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STIs IN GENERAL What are STIs (sexually transmitted infections)?

These are infections that are passed between one partner to another during any form of sexual activity. Some infections have symptoms while others may not.

How do I know if I am infected?

If you have any of the following symptoms you should be checked to see if it is due to an STI. These include bumps; blisters; sores; itching; irritation; burning with sex or urination; blood in your urine, semen or vaginal fluid; pain with sex; bleeding after sex; abdominal cramping; a change in your normal menstrual period (more cramping, irregular bleeding) and other symptoms in these areas. There are other reasons for these symptoms, but only a healthcare provider and testing can tell if you are infected.

Remember there are many cases of STIs including infection with the HIV virus that occur without symptoms which means that you can have an infection that you are unaware of and you may also be contagious. If you notice anything unusual, you should always let your healthcare provider know about your concerns.

Testing for STIs

Testing is quick, relatively painless (other than a possible blood draw), and some results are back the same day.

ASU Campus Health provides a routine STI check for those without symptoms of infection consisting of gonorrhea, chlamydia, HIV, and syphilis for females, and chlamydia, HIV, and syphilis for males. If you would like to make an appointment, please call Campus Health at 480.965.3349 and we will be happy to help you!

Your healthcare provider will ask you a set of confidential questions regarding your sexual practices to get an idea of your individual risk factors. All people who are sexually active are considered to be potentially at risk. If you are in the high-risk category, you may be able to be tested to see if you are infected. It is very important to let your healthcare provider know if you feel you are at a higher risk of having an STI so that additional testing can be considered according to your personal history.

Some STIs cannot be tested for and some STIs are only tested if you are having symptoms of the infection (bumps, blisters, burning with urination, sores, etc.). If you have symptoms of an infection, your healthcare provider will determine what tests are important in addition to the above tests and discuss that information with you at the visit.

Paying for testing

If you choose to bill your private insurance, we cannot always guarantee payment for the tests by your insurance. Insurance companies will send information on tests they paid for to the addressee of the insured. You may also choose to pay for your testing on the day of your visit or to charge it to your student account.

If you want the most affordable testing possible, your healthcare provider can refer you to public health clinics that may be able to provide testing at a slightly reduced price. You may contact the Maricopa County Health Department for further information or testing: http://www.maricopa.gov/Public_Health/ControlPrevention/STDs/default.aspx; or call 602.506.1678.

How can I prevent getting infected?

The only 100 percent certain way to avoid catching an STI is through abstinence. If abstinence is not a realistic option for you, the next best plan is to only have sex after both partners have been tested and within the context of a mutually monogamous relationship using condoms. There are still STIs that can still be transmitted even while using condoms, so it is important to choose partners carefully and get tested regularly.

The following individuals are considered by health guidelines to be at the highest risk of catching or transmitting an STI:

  1. Men who have sex with men
  2. Intravenous drug users
  3. Sex workers
  4. Recently incarcerated individuals
  5. Individuals testing positive for an STI in the previous six months (other than HPV)
  6. Individuals whose partners are known to have one of the above risk factors   

HUMAN PAPILLOMAVIRUS

Human Papillomavirus (HPV) is the name of a family of viruses known to cause all types of warts. There are more than 100 identified strains of HPV, and approximately 40 of these known types can affect the genitals of sexually active people. Some studies suggest that more than 80 percent of sexually active people have been exposed to HPV at some time in their sexual history.

How do I know if I am infected?

The vast majority of infections of HPV will come and go without any signs or symptoms, so most people have no way of knowing that they have been infected and are potentially contagious. Some people will develop external bumps on the genitals due to HPV infection – these are genital warts and they can have all sorts of shapes and sizes – a person may have one bump or multiple bumps. Some women will develop problems on the inside of the vagina, most importantly on the cervix (found at the very top of the inside of the vagina). Abnormalities such as these can sometimes lead to cervical cancer.

Testing for HPV

Currently there is no approved test that can detect HPV in men. For women, HPV abnormalities are detected during a woman’s pap test. This test should be done by your healthcare provider starting three years after you begin having intercourse or when you turn 21 years old. Unless your healthcare provider tells you otherwise, it is recommended that you have a pap test yearly to check for changes due to HPV infection.

How can I prevent getting infected?

HPV can still be contagious even if you use condoms and even if you have no symptoms of an active infection. Due to the high rates of infection among sexually active people, it may be best to assume that any potential sexual partner may be carrying an infection and contagious.

In 2006, the FDA approved a new vaccine designed to prevent new infections of HPV virus. At this time, the vaccine is approved for females ages 9-26, but if you are planning to have new sexual partners at any time, you should discuss the vaccine with your healthcare provider. Most people are very good candidates for vaccination. It is the policy of ASU Campus Health to strongly advocate the vaccination of all sexually active females.

Treatment for HPV

In the past it was believed that HPV infection would stay with a person forever, but recent studies show that in younger people with healthy immune systems, the virus often resolves completely or is reduced to undetectable levels. If you develop visible genital warts, you may have them removed by your healthcare provider or treat them with a topical medication.

GONORRHEA

How do I know if I am infected?

Most cases of gonorrhea come with symptoms of vaginal or penile discharge, but some individuals may have no symptoms of any kind.

Testing for gonorrhea

Tests for gonorrhea are very simple and accurate. For men and women, there are urine tests that check for the DNA of the bacteria. In some cases, your healthcare provider may swab the urethra in men or the cervix in women if you are having symptoms, but most of the time, a simple urine sample is all that is needed. Tests are usually back within a week.

How can I prevent getting infected?

Like most STIs, gonorrhea is best prevented through abstinence or consistent use of condoms.

Treatment for gonorrhea

Gonorrhea is easily treated with an antibiotic when detected early.

 

CHLAMYDIA

How do I know if I am infected?

Sometimes chlamydia causes burning with urination or abnormal drainage from the penis or vagina, but often it causes no symptoms at all. This infection, if untreated, is also the most common cause of pelvic inflammatory disease (PID) in women which can lead to internal scarring and infertility.

Testing for chlamydia

Tests for chlamydia are the same as for gonorrhea (see above); a simple urine test for most people is sufficient, but your healthcare provider will discuss with you the need for a more extensive examination depending on your symptoms. Test results are usually back within one to two days, but could take as long as a week.

How can I prevent getting infected?

Infection with chlamydia is best prevented through abstinence and use of condoms.

Treatment for chlamydia

Chlamydia is easily treated with an antibiotic (often in a single dose), except in cases that have progressed further into PID. PID must be treated with a longer course of antibiotics and may require a hospital stay in severe cases.

 

HIV/AIDS  

How do I know if I am infected?

Most young, healthy people will not have symptoms of HIV/ AIDS for a very long time after infection. Early symptoms are usually subtle signs that the immune system is not functioning well, such as frequent colds and other illnesses. Some people will begin to feel very tired or have sweating in the night.

Testing for HIV/AIDS

Tests for HIV/AIDS can be obtained through an oral swab of saliva or a blood test. Both are very accurate and results are back the same day at CHS. If you have had recent exposure or a new partner that you are concerned may be at high risk, we suggest you repeat the test every three to four months for about six months.

How can I prevent getting infected?

HIV/AIDS is best prevented through abstinence and consistent use of condoms. You may also reduce your risk by avoiding sexual contact with especially high risk people.

Treatment for HIV/AIDS

Since HIV/AIDS is a virus, there is currently no cure. Research is underway to develop a vaccine, as well as an effective treatment, but for now, we can only provide medications to fight infection and support the body’s own immune defense. Today, many people are able to live long, fairly healthy lives with the use of multiple medications, but a cure remains elusive.

 

SYPHILIS

How do I know if I am infected?

Often, syphilis will start with a shallow sore or ulceration on the genital and then progress to a rash on the body. The bacteria can enter the body through any intimate contact with an infected person, even without having vaginal intercourse (i.e., oral or anal sex).

Testing for syphilis

Currently, tests for syphilis must be done with a blood test. CHS provides this service and results are usually back within one to two days.

How can I prevent getting infected?

Syphilis is most common in higher risk groups (see list), but it is on the rise in all groups. Most transmission can be prevented through the use of condoms, but you should also be sure you and your partners are getting tested on a regular basis.

Treatment for syphilis

Syphilis is easily treated in early stages with an antibiotic. In later stages, it can progress into multiple organs and systems of the body (including the brain) and it becomes more difficult to diagnose and treat.

 

HERPES SIMPLEX VIRUS (HSV), TYPES 1 & 2

The following information was written by Dr. John Dorman of Stanford University School of Medicine and is used with his permission. Some details have been adapted.

How do I know if I am infected?

If you have had cold sores (fever blisters) around the mouth (not canker sores in the mouth), you probably have HSV 1. Testing doesn’t test for the virus but tests for the body’s reaction to the virus. Unfortunately, up to 80 percent of adults in the US are positive to the type 1 Herpes simplex virus that causes cold sores. Although Type 1 HSV can cause up to 50 percent of genital herpes, the blood test cannot differentiate where you had HSV. HSV 2 is positive in about 20-25 percent of adults in the U.S. and is almost always genital.

Testing for HSV

A simple blood test can usually tell if your body has been exposed to HSV 1 or 2. If you have an active blister, we can also test for the virus itself. Testing may be especially relevant in couples where one of them is infected and the other is not. If both are infected or if neither one tests positive, herpes becomes a non-issue for that relationship.

Is there a downside to testing?

There is no FDA approved treatment and no evidence for treating patients with positive blood tests but with no symptoms. There is good evidence to treat patients with recurrent outbreaks of HSV 1 or 2 with medications even between outbreaks to decrease the risk of infecting others.

How can I prevent getting infected?

Abstinence is the best method, but if not feasible or desired, then using a condom is the best method. The highest risk for transmission is right before or during an outbreak, but it can be passed on even in between outbreaks.

Two circumstances are medically important with respect to herpes

  1. If a woman gets genital herpes for the first time in the third trimester of pregnancy, just as she is preparing to deliver a baby, the baby may be significantly infected, with major consequences.
  2. If you have herpes, especially with a sore, and you have unprotected sex with a person definitely infected with HIV, you have a significantly increased risk of getting HIV from this encounter. 

Otherwise, herpes is generally a nuisance problem, although it is never a great experience to have genital herpes, or even more, to give someone else genital herpes.

Consequently, you need to think hard as to whether it would be helpful for you to know if you are infected and are potentially contagious for herpes of either type. Keep in mind that herpes, while an STI and often extremely uncomfortable, does not have any severe complications, with the above two exceptions.

Treatment for HSV

Ongoing preventive use of anti-herpes drugs, such as acyclovir, Valtrex or Famvir, may decrease the spreading of the virus and the contagion in those with frequent outbreaks, but not to zero.