Sexually Transmitted Infections

When To Call

Go to ER Now

• You had sex (oral, vaginal or anal) in the past 72 hours with someone who has, or is suspected of having, HIV (AIDS). Note: do not have sex until you see a doctor.
• You were forced to have sex (assault or rape)

Contact Doctor Within 24 Hours

• You are a woman and have symptoms that could be from an STI, such as:
  • vaginal discharge
  • pain during sex
  • vaginal itching
• You are a man and have symptoms that could be from an STI, such as:
  • pus or discharge from the penis
  • pain in the scrotum
• Pain or burning when passing urine
• Rectal discharge or pus
• Painful tiny water blisters in the genital area

Contact Doctor During Office Hours

• You had sex (oral, vaginal or anal) with someone who has or is suspected of having an STI. You may need testing. Note: do not have sex until you see a doctor.
• You are worried you might have an STI but have NO symptoms. Note: do not have sex until you see a doctor.
• You have other questions or concerns

Self Care at Home

• How to prevent STIs, questions about
• STIs, facts about each

Care Advice

STI Prevention

Abstinence and Other "Safe" Sexual Activities:

• Abstaining from sex (vaginal, oral or anal) is the only 100% effective means of not getting STIs.
• Actions which are believed safe (and don't often spread STIs) are holding hands, hugging, touching and kissing (as long as there are no sores on the lips or in the mouth).

How to Prevent Sexually Transmitted Infections (STIs):

• Most STIs are spread by exchange of body fluids (semen, vaginal fluids or blood) during oral, anal or vaginal sex.
• They can also result from direct contact with any sores during sex.
• Condoms are the only trusted way to prevent most STIs during sex.

Use of Condoms:

• Condoms are the only trusted way to prevent most STIs during sex.
• Putting on a condom: (1) Hold the condom at the tip to squeeze out the air. (2) Roll the condom all the way down the erect penis. Don't try to put a condom on a soft penis.
• Taking off a condom: (1) After sex, hold onto the condom while the penis is being pulled out. This will keep the condom from coming off before the penis is out. (2) The penis should be pulled out while still erect, so that sperm (semen) doesn't leak out of the condom.
• Buy latex rubber or plastic condoms. Never use condoms made from animal skins; they can leak.
• If you use a lubricant during sex, make sure it is water-based (like K-Y Liquid). Do not use petroleum jelly, vegetable oil or baby oil. These can cause a condom to break.
• For more facts about condoms, see website Condom Effectiveness.

Actions that Don't Prevent STIs:

• Douching (rinsing out the vagina with water or other fluids) or showering after sex does not prevent STIs.
• Withdrawal (when a man pulls his penis out before he ejaculates or 'comes') is not a way to prevent STIs or pregnancy.
• Having an STI once does not prevent you from getting it, or a different type, again.
• Using other forms of birth control, such as the IUD, birth control pill, implant or shot, doesn't prevent you from getting an STI.
• You still need to protect yourself with condoms.

Call Your Doctor If:

• You have any symptoms that you think might be an STI.
• You have sex without a condom or the condom breaks during sex.
• You are a woman and you miss your period and might be pregnant.
• You have other questions or concerns.

STI Facts (12 topics in alphabetical order)

AIDS (HIV)

• Cause: a virus. HIV (Human Immunodeficiency Virus) is the cause of AIDS (Acquired Immunodeficiency Syndrome).
• Symptoms: flu-like symptoms start in 2-6 weeks. They are fever, sore throat, swollen lymph nodes, rash and muscle pains. These symptoms last 1 to 2 weeks. After many years of silence, the virus attacks a person's immune system (AIDS). That causes fevers, rapid weight loss, long-term diarrhea, pneumonia and many other severe infections.
• How it is spread: by any sexual acts that involve the exchange of body fluids, such as vaginal fluids, semen or blood. Also spread by injecting drugs with dirty (used) needles or syringes. Can be spread from a mother to her baby during pregnancy or giving birth, or during nursing.
• These do NOT spread HIV: saliva, tears, sweat or urine. It is rare that a human bite would spread HIV. Donating blood does not spread HIV. All donated blood in the U.S. is screened for HIV so that getting a blood donation is believed to be safe.
• Incubation Period: in 6-12 weeks after exposure, the HIV antibody test becomes positive. HIV often does not cause any symptoms of AIDS for many years (1-10 years).
• HIV Exposure: risk must be checked right away. If you are at high risk for HIV and were exposed less than 72 hours ago, medicine may be helpful.
• Testing: a blood test is often performed 3 months after exposure if there are no symptoms. This test may be done anonymously (without giving your name) or confidentially, through your doctor. Find anonymous testing sites by calling the CDC AIDS Hotline at 1-800-342-AIDS. Whether done anonymously or confidentially, it is important that you share the information with a trusted doctor.
• Treatment: there is no current cure for HIV/AIDS. There are many drugs that can control HIV and prevent future problems. Most people with HIV can be kept feeling healthy for many years. All sex partners should be tested.

Bacterial Vaginosis (Gardnerella)

• Cause: a common vaginal infection in post-puberty young women. It is caused by an overgrowth of certain bacteria in the vagina.
• Symptoms: may cause a thin, white vaginal discharge with foul (fishy) odor. Often doesn't cause itching or pain. May also have no symptoms.
• How it is spread: this is not clear, but it does not have to be spread through sex. Can also occur in non-sexually active teens.
• Incubation Period: unknown.
• Testing: a sample of vaginal discharge is looked at under a microscope.
• Treatment: oral medicine that needs a prescription. Sometimes vaginal cream is prescribed.
• Prevention of Spread: this is not an STI. Men do not get this infection. Treatment of male sex partners is not needed.

Chlamydia

• Cause: Chlamydia bacterium.
• Symptoms:
• In women, Chlamydia is mostly an infection of the cervix. If a woman has symptoms, she will have a vaginal discharge (often yellow or green).
• In men, Chlamydia causes swelling of the urethra (the duct or tube that pee or semen travel through). Men with symptoms will have discharge from penis and/or problems peeing.
• It often causes no symptoms in men or women.
• How it is spread: by sex (vaginal or anal).
• Incubation Period: varies from days to weeks.
• Testing: it is diagnosed by a urine test or a swab taken from the urethra or vagina.
• Treatment: antibiotics. Re-infection is common. Sex partners should be treated. If not treated, it can result in future problems, such as pelvic inflammatory disease, ectopic pregnancy, or infertility.
• Prevention of Spread: do not have sex until treatment is done and all symptoms are gone.

Gonorrhea

• Cause: Neisseria gonorrheae bacteria.
• Symptoms:
• In women, it often causes an infection of the cervix. Symptoms for women may be vague: more vaginal discharge than normal, abnormal period, pain with sex or pain with passing urine. Many women have no symptoms.
• In men, it causes infection of the urethra. Symptoms in men are penis discharge and/or pain with passing urine. Most men will have symptoms.
• In both men and women, can also be an infection of the throat (from oral sex) or of the rectum (from anal sex). Throat infections may cause a sore throat with pus on the tonsils or no symptoms at all.
• How it is spread: by vaginal, anal or oral sex.
• Incubation Period: often 2-7 days.
• Testing: diagnosed by a urine test or a swab taken from the urethra, vagina, rectum or throat.
• Treatment: antibiotics. Sex partners should be treated. If not treated, can result in future problems, such as pelvic inflammatory disease and possible infertility, ectopic pregnancy in women. In men, it can result in epididymitis (inflamed tube behind the testicles).
• Prevention of Spread: do not have sex until treatment is done and all symptoms are gone.

Hepatitis B (HBV)

• Cause: Hepatitis B Virus (HBV). Hepatitis means swelling of the liver.
• Symptoms:
• Hepatitis from HBV is a serious illness. But, it affects different people in different ways. Some people have no symptoms. Some people feel tired, have nausea, muscle aches, fevers, yellow eyes, and yellow skin. Some people are never able to fully fight off the infection. These people go on to have long-term hepatitis.
• Sometimes people die from hepatitis B.
• How it is spread: HBV can be spread by any sex acts that involve the exchange of body fluids, such as vaginal fluids, semen or blood. The highest amounts of HBV are found in the blood.
• Safe Body Fluids: these body fluids do not spread HBV: saliva, tears, sweat or pee.
• It also can be spread by injecting drugs with dirty (used) needles or syringes.
• Can be spread from a mother to her baby during pregnancy, giving birth, or nursing.
• Incubation Period: 6 weeks to 6 months.
• Testing: blood tests.
• Treatment: there are many anti-viral drugs for treating hepatitis from HBV.
• Prevention of Spread: there are two different meds that help prevent HBV: hepatitis B vaccine and hepatitis B immune globulin.
• Vaccine: the Hepatitis B vaccine helps prevent getting HBV in the future. It is recommended for all newborns. It is also recommended for any teen or adult at risk for getting HBV. All health care providers should get this vaccine.
• Immune Globulin: hepatitis B immune globulin (HBIG) is used to prevent HBV after you have been exposed to it. HBIG is not needed after an HBV exposure if you have already gotten the HBV vaccine.

Herpes Simplex (Genital Herpes)

• Cause: the herpes simplex virus.
• Symptoms: painful, fluid-filled blisters which often are grouped in clusters. They occur any place around the vagina or on the penis. The blisters dry out, crust over and heal in 7-10 days. With the first event, the symptoms are worse. The blisters can come back and are often less painful and last a shorter amount of time.
• How it is spread: genital herpes is spread by sex (vaginal or anal) or by any direct contact with the genitals of a person who has an active herpes infection (first or repeat episodes). Oral herpes (fever blisters) can also be spread to the partner's genitals during oral sex.
• Incubation Period: 2 days to 2 weeks.
• Testing: genital herpes can be diagnosed with a swab taken from a blister.
• Treatment: anti-viral drugs may be used for genital herpes if they are started within the first 3 days of having the blisters. These drugs don't cure the disease, but can shorten the time the symptoms last. Sex partners should be tested.
• Prevention of Spread: do not have sex or contact with the blisters until treatment is done and all symptoms are gone.

Lice (Genital or Pubic Lice)

• Cause: a parasite, also known as the pubic louse or "crab louse." The lice most often infest the genital and anal areas, though other hairy parts of the body may also be involved. But, the scalp is rarely involved by the pubic louse.
• Symptoms: itching and a rash are common symptoms.
• How it is spread: it is most often spread by contact through sex, but may also be transferred through items such as clothing and bedding.
• Incubation Period: symptoms of itching may occur 1-2 weeks after contact.
• Testing: eggs (nits), nymphs and adult lice may be seen with the naked eye. Nits are small, yellowish-white, oval eggs attached to pubic hair shafts. Lice are grayish-white, oval, wingless insects 1-4 mm in length.
• Treatment: medicines which kill the lice can be found over-the-counter and by prescription. A common brand is Nix. A second treatment is suggested 7-10 days after first treatment. Bedding and clothes should be machine washed after treatment to kill all parasites. All sex contacts within the last month should be treated. Re-infection is possible.
• Prevention of Spread: do not have sex until treatment is done and all symptoms are gone.

Molluscum Contagiosum

• Cause: a virus.
• Symptoms: flesh-colored round bumps on skin, sometimes with a dimple in the center. Often cause no other symptoms.
• How it is spread: by direct contact with molluscum any place on the body. May or may not be spread through sex. May also be spread by sharing towels with an infected person.
• Incubation Period: a few weeks to a few months.
• Testing: most often by visual appearance. Sometimes fluid is squeezed from one of the bumps and sent to the lab.
• Treatment: medicines put on the bumps or 'freezing' with liquid nitrogen. Sex partners should be checked and treated if molluscum are seen.
• Prevention of Spread: do not have sex until treatment is done and all symptoms are gone.

Syphilis

• Cause: Treponema pallidum bacteria.
• Symptoms: syphilis first causes a chancre (syphilis sore) which is a skin ulcer on the genitals, anus or mouth. It's often painless, so it may not be noticed. Many weeks after the chancre, a viral-like illness with a rash may occur. After 3-6 weeks, the chancre goes away on its own, but the person is still infected.
• How it is spread: mainly by sexual contact, such as vaginal, anal or oral sex. Also by kissing (if the syphilis sore is in or on the mouth), or by touching someone's open syphilis sore. Any person who may have been exposed should have a blood test. Reason: many infections occur with no symptoms.
• Incubation Period: chancre (sore) grows within 10-90 days (average is 3 weeks).
• Testing: blood tests and sometimes a sample taken from an open sore.
• Treatment: antibiotics. Sex partners should be tested and treated. With no treatment, syphilis can lead to many future problems, such as disease of the brain and problems with pregnancy.
• Prevention of Spread: do not have sex until treatment is done and all symptoms are gone.

Trichomonas

• Cause: Trichomonas vaginalis protozoa.
• Symptoms: in women, this may cause a bad-smelling, yellow, sometimes bubbly vaginal discharge. May also cause vaginal itching and redness, or pain with passing urine. Many women and most men do not have symptoms.
• How it is spread: by sex. Re-infection is common.
• Incubation Period: can range from 4-28 days.
• Testing: check a sample of the vaginal discharge under the microscope. May also be found on a PAP smear.
• Treatment: antibiotics. Sex partners should be tested and treated.
• Prevention of Spread: do not have sex until treatment is done and all symptoms are gone.

Genital Warts

• Cause: Human papilloma virus (HPV). Some types of these viruses also cause 'common' warts on other parts of the body. These are different from warts spread through sex.
• Symptoms: warts are skin-colored growths. They may be very flat and hard to notice or have a cauliflower-like surface. They can grow together and become quite large. Warts can occur any place on the genitals of men or women, and on the anus. Most warts do not have symptoms.
• How it is spread: by vaginal, anal or oral sex.
• Incubation Period: varies from 3 months to 2 years.
• Testing: most often by visual appearance. Sometimes needs magnification in the doctor's office to be able to see the infection. In women, warts occurring inside the vagina or on the cervix need a pelvic exam for diagnosis.
• Treatment: varies. Applying meds in the doctor's office or 'freezing' with liquid nitrogen are the most common. It often needs many retreatments over time. Over-the-counter wart meds for 'common' warts are not useful in the treatment of sexual warts. All sex partners should be checked. Reason: re-infection by untreated partners is common.
• Prevention of Spread: the Human Papilloma Virus vaccine (HPV) can prevent most genital warts and cervical cancer. Between 15 and 24 years of age, 25% of sexually active teens become infected with HPV. Young girls should be vaccinated before they become sexually active, if possible. The target age is 11-12 years. The vaccine is also urged for boys at the same age.
• Prevention of Spread: the Human Papilloma Virus vaccine (HPV) can prevent most genital warts and cervical cancer. Between 15 and 24 years of age, 25% of sexually active teens become infected with HPV. Young girls should be vaccinated before they become sexually active, if possible. The target age is 11-12 years. The vaccine is also urged for boys at the same age.

Yeast Infection

• Cause: a yeast, Candida albicans. This is not often thought to be an STI.
• Symptoms: vaginal discharge (often thick and white), vaginal-area itching, redness, or pain. Also pain with passing urine can happen.
• How it is spread: Candida is found everywhere on the body. It normally lives on the skin, in the mouth, in the vagina, and in the intestines of healthy people without causing infection or symptoms. Overgrowth of yeast can occur with diabetes, taking antibiotics and for unknown reasons. It is when there is overgrowth that you may notice symptoms.
• Incubation Period: unknown.
• Testing: a swab taken from the vagina is looked at under the microscope or cultured.
• Treatment: anti-yeast medicines. Some meds, such as Clotrimazole and Miconozole, can be purchased over-the-counter.
• Prevention of Spread: this is not an STI. Men do not get this infection. Treatment of male sex partners is not needed.

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