STD Awareness: HIV and AIDS

Our immune systems are beautiful things, refined through millions of years of evolution. The immune system’s complexity is testament to the “arms race” that has been taking place between our species and the harmful pathogens that surround us. Last century, a virus called human immunodeficiency virus (HIV) emerged, and it found a weak spot in our immune system’s armor. HIV has been exploiting this weakness ever since, and an HIV infection can eventually progress to a disease called AIDS, or acquired immune deficiency syndrome. AIDS is a condition that disables our immune system’s ability to function properly, rendering us vulnerable to a host of opportunistic infections and cancers.


Even if you don’t think you’ve been exposed, HIV testing can be a good idea.


HIV is transmitted via bodily fluids: blood, semen, pre-seminal fluid (which can be present without ejaculation), breast milk, vaginal fluids, and rectal mucus. (It can also be present in bodily fluids like amniotic fluid, cerebrospinal fluid, and synovial fluid, to which health-care workers might be exposed.) The virus is not transmitted by fluids like snot, saliva, sweat, tears, and urine — unless blood is present.

Activities that can bring you into contact with HIV-infected bodily fluids include injection drug use and sexual activities like anal, vaginal, or oral sex. It can also be transmitted to a fetus or baby during pregnancy, childbirth, or breastfeeding. In the early days of HIV, many infections occurred as a result of blood transfusions or organ transplants — though nowadays this is a rarity thanks to tissue screening. Lastly, health-care workers might be exposed to HIV through accidents involving needlesticks or cuts. Continue reading

Allergic to Latex? You Can Still Have Safer Sex

Condoms offer fantastic protection against STDs and reduce pregnancy risk. Most are made from latex, to which some people are allergic.

Latex condoms are a well-rounded form of birth control: Not only are they great for preventing pregnancy, but they reduce the risk of passing on or receiving a sexually transmitted disease (STD). When used consistently and correctly, they offer fantastic protection. Although condoms have been around for centuries, their modern construction from latex is a vast improvement over the silk and viscera of yore. A product of the industrial age, they are manufactured by dipping a porcelain mold into natural rubber latex, a material that originates from a tree.


Latex is tops, but other options include polyisoprene and polyurethane. Beware: Lambskin isn’t effective STD protection.


Because of latex’s many advantages, the majority of condoms are manufactured from this material. However, up to 6 percent of the population is allergic to latex. There is a range of symptoms associated with latex allergies. Most people with latex allergies experience only a localized reaction on the vulva or penis (contact dermatitis); systemic reactions (like asthma or anaphylaxis) are rare. Allergy tests can be performed on people who suspect they might be sensitive to latex.

Luckily, even if you have a latex allergy you can still find condoms to facilitate your safer-sex experiences, including condoms made out of polyurethane and polyisoprene. Not all condoms protect against pregnancy or STDs, so read the label carefully. In the United States, if the packaging doesn’t explicitly state that the condoms are made to prevent disease, they haven’t been approved by the FDA for that purpose. Continue reading

STD Awareness: “Can I Get an STD from Oral Sex?”

As tools to reduce risk for STD transmission, dental dams are not to be ignored.

Editor’s Note: Other posts of interest to readers include: “STD Awareness: Gonorrhea of the Throat,” “STD Awareness: Oral Herpes,” and “Can Oral Herpes Be Spread to Genitals?

Many consider oral sex to be a safer form of sexual activity compared to vaginal or anal intercourse. For this reason, they might put less emphasis on the use of latex barriers, such as dental dams and condoms, during oral sex. Unfortunately, this idea is misguided and can lead to the transmission of preventable infections.

It is generally true that oral sex presents less of a risk for contracting sexually transmitted diseases (STDs) — but this risk is not trivial, especially when people are under the impression that they don’t need to use barrier methods during oral sex. Most sexually transmitted diseases can be passed along by oral sex, including chlamydia, gonorrhea, syphilis, hepatitis B, herpes (which can be transmitted back and forth from the mouth, as cold sores, to the genital region, as genital herpes), human papillomavirus (HPV), and HIV. Even pubic lice can be transferred from the genital region to eyelashes and eyebrows! Additionally, intestinal parasites are more likely to be transmitted via oral sex than through vaginal sex. A microscopic amount of fecal matter containing parasites can be infectious, and can be unknowingly ingested when present on genitals.


Seventy percent of adolescents who reported engaging in oral sex had never used a barrier to protect themselves from STDs during oral sex.


Some bacterial STDs, such as gonorrhea and syphilis, can do permanent damage if not treated in time. Furthermore, gonorrhea of the throat is much more difficult to treat than gonorrhea in the genital or rectal areas. And some viral STDs can’t be cured (such as herpes and HIV), while others can cause chronic infections that have been linked to cancer (such as hepatitis, which is associated with liver cancer, and HPV, which is associated with throat cancer as well as cervical cancer and anal cancer). Continue reading

STD Awareness: Intestinal Parasites

This colorized scanning electron micrograph shows Giardia lamblia reproducing asexually. Image: Stan Erlandsen, CDC’s Public Health Image Library.

This colorized scanning electron micrograph shows Giardia lamblia reproducing asexually. Image: Stan Erlandsen, CDC’s Public Health Image Library.

Most sexually transmitted diseases are caused by bacteria or viruses, but some are caused by organisms that are classified as completely different lifeforms. Trichomoniasis, for example, is caused by a protozoan organism; protozoa occupy their own kingdom, separate from plants, animals, and bacteria. Intestinal parasites are often protozoan organisms, but can also include parasitic worms (which are members of the animal kingdom). They are spread through contact with fecal matter — and as such, they can be transmitted sexually as well as nonsexually. Intestinal parasites are usually transmitted by fecal contamination of food or water, and are most common in areas with insufficient sewage treatment and untreated water in the wilderness. Some pathogens, however, have low infectious doses, making their sexual transmission more likely.


What has eight flagella and can live in your intestines?


Oral contact with the anus, also called anilingus or rimming, is the primary means of the sexual transmission of these pathogens. Putting fingers or hands in your mouth after they have had contact with the anus is also risky. Other modes of transmission include oral sex, as genitals can be contaminated with feces, as well as sharing sex toys and other equipment. For these reasons, it is very important to use dental dams or latex gloves during contact with the anus; to clean the anus before engaging in rimming; to clean or use condoms on shared sex toys; and to use condoms or dental dams during oral sex. Continue reading

STD Awareness: Cytomegalovirus and Molluscum Contagiosum

Most sexually transmitted diseases (STDs) are caused by microorganisms – lifeforms that are too small to be seen without a microscope. Many STDs, however, are caused by viruses, which technically aren’t even alive. Rather, viruses are pieces of genetic information that are stored in protein capsules. When these capsules come into contact with a host cell, the genetic information is able to enter the cell and hijack its machinery so that the host cell manufactures copies of the virus, as well as potentially harmful viral proteins. Many well-known STDs, such as herpes and HIV/AIDS, are caused by viruses, but this month we will focus on two lesser-known viral STDs, cytomegalovirus and molluscum contagiosum. Your local Planned Parenthood health center, as well as other clinics, health departments, and private health-care providers, can help you get a diagnosis and treatment for these STDs.

Cytomegalovirus leaves granules inside its host cells called inclusion bodies, pictured here. Photograph from the CDC’s Public Health Image Library.

Cytomegalovirus leaves granules inside its host cells called inclusion bodies, pictured here. Image: Public Health Image Library, CDC

Cytomegalovirus

The bad news is that most people are infected with cytomegalovirus (CMV) at some point in their lives. About 80 percent of the U.S. population is estimated to be carriers, about 4 in 10 Americans are infected with CMV before puberty (usually through contact with saliva), and adults can be reinfected through sexual activity. The good news is that among healthy adults, a CMV infection usually does not have any symptoms, though if they do they could seem like a mild case of mono. Being reinfected with the virus later in life also carries with it only a small risk for symptoms in healthy adults.

And back to the bad news: While an infection with cytomegalovirus usually does not have symptoms, if someone is infected while pregnant it can harm the fetus. About 1 in 100 U.S. babies is infected with CMV, but usually doesn’t show symptoms. Every year in the United States, around 5,500 babies are born with symptomatic cytomegalic inclusion disease (CID). Symptoms of CID vary, but the most severe include mental retardation and hearing loss. If the mother was already infected before conception, there is a 2 percent chance the virus will be transmitted to the fetus; however, if the infection occurs during pregnancy, this risk jumps into the 40 to 50 percent range. Continue reading

STD Awareness: Trichomoniasis

Trichomonas vaginalis, normally pear-shaped, flattens itself out after attaching to vaginal epithelial cells, maximizing surface area between parasite and host. The purple rod-shaped organisms are bacteria. Image courtesy of Antonio Pereira-Neves and Marlene Benchimol, Santa Ursula University, Rio de Janeiro, Brazil

Trichomonas vaginalis, normally pear-shaped, flattens itself out after attaching to vaginal epithelial cells, maximizing surface area between parasite and host. The purple rod-shaped organisms are bacteria. Image courtesy of Antonio Pereira-Neves and Marlene Benchimol, Santa Ursula University, Rio de Janeiro, Brazil

Most sexually transmitted diseases are caused by viruses or bacteria. STDs caused by viruses include herpes and genital warts, and the viruses that cause them aren’t even technically living organisms — they are pieces of genetic information that are able to infect a host cell. STDs caused by bacteria include gonorrhea and syphilis; bacteria are microscopic, single-celled organisms with relatively simple cell structures.

But some STDs are caused by other types of living organisms. Protozoan organisms are microscopic and unicellular, like bacteria; unlike bacteria, their cell structures more closely resemble that of the so-called “higher” life forms such as animals and plants. While protozoa are considered to be “animal-like,” they are not animals at all — they are single-celled organisms that reproduce asexually. When certain types of protozoans get into your body, they can cause infections — such as trichomoniasis, the most common curable STD among young females (as well as more females over 40 than previously thought). It is estimated that 7.4 million new cases of trichomoniasis occur annually in the United States; worldwide, there are about 170 million cases each year.

Trichomoniasis, colloquially known as trich, is spread by vaginal or anal intercourse, direct vulva-to-vulva contact, and other activities that involve passing secretions from one partner to another (e.g., sharing sex toys or mutual masturbation). Sexually active people can reduce the risk of contracting trichomoniasis by using latex barriers, such as condoms. Continue reading

STD Awareness: Scabies and Pubic Lice

Latex barriers, such as condoms and dental dams, offer fantastic protection against most sexually transmitted diseases (STDs). They are not 100 percent effective, however, and there are even some STDs for which latex poses no obstacle. Because barriers only cover a portion of the genital area, they do not offer sufficient protection against scabies or pubic lice, both of which are caused by infestations of tiny arthropods.

Both scabies and pubic lice are treated with topical medications. A Planned Parenthood health center, as well as other health care providers, clinics, and health departments, can provide testing and treatment. Follow treatment instructions to the letter to ensure success. During this time, you can take actions to prevent reinfection, including vacuuming floors and cleaning rooms, and thoroughly washing all clothing, towels, and bedding in hot water. Your sexual partner(s) might also need to receive treatment.

Now let’s learn more about both specific STDs.

Scabies

Sarcoptes scabiei, the mite that causes scabies. Image from the Public Health Image Library.

Three-hundred million people carry the eight-legged mite that causes scabies, Sarcoptes scabiei var. hominis. While it’s so small that you need a microscope to see it, it causes an itchy condition that you can definitely feel. The female mite burrows under the skin, usually starting between the fingers and then spreading to the rest of the body, digging until she dies and laying eggs along the way. When the eggs hatch, the nymphs travel to the surface of the skin, where they may transfer to another host or reinfect the original host. Continue reading