All You Need to Know About Chlamydia

What is Chlamydia?

Chlamydia is an easily curable sexually transmitted infection caused by the bacteria chlamydia trachomatis. Chlamydia is a common STD in the United States as it is unknowingly passed between sexual partners. Women get chlamydia on the cervix, rectum, and throat while men get it on the urethra, throat, and rectum.

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How is Chlamydia Transmitted?

Chlamydia is transmitted when having oral, anal, or vaginal sex with a person who is already infected. Pregnant women can also pass chlamydia to their children through childbirth. In this case, transmission may lead to health complications in the infant, including pneumonia.

Genital contact can also transmit chlamydia. However, chlamydia cannot be transmitted through touching a toilet seat that has been used by an infected person or sharing a swimming pool with an infected person

Symptoms

Symptoms of chlamydia are not pronounced in the initial stages and often go undetected. When symptoms do occur, they manifest within 1-3 weeks of infection. It is important to note that people who do not manifest the symptoms can still transmit the disease to another person.

People with female genitalia may experience:

  • Burning sensation during urination
  • Itchy or burning sensation around the vagina
  • Painful experiences during sex
  • Fever accompanied by abdominal pains
  • Painful periods
  • Bleeding in between periods
  • Abnormal vaginal discharge that may have an odor

People with male genitalia may experience:

  • Pain during urination
  • Swelling and pain around the testicles
  • Burning and itchy sensation around the opening of the penis
  • A clear or cloudy discharge from the tip of the penis

When chlamydia infects the rectum, symptoms may include rectal pain and bleeding or discharge from both male and female genitalia.

Diagnosis

A physical examination can determine the presence of chlamydia in cases where symptoms manifest. Chlamydia can also be identified through lab tests. Health care providers can take samples from the urine, urethra, or cervix to test for the presence of the bacteria. For some people, rectal or throat testing may be necessary. Only a qualified health care provider can determine the proper method of testing for any individual.

Who Should be Tested for Chlamydia?

The CDC recommends chlamydia screening for all sexually active individuals, especially those who engage in unprotected vaginal, anal, or oral sex and/or sex with multiple partners. Testing is recommended especially for sexually active people under the age of 25, as biological and behavioral factors make young people more susceptible to chlamydia. The CDC also recommends that pregnant women get tested.

Reducing the Risk of Acquiring Chlamydia

Sexually active people can reduce the risk of acquiring chlamydia by:

  • Only having sex with one or more partners who have tested negative for STDs
  • Proper use of condoms and dental dams
  • Regular screening to check for re-infection
Is Chlamydia Curable?

Chlamydia is curable when proper treatment is administered. Medication stops the infection and minimizes the chance of developing secondary complications. These secondary complications can be irreversible if chlamydia is discovered late. Thus, early treatment is most effective.

If your health care provider prescribes a single dose of chlamydia medication, ensure that you wait for seven days before resuming sexual intercourse. Re-infection can occur after treatment, so testing is recommended three months after the initial treatment.

What Happens When Chlamydia Isn’t Treated?

While initial effects of chlamydia are unnoticeable, the infection can lead to serious health problems in the future. Complications include:

  • Pelvic Inflammatory Disease (PID): An infection that attacks the uterus, ovaries, and fallopian tubes. Untreated PID can result in infertility, deadly ectopic pregnancies, and chronic/long-term pelvic pains.
  • Cervicitis: Inflammation of the neck of the womb.
  • Salpingitis: Inflammation of the fallopian tube which significantly increases the risk of ectopic pregnancies.
  • Urethritis: Inflammation of the urethra.
  • Epididymitis: An inflammation of the epididymis resulting in a red and swollen scrotum.
  • Reactive Arthritis: A type of chronic inflammatory arthritis
Chlamydia Treatment

Chlamydia is a bacterial infection treated using antibiotics that come in the form of pills, including:

  • Azithromycin: Administered to the patient as a single dose.
  • Doxycycline: Administered to the patient over the course of a week. The medication must be completed to avoid re-infection. This is rarely given to pregnant women as it can have a negative effect on fetal bone and tooth development.

The CDC recommends the following alternative antibiotics:

  • Erythromycin
  • Ofloxacin
  • Levofloxacin

When taking this medication, some people experience side effects including gastrointestinal issues, diarrhea, stomach pains, and nausea. Most side effects are mild. For patients taking doxycycline, a skin rash may develop if they are exposed to sunlight.

The infection should go away within a week or two after treatment. Women with chlamydia complications may require hospitalization to administer pain medication and intravenous antibiotics.

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All You Need to Know About Genital Herpes

What is Genital Herpes?

Genital herpes is a common STD transmitted almost exclusively through sexual intercourse caused by herpes simplex virus type 2 (HSV-2).

A World Health Organization study shows that in 2012, approximately 417 million people lived with the STD globally. Two-thirds of those infected were women. Africa had the highest rate of infection at 31.5% of the population, followed by the United States at 14.4%. The study also found that prevalence increases with age, though adolescents had the newest infections.

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How is Genital Herpes Transmitted?

Genital herpes is contracted as a result of genital contact with the mouth or genitals of an infected person. The virus is transmitted through the sores, genital secretions, saliva, and skin of the person who is infected. Genital herpes is not transmitted through personal effects such as towels or soap.

Symptoms

People often experience no symptoms or very mild symptoms when infected with genital herpes. An infected person may experience a tingling or burning sensation in the buttocks, hips and legs before the genital ulcer develops. Further symptoms may include:

  • Swollen lymph nodes
  • Body aches
  • Multiple clustered blisters that rupture easily and cause painful ulcers
  • Lesions in the vulva, vagina, and cervix in women
  • Systemic symptoms such as myalgia and fever may also appear

After the initial infection with genital herpes, symptoms may recur, but the severity lessens. Outbreaks also reduce in frequency with time. Occasionally, severe complications such as autonomic neuropathy and urinary retention may occur.

When the infection is asymptomatic, people will not notice that they are infected. However, they are still capable of transmitting the virus when it sheds into their genital tract. Most transmissions come from people who do not know that they are infected.

Diagnosis

HSV-2 can be diagnosed through an observational examination of visible symptoms. Further testing can be done by collecting samples from spinal fluid, blood, sores, or blisters. A recent NIH study concluded that a Polymerase Chain Reaction (PCR) test is the most effective way to determine if a person has herpes. A PCR test entails copying the DNA of blood or tissue sample and testing it for the herpes virus. All of these tests help distinguish HSV-2 from other allergic reactions and infections.

Treatment

Genital herpes has no cure. However, antiviral medications are effective in reducing and preventing outbreaks and daily suppressive therapy can reduce the possibility of transmission to partners. There have been several clinical trials for herpes vaccines, but none are currently available to the public.

During treatment, your healthcare provider may recommend the following medication:

  • Valtrex
  • Zovirax
  • Famvir

When experiencing an outbreak, the following steps can be taken to speed up the healing process and minimize the risk of spreading the infection to others:

  • Keep the affected area clean and dry to prevent further infection.
  • Avoid touching herpes sores and wash hands thoroughly after touching the sores.
  • Avoid sexual contact after seeing the symptoms.
Prevention

To reduce the risk of acquiring genital herpes, sexually active people can practice safe protected sex and ensure that their partner or partners undergo routine testing. It is important to know that herpes sores can occur outside the range of skin that condoms cover. The virus can also be transmitted from skin areas that do not have sores.

If you are in a relationship with a person who is sick with genital herpes you can help reduce the risk of contracting the virus by ensuring that your partner uses anti-herpes medication daily as directed by their health care provider. Avoid engaging in sex with your partner when symptoms of herpes are visible (during an outbreak).

For pregnant women with herpes, ensure that your health care provider gives you anti-herpes medicine to prevent transmitting the infection to the child. The medicine will minimize the risk of an outbreak during birth. In addition, your health care provider should examine you properly for herpes symptoms. If herpes symptoms show up during delivery, a C-Section is often performed.

IS Genital Herpes Linked to HIV?

Genital herpes infection can cause breaks in the skin around the genital area, providing a way for HIV to enter the body. Infection with herpes also increases the number of CD4 cells in the blood. HIV attacks these cells, so their increased presence makes HIV contraction more likely.

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All You Need to Know About Hepatitis A

What is Hepatitis A?

The hepatitis A virus (HAV) is a highly contagious viral infection that impacts the liver.

In 2017, the CDC estimated that there were 6,700 HAV cases in the United States. than 25000 cases have been identified.

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How is Hepatitis A Spread?

Hepatitis A spreads through ingestion of food and drinks contaminated by stool from an infected person. Hepatitis is also spread through one-on-contact such as sex or when taking care of an ill person.

Spread of hepatitis A through contaminated food and water is likely to occur in places where there are poor sanitary conditions or where personal hygiene is not observed. Taking raw shellfish from sewage-polluted water can also lead to infection with hepatitis A virus.

Symptoms

The virus infects liver cells and results in inflammation. During the 14-28 days of HAV incubation, symptoms range from mild to severe and include:

  • Loss of appetite
  • Fatigue
  • Sudden nausea and vomiting
  • Malaise
  • Abdominal discomfort
  • Fever
  • Jaundice
  • Dark colored urine

According to the WHO, symptoms intensify with age.

Diagnosis

Diagnosis of hepatitis A is done through observation of symptoms and a blood test. The blood test detects immunoglobulin G antibodies, which are specific to HAV in the blood. Other additional tests can include an RT-PCR (reverse-transcriptase polymerase chain reaction) test to check for the presence of the virus RNA of hepatitis A.

Treatment

Hepatitis A does not have a specific treatment or cure, but patients tend to get better within a varying amount of time.

Ways to reduce symptoms include:

  • Plenty of rest, especially during onset
  • Prescribed medication for pain, itching, and/or nausea
  • A cool and ventilated environment, loose clothing, cool showers to alleviate itching
  • Eating in small quantities to ease nausea and vomiting
  • Avoiding alcohol and other substances that strain the liver
Prevention

The transmission and spread of Hepatitis A virus can be prevented using the Hepatitis A vaccines.

There are two types of HAV vaccines:

  1. Formaldehyde inactivated vaccines
    • Used in many countries
    • Available in pediatric and adult doses
    • Two-dose schedule usually administered six weeks apart
    • Can produce anti-HAV antibodies that last for up to 25 years
  2. Live attenuated vaccines
    • Mainly used in China and India’s private sector.
    • Administered 12-23 months after birth
    • Available to older children and adults as needed
    • Safe and efficient in protecting against clinical infections for three years

Proper hygiene can reduce the spread of hepatitis, including hand washing after using the bathroom and/or coming into contact with an infected person’s stool, blood, or bodily fluids.

Boiling drinking water can be effective in areas with no access to purified water. Food must be washed and cooked thoroughly to prevent the spread of HAV.

A hepatitis A vaccine is recommended when:

  • Traveling to countries where Hepatitis A is common
  • You are sexually active
  • You are a recreational drug user
  • You have hepatitis B, C, or chronic liver disease

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All You Need to Know About Hepatitis B

What is Hepatitis B?

The hepatitis B virus (HBV) is an infection that attacks the liver cells.

According to the CDC, approximately 862,000 people in the United States and 257 million worldwide are infected with HBV.

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How is Hepatitis B Spread?

Hepatitis B is primarily spread through bodily fluids including blood and semen from an infected person to a healthy person. Transmission often occurs before the infection is detected.

In endemic places, the most common modes of transmission are childbirth and exposure to infected blood.

The disease also spreads through:

  • Sharing unsterilized piercing equipment like needles injecting drugs
  • Sharing tattoo equipment
  • Birth (from an infected mother to newborn baby)
  • Direct contact with open sores or blood of an infected person
  • A bite from an infected person
  • Sharing of personal effects such as razors and toothbrushes
  • Unprotected sex

HBV can survive outside the body for 7 days but does not spread through food, water, utensils, saliva, or sweat.

Symptoms

Hepatitis B can appear in the form of a mild acute infection lasting for a few weeks, to a chronic disease that may be lifelong.

Many newly acquired (acute) HBV infections are asymptomatic and go undetected. If the person’s immune response does not overcome the acute infection in six months, the infection turns chronic.

Symptoms range from mild to serious and include:

  • Jaundice (yellowing of the eyes and skin)
  • Extreme fatigue
  • Passing dark urine abdominal pains
  • Nausea
  • Vomiting
  • Acute liver failure causing death
Diagnosis

It is not possible to differentiate hepatitis B from other hepatitis viruses without laboratory tests. Several blood tests are available to diagnose both acute and chronic infections. The tests aim to detect the presence of hepatitis B surface antigen HBsAg.

Treatment

There is no known treatment for acute HBV.

Proper nutrition and adequate hydration can help infected individuals feel more comfortable. To further reduce discomfort, the WHO advises avoiding certain pain relief and anti-nausea medications.

Medical treatment can slow down the progress of HBV complications like liver cancer and cirrhosis. According to the WHO, antiviral agents such as tenofovir and entecavir are the most efficient anti-HBV drugs as they rarely result in drug resistance.

Though treatment does not cure HBV infection, it slows down the rate of viral replication over the course of an infected person’s life.

Prevention

The WHO recommends administration of the HBV vaccination within 24 hours of birth. As a result of widespread vaccinations in the United States, only 1.3% of U.S. children under five were infected in 2015.

The HBV vaccine can be administered in the following ways:

  1. A schedule of 4 doses: A monovalent dose during birth, followed by 3 combined or monovalent doses given together with other vaccines during infancy.
  2. A schedule of 3 doses: A monovalent dose during birth. The second and third doses are given at the same time during the first and third doses of Diphtheria, Whooping cough, and tetanus.

A complete vaccine series induces the development of protective antibody levels in more than 95% of children and young adults. The WHO does not recommend booster doses for people who have already had a complete dose series.

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All You Need to Know About Hepatitis C

What is Hepatitis C?

Hepatitis C (HCV) is a viral disease spread through contact with infected blood.

The CDC reports that hepatitis C is the most common viral blood infection in the United States, impacting 75% of the U.S. population born between 1945 and 1975.

How Is Hepatitis C Spread?

Infection with HCV is commonly spread through exposure to an infected person’s blood.

Methods of infection include:

  • Coming into contact with a needle used on an infected person; including medical, tattoo, and recreational drug equipment
  • Touching an open sore or blood of an infected person
  • Having unprotected sex with an infected person
  • Sharing personal effects that may have come into contact with the blood of an infected person
  • Mother to child transmission during birth
Symptoms

Hepatitis C symptoms range from undetectable to mild to serious and can lead to chronic disease and liver damage.

There are three stages of Hepatitis C symptoms:

  1. Prodromal Stage
    • Rash
    • Edema (swelling)
    • Arthritis/joint pains
    • Fever
    • Rash
  2. Preicteric Phase
    • Myalgia
    • Fatigue
    • Fever
    • Cough
    • Anorexia
    • Nausea/vomiting
    • Dark urine and light stool color
    • Abdominal pains or diarrhea
  3. Icteric Stage
    • Yellowing of the whites of the eyes and the skin (jaundice)
    • Anorexia, vomiting, and nausea may worsen
    • Irritated skin lesions
Diagnosis

Because HBV can be asymptomatic, early infection is often only discovered during routine checkups. When tests show abnormal liver enzymes in the blood, two further tests include:

  1. Serological Test: identifies anti-HCV antibodies; confirms infection
  2. Nucleic Acid Test: identifies presence of HCV ribonucleic acid; confirms chronic infection

After a chronic HCV infection diagnosis, a liver biopsy tests can estimate the extent of liver damage and inform individual treatment.

Treatment

A therapeutic approach to treating HCV involves pan-genotypic direct acting virals (DAAs). DAAs cure most people who are suffering from hepatitis C and the treatment period is between 12 and 24 weeks.

Prevention

There are no vaccines that prevent the hepatitis C virus from causing infection. Primary interventions that limit exposure include:

  • Proper and safe use of healthcare injections
  • Safe handling and disposal of sharp objects and waste material
  • Pre-screening donated blood for the presence of HCV and other infections
  • Proper and consistent use of condoms

Secondary prevention practices help protect people infected with chronic hepatitis C. These practices include:

  • Education and counselling on care and treatment options
  • Immunization with vaccines for hepatitis A and B to prevent coinfection
  • Routine monitoring and early diagnosis of chronic liver disease

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All You Need to Know About HIV Seroconversion

What is HIV Seroconversion?

HIV seroconversion is the point after initial HIV infection when HIV-specific antibodies become detectable, indicating an immune response to that infection. It involves the conversion of the sero status (types of antibodies in the plasma) from HIV antibody-negative to HIV antibody-positive.

During the seroconversion stage, the immune system begins to develop antibodies in an attempt to rid the body of the virus. Since many HIV tests involve detecting the presence of HIV antibodies in the blood, taking an HIV test before seroconversion will result in a false negative test for HIV.

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How Long is the HIV Seroconversion Process?

The time period between HIV infection and when the infection becomes detectable is called the window period. For some people, the window period lasts only a few weeks; for others, it may last up to 12 weeks. The timing of any HIV seroconversion process depends on an individual's immune system.

Symptoms of HIV Seroconversion

Seroconversion symptoms resemble those of a heavy cold. Some people exhibit symptoms severe enough to require medical attention, while others do not display any symptoms.

The most common symptoms include:

  • Fever
  • Body aches
  • Sore throat
  • Rash
  • Headaches
  • Swollen lymph nodes
  • Fatigue
  • Joint pains

An individual may exhibit any or all of these symptoms concurrently. It can take only a few days or as long as several weeks for these symptoms to resolve. This time frame also depends on the individual’s immune response.

Can HIV Transmission Happen Before Seroconversion?

It is possible to transmit HIV prior to seroconversion. The virus is still active and therefore transmittable before the body creates antibodies.

The period between HIV infection and the immune system’s first response is known as the acute stage. During this stage, the viral load in the body is high. Most people at this stage of infection are not aware of their HIV status and an HIV test will produce a false negative result.

What to do After Exposure to HIV

Upon suspicion of exposure to HIV, contact a healthcare provider and/or the department of public health to find a testing center. Testing sites offer anonymous or confidential testing depending on the laws of the state or local area.

In anonymous testing, names are not recorded by the site where tests are done. In confidential testing, a healthcare provider has access to the test results and the results may be recorded in a person’s medical file at the testing site.

Understanding the Pre-Exposure and Post-Exposure Prophylaxis of HIV

1. Pre-Exposure Prophylaxis

Pre-exposure prophylaxis (PrEP) is a method of preventing HIV. It involves the use of HIV medicine for people who are HIV negative to reduce the risk of getting HIV, especially if they are exposed to HIV.

PrEP is prescribed to adolescents and adults at high risk of acquiring HIV through sex or drug-use injections.

The FDA approves one combination of two anti-HIV drugs: Emtricitabine and Tenofovir disoproxil fumarate. These drugs are sold as a single pill under the brand name Truvada.

PrEP is effective and highly recommended as it reduces the risk of exposure to HIV by more than 90%. For drug users who use injection tools, it reduces the risk of exposure by more than 70%.

2. Post-Exposure Prophylaxis

Post-exposure prophylaxis (PEP) is the prevention of the spread of HIV using HIV medication, 72 hours after a possible predisposition to HIV. It is meant to prevent HIV infection.

PEP is used only in emergency situations and is not meant for regular use by people who are at a high risk of exposure to HIV. It is also not meant to replace the common methods of HIV prevention such as use of condoms or pre-exposure prophylaxis.

PEP is important for those who have recently been exposed to HIV.

Upon suspicion, the individual must contact their healthcare provider. It will generally be prescribed if a person is HIV negative and has been in the following situations within a period of 72 hours:

  • Unprotected sex
  • Sharing needles or other equipment for drug use
  • Sexual assault

The CDC provides guidelines for medication use in post-exposure prophylaxis. The recommended medications vary for specific sets of people; including adults, adolescents, pregnant women, people with kidney problems, and children.

PEP can be effective when taken under the direction of a healthcare provider, though it is not foolproof. PEP must be taken within the first 72 hours of exposure to HIV. The sooner an individual consumes PEP, the greater the chances of preventing an HIV infection.

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All You Need to Know About HIV

What is HIV?

HIV (Human Immunodeficiency Virus) is a virus that weakens the immune system by attacking infection-fighting cells known as CD4 cells.

HIV leaves the body vulnerable to common germs, viruses, fungi and other disease-causing organisms. Without treatment, HIV destroys the immune system and advances to AIDS (Acquired Immune Deficiency Syndrome).

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How Is HIV Spread?

HIV is transmitted through select body fluids of an infected person. These fluids include:

  • Semen
  • Vaginal fluids
  • Rectal Fluids
  • Breast Milk
  • Pre-seminal fluid

The primary methods of HIV contraction in the U.S. are anal and vaginal sex with an infected person during unprotected sex. Using drug equipment such as injection needles also contributes significantly to the transmission of HIV among recreational drug users. Unsterilized tattooing material can also contribute to the spread of HIV.

In pregnant women, HIV is transmitted from a mother to the child during birth or during breast-feeding (also known as mother-to-child transmission.).

Although rare, you can also acquire HIV through a blood transfusion that was donated by an infected individual.

HIV Stages

Stage 1: Acute Stage

This stage starts 2-4 weeks after infection. During this stage, symptoms resemble the flu and may for several weeks. This is a normal reaction of the body to the infection. During this stage, the amount of HIV in the body is high and the blood of the infected individual is very contagious. At this stage, most people cannot tell that they are infected since there are no visible symptoms of HIV infection.

Stage 2: Clinical Latency Stage

This stage is also known as the asymptomatic stage. At this stage, HIV is active in the blood but the rate of viral multiplication slows down. Most people do not show any symptoms of sickness at this stage. For people who are on medication, this stage can last up to a decade, but it progresses rapidly for unmedicated people. At the end of this stage, the viral load starts to rise while the CD4 cell count begins to lower. Further symptoms appear and the infection then progresses to stage 3.

Stage 3: Acquired Immunodeficiency Virus

This is the final and most severe stage of HIV infection. In this stage, the immune system of the infected person is severely destroyed by HIV, increasing susceptibility to illnesses. Without treatment, this stage lasts up to 3 years. Symptoms may include:

  • Swollen lymph nodes
  • Sweats
  • Fever
  • weight loss
  • General body weakness and fatigue
Diagnosis

Blood tests are the best method of diagnosing HIV. These tests involve the identification of antibodies specific to HIV that are created in an attempt to fight off the virus.

The primary tests for HIV are:

  1. ELISA Test: ELISA stands for Enzyme Linked Immunosorbent Assay. When the outcome of this test is positive, a Western blot test follows to confirm diagnosis of HIV. Since antibodies are not produced immediately after HIV infection, the test sometimes produces a false negative. Thus, it can be repeated three months after the initial test.
  2. Saliva Test: Using a cotton pad to obtain saliva from your tongue. The saliva is sent to a laboratory for further testing and the results are prepared within three days. A blood test should follow to confirm the results.
  3. Viral Load Test: Determines the amount of HIV in the blood. This test detects early infection and is generally used in monitoring of treatment. The test involves three main technologies: Reverse transcription polymerase reaction (RT-PCR), Branched DNA (bDNA), and Acid sequence-based amplification assay (NASBA).These help in detecting HIV using DNA sequences that specifically bind to sequences in viruses.
  4. Western Blot Test: A sensitive blood test that follows an ELISA test to confirm HIV results.
Prevention of HIV

For sexually active people, HIV can be prevented through proper and consistent use of contraception and use of antiretroviral (ARV) drugs for pre-exposure prophylaxis (PEP).

According to the WHO, male circumcision reduces the risk of female-to-male transmission of HIV by 60%. However, circumcision should not replace other prevention methods such as the use of condoms.

HIV Treatment

After detecting HIV in the blood, doctors begin antiretroviral therapy using a combination of ARV medication. These drugs suppress the virus and stop the disease from progressing.

ARV drugs are offered as a daily dose. Failure to follow the medication schedule can lead to the virus changing into a harder-to-treat strain. Many people tolerate ARVs with little to no side effects. When side effects do occur, they include:

  • Fatigue
  • Nausea
  • Yellowing skin and skin rashes
  • Loss or gain of body fat
  • Insomnia or nightmares
  • Liver and Kidney problems
  • Weak bones
Is there a Cure for HIV?

There is currently no effective cure for HIV. However, with proper medical care, HIV can be controlled using antiretroviral therapy (ART). When ART is followed as prescribed by a healthcare professional, the viral load may become undetectable in the blood, allowing an infected person to enjoy a long and healthy life without transmitting HIV to an uninfected person.

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All You Need to Know About HPV

What is HPV?

HPV (human papillomavirus) is a viral infection transmitted from one person to another through surface contact.

There are over 100 strains of HPV and more than 40 strains spread through sexual contact. According to the CDC, HPV is the most common sexually transmitted infection. CDC statistics show that 14 million new cases of HPV are diagnosed every year.

Most types of human papillomavirus are harmless, go unnoticed, and subside without medical intervention. However, some types of the virus can lead to genital warts and cancer. The CDC found that in the United States, approximately 12,100 men and 19,400 women are affected by cancers that result from HPV.

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Causes of HPV

HPV is transmitted primarily through skin-to-skin contact, either through sexual intercourse or other forms of physical contact. It is likely that sexually active individuals contract the virus at least once in their lifetime.

Pregnant and infected mothers with warts on their genital areas can transmit the infection to their babies. In this case, the transmitted infection may cause a non-cancerous growth on the baby’s larynx.

HPV can also be transmitted by direct or indirect contact with warts or surfaces exposed to warts through rubbing or touch.

Genital HPV is transmitted through vaginal, anal, and sometimes oral sex with an individual who is already infected.

Factors that Increase the Risk of HPV Infection
  1. Multiple sexual partners: Multiple sexual partners increase the risk of contracting HPV. Having sex with a person who has had multiple sexual partners also increases the risk of contraction.
  2. Age: Genital warts are most common in young adults and children. Common warts primarily appear in children.
  3. Weak immune system: People who suffer from a weak immune system are prone to acquiring HPV. Taking HIV/AIDS medication and immune suppressing drugs after undergoing organ transplants further weakens the immune system.
  4. Damaged skin: Open skin, cuts, and abrasions make the body susceptible to acquiring HPV through common warts.
  5. Physical contact: HPV can be contracted when a person touches a wart on an infected person’s skin without wearing protective gloves. Touching surfaces that have come into contact with HPV (like swimming pools) also increases the risk of contraction.
Signs and Symptoms of HPV

After contracting HPV, most individuals do not experience symptoms. Many infections go away unnoticed. However, symptoms sometimes take several years to appear. It is therefore difficult to discern when an individual contracted HPV and if or when they will show symptoms.

Warts

Most immune systems are capable of fighting the HPV infection before warts develop. When warts do manifest, their appearance varies depending on the type of HPV an individual contracted.

There are four types of warts:

  1. Genital Warts: Flat lesions, stem-like protrusions, or bumps looking like cauliflowers. Genital warts appear on females on the vulva and sometimes on the vagina or cervix. For males, genital warts appear on the scrotum, penis, and anus.
  2. Common Warts: Rough bumps that appear raised on the hand and fingers. They sometimes cause pain and are prone to injury and bleeding.
  3. Flat Warts: Slightly raised lesions with a flat top appearance. They appear anywhere on the body. Children tend to experience them on the face, men around the beard area, and women on the legs.
  4. Plantar warts: Stiff, grainy growths that appear on the heels and balls of the feet, often causing discomfort.

Cervical Cancer

The HPV infection causes nearly all cases of cervical cancer and it can take as many as 20 years for the cancer to develop after infection. Both HPV and early cervical cancer do not show any notable symptoms.

The CDC recommends the HPV vaccination as a safe and effective way to prevent all HPV-related health consequences, including cervical cancer.

Diagnosis of HPV

HPV can be diagnosed through a physical inspection where warts or lesions are visible.

Additional tests include:

  1. Pap smear test: The collection of cervical cells to reveal abnormalities in the cells that can cause cancer. This is a recommended test for women who are 30 years or older.
  2. DNA test: Evaluates whether an individual has a high risk of contracting HPV. The test is especially recommended for women who are 30 years or older.
  3. Acetic acid solution test: Warts caused by HPV infection turn white when acetic acid solution (vinegar) is applied on the warts. The test helps identify flat lesions that may be difficult to see.
HPV Prevention

The following measures can help reduce the risk of contracting the human papilloma virus:

  • Practicing protected sex
  • Sticking to one sexual partner or abstaining from sex
  • Avoiding sexual intercourse with a partner that has visible warts on their genitalia

Common warts are difficult to prevent. To prevent infection, avoid biting and picking at them. In the case of plantar warts, ensure that you wear sandals or shoes in public utilities such as locker rooms and swimming pools.

According to the CDC, vaccinating children at the age of 11 to 12 years reduces the risk of future development of cervical and other cancers.

HPV Treatment

Although there is no treatment for HPV, further types of testing can lead to early detection of high-risk HPV infections that cause cancer.

In the case of an abnormal pap test, subsequent tests include:

  1. Colposcopy: A Procedure that involves a detailed probe of the cervix to determine the presence of precancerous cells.
  2. Cryotherapy: A treatment that involves the freezing and removal of precancerous cells from the cervix.
  3. LEEP (Loop Electrosurgical Excision Procedure): A treatment that involves the removal of cancerous cells from the cervix using an electrical current.

Sources

All You Need to Know About Oral Herpes

What is Oral Herpes?

Oral herpes is a common infection, usually in the mouth area, caused by the herpes simplex virus type 1 (HSV-1). Most people refer to the virus as a fever blister or cold sore.

Johns Hopkins estimates that 50 to 80 percent of adults in the U.S. have HSV-1 and that 90% of adults encounter oral herpes by the age of 50. A study by the WHO shows that in 2012, 67% of the global population (3.7 billion people) had HSV-1. Rates of HSV-1 were highest in Africa, affecting 87% of the population.

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Causes

HSV-1 causes cold sores or blisters and is mostly acquired during childhood. The cold sores are highly contagious when the blisters present are oozing with fluid. However, a person can still transmit the infection when they do not have cold sores.

An infected person is likely to pass the infection during:

  • Kissing
  • Touching a person’s skin (i.e. pinching the cheek of a child)
  • Sharing objects such as towels, razors, and utensils

After the initial infection, the virus lies dormant in nerve cells unless triggered by the following things:

  • Stress
  • Fatigue
  • Exposure to Wind and Sunlight
  • Hormonal imbalances
  • Fever and viral infections
  • Changes in the immune system
Symptoms

For many people, oral herpes symptoms do not manifest after infection. When present, symptoms include open sores or painful blisters inside or around the mouth and lips. The blisters are tiny and filled with fluid, appearing in clustered patches. They often heal within 2 to 4 weeks without scarring. Recurring blisters appear in the same spot at all times and the severity of symptoms reduces with each recurrence.

After initial infection, the infection lies dormant in the body for the rest of a person’s life. Reinfection is also possible and varies from one person to another.

During initial outbreaks, some people may experience:

  • Burning or tingling in and around the mouth and lips
  • Sore throat
  • Headache
  • Muscle Aches
  • Painful and eroded gums
  • Fever
  • Swollen lymph nodes

For children under the age of 5 years, the cold sores may form inside the mouth and can be mistaken for canker sores.

Diagnosis

During an outbreak, HSV is primarily diagnosed through direct observation and examination of sores. Healthcare providers order HSV-1 tests to determine whether sores on the mouth are due to herpes infection. These tests also diagnose the infection in a pregnant woman and determine whether a newborn is infected.

HSV-1 testing helps distinguish HSV-1 from other infections and allergic reactions. These tests include a Polymerase Chain Reaction (PCR) test and a blood test or biopsy. The PCR test involves copying DNA from a sample collected from the blister, sore, blood, or spinal fluid and testing it for the presence of herpes virus. During a biopsy, a sample from a sore or blister is collected to observe in a lab. A blood sample may also be taken to observe.

Treatment

There are several treatment options for HSV-1 that vary on the basis of:

  • Age
  • Personal preference
  • Tolerance to specific medication
  • Medical history and overall health
  • Expected outcomes

While treatment may vary due to the above factors, the most effective medication is the use of antiviral medicines such as famciclovir, valacyclovir, and acyclovir. These medications merely reduce recurrence as there is no known cure for the herpes simplex virus.

Prevention

Your healthcare provider may recommend antiviral treatment for regular use if you are at high risk of developing complications or if you develop cold sores regularly. If sunlight triggers the recurrence of cold sores, applying sunblock to the sore area may help.

The following precautions also prevent spreading cold sores from one person to another:

  • Avoid sharing used items: Items such as towels, spoons, cups, lipstick, lip balms, and other oral items will spread the virus if blisters are present.
  • Always keep your hands clean: Wash your hands carefully before touching other people.
  • Avoid skin contact with other people: The virus spreads when blisters are moist. Avoid touching people to prevent transmitting the disease to uninfected people.

Sources

All You Need to Know About Oral Sex

What is Oral Sex?

Oral sex is using the mouth and tongue to stimulate the genitals for sexual pleasure. Though STD transmission via oral sex poses different sets of circumstances than other forms of transmission, oral sex is not necessarily safer than any other form of sexual contact.

Is Oral Sex Common?

The CDC reports that 85% of adults between the ages of 18 and 44 years participate in at least one encounter of oral sex with a partner of the opposite sex in their lifetime. A separate CDC survey showed that between 2007 and 2010, 33% of teenagers aged 15-17 years reported having oral sex with a member of the opposite sex.

Though both CDC studies surveyed individuals who engaged in heterosexual sexual relations, same-sex couples also face the risk of contracting STDs during oral sex.

STDs Transmitted Through Oral Sex

Eight known STDs can be transmitted through oral sex with an infected individual. It is difficult to know if someone is infected because many STDs exhibit no symptoms.

STDs commonly transmitted during oral sex include:

  • Herpes: This virus is highly contagious and spreads most aggressively during an outbreak. Symptoms that result from contraction via oral sex include sores on or around the genital areas, buttocks, thighs, lips, mouth, and/or tongue. Although using condoms or a dental dam during oral sex may prevent infection from sores on the genitals, the virus can still be transmitted from open sores on unprotected parts of the body. Herpes has no cure, but medication helps in handling the symptoms.
  • Gonorrhea: Most people infected with gonorrhea as a result of oral sex do not show any symptoms. When symptoms are visible, they may include a sore throat, swelling on the vulva and testicles, colored discharge from the penis and vagina, and pain during urination. The infection can be prevented by practicing safe oral sex using condoms and dental dams. Although this STD is curable and sometimes subsides without medical treatment, serious health complications can develop if the infection is unidentified or ignored.
  • Syphilis: Syphilis is a bacterial STD also transmitted through sores on the skin. During oral sex, syphilis can spread to the lips, mouth, throat, genitals, anus, and rectum. Signs of syphilis appear in the form of sores and ulcers, rashes, and flu-like symptoms. Syphilis is also treatable but can lead to serious health issues without intervention.

STDs less frequently spread as a result of oral sex include:

  • Chlamydia: During oral sex, chlamydia can be spread to the throat, genitals, urinary tract, or rectum. Symptoms of throat infection do not always manifest; when they do, people experience a sore throat. When symptoms of urinary tract, genital, and rectal chlamydia infections appear, they include a burning feeling when urinating, discharge from the penis or vagina, swollen testicles, and rectal pain and/or discharge.
  • HPV: During oral sex, HPV can be spread via the throat, genitals, and rectum. When symptoms of the virus occur, they include warts on the infected part of the body and abnormal cell changes in the vagina, cervix, or anus. According to the CDC, the best way to prevent HPV is to receive the vaccine. If left untreated, HPV can develop into cancer.
  • Pubic Lice: Public lice are spread easily through close contact when the lice jump from one person to another. During oral sex, they can spread from pubic hair to eyelashes, eyebrows, beards and mustaches, chest hair, and armpit hair.
  • HIV: Though HIV is not commonly spread during oral sex, certain factors increase risk of transmission. These include sores on the mouth or genitals, contact with menstrual blood, bleeding gums, and presence of other STDs. The possibility of transmission also increases with an infected person ejaculates directly into the mouth. Certain forms of contraception may decrease the likelihood of HIV spreading during oral sex. The risk of contraction is also less likely if the HIV-negative partner is taking medication that prevents HIV.
Preventing STD Transmission Through Oral Sex

For sexually active individuals, the following measures can reduce the risk of contracting STDs when engaging in oral sex:

  • Engage in regular STD testing
  • Use protection such as condoms and dental dams
  • Avoid sexual activity with people who have visible symptoms of infection
  • Seek prompt treatment to reduce the risk of spreading an infection

Sources

Risk of Contracting STDs When Using Condoms

Do Condoms Prevent STDs?

The proper and consistent use of male latex condoms can help reduce the transmission of STDs and HIV. However, condoms do not offer absolute protection.

Laboratory studies indicate that a condom provides an effective barrier against even the smallest of STD pathogens. Epidemiological studies–which analyze the incidence, distribution, and possible control measures of a disease–indicate that while condoms are effective during sexual activity, they are not foolproof. Epidemiological studies, unlike laboratory studies, take into account behaviors beyond direct sexual contact that cannot be easily quantified.

Male condoms effectively protect against STDs transmitted through genital fluids alone. However, condoms do not entirely cover all potentially infected areas of the body. There is a great deal of speculation about the effectiveness of condoms in preventing transmission of STDs that are spread primarily through skin contact in areas where the condom cannot cover.

Another study involving the review of bibliographical evidence from key medical info resources showed that the use of condoms by heterosexual partners offered a 60-95% protection against the transmission of STDs. Results obtained also indicated that condoms did not offer any protection against HPV-1.

How do Condoms Work?

Condoms act as a physical barrier during sexual intercourse to prevent the transmission of blood, semen, or vaginal fluids that may contain pathogens that cause STDs.

Types of condoms differ based on gender and material. Male condoms are commonly made of latex rubber. Polyurethane condoms have recently been introduced as an alternative for people who are allergic to latex. Natural condoms made from animal membranes are also available for purchase but are more costly and may be less effective in preventing STDs. In the United States, condoms can be purchased at local drug stores and are often available in restroom vending machines.

Condoms must be used consistently and correctly in order to be effective.

Which STDs do Condoms Prevent?
  • Herpes Simplex Virus-Type 2 (HSV-2): Studies carried out by NIH in collaboration with the CDC, FDA, and USAID indicate that condoms offer protection against HSV-2 (genital herpes) when condoms are used properly and in all sexual encounters. However, the study found that in rare cases, correct and consistent condom use did not prevent the disease from spreading from an infected to a non-infected person.
  • Gonorrhea, Trichomoniasis, Syphilis, and Chlamydial Infection: According to NIH studies, condoms provide a significant level of protection against all four of these infections if used properly during any and all forms of sexual contact. However, cases of infection were still found in some people who implemented correct prevention methods.
  • Human Papillomavirus Infection: The National Institute of Health reports that condom use is not effective in preventing HPV transmission from an infected partner to a new uninfected partner.

Sources

STD Prevalence in the United States

The CDC estimates that there are approximately 20 million new STD infections reported every year in the United States. The actual number of cases may be much higher, as many STDs are asymptomatic and go unreported.

Factors that Contribute to the Spread of STDs

Biological factors

When an STD is asymptomatic, people experience very mild signs and symptoms of infection, if any. Infected individuals are therefore unaware of their medical condition and do not seek medical attention.

Women are more prone to STDs than men. According to the CDC, half of the 1.7 million cases of STDs in the United States in 2017 impacted women between the ages of 15 and 24. Cisgendered women can experience severe symptoms like pelvic inflammatory disease and ectopic pregnancies. Adolescent females are more exposed to infections due to increased ectopy of the cervix.

Young people, in general, are more prone to contracting STDs. The CDC found that while young people between the ages of 15 and 24 account for only a quarter of the population, they experience half of all annual STD cases in the United States. Reports on STDs surveillance in 2016 show that chlamydia and gonorrhea are the most common STDs among adolescents. Genital herpes and Trichomonas vaginalis are also common, but it is difficult to predict epidemiological trends because the STDs are not reported nationally.

Social and Economic Factors

Social, behavioral, and economic factors act as a great barrier to STD prevention efforts. Networks and norms regarding sexuality and sex vary greatly throughout the United States, and despite the nation’s wealth, health care is often inaccessible. People experiencing poverty especially lack access to the education and resources needed to prevent and treat STDs. Socioeconomic and cultural disparities reflect geographically in the United States, and certain STDs are prevalent in different areas of the country. For example, rates of chlamydia and gonorrhea are highest in the Southern United States, while syphilis is most common in the Western United States.

Challenges to STD Treatment

The annual incidence of STD cases has increased by over fifty percent between 1995-2008 due to a lack of accurate and cheaply available diagnostic tests, especially for gonorrhea and chlamydia.

There is an acute shortage of penicillin benzathine G, the recommended medicine for treating syphilis and the only recommended treatment for pregnant women. Most hospitals and medical centers are not equipped with the drug.

In recent years, there has also been a rise in resistant strains of certain STD pathogens. One example is the prevalence of resistant gonorrhea strains that do not adhere to routine bacterial treatment. Furthermore, newly emerged resistant gonococcal strains now require a two-drug therapy that utilizes azithromycin and injectable ceftriaxone. This therapy applies to people of all ages with no regard to the anatomical site of infection.

Partner notification and treatment is a highly effective means of managing STDs that is underutilized by people in the United States. In particular, adolescents with many partners often refrain from practicing this prevention method.

STD Diagnosis

Highly accurate tests are available in the United States and other high-income countries, though not everyone in the United States has access to testing.

Rapid tests diagnose only syphilis and HIV and provide results in about 15 minutes. Urine samples, fluid samples collected from sores, and blood samples can be analyzed in a lab to diagnose most other STDs.

STD Screening

Often, STDs present no symptoms and the presence of STDs in the body can only be determined through testing. Although there are exceptions, screening is not often a routine health care practice.

A blood or saliva test is recommended for all people between the ages of 13-64 to screen for HIV. An annual test is further recommended for people at a high risk of infection. In the United States, Hepatitis C is prevalent in people born between 1945-1965. Most cases of the infection are asymptomatic, so screening is the only way to determine its presence.

It is generally advised that pregnant women be screened for STDs like chlamydia, syphilis, hepatitis B, and HIV at least once during the period of pregnancy.

STD Prevention

Counseling, behavioral intervention, and comprehensive sexual education prove most effective in reducing the prevalence of STDs in the United States.

STDs are caused by a variety of pathogens that require different medical treatments. Most STDs are either bacterial or viral.

Bacterial STDs are generally treated with antibiotics. Most antibiotics are administered orally, but some require injection or direct topical application to the infected area. If syphilis is recognized in its early stages, it can be treated with a single intramuscular injection of antibiotics. Infections like bacterial vaginosis are treated with topical antibiotics.

Viral STD treatments reduce the severity of symptoms, slow the progress of the infection, and prevent the spread of other opportunistic infections. For people with HIV, special antiretroviral drugs are used to reduce the body’s viral count. Some STDs, like human papillomavirus, do not have a cure but can be prevented with vaccinations.

Sources

All You Need to Know About Syphilis

What is Syphilis?

Syphilis occurs when the body is infected by the bacteria Treponema pallidum. The infection occurs in four stages: primary, secondary, latent, and tertiary. During each stage, damage to the body progresses.

The World Health Organization (WHO) estimates that there are 10.6 million new cases of Syphilis infection in the world annually.

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How is Syphilis Transmitted?

Syphilis is transmitted when an uninfected person encounters a syphilis sore from an infected person.

In most cases, the contact is through oral, anal, or vaginal sex with an infected person as sores are mostly found on the penis, rectum, vagina, and vulva. Syphilis may also be transmitted through direct contact with open lesions on other parts of the body.

Pregnant women can transmit syphilis to an unborn child through the placenta or during childbirth.

Symptoms and Stages

Syphilis develops in four sometimes overlapping stages that present varying symptoms.

  1. Primary stage: This is the first stage of infection when a one or more sores appear. The sore is a painless round and firm lesion that can easily come and go without being noticed. The sore may last from 3-6 weeks and ultimately heals with or without treatment. Without treatment, infection remains even after the sore has gone away. It is important to seek treatment at this stage before the infection advances to the secondary stage.
  2. Secondary Stage: This stage begins when sores from the primary stage heal. The primary symptom in this stage is the development of a rash on the soles of the feet and palms of the hands. The rash may also be accompanied by wart like sores in the mouth and genitals. Other symptoms may include muscle aches, fever, loss of hair, and swollen lymph nodes. This phase may last for 2-6 weeks, after which symptoms disappear.
  3. Latent Stage: The onset of this stage starts when the secondary stage symptoms heal. This stage is not marked by any visible symptoms, but infection continues to cause damage in the body and can last for many years.
  4. Tertiary Stage: The final stage of syphilis infection. 15%-30% of people who do not get any treatment develop complications during this stage. At this stage, the infection may cause irreparable harm to the brain, blood vessels, eyes, joints, bones, liver, and heart. Symptoms include major medical complications involving the heart, eyes, brains, and other organs. During the tertiary stage, symptoms are not visible but organ deterioration proceeds inside the body. People infected with syphilis at this stage may suffer from numbness, lack of coordination, blindness, dementia, and paralysis.

In cases when the infection is transmitted to a new-born baby, the infant might not show any symptoms. However, some may develop a rash on their palms and the soles of their feet. Later in life, the infected children may develop symptoms such as teeth deformities, deafness, and saddle nose (collapsing of the nose bridge.)

Diagnosis

Diagnosis of syphilis is mainly done through physical examinations and dark field microscopy of samples collected from sores, blood tests, and cerebrospinal fluid tests.

Blood tests help confirm if the body is producing antibodies that fight infection. These antibodies can remain in your blood for years and can indicate both current and past infections. There are two types of blood tests:

  • Non-treponemal tests: Inexpensive and simple tests that help screen the blood for syphilis. As they are not syphilis-specific and can produce false-positive results, the test is not an entirely sufficient method of testing for syphilis.
  • Treponemal tests: Tests that detect the specific syphilis antibodies in the blood.

Cerebrospinal fluid tests are done when upon suspicion of complications in the nervous system. During the test, spinal fluid is collected for lab analysis.

Risk Factors

Factors that may expose you to acquiring syphilis include:

  • Direct unprotected contact with an open sore
  • Unprotected sex with an infected person
  • Having HIV
Prevention

There is no syphilis vaccine. Sexually active individuals can lower risk of contracting the STD by using effective protection, like latex condoms and dental dams, and avoiding sex when inhibited by drugs or other substances.

Upon testing positive with syphilis, a person should inform all sexual partners so they can also get tested. Partner notification is an important preventive strategy that helps limit the spread of syphilis.

Screening is also crucial in preventing the spread of syphilis, as the infection often goes unnoticed. Health officials recommend that pregnant women be screened to prevent transmission to the fetus.

Treatment

Syphilis is cured easily when treated during the early stages.

During the first year of infection, the recommended treatment is a single shot of penicillin. If the infection has progressed for more than one year, several more doses of penicillin may be required.

Alternative and modified treatments are available for people who are allergic to penicillin, including pregnant women.

Follow-up treatments include:

  • Having regular blood examinations and blood tests
  • Abstaining from sex with new partners until treatment is completed and blood tests indicate that the infection is cured
  • Notifying sex partners

Sources

STDs: Facts & Figures


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