Section One

Common Health Problems

STIs / HIV

Sexually transmitted infections (STIs) are ones that pass from one person to another through sexual contact (e.g., vaginal, anal, and oral sex, and genital-to-genital contact). STIs are also called sexually transmitted diseases (STDs).

Seventy-five percent of STIs are acquired in persons who range in age from 15 to 24 years old.

Common STIs in the U.S. are: Chlamydia; genital herpes; gonorrhea; hepatitis B; HIV/AIDS; human papillomavirus (HPV) – the cause of genital warts; and trichomoniasis. The most common ones among college students are chlamydia and HPV.

Syphilis, another STI, is not as common as it used to be, but still exists. For information on this STI, access www.cdc.gov.

photo of student speaking with health care provider

Follow your health care provider’s advice.

More than one STI can be present at the same time. Some can be present without symptoms. If you are sexually active or have ever had sex without adequate “barrier” protection (e.g. latex or polyurethane condom), you could have an STI and not even know it.

Treatment

Call your health care provider, your school’s Health Service, or the National STD Hotline (800.227.8922) to find out how to get tested for STIs. Testing may be free at your college’s Health Service. Treatment depends on proper diagnosis.

Chlamydia

Signs, Symptoms & Causes

Chlamydia is caused by different strains of the bacterium chlamydia trachomatis.

About 25 percent of males have few or no symptoms, but can still transmit the disease. Symptoms may show up 2 to 4 weeks after infection and include: Watery, mucous discharge from the penis; burning or discomfort when urinating; and pain in the scrotum.

Seventy-five percent of females have few or no symptoms, but can still transmit the disease.

When present, symptoms show up 2 to 4 weeks after infection and include: Slight yellowish-green vaginal discharge; vaginal irritation or pain or burning feeling when urinating; abdominal pain; and abnormal vaginal bleeding. In females, chlamydia can cause pelvic inflammatory disease (PID), which can cause infertility. (See “Pelvic Inflammatory Disease” (PID).)

Treatment

  • Oral antibiotics for the infected person and his or her partner(s).
  • Avoiding sex until treatment is completed in the infected person and his or her partner(s).

Genital Herpes

Signs, Symptoms & Causes

The Herpes simplex virus (HSV-1 or HSV-2) causes genital herpes. HSV-1 often affects the oral area, showing up as cold sores, but can affect the genital area, too. HSV-2 usually affects the genital area, upper thighs, and area near the anus, but can also affect the oral area. The virus is spread by direct skin-to-skin contact from the site of infection to the contact site, but can also be spread when no symptoms are noticed. Oral sex can spread herpes from the mouth to the genital area and from the genital area to the mouth.

Signs and symptoms (which may appear as early as 2 to 20 days after contact) include:

  • Painful blisters and/or sores on the genital area, anus, and thighs and/or buttocks.
  • Itching, irritation, and tingling in the genital area 1 to 2 days before the blisters appear.
  • After a few days, the blisters break open and leave painful, shallow ulcers, which can last from 5 days to 3 weeks.

With outbreaks, especially the first one, there may be flu-like symptoms (swollen glands, fever, body aches). Outbreaks that follow are usually milder and shorter. Stress, fatigue, illnesses, vigorous sexual intercourse, sunburn, etc. may trigger outbreaks.

Using a latex or polyurethane barrier (condom, dental dam, etc.) when you have sex or skin-to-skin contact may help prevent transmission, but this is not guaranteed.

The sores may be located on skin areas not covered by the latex or polyurethane barrier. The virus can also be transmitted when sores are not present. This is known as “viral shedding.”

Treatment

  • There is no cure. Symptoms occur, though, only during flare-ups.
  • Oral antiviral medicines (e.g. acyclovir, valacyclovir) can help prevent outbreaks and shorten how long the outbreaks last.
  • Self-Care measures listed below.

Gonorrhea

Signs, Symptoms & Causes

Gonorrhea is also called “the clap,” “dose,” or “drip.” It is caused by a specific bacterial infection. If not treated, it can spread to joints, tendons, or the heart. In females, it can cause pelvic inflammatory disease (PID), which is directly linked to infertility in females. (See “Pelvic Inflammatory Disease (PID).”)

Sixty to 80% of females have no symptoms. If symptoms are present, they appear 2 to 10 days after infection and include: Mild vaginal itching and burning; thick, yellow-green vaginal discharge; burning when urinating; and severe pain in lower abdomen.

In males, signs and symptoms include: Pain at the tip of the penis; pain and burning during urination; and a thick, yellow, cloudy, penile discharge that gradually increases.

Treatment

  • Antibiotics.
  • Pain relievers.
  • Treating sexual partner(s) to avoid re-infection.
  • Follow-up test to find out if the treatment was effective.

Hepatitis B

Signs, Symptoms & Causes

Hepatitis B is a virus that causes liver inflammation. The virus can be spread from contact with blood or bodily fluids from an infected person. Examples are having sex and/or sharing drug needles with an infected person and exposure to infected blood through cuts, open sores, and unsterilized instruments used for body piercing.

Sharing razors with an infected person and exposure to an infected person’s saliva may transmit the virus. Hepatitis B is not spread through food or water or by casual contact.

Three doses of Hepatitis B vaccine can prevent getting this virus. Consult your health care provider if you have not yet received this vaccine.

Some persons have no symptoms. When symptoms first occur, they are flu-like (fatigue, fever, appetite loss, nausea and vomiting, and joint pain).

Later, symptoms include jaundice, dark urine, and pale, clay-colored stools.

Treatment

  • Self-Care measures listed below.
  • Medication may be prescribed for chronic cases.

While most people with this type recover, up to 10% can become chronic. (The person can spread the infection even though he or she has no symptoms.) This type can lead to cirrhosis of the liver and liver failure in some persons.

HIV/AIDS

photo of student hugging and kissing another on the cheek

You cannot get HIV from hugging a person with HIV.

Signs, Symptoms & Causes

HIV stands for human immunodeficiency virus. AIDS, acquired immune deficiency syndrome, is caused by HIV. HIV destroys the body’s immune system leaving a person unable to fight off diseases. The virus also attacks the central nervous system causing mental and neurological problems.

HIV is spread when body fluids, such as semen and blood, pass from an infected person to another person. Usually, the virus is spread by sexual contact or by sharing drug needles. It can also be passed from an infected female to her baby during childbirth or breast-feeding.

You cannot get HIV from donating blood, touching, hugging, or social (dry) kissing a person with HIV. You cannot get HIV from a cough, a sneeze, tears, sweat, or from using a hot tub, telephone, or restroom.

Symptoms of HIV before the Onset of AIDS

  • Swollen glands.
  • Fatigue. Weight loss.
  • Fever and sweating. These occur often.
  • Skin rashes that persist. Flaky skin.
  • Infections. These include herpes, shingles, and yeast infections.
  • Short-term memory loss.
  • Getting sick often.

When HIV invades the brain, impaired speech, trembling, and seizures can occur.

AIDS is the most advanced stage of HIV. With AIDS, a low level of cells in the blood called T4 cells occurs. Persons with AIDS get many illnesses. These include skin infections, tuberculosis, pneumonia, and cancer.

Treatment

  • Medications. These are often used in multidrug combinations.
  • Treating infections, such as pneumonia.

Human Papillomavirus (HPV) - Genital Warts

Signs, Symptoms & Causes

About 25 types of HPV can infect the genital area. Only a few types cause genital warts. Other types increase the risk for cervical cancer.

Often, there are no visible signs or symptoms. Genital warts are often skin-colored, do not hurt, and may be located inside the vagina or the head of the penis, or in the anus. This makes them hard to see. To find out if you have genital warts, a health care provider can put a solution of acetic acid (vinegar) on the genitals.

HPV is spread by direct skin-to-skin contact during vaginal, anal, or (rarely) oral sex with an infected partner. You don’t get genital warts from touching warts on other parts of the body, such as the feet or hands.

Genital warts can appear several weeks after being infected or may not show up for months or even years. This makes it hard to know when the virus was acquired and which partner was the carrier.

Three doses of HPV vaccine can prevent the most common types of HPV that are associated with cervical cancer in females and genital warts in females and males. (See “Immunizations”).

You can also lower the risk for getting HPV by using latex or polyurethane condoms, which are more likely to cover potentially affected areas of the body. (A diaphragm will not prevent transmission.)

Treatment

  • The warts can be treated with topical creams or a gel prescribed by a doctor. You apply these yourself.
  • The warts can be removed medically by cryosurgery (freezing them); an acidic chemical that burns them; or laser surgery.
  • Females who have had HPV should get Pap tests as often as advised by their health care providers to screen for signs of cervical cancer. These females should not smoke.

Trichomoniasis

Signs, Symptoms & Causes

Trichomoniasis is caused by a protozoan, not by bacteria or a virus.

In females, the protozoan can be present in the vagina for years without causing symptoms. If they do occur, typical symptoms include:

  • Vaginal itching and burning.
  • A yellow-green or gray vaginal discharge with an odor.
  • Burning or pain when urinating.
  • Painful sexual intercourse.

In males, symptoms are not usually present. Males may infect their sexual partners and not know it. When present, symptoms include:

  • Discomfort when urinating.
  • Pain during intercourse.
  • Irritation and itching of the penis.

Treatment

  • The oral medication metronidazole (Flagyl). {Note: Don’t drink alcohol for 24 hours before, during, and 24 hours after taking metronidazole. The combination causes vomiting, dizziness, and headaches.}
  • Treating sexual partners to prevent spreading the infection and getting it again.

Questions to Ask

Do you test positive for HIV or do you have signs and symptoms of any STI listed in this topic?

if yes, see provider
if no, proceed to next question

Do you already have a diagnosis of genital herpes and do you have severe pain and blistering and/or are you having outbreaks often?

if yes, see provider
if no, proceed to next question

Are you symptom-free, but worried that you got an STI from someone you suspect may have one?

if yes, see provider
if no, proceed to next question

Do you want to rule out an STI because you have had many sex partners and you are considering a new sexual relationship or planning to get married or pregnant?

if yes, see provider
if no, proceed to next question

Do sores appear in the genital area only after taking a recently prescribed medicine?

if yes, see provider
if no, use self care

Self-Care

Sexually transmitted infections need medical care.  Along with medical care, do the following:

For Genital Herpes

  • If prescribed an oral antiviral medicine, take it as directed.
  • Bathe the affected area twice a day with mild soap and water. Pat dry with a towel or use a hair dryer set on warm. Using a colloidal oatmeal soap or bath may be soothing.
  • Use a sitz bath to soak the affected area. You can buy a sitz bath basin from a medical supply or drug store.
  • Apply ice packs on the affected genital area for 5 to 10 minutes to relieve itching and swelling.
  • Wear loose fitting pants or skirts. Don’t wear pantyhose. Wear cotton (not nylon) underwear.
  • If pain is made worse when you urinate, squirt tepid water near the urinary opening while you pass urine or urinate while using a sitz bath.
  • Take a mild pain reliever as directed.
  • Ask your doctor about using a local anesthetic ointment, such as lidocaine, during the most painful part of an outbreak.
  • Wash your hands if you touch the blisters or sores. To avoid spreading the virus to your eyes, don’t touch your eyes during an outbreak.
  • To help avoid spreading the virus to others, use latex barriers during sex and skin-to-skin contact.

For Hepatitis B

  • Rest. Drink at least 8 glasses of fluids a day.
  • Avoid alcohol and any drugs or medicines that affect the liver, such as acetaminophen.
  • Follow a healthy diet. Take vitamin and mineral supplements as advised by your health care provider.
  • Use latex condoms during sexual intercourse to help avoid spreading the virus.

For HIV/AIDS

Medical care, not self-care alone, is needed to treat HIV/AIDS. Self-care measures include:

  • Taking steps to reduce the risk of getting infections and diseases:
    • Get adequate rest and proper nutrition. Take vitamin supplements as advised by your doctor
    • Get emotional support. Join a support group. Also ask your family and friends for support.

For more information, contact:

AIDSinfo  |  800.HIV.0440 (448.0440)  |  www.aidsinfo.nih.gov

American Social Health Association (ASHA)  |  ASHA’s STI Resource Center Hotline – 919.361.8488  |  www.ashastd.org

CDC National AIDS and STD Hotline  |  800.CDC.INFO (232.4636)