Sexually Transmitted Infections
Sexually transmitted infections (STIs): The basics
Sexually transmitted infections (STIs), which used to be known as sexually transmitted diseases (STDs), are a group of infections similar to one another only in that they can be "caught" through sexual contact. STIs are caused by different organisms, usually bacteria or viruses, and have a wide variety of symptoms. Some can be cured with antibiotics. Others cannot be cured – only controlled. The following are the STIs usually seen in North America.
- Chlamydia is a very common sexually transmitted infection in North America, affecting both men and women, especially those in their teen or young adult years. Chlamydia is caused by a bacterium called Chlamydia trachomatis. It is contracted by having unprotected oral, vaginal, or anal sex with an infected person. Even if you are infected, you may not be aware of it. If you are female, symptoms include a change or increase in vaginal discharge, vaginal itchiness or bleeding, lower abdominal pain, and pain during urination. Males may notice painful urination, testicular pain, a watery or milky discharge from the penis, or burning and itching. It's easily treated with antibiotics, but it can sometimes lead to serious complications such as infertility, pelvic inflammatory disease (PID), and Reiter's syndrome (an arthritis-like condition) if it isn't caught early enough. It can also be passed on to a newborn baby during delivery.
- Gonorrhea is another very common STI in North America. It is contracted the same way as chlamydia and has very similar symptoms (males may notice a thick greenish-yellow discharge from the penis). Quite often, people infected with chlamydia are also infected with gonorrhea. As with chlamydia, gonorrhea can lead to serious complications in women, such as infertility and PID. Gonorrhea is caused by bacteria, and it can be treated with antibiotics. The disease can affect mucous linings in the vagina, cervix, penis, rectum, throat, and eyes. Gonorrhea is also known as "the clap."
- Syphilis used to be a leading cause of death and disability but it's much less common today in the age of antibiotics. However, the rate of infection is on the rise, especially in men. Syphilis causes painless sores (called chancres) on the genitals, or in the vagina, rectum, and mouth. A body rash can also been seen. It is passed on from person to person through contact with the sores or rashes. It is very dangerous during pregnancy, as it can be passed on to an unborn baby, leading to birth defects or death. Therefore, screening of the mother for syphilis is a routine practice that occurs in all provinces. It can be treated with antibiotics if caught early. If left untreated, it can come back later to cause damage to the heart, nerves, brain, bone, joints, liver, and blood vessels. Syphilis is also known as "syph" (and in some older literature it is known as "the pox").
- HIV is the viral infection that can cause AIDS. The virus attacks cells of the immune system, leaving a person defenceless against many other infections and their complications. The virus can be found in the blood, semen, vaginal fluid, and breast milk. HIV can be contracted through unprotected sex, sharing needles or other drug equipment, or items like razor blades or toothbrushes that have blood on them. A person cannot get HIV by hugging, kissing, shaking hands, or sharing toilet seats. People who have HIV may not know about it for years, but sometimes develop mild flu-like symptoms 2 to 4 weeks after becoming infected. There is no cure, but antiviral medications can be used to control the progression of the disease.
- Hepatitis B is caused by a virus that infects the liver. Hep B is passed on from an infected person through blood, semen, vaginal fluid, or saliva. It can also be passed on by sharing personal items like toothbrushes or razors, or by sharing needles or tattoo equipment. A mother can also pass Hep B on to their unborn baby. Some general symptoms of Hep B include tiredness, abdominal pain, discoloured urine or stool, yellowish skin and eyes (jaundice), loss of appetite, and nausea. It can lead to chronic liver disease and liver cancer. Most people who are infected do not have any symptoms, but they can still pass the virus on. It cannot be cured, but a vaccine is available to help prevent it.
- Genital herpes, which produces cold-sore-type skin lesions in the genital area, is also caused by a virus (known as herpes simplex virus, HSV, types 1 or 2). It can be contracted by having oral sex with someone who has cold sores on their mouth. You can also get herpes in your eyes, mouth, and genitals by touching the sores. It can be passed on to an unborn baby, but there are medications available to reduce the risk of infecting the baby during pregnancy. The condition comes and goes, with skin lesions "flaring up" from time to time. Re-infection may occur if you are under stress, ill, feverish, or exposed to too much sunlight. You may notice itching or tingling on the skin, followed by the development of painful blisters. There is no cure, but antiviral medications are available to treat the outbreaks and reduce the frequency of flare-ups, and some can reduce the risk of transmission of the virus (in other words, it can reduce the risk of passing on genital herpes to a sex partner).
- Chancroid, a bacterial infection of the genitals that causes painful sores, was once rare in North America. But it has cropped up more frequently in recent years. It can be treated with antibiotics.
- Crabs, also known as pubic lice, are lice (tiny, wingless insects) that live in the genital area. They can be treated with medication.
- HPV, or human papillomavirus, is a virus that affects the skin in the genital area, causing wart-like growths. It can also affect a woman's cervix, and it increases the risk of cancer of the cervix. It is important for women to have regular Pap tests (usually at their yearly physical exam) to catch any precancerous changes (changes in the cells of the cervix that may lead to cancer) so that they can be treated before they develop into cancer. There are vaccines available that help your immune system prevent some types of HPV infection.
There are 2 types of human papillomavirus (HPV) vaccines available in Canada. One is approved for girls and young women aged 9 to 26 and boys and young men aged 9 to 26. This vaccine protects against the 2 types of HPV that cause approximately 70% of all cervical cancers (types 16 and 18) and the 2 types of HPV that cause about 90% of all genital warts (types 6 and 11). The other vaccine is approved for girls and young women aged 10 to 25. This vaccine protects against the 2 types of HPV that cause approximately 70% of all cervical cancers (types 16 and 18).
- Trichomoniasis is caused by a parasite. It usually causes no symptoms in men, although many women have symptoms. It can cause infection of the uterus and fallopian tubes, possibly leading to infertility. In pregnancy it can cause a baby to be born early or have low birth weight. Some symptoms include strange vaginal or penis discharge, painful sex (for females), itchiness of the vagina or penis, or burning while urinating. It can be cured with antibiotics.
- Lymphogranuloma venereum, or LGV, is caused by a subtype of the bacteria that causes chlamydia, but it is more invasive. LGV was previously rare in Canada and is typically seen in tropical regions of the world, such as South America, Asia, and the Caribbean. However, there has been a recent increase in the number of reported cases in North America. LGV is characterized by a painless lump that appears where the bacteria entered the body, flu-like symptoms, swollen lymph nodes, and genital or anal discharge. If left untreated, LGV can lead to scarring, deformity of the genitals, and, rarely, brain infection or hepatitis. Fortunately, this infection can be treated with antibiotics.
Many STIs can lead to health problems later on if they are not found and treated. Being infected with HPV can increase a woman's risk of cervical cancer. Chlamydia can lead to infertility and long-term pain in women by damaging the fallopian tubes, which are an important part of the reproductive system. HIV/AIDS eventually destroys the immune system, leading to an increased risk of infections, cancers, and death. Therefore, it is very important to practice safe sex.
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