Frequently asked
questions (FAQ) about Sexually Transmitted Diseases (STDs)
FAQ List
What are sexually
transmitted diseases (STDs)?
Sexually transmitted diseases are diseases that can be passed
from person to person through sexual contact. Depending on the
STD, sexual contact that causes transmission can include penis-vagina
penetration, oral sex, anal sex, and/or mutual masturbation
(touching someone else’s genitals and then touching yours).
Some of these diseases can be transmitted by exchange of sexual
fluids such as semen or vaginal discharge. Others are usually
transmitted by open sores or warts of an infected person coming
into contact with the skin of an uninfected person. Occasionally,
STDs can be transmitted in non-sexual ways, such as through
casual contact, by sharing needles, or from an infected mother
to her baby during pregnancy or delivery.
There are many different kinds of STDs: some are easily cured
with simple drugs, some take multiple kinds of treatments and
drugs to cure, and some can only be treated and not cured. It
is important to understand STDs to be able to protect yourself
from future infection, to be able to recognize the symptoms
of STDs, and to be able to seek treatment if you think you might
have an STD.
Are sexually transmitted infections
(STIs) different from sexually transmitted diseases (STDs)?
Sometimes the terms STI and STD are used interchangeably. This
can be confusing and not always accurate, so it helps first
to understand the difference between infection and disease.
Infection simply means that a germ – virus, bacteria, or
parasite – that can cause disease or sickness is present
inside a person’s body. An infected person does not necessarily
have any symptoms or signs that the virus or bacteria is actually
hurting their body (they do not necessarily feel sick). A disease
means that the infection is actually causing the infected person
to feel sick, or to notice something is wrong. For this reason,
the term STI – which refers to infection with any germ
that can cause an STD, even if the infected person has no symptoms
– is a much broader term than STD.
The term STD refers only to infections that are causing symptoms
or problems. Because most of the time, people don’t know
they are infected with an STI until they start showing symptoms
of disease, the AIDS Resource Center uses the term STD, even
though the term STI is also appropriate in many cases.
Depending on the STI, a person may or may not still be able
to spread the infection if no signs of disease are present.
For example, a person is much more likely to spread herpes infection
when blisters are present (STD) than when they are absent (STI).
However, a person can spread HIV infection (STI) at any time,
even if they haven’t developed symptoms of AIDS (STD).
How common are STDs?
In sub-Saharan Africa, 65 million new cases of curable STDs
occur among adults every year (WHO 1998). It is estimated that
for every 1,000 people in sub-Saharan Africa, 254 people become
infected with a curable STD each year. It is estimated that
for women ages 15-44, STDs (excluding HIV) are the second most
common cause of healthy life lost, after the risks of death
and infirmity associated with childbearing.
What is the relationship between
STDs and HIV?
A person who has an STD is much more likely than someone without
an STD to become infected with HIV if they have unprotected
sex (sex without a condom) with an HIV-infected person. This
is especially true for people infected with an STD that causes
genital ulcerations (cuts/open sores on the vagina or penis,
or nearby areas). Cuts and open sores provide an easy route
for HIV to enter the bloodstream. STDs that can cause genital
ulcerations include herpes, syphilis, chancre, gonorrhea, trichomoniasis,
and scabies.
Why can it be hard to notice if
I have an STD?
Most people with STDs have no symptoms. When symptoms
are present, they are often hard to recognize because they can
be confused with non-sexual diseases. This is especially true
for women. This is why it is good to have routine check-ups
if you are sexually active, especially if you have had multiple
sexual partners (even if you used a condom every time).
However, there are some symptoms to look for if you think you
might have an STD.
In women, the most common symptoms of an STD are:
- unusual or bad-smelling vaginal discharge,
- severe itching or burning in the genital area,
- unusual bleeding,
- pelvic pain,
- pain during sex,
- rashes on the genitals,
- open sores or warts on the genital area, and/or
- recurrent urinary tract infections.
In men, the most common symptoms of an STD are:
- pain when urinating,
- open sores or warts on the genital area,
- rashes on the genitals,
- discharge from the penis, and/or
- pain in the scrotum/testicles.
However, in both men and women, STDs can cause symptoms in
other parts of the body besides the genitals and bladder, including:
- discharge from the anus,
- swelling of the groin,
- jaundice (yellowing of the skin and whites of the eyes),
- arthritis,
- oral thrush (white tongue),
- sores or bumps in and around the mouth, and
- generalized rashes.
In general, if you:
- notice any sores or warts on or near your genitals,
- have a rash in your genital area,
- have severe itching of your genitals, or
- notice unusual or bad-smelling discharge from your penis
or vagina,
Go to a clinic
or the hospital for treatment. Early treatment increases
your chances of being cured, if a cure is possible. If a cure
is not possible, early treatment improves your ability to prevent
negative consequences of infection, including infection with
other STDs.
What are the symptoms of common
STDs?
Specific causes and symptoms associated with some of the more
common STDs are described below. However, in general, if you
experience any of the
symptoms listed in the previous section, visit your
clinic or hospital for a check-up.
Chancre – Chancre, caused by bacteria, results
in one or more ulcer(s) (open sores) on the genitals within
a week after exposure, as well as swollen lymph nodes on one
or both sides of the groin. Sometimes the lymph nodes swell
and form an abscess. The condition can be extremely painful,
but can easily be treated with antibiotics.
Chlamydia – Chlamydial infections often have
no symptoms, and may occur alongside other STDs, such as gonorrhea.
However, chlamydia can sometimes cause pain when urinating
in both men and women, as well as abnormal discharge from
the tip of the penis or the vagina. Chlamydia can also cause
pelvic inflammatory disease (including chronic pain in the
abdomen and abnormal menstruation) in women, which can be
very painful and can lead to inability to bear children. Chlamydia
can be easily treated with antimicrobial drugs, but both
partners should be treated to avoid re-infection.
Gonorrhea – Gonorrhea, also called “the
clap,” is a very common STD, and frequently occurs as
co-infection with chlamydia. Men with gonorrhea often experience
discharge from the end of their penis, and feel pain when
urinating. In women, gonorrhea has no symptoms in almost 70%
of cases, but some women experience unusual vaginal discharge,
or have pain when urinating and have to urinate more often
than normal. Occasionally, gonorrheal infection can spread
through the body and cause sores like pimples on many different
parts of the body including hands, back, legs, and shoulders,
as well as cause a rash or arthritis-like symptoms. Treatment
is simple: gonorrhea is easy to cure with antibiotics, but
both partners need to be treated or re-infection will
occur.
Genital warts (or HPV) – Genital warts are caused
by a virus called the human papilloma virus. The virus is
extremely contagious: genital warts are one of the most common
STDs. Warts can affect the penis or anal area in men, and
the outer areas of the vagina, the anal area, and even the
surface of the cervix and inner walls of the vagina in women.
Genital warts are often painless and can be hard to see, however,
they sometimes grow in number or size. They usually look like
raised bumps or growths with a rough, uneven surface. Genital
warts on the cervix tend to be flat, and can be hard to feel
or notice. If left untreated over many years, HPV of the cervix
can lead to cervical cancer. HPV infection of the cervix can
be detected by having routine Pap smears every year or two.
HPV infection cannot be cured, but warts can be removed with
medical treatment (even though they often come back). If you
have all your HPV warts removed, you are much less likely
to infect your partner.
Herpes – Herpes is caused by a virus, and unfortunately,
there is no cure. Herpes causes multiple painful open sores
on the penis or nearby areas (scrotum, anus, buttocks, or
thighs) in men, or on the vulva and cervix, or nearby areas
(anus, buttocks, or thighs) in women. Herpes sores tend to
happen in outbreaks – a person might have multiple sores
for a while, but they go away in 3 to 4 weeks, and come back
a few months later. Outbreaks can happen at any time, but
are encouraged by stress, poor nutrition, other illnesses,
or physical weakness. When a person has herpes sores, he or
she is much more likely to infect someone else if he or she
has sex (or other intimate contact) with them. If a person
has no sores, it is possible but not as likely that their
sex partner will become infected. Sex with a condom when you
are not experiencing a herpes outbreak is the best
way to protect your sexual partner if you have herpes infection.
If you have herpes sores, a condom is not effective
in preventing transmission of herpes infection. While some
medications are under development that can reduce the frequency
of outbreaks, they are unfortunately hard to find in Ethiopia.
HIV – Even though HIV can be transmitted in non-sexual
ways, it is spread primarily through sexual activity in Ethiopia,
and so it is considered an STI. When HIV has weakened the
immune system so much that a person gets sick with other diseases
easily, the person is said to have AIDS (considered an STD).
HIV infection usually has no symptoms, but if you think you
could have been exposed to the HIV virus (you had sex, especially
unprotected sex, with a person who has HIV or AIDS, or who
died from AIDS or unknown causes), you can increase your chances
of living a long and healthy life by getting tested for HIV
before symptoms of AIDS appear.
Symptoms of AIDS can vary greatly. Usually, a person who
has AIDS has a very weak immune system, and so they often
get unusual diseases (called opportunistic infections) that
an ordinary healthy person would not get. These diseases include
untreatable yeast infections, rare cancers, rare pneumonias,
active tuberculosis disease, and other chronic viral infections.
People with AIDS often lose a lot of weight rapidly and for
no apparent reason. Most opportunistic infections can be treated
successfully, especially if they are treated early before
the body gets too weak to handle strong medicines. For this
reason, knowing your HIV status can do a lot to prolong your
life by helping you change your behaviors, whether or not
you have the virus. You can find out your HIV status for around
10 birr at places called voluntary counseling and testing
(VCT) sites. Visit
the AIDS Resource Center website (www.etharc.org) for contact
information of VCT sites in Ethiopia.
If you still have questions
about HIV and AIDS, click here to read a list of FAQ’s
about HIV and AIDS.
Scabies – Scabies is caused by a mite, a small creature
that lives in the skin around the genitals. It causes severe
itching, especially during the night. Symptoms appear 2-6
weeks after contact with another person who has scabies. The
infestation causes a rash on the fingers, wrists, and (in
males) the penis, as well as blisters on these areas as well
as elbows, armpits, (in females) breasts, abdomen, (in males)
scrotum, buttocks, and/or thighs. Bathing frequently helps
to reduce the bites and itching, but treatment with malathion
or permethrin can kill the mites.
Syphilis – Almost 1/3 of the world’s new syphilis
cases each year occur in sub-Saharan Africa, making it one
of the most common, and potentially most deadly, STDs in Africa.
People infected with syphilis have symptoms early after infection,
when the disease can be easily treated with penicillin or
other common drugs. However, the longer a person has had syphilis,
the harder it is to treat.
9 to 90 days after a person is infected with syphilis, a
person develops a single, round, open sore on the penis, vagina,
or nearby area. It is usually painless, and heals in 3 to
10 weeks. Because it is painless and can sometimes occur in
hard-to-see places (such as the cervix, underside of the penis,
and inside the rectum, many people with syphilis never notice
this stage. Four to eight weeks after the first open sore
appears, many more appear (either as individual sores or a
generalized rash) anywhere on the body.
Syphilis eventually enters a long inactive, or latent, phase
where no symptoms are noticed. After the latent phase, very
serious symptoms appear, including blindness, insanity, paralysis,
convulsions, and joint pain. At this point, syphilis is much
harder to treat, and symptoms may not be reversible.
Pregnant women are often tested for syphilis, as syphilis
can be passed to the baby while the mother is pregnant, and
can cause deformities, sores, blindness, and bone development
problems in the baby.
Trichomoniasis – Trichomoniasis is caused by a parasite
that lives in the tissue lining the vagina, penis, prostate,
and semen ducts. In women, infection often causes a bad-smelling
vaginal discharge, and sometimes itching, swelling, pain during
sex, and pain while urinating. Still, some women may have
no symptoms. In men, infection rarely causes any symptoms,
though occasionally they may experience pain while urinating.
Trichomoniasis is easily treated with a medicine called metronidazole,
but both partners must be treated to prevent recurrence of
the infection.
What should I do if I think I might
have an STD?
If you have any of the symptoms
described above, or you suspect you could have been exposed
to an STD, it’s important to get medical help.
People who think they might have an STD often feel scared or
embarrassed. It is normal to feel this way, but it is important
to keep your feelings from getting in the way of seeking medical
help. Untreated STDs usually get worse, making you even more
scared and embarrassed. Some STDs can make you very sick or
even kill you. If you have an untreated STD, you can infect
anyone else you have sex with.
If you are worried people might find out you are getting tested
or treated for an STD, many clinics and hospitals provide anonymous
testing, and even free treatment if you have an STD.
If you think or know you have an STD, it is important to consider
changing your sexual behavior. Because some STDs, like herpes
and HPV, cannot always be prevented with condoms, you may consider
abstinence (not having sex) as an option. You may also wish
to take precautions with your sexual partner(s). This means
talking to them about your sexual history and any infections
you have, encouraging them to seek diagnosis and treatment if
it is possible they have an STD, encouraging faithfulness to
one another, and using a condom.
If you find out you have an STD, it is important to:
- avoid sex while being treated;
- follow the full treatment regimen prescribed by your doctor;
and
- tell recent sexual partners, so they can seek treatment
themselves if they are infected, and avoid infecting others.
Why is knowing whether I have an
STD important if I am pregnant or planning to become pregnant?
Many STDs can be passed from a mother to her baby either while
she is pregnant (syphilis) or while the baby is passing through
the birth canal during delivery (chlamydia, gonorrhea, herpes,
and others). The consequences of STD infection in infants can
be extremely serious and lifelong, including blindness, deformity,
brain damage, deafness, pneumonia, and even fetal or infant
death.
With medicines and appropriate medical care, it is easy to
prevent the transmission of STDs from the mother to her child.
This is why it is important for women planning to have children,
or who are already pregnant, to seek testing and treatment for
STDs if they could have been exposed.
How can I avoid getting an STD?
The best way to avoid getting an STD is by abstaining from
(not having) sex. This includes oral, vaginal, and anal sex.
Some STDs, like herpes and HPV, cannot always be prevented with
condoms, so not having sex protects you from this risk.
If you are a teenager, delaying having sex until your twenties
can reduce your risk of getting an STD. The younger you are
when you start having sex, the more likely you are to get an
STD. Also, the more sexual partners you have in a lifetime,
the greater your risk.
If you are sexually active, take precautions with your sexual
partner(s). This means talking honestly about your sexual experiences
in the past and your faithfulness in the present, and going
to a clinic (separately or together) to make sure neither of
you have an STD, even if you have no symptoms. Staying faithful
to one another once you know you are both uninfected is the
second best way to avoid getting an STD.
If abstinence or being faithful to one uninfected partner is
not possible for you, consider using a condom every time you
have sex. While condoms are not 100% effective in preventing
the transmission of STDs, they help reduce your risk of getting
almost all STDs. Especially when having sex with a new partner,
have regular check-ups to screen for STDs. Additional ways to
reduce your risk include avoiding sex during a woman’s
menstrual period, avoiding douching (for women), avoiding anal
sex without a condom, and learning to recognize symptoms early.
Where can I get more information
on STDs?
Helpful information on STDs is available by visiting the STD/STI
links on the AIDS Resource Center (www.etharc.org) Links page.
You can also visit the AIDS Resource Center on Dembel City Center
- 9th Floor, which has many different books, articles, posters,
and videos about STDs to help you learn more about these diseases
and their treatment on your own. You can also ask your doctor
or health care provider any questions you may have about STDs
and their prevention and treatment.
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