous membranes and usually causes no symptoms. Some people get genital warts or have pre-cancerous changes in the cervix, vulva, anus, or penis. Rarely, HPV infection results in anal or genital cancers. Genital warts usually appear as soft, moist, pink or flesh-colored swellings, in the genital area. They can be raised or flat, single or multiple (cauliflower shaped), and small or large. After transmission, warts may appear within weeks, months, or not at all. Genital warts are diagnosed by a visual inspection. Genital warts can be removed by medications applied by the patient or by treatments performed by a doctor. There is no “cure” for HPV infection. In most women the infection goes away on its own. Approximately 10 of the 30 identified genital HPV types can lead to development of cervical cancer. A Pap test can detect cancer cells. Regular Pap testing, careful medical follow-up, and treatment if necessary can help ensure that changes detected in a Pap test do not develop into life threatening cervical cancer. The American Cancer Society estimates that about 11,000 women will develop invasive cervical cancer and about 4,000 women will die from this disease each year.

There are several tactics you can use to prevent STDs. Abstaining from sex (yep, all of them – vaginal, anal, and oral) is a sure-fire way to avoid an STD. If you have made the choice to have sex, you can lessen your chance of catching an STD by only having sex within a long-term monogamous relationship. If your sexual habits include multiple partners, make sure you use condoms. While oral birth control, Depo-Provera injections, and other birth control methods will prevent pregnancy, they won’t prevent STDs. When using condoms, make sure you are using them correctly. Most birth control methods fail due to user error. Some things to remember when using condoms:

  • Use a new condom for every sex act. Do not unroll the condom before placing it on the penis.
  • Put the condom on after the penis is erect and before any contact is made with any part of your partner’s body.
  • If the condom doesn’t have a reservoir tip, pinch the tip enough to leave a half-inch space for semen to collect. Eliminate any air in the tip to help keep the condom from breaking.
  • Holding the condom rim, place the condom on top of the penis. Continue holding it by the rim while unrolling it to the base of the penis.
  • If you feel the condom break, stop immediately, withdraw, and put on a new condom.
  • After ejaculation and before the penis becomes soft, hold the rim of the condom and withdraw carefully.
  • Remove the condom by gently pulling it off the penis, being careful not to spill anything.
  • Throw the condom away. Do not flush them down the toilet, they can cause plumbing problems.

If you have multiple partners, not only should you use protection, but you should get screened for STDs on a regular basis. Two times a year would be sufficient. Check at your student health center, county health departments, and Planned Parenthood for low-cost STD testing and condoms.


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