Countryside Public Health

Sexually Transmitted Diseases/Sexually Transmitted Infections and Testing

You've probably heard the expression "it won't happen to me" or maybe have even said or thought it yourself. Many teens report they thought that exact thing before they chose to participate in sexual activities that lead to a sexually transmitted disease.

Sexually Transmitted Diseases (STD's), also known as Sexually Transmitted Infections are transferred from one individual to another through sexual contact. Adolescents and teens are among the highest number of cases, with 3 million new cases reported each year.

There are several types of STD's, many that can be very serious if left untreated. Some common STD's include:

Chlamydia
  • Chlamydia is the most common STD with an estimated 4 million cases reported in the United States. People ages 15-19 account for 46% of the reported cases.
  • It is caused by a bacteria called Chlamydia trachomatis.
  • Chlamydia is easily treated with antibiotics so it's important to be tested if you have had unprotected sex and are at risk.
  • Symptoms
    • Usually appear within the first month after exposure
    • May not experience symptoms in early stages, 75% of females and 15-20% of males have no symptoms
    • Male: unusual discharge of fluids from the penis
      Painful, burning or frequent urination
    • Female: Vaginal discharge of fluids
      Pain in the pelvic area
      Bleeding between menstrual periods
Diagnosis and Treatment

Chlamydia is difficult to diagnose because people may not have symptoms. Many times people are infected with both Chlamydia and Gonorrhea at the same time, so make sure to get tested for both. Lab tests are done to diagnose the nature of the infections. Chlamydia can be easily treated with antibiotics.

If Chlamydia goes untreated, the infection starts to attack both male and female reproductive organs. Males may experience pain and swelling of the scrotom and sterility. Females are at high risk for developing more serious problems including Pelvic Inflammatory Disease and Nongonococcal Urethritis (NGU)

Pelvic Inflammatory Disease is a painful infection of the fallopian tubes, ovaries or both. If this goes untreated it can cause scar tissue in the fallopian tubes and can lead to infertility.

Nongonococcal Urethritis is caused by several bacteria like organisms that infect the urethra in males and cervix in females. Males are also at risk for developing this and have more noticeable symptoms than females. Symptoms a male will experience include discharge from the penis 1-3 weeks after they become infected and mild burning during urination. Females will experience vaginal discharge and pain in their lower pelvic area.



Gonorrhea
  • Gonorrhea is the most common STD after Chlamydia. It is caused by a bacteria called Neisseria Gonorrhea.
  • The bacteria grow in warm, moist places including the cervix, uterus, fallopian tubes and urethra. It can also grow in the mouth, throat and rectum.
  • Each year 650,000 people in the U.S. are infected with this disease.
  • Symptoms
    • Usually symptoms appear within 3-7 days after sexual contact and are not always obvious.
    • Females may never know they have the disease because the symptoms can be so slight they may go unnoticed. They are also often times mistaken for a vaginal infection because the symptoms are similar.
    • Females: thick-whitish/yellow discharge, burning sensation with urination, frequent urination, abdominal pain and pelvic inflammatory disease

      Male: thick whitish-yellow discharge, burning sensation with urination or painful/swollen testicles
Diagnosis and Treatment
  • Gonorrhea can only be confirmed by medical diagnosis
  • Males are diagnosed by examining the discharge from the penis under a microscope
  • A sample of cells from the vagina is examined under a microscope to diagnose a female.
  • can be easily cured with antibiotics if diagnosed early
  • If left untreated the disease spreads quickly through the body and can cause long term effects including damage to your joints, heart tissue and other organs. It can also lead to sterility in both men and women.
  • If you are pregnant and have untreated Gonorrhea, there is an increased chance of having a premature birth or stillborn baby. If it is passed along to your child during birth they are at risk for eye infections that could lead to blindness. *Most states require all newborns to be treated with eye drops as soon as they are born


Syphilis

Syphilis is caused by a bacteria called spirochete and is one of the most dangerous STD's because it enters the body through soft inner skin (vagina, anus, penis or mouth) and goes directly into the blood stream, which goes through your entire body.

Symptoms
  • Stage 1: Characterized by small, red painless sores called chancre-these sores are not always noticeable on females because they appear where the pathogen entered the body which is most commonly the penis for males and vagina or cervix for females. Chancre usually disappear within 1-5 weeks but the disease continues to spread throughout the body.
  • Stage 2: Within 1-5 months the disease will produce symptoms including muscular or joint pain, swollen lymph nodes, nausea, headache, loss of appetite, fever or a general sick feeling. The most common symptom is a highly contagious rash that may appear anywhere on the infected person's body, for females it commonly occurs on the outer edge of the vagina. Eventually the rash turns into sores which ooze fluid, providing an easy entry for other infections including HIV. Without treatment, the symptoms usually go away within 4-12 weeks.
  • Latent Stage: This stage begins 2 or more years after the initial infection and the symptoms appear to have disappeared or people believe they did not have the disease at all. For some, the symptoms may never return, for others, they will go into the fourth stage.
  • Neurosyphillis Stage: Occurs years after the infection when the bacteria begins to attack the heart, blood vessels, bones, liver and central nervous system. This damage occurs at a slow and steady rate and eventually leads to blindness or insanity.
Diagnosis and Treatment

The Venereal Disease Research Laboratory is a blood test that is done to test for syphilis. The presence of spirochete in the blood or fluid from sores indicates the disease.

Syphilis can be treated with Tetracycline or penicillin but it's important to know that a person can be reinfected at any time. Treatment does not create immunity to the disease; it only stops it from progressing and causing further damage to your body.

Congenital Syphilis

Syphilis can be transferred to an unborn child any time after the 5th month of pregnancy. Penicillin can be used to protect the unborn fetus.

Without treatment the mother's risk of having a miscarriages 4 times greater and the chance of having a stillborn baby is 2 times higher. If the baby is born with syphilis, the symptoms usually appear within 3-4 weeks after birth and can result in deafness and bone, teeth and liver damage.



Genital Herpes

Herpes Simplex Virus (HSV) is a viral infection that causes clusters of sores or lesions at a person's genital areas. There are two stands of Herpes, HSV-1 and HSV-2. Genital Herpes are caused by HSV-2, but if a person has HSV-1, they can pass the virus along. This means that if a person has oral herpes, they can be passed along and cause genital herpes and vice versa.

Genital Herpes can be transmitted when there is close oral, anal or genital contact including kissing, direct skin to skin contact that allows exchange of body fluids or masturbation.

Symptoms

Symptoms will appear differently in each individual, but approximately 2-20 days after a person becomes infected, they may experience some of the following symptoms: vaginal discharge, abdominal pressure, burning, itching or pain in their genital area, buttocks or legs. The most common symptom is small red bumps or blisters that crust over and heal within a couple days.

A person is considered contagious when symptoms or sores are present and while the sores are healing. It's very important to know that a person can be contagious even if they have no symptoms at the time so protect yourself at all times. Nobody is immune from this disease.

Treatment

Unfortunately there is no cure for genital herpes, but there are medications available to help reduce the signs during an outbreak.



Hepatitis B

Hepatitis B is caused by a virus known as Hepatitis B virus (HBV). The HBV attacks the liver and can lead to several serious complications including scarring of the liver which is called cirrhosis, liver cancer, liver failure and possibly death. About 60,000 people are infected each year with this disease. People ages 20-49 have the highest rate of occurrence.

This disease can is transmitted by blood or body fluids that contain blood. Some examples include: Unprotected sex, using injection drugs (sharing of needles) or sharing razors or toothbrushes with a family member that is infected

Symptoms

There are several symptoms a person may experience. The symptoms include: diarrhea/nausea, dark, foamy urine, pale stool, abdominal pain, joint pain, loss of appetite, fatigue and yellowing of skin and the white area of a person's eyes.

Treatment

There is a vaccination to prevent against this disease. There are also medications that can be taken to help, but there is no cure. Remember to use protection if you are sexually active and avoid using anything that could transfer blood from one person to another, such as needles. This includes tattoos and body piercing, if you are going to get one, make sure you go to a place you know.



Genital Warts (HPV)

Genital Warts are also known as venereal warts. They are transmitted through direct skin to skin contact during intercourse. Genital warts are caused by Human Papillomavirus (HPV). A person can not get genital warts if they are in contact with someone that has warts on their hands or feet; these warts are caused by a different virus.

Genital warts are very common in the U.S. with approximately 6 million new cases occurring each year.

A person could be infected for years before symptoms appear. Typically the virus is dormant for 1-6 months before any symptoms would appear.

Symptoms

When a person does experience symptoms, they include small, hard, bumps that look like cauliflower on the area that was infected. They can vary in size and shape but are usually flesh colored and painless. Some strains of HPV have also been known to cause cervical cancer due to changes in cervix caused by the virus.

Treatment

There is a vaccination available for females- ages 9-26 called Gardasil to help prevent the HPV infection. This website will provide you with more information about the vaccination. http://pediatrics.about.com/od/immunizations/p/06_gardasil.htm/

There is no cure for HPV, but there are ways to treat the warts when they appear. Some of these options include: prescription medications/creams on the warts, using liquid nitrogen to freeze the warts or laser treatment.



Trichomoniasis

Trichomoniasis is a sexually transmitted disease that is caused by a parasite called Trichomonas vaginalis. The vagina is the most common site of infection for women and the urethra for men. This virus affects approximately 7.4 million Americans each year.

Symptoms

The symptoms for men may be very slight, if they have any at all. They may notice a thin, white discharge from their penis or painful urination.

Females are more likely to have symptoms, but may not experience any. Some symptoms for females include: vaginal discharge, itching, redness or swelling in the vagina, burning sensation with urination and pain during sex.

Pregnant females are at risk for complications during their pregnancy including premature delivery and low birth weight babies.

Diagnosis and Treatment

This disease is diagnosed by a physical exam and lab tests. Women may have to have a pelvic exam to exam the vaginal wall of cervix.

This disease can be easily treated with antibiotics. The most common one being metronidazole. Both people should be treated because anyone can get the disease, even if they have had it and successfully treated it in the past.



HIV/AIDS

Human Immunodeficiency Virus (HIV), is the virus the causes Acquired Immunodeficiency Syndrome (AIDS). It is spread through intercourse with an infected person; injection drug use with infected blood or through a mother to her baby during pregnancy, childbirth or breast-feeding. It can be easily spread if protection is not used.

The HIV virus attacks your T4 cells, which are cells that aid in fighting off illness. Eventually your immune system is so weak that it is unable to fight off different infections, when this happens, a person is considered to have AIDS.

Immune System

Your body is a pretty amazing organism when you stop and think of all the ways it works to protect you from infections. Your skin is your body's first line of defense. If something gets in through your skin, you have your next line of defense which includes all of your major body systems. Your immune system is your body's last

line of defense against infection. The immune system is responsible for recognizing, finding, and killing germs that make you sick. It can also remember germs that have invaded your body in the past and fight them off. There are two types of T cells in a person's body. The Helper T cells regulate the immune system by going around and searching for new pathogens. The Killer T cells are responsible for attacking the foreign pathogens when they are found.

HIV attacks the immune system by entering inside the Helper T cells and reproducing more HIV. Because HIV is part of the Helper T cells, the Killer T cells do not recognize it as an infection and does not attack it. Eventually the Helper T cells break open and release new viruses that attack other Helper T cells. B cells are responsible for producing antibodies; these antibodies are the same antibodies that are looked for when a person getstested.

Symptoms of HIV

Typical symptoms of someone infected with HIV include tiredness, swollen lymph glands, fever, loss of appetite and weight, muscle aches, body rash, purple lesions on skin or in mouth, easy bruising, chronic oral yeast infections (thrush), diarrhea and night sweats.

People infected with HIV will go through periods of both health and illness, but eventually their body will not be able to fight the illness and they will be sick more often. HIV can be passed along to another person even if they do not have symptoms present.

Diagnosis and Treatment

There is no cure for HIV but there are several medications to slow down the process of AIDS. By taking the medications as prescribed, some people can live with HIV for approximately 15 years before it develops to AIDS.

HIV is most commonly diagnosed by doing an HIV antibody test with a blood sample. A sample of mouth fluid, urine or cheek scrapings can also be tested. The presence of antibodies show a positive test.

A person is considered to have AIDS when they have a T4 count of less than 200. A normal T4 count is around 1,000. The presence of opportunistic infections is also a part of the AIDS diagnosis. Some of the symptoms of AIDS are listed on the following link.

Symptoms of AIDS

Kaposi's Syndrome, severe bacterial infections, lymphoma, recurrent pneumonia, toxoplasmosis of the brain, pulmonary tuberculosis and candidiasis of the esophagus, trachea, bronchi and/or lungs

HIV/AIDS is a very complex and serious disease. The learn more about it check out these websites.
http://www.thebody.com

http://www.mayoclinic.com/health/hiv-aids/DS00005

STD and HIV/AIDS testing

SMOC 1-800-658-2444 number.
  • Worthington, MN is the only office open 5d/wk.
  • Marshal, MN Tuesday & Thursday
  • Montevideo, MN Thursday
  • Ortonville, MN Wednesday
  • Redwood, MN 2d/mo.
Please call ahead to let them know which location they should go to and when.
Planned Parenthood 320-235-9150 or 1-800-230-PLAN - Request the Willmar, MN site.

HIV/AIDS testing sites in MN:
http://www.health.state.mn.us/divs/idepc/diseases/hiv/testingsites.html#public

Rural Aids Action Network-providing Care, Service, and Support
1800-966-09735

Little Falls, MN
http://www.raan.org/

How to Protect Yourself

There are several options available to protect yourself from STD's. Here are some ideas:
  1. 1. Abstinence: the best way is to avoid STD's is to not have sex
  2. 2. If you are sexually active, the next best option is to use a latex or plastic condom if you are having oral or vaginal sex.
  3. 3. Know your partners past sexual history, although it may be uncomfortable to talk about, it's important to understand that your chances of getting infected with an STD increase with every sexual partner someone has had if they did not use protection.
  4. 4. Know the signs and symptoms of STD's, if you are experiencing any of them, refrain from sexual activity and get tested right away. If you recognize any symptoms in your partner, you both should be tested.
  5. 5. If you do have an STD, refrain from sexual activity until you have completed the full treatment cycle.
For more information on these and other sexually transmitted diseases, check out this site: http://www.cdc.gov/std/default.htm

CDC National STD and AIDS Hotline:
1-800-227-8922 (English)
1-800-344-7432 (Spanish)
1-800-243-7889 (TIY)



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