STD Awareness

What is a sexually transmitted disease (STD)?
How many people have STDs?
How do you get an STD?
What are the symptoms of STDs?
How do you get tested for STDs?
Can STDs cause health problems?
How are STDs treated?
How do STDs affect pregnant women and their babies?
What can pregnant women do to prevent problems from STDs?
Do STDs affect breastfeeding?
What can I do to avoid getting an STD?

What is a sexually transmitted disease (STD)?

It is an infection or disease passed from person to person through sexual contact.

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How many people have STDs?

The United States has the highest rates of STDs in the industrialized world. In the United States alone, an estimated 15.3 million new cases of STDs are reported each year. Women suffer more frequent and more serious complications from STDs than men.

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How do you get an STD?

You can get and pass STDs through vaginal, anal, or oral sex. Trichomoniasis can also picked up from contact with damp or moist objects such as towels, wet clothing, or a toilet seat, if the genital area gets in contact with these damp objects. Some STDs cause no symptoms. But STDs can still be passed from person to person even if there are no symptoms.

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What are the symptoms of STDs?

Here are some STDs and their symptoms.

STD	Symptoms
BV	Most women have no symptoms. Women with symptoms may have: vaginal itching pain when urinating discharge with a fishy odor
Chlamydia	Most women have no symptoms. Women with symptoms may have: abnormal vaginal discharge burning when urinating bleeding between menstrual periods Infections that are not treated, even if there are no symptoms, can lead to: lower abdominal pain low back pain nausea fever pain during sex bleeding between periods
Genital Herpes	Some people may have no symptoms. During an “outbreak,” the symptoms are clear: small red bumps, blisters, or open sores on the penis, vagina, or on areas close by vaginal discharge fever headache muscle aches pain when urinating itching, burning, or swollen glands in genital area pain in legs, buttocks, or genital area Symptoms may go away and then come back. Sores heal after two to four weeks.
Gonorrhea	Symptoms are often mild, but most women have no symptoms. Even when women have symptoms, they can sometimes be mistaken for a bladder or another vaginal infection. Symptoms are: pain or burning when urinating yellowish and sometimes bloody vaginal discharge bleeding between menstrual periods
Hepatitis B	Some women have no symptoms. Women with symptoms may have: mild fever headache and muscle aches tiredness loss of appetite nausea or vomiting diarrhea dark-colored urine and pale bowel movements stomach pain skin and whites of eyes turning yellow
HIV/AIDS	Some women may have no symptoms for 10 years or more. Women with symptoms may have: extreme fatigue rapid weight loss frequent low-grade fevers and night sweats frequent yeast infections (in the mouth) vaginal yeast infections and other STDs pelvic inflammatory disease (PID) menstrual cycle changes red, brown, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
Human Papillomavirus (HPV)	Some women have no symptoms. Women with symptoms may have: visible warts in the genital area, including the thighs. Warts can be raised or flat, alone or in groups, small or large, and sometimes they are cauliflower-shaped. lesions on the cervix and in the vagina
Pubic Lice	Itching finding lice
Syphilis	Symptoms in the first, or primary stage: a single, painless sore appears, usually in the genital areas but may appear in the mouth if infection is not treated, it moves to the next stage Symptoms in the next, or secondary, stage are: skin rash on the hands and feet that usually does not itch and clears on its own fever swollen lymph glands sore throat patchy hair loss headaches weight loss muscle aches tiredness In the latent, or hidden, stage, the symptoms listed above disappear, but the symptoms from the second stage can come back. In the late stage, infection remains in the body and can damage the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints.
Trichomoniasis	Symptoms usually appear 5 to 28 days after exposure and can include: yellow, green, or gray vaginal discharge (often foamy) with a strong odor discomfort during sex and when urinating irritation and itching of the genital area lower abdominal pain in rare cases

How do you get tested for STDs?

Talk with your doctor or nurse about getting tested for STDs. She or he can tell you how to test for each STD.

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Can STDs cause health problems?

Yes. While each STD causes different health problems, overall, they can cause cervical cancer and other cancers, liver disease, pelvic inflammatory disease, infertility, pregnancy problems, and other complications. Some STDs increase your risk of getting HIV/AIDS. HIV/AIDS can cause a number of health problems and raise the risk of getting life-threatening diseases and certain forms of cancer.

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How are STDs treated?

The treatment depends on the type of STD. For some STDs, treatment may involve taking medicine or getting a shot. For other STDs that can’t be cured, like herpes, there is treatment to relieve the symptoms.

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How do STDs affect a pregnant women and her baby?

STDs can have many of the same consequences for pregnant women as women who are not pregnant. STDs can cause cervical and other cancers, chronic hepatitis, pelvic inflammatory disease, infertility, and other complications. Many STDs in women are silent; that is, without signs or symptoms.

STDs can be passed from a pregnant woman to the baby before, during, or after the baby's birth. Some STDs (like syphilis) cross the placenta and infect the baby while it is in the uterus (womb). Other STDs (like Gonorrhea, chlamydia, hepatitis B, and genital herpes) can be transmitted from the mother to the baby during delivery as the baby passes through the birth canal. HIV can cross the placenta during pregnancy, infect the baby during the birth process, and unlike most other STDs, can infect the baby through breastfeeding.

A pregnant woman with an STD may also have early onset of labor, premature rupture of the membranes surrounding the baby in the uterus, and uterine infection after delivery.

The harmful effects of STDs in babies may include stillbirth (a baby that is born dead), low birth weight (less than five pounds), conjunctivitis (eye infection), pneumonia, neonatal sepsis (infection in the baby's blood stream), neurologic damage, blindness, deafness, acute hepatitis, meningitis, chronic liver disease, and cirrhosis. Most of these problems can be prevented if the mother receives routine prenatal care, which includes screening tests for STDs starting early in pregnancy and repeated close to delivery, if necessary. Other problems can be treated if the infection is found at birth.

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What can pregnant women do to prevent problems from STDs?

STDs affect women of every socioeconomic and educational level, age, race, ethnicity, and religion. The CDC 2006 Guidelines for Treatment of Sexually Transmitted Diseases recommend that pregnant women be screened on their first prenatal visit for STDs which may include:

• Chlamydia
• Gonorrhea
• Hepatitis B
• HIV
• Syphilis

In addition, some experts recommend that women who have had a premature delivery in the past be screened and treated for bacterial vaginosis at the first prenatal visit.

Pregnant women should ask their doctors about getting tested for these STDs, since some doctors do not routinely perform these tests. New and increasingly accurate tests continue to become available. Even if a woman has been tested in the past, she should be tested again when she becomes pregnant.

The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex condoms, when used consistently and correctly, are highly effective in preventing transmission of HIV, the virus that causes AIDS. Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea, chlamydia, and trichomoniasis Correct and consistent use of latex condoms can reduce the risk of genital herpes, syphilis, and chancroid only when the infected area or site of potential exposure is protected by the condom. Correct and consistent use of latex condoms may reduce the risk for genital human papillomavirus (HPV) and associated diseases (e.g. warts and cervical cancer).

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Do STDs affect breastfeeding?

Talk with your doctor, nurse, or a lactation consultant about the risk of passing the STD to your baby while breastfeeding. If you have either chlamydia or gonorrhea, you can keep breastfeeding. If you have syphilis or herpes, you can keep breastfeeding as long as the sores are covered. Syphilis and herpes are spread through contact with sores and can be dangerous to your newborn. If you have sores on your nipple or areola (darker skin around the nipple), you should stop breastfeeding on that breast. Pump or hand express your milk from that breast until the sore clears. Pumping will help keep up your milk supply and prevent your breast from getting engorged or overly full. You can store your milk to give to your baby in a bottle for another feeding. But if parts of your breast pump that contact the milk also touch the sore(s) while pumping, you should throw the milk away.

If you are being treated for an STD, ask your doctor about the possible effects of the drug on your breastfeeding baby. Most treatments for STDs are safe to use while breastfeeding.

If you have HIV, do not breastfeed. You can pass the virus to your baby.

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What can I do to avoid getting an STD?

There are steps you can take to keep from getting an STD:

• Don’t have sex. The best way to prevent any STD is to practice abstinence, or not having vaginal, oral, or anal sex.
• Be faithful. Have a sexual relationship with one partner who has been tested for STDs and is not infected is another way to reduce your chances of getting infected. Be faithful to each other, meaning that you only have sex with each other and no one else.
• Use condoms. Protect yourself with a condom EVERY time you have vaginal, anal, or oral sex. Condoms should be used for any type of sex with every partner. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex, use a dental dam. A dental dam is a rubbery material that can be placed over the anus or the vagina before sexual contact.
• Know that some methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STDs. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sex.
• Talk with your sex partner(s) about STDs and using condoms. It’s up to you to make sure you are protected. Remember, it’s YOUR body! For more information, call the Centers for Disease Control and Prevention at (800) 232-4636.
• Talk frankly with your doctor or nurse and your sex partner(s) about any STDs you or your partner have or had. Try not to be embarrassed.
• Have regular pelvic exams. Talk with your doctor about how often you need them. Many tests for STDs can be done during an exam. Ask your doctor to test you for STDs. The sooner an STD is found, the easier it is to treat.

For more information about STDs, including specific fact sheets, visit the CDC at www.cdc.gov/hiv/resources/. The fact sheets are updated regularly and all offer valuable information, often in more than one format.

The following web pages will help improve your awareness about STDs, and provide prevention information and practices:

The CDC's Division of Sexually Transmitted Diseases
The CDC's Divisions of HIV/AIDS Prevention