April marks STD Awareness Month. If you didn’t know, you’re not alone. Despite the fact that more than half of all Americans will contract a sexually transmitted disease sometime in their lifetime, we are strangely reluctant to talk about it.
So first, let’s be clear about what we’re talking about.
An STD (interchangeably referred to as an STI, or sexually transmitted infection) is any disease or infection passed from one person to another through sexual contact, such as vaginal, oral or anal sex. A few types of STDs, such as scabies and crabs, can be passed through close (skin-to-skin) contact or even prolonged exposure to infested bed linens, but for the most part, these types of infections are transmitted through sexual contact. Among some of the most common STDs are human papilloma virus (HPV), chlamydia, gonorrhea, genital herpes, viral hepatitis, human immunodeficiency virus (HIV) and syphilis.
Due to the large variety of STDs and space constraints, it simply is not feasible to list all the symptoms of all the many varieties of STDs here. Rashes, blisters, itching and redness in the genital areas can often be signs of infection but, depending on the particular disease, may appear early on and then go away, even though the infection itself has not resolved. In fact, oftentimes no obvious symptoms develop and many people who contract STDs are unaware that they, or their partners, are at risk.
Bacterial STDs can often be cured with antibiotics, but often go undetected in the early stages. Chlamydia, which is bacterial in origin, has no symptoms in 75 percent of cases among women and 25 percent of men. In part because of this, chlamydia claims the dubious distinction of being the most commonly reportedly STD. Left undetected, this disease can spread and cause Pelvic Inflammatory Disease (PID) in women, which if gone untreated, can lead to chronic pain and infertility. Annual testing is recommended, especially for sexually active women under age 25.
Syphilis is another curable STD, treated with antibiotics (usually penicillin). But again, left untreated, the disease will progress with increasingly serious symptoms. In the early stages of this disease, symptoms (such as a single raised, painless sore on or near the genitals, anus or the mouth; or later, a rash on the hands, feet or body or patchy hair loss) may appear, but then disappear after a few weeks. This does not mean the infection has gone away. Often, there are no symptoms at all, so if you (or your partner) are sexually active with more than one partner, you should be tested regularly. Syphilis is especially prevalent in Philadelphia (and other urban areas) among gay, bi and other men who have sex with men (MSM). This disease has much more serious implications if not detected until the later stages. If you are having sex with a man who has sex with other men, you should get tested every six months for syphilis. Gonorrhea, like syphilis, is also a curable bacterial infection that can be easily treated with antibiotics. But again, if left untreated, complications such as PID or infertility can arise and are often irreversible.
Some STDs are viral in origin and, as such, may not be “curable.” However, they are treatable and, in nearly every case, preventable.
Viral hepatitis is a disease that affects the liver and is caused by a group of viruses. Of the five major types, Hep A and B are the most common, and are most closely associated with sexual activity (though not exclusively). The good news is that they are completely preventable through a series of vaccinations. Currently there is no vaccine for Hep C (a virus spread mostly through blood contact), although trial vaccine studies are underway.
Herpes is another common viral STD. Fifty to 80 percent of Americans have oral herpes (commonly known as cold sores or fever blisters), while genital herpes affects about one in five Americans. While both types of herpes are generally not dangerous, they can be uncomfortable. Genital herpes, in particular, can also raise certain emotional issues associated with social stigma. But understanding it for what it is — a common, manageable virus — is the first step in overcoming any feelings of shame, guilt or inadequacy.
Perhaps the most serious, and dreaded, of viral STDs is human immunodeficiency virus. HIV, of course, is the virus that causes AIDS, and the implications of this disease are well-documented. For the purposes of this discussion, however, let it suffice to say that, like the other diseases mentioned above, HIV is not curable, but it is treatable. But certainly, as is true of all STDs, HIV is highly preventable.
Abstinence from sex or being in a mutually monogamous relationship with a partner who is also free from STDs is the surest way to avoid becoming infected yourself. Barring that, condoms are still the only widely available, proven method for reducing transmission of HIV and other STDs. Health organizations around the world recommend condom use for the prevention of HIV and STDs.
If sexual intercourse can be said to be at the center of most of these types of infections, then another form of social intercourse — human conversation — can certainly play an important role in reversing their spread. Let STD Awareness Month be the impetus to have the conversation with your sexual partner(s). It may be uncomfortable, but it is certainly less so than the alternatives.
Robert Winn is the medical director at Mazzoni Center, the region’s only LGBT-specific health center. Mazzoni Center offers rapid HIV testing and STD screening that is confidential. Make an appointment or see your own healthcare provider and GET TESTED.