Sexually transmitted diseases (STDs) are infectious diseases that spread from person to person through intimate contact. STDs can affect guys and girls of all ages and backgrounds who are having sex — it doesn’t matter if they’re rich or poor.
Unfortunately, STDs (sometimes also called STIs for “sexually transmitted infections”) have become common among teens.
Because teens are more at risk for getting some STDs, it’s important to learn what you can do to protect yourself.
STDs are more than just an embarrassment.
They’re a serious health problem.
If untreated, some STDs can cause permanent damage, such as infertility (the inability to have a baby) and even death (in the case of HIV/AIDS).
How STDs Spread
One reason STDs spread is because people think they can only be infected if they have sexual intercourse. That’s wrong. A person can get some STDs, like herpes or genital warts, through skin-to-skin contact with an infected area or sore.
Another myth about STDs is that you can’t get them if you have oral or anal sex. That’s also wrong because the viruses or bacteria that cause STDs can enter the body through tiny cuts or tears in the mouth and anus, as well as the genitals.
STDs also spread easily because you can’t tell whether someone has an infection. In fact, some people with STDs don’t even know that they have them. These people are in danger of passing an infection on to their sex partners without even realizing it.
Some of the things that increase a person’s chances of getting an STD are:
- Sexual activity at a young age. The younger a person starts having sex, the greater his or her chances of becoming infected with an STD.
- Lots of sex partners. People who have sexual contact — not just intercourse, but any form of intimate activity — with many different partners are more at risk than those who stay with the same partner.
- Unprotected sex. Latex condoms are the only form of birth control that reduce your risk of getting an STD, and must be used every time. Spermicides, diaphragms, and other birth control methods may help prevent pregnancy, but they don’t protect a person against STDs.
How common are STDs?
STDs are common, especially among young people.
There are about 20 million new cases of STDs each year in the United States.
About half of these infections are in people between the ages of 15 and 24.
Young people are at greater risk of getting an STD for several reasons:
- Young women’s bodies are biologically more prone to STDs.
- Some young people do not get the recommended STD tests.
- Many young people are hesitant to talk openly and honestly with a doctor or nurse about their sex lives.
- Not having insurance or transportation can make it more difficult for young people to access STD testing.
- Some young people have more than one sex partner
What can I do to protect myself?
People who are considering having sex should get regular gynecological or male genital examinations.
There are two reasons for this.
- First, these exams give doctors a chance to teach people about STDs and protecting themselves.
- Second, regular exams give doctors more opportunities to check for STDs while they’re still in their earliest, most treatable stage.
In order for these exams and visits to the doctor to be helpful, people need to tell their doctors if they are thinking about having sex or if they have already started having sex.
This is true for all types of sex — oral, vaginal, and anal.
And let the doctor know if you’ve ever had any type of sexual contact, even if it was in the past.
Don’t let embarrassment at the thought of having an STD keep you from seeking medical attention.
Waiting to see a doctor may allow a disease to progress and cause more damage.
If you think you may have an STD, or if you have had a partner who may have an STD, you should see a doctor right away.
If you don’t have a doctor or prefer not to see your family doctor, you may be able to find a local clinic in your area where you can get an exam confidentially.
Some national and local organizations operate STD hotlines staffed by trained specialists who can answer your questions and provide referrals. Calls to these hotlines are confidential.
Not all infections in the genitals are caused by STDs. Sometimes people can get symptoms that seem very like those of STDs, even though they’ve never had sex.
For girls, a yeast infection can easily be confused with an STD. G
uys may worry about bumps on the penis that turn out to be pimples or irritated hair follicles.
That’s why it’s important to see a doctor if you ever have questions about your sexual health.
- The surest way to protect yourself against STDs is to not have sex. That means not having any vaginal, anal, or oral sex (“abstinence”). There are many things to consider before having sex. It’s okay to say “no” if you don’t want to have sex.
- If you do decide to have sex, you and your partner should get tested for STDs beforehand. Make sure that you and your partner use a condom from start to finish every time you have oral, anal, or vaginal sex. Know where to get condoms and how to use them correctly. It is not safe to stop using condoms unless you’ve both been tested for STDs, know your results, and are in a mutually monogamous relationship.
- Mutual monogamy means that you and your partner both agree to only have sexual contact with each This can help protect against STDs, as long as you’ve both been tested and know you’re STD-free.
- Before you have sex, talk with your partner about how you will prevent STDs and If you think you’re ready to have sex, you need to be ready to protect your body. You should also talk to your partner ahead of time about what you will and will not do sexually. Your partner should always respect your right to say no to anything that doesn’t feel right.
- Make sure you get the health care you Ask a doctor or nurse about STD testing and about vaccines against HPV and hepatitis B.
- Girls and young women may have extra needs to protect their reproductive Talk to your doctor or nurse about regular cervical cancer screening, and chlamydia and gonorrhea testing. You may also want to discuss unintended pregnancy and birth control.
- Avoid mixing alcohol and/or recreational drugs with If you use alcohol and drugs, you are more likely to take risks, like not using a condom or having sex with someone you normally wouldn’t have sex with.
Can STDs be treated?
Your doctor can prescribe medicine to cure some STDs, like chlamydia and gonorrhea.
Other STDs, like herpes, can’t be cured, but you can take medicine to help with the symptoms.
If you are ever treated for an STD, be sure to finish all of your medicine, even if you feel better before you finish it all.
Ask the doctor or nurse about testing and treatment for your partner, too. You and your partner should avoid having sex until you’ve both been treated.
Otherwise, you may continue to pass the STD back and forth. It is possible to get an STD again (after you’ve been treated), if you have sex with someone who has an STD.
What happens if I don’t treat an STD?
Some curable STDs can be dangerous if they aren’t treated. For example, if left untreated, chlamydia and gonorrhea can make it difficult—or even impossible—for a woman to get pregnant. You also increase your chances of getting HIV if you have an untreated STD. Some STDs, like HIV, can be fatal if left untreated.
What if my partner or I have an incurable STD?
Some STDs, like herpes and HIV, aren’t curable, but a doctor can prescribe medicine to treat the symptoms.
If you are living with an STD, it’s important to tell your partner before you have sex.
Although it may be uncomfortable to talk about your STD, open and honest conversation can help your partner make informed decisions to protect his or her health.
Common STDs
Chlamydia
What Is It?
Chlamydia (pronounced: kluh-MID-ee-uh) is a sexually transmitted disease (STD) caused by bacteria called Chlamydia trachomatis. Although you may not be familiar with its name, chlamydia is one of the most common STDs. Because there often aren’t any symptoms, though, lots of people can have chlamydia and not know it.
The bacteria can move from one person to another through vaginal, oral, or anal sex. If someone touches body fluids that contain the bacteria and then touches his or her eye, a chlamydial eye infection (chlamydial conjunctivitis) is possible.
Chlamydia also can be passed from a mother to her baby while the baby is being delivered. This can cause pneumonia and conjunctivitis, which can become very serious for the baby if it’s not treated. You can’t catch chlamydia from a towel, doorknob, or toilet seat.
How Does a Girl Know She Has It?
It can be difficult for a girl to know whether she has chlamydia because most girls don’t have any symptoms. Because of this, it’s very important to see a doctor and get tested for chlamydia at least once a year if you are having vaginal, oral, or anal sex. Your doctor can tell you about how to test for chlamydia, even if you don’t have any symptoms.
Much less often, a girl can have symptoms, such as an unusual vaginal discharge or pain during urination (peeing). Some girls with chlamydia also have pain in their lower abdomens, pain during sexual intercourse, or bleeding between menstrual periods.
How Does a Guy Know He Has It?
It also can be difficult for guys to know if they have chlamydia. Many who do have it will have few or no symptoms, so any guy who is having vaginal, oral, or anal sex should be tested by a doctor at least once a year.
When symptoms are there, guys may have a discharge from the tip of the penis (the urethra — where urine comes out), or itching or burning sensations around the penis. Rarely, one of the testicles may become swollen.
When Do Symptoms Appear?
Someone who has chlamydia may see symptoms a week later. In some people, the symptoms take up to 3 weeks to appear, and many people never develop any symptoms.
What Can Happen?
If left untreated in girls, chlamydia can cause an infection of the urethra (where urine comes out) and inflammation (swelling and soreness caused by the infection) of the cervix. It can also lead to pelvic inflammatory disease (PID), which is an infection of the uterus, ovaries, and/or fallopian tubes. PID can cause infertility and ectopic (tubal) pregnancies later in life.
If left untreated in guys, chlamydia can cause swelling and irritation of the urethra and epididymis (the structure attached to the testicle that helps transport sperm).
How Is It Treated?
If you think you may have chlamydia — or if you have had vaginal, oral, or anal sex with a partner who may have chlamydia — you need to see your family doctor, adolescent doctor, or gynecologist. Some local health clinics, such as Planned Parenthood, also can test and treat people for chlamydia. It’s now routine for doctors to check all teens 15 years of age and up for chlamydia, regardless of whether they say they’re having sex — this is to make sure that everyone who needs treatment gets it.
Doctors usually diagnose chlamydia by testing a person’s urine. If you have been exposed to chlamydia or are diagnosed with chlamydia, the doctor will prescribe antibiotics, which should clear up the infection in 7 to 10 days.
Anyone with whom you’ve had sex will also need to be tested and treated for chlamydia because that person may be infected but not have any symptoms. This includes any sexual partners in the last 2 months or your last sexual partner if it has been more than 2 months since your last sexual experience. It’s very important for people diagnosed with chlamydia to abstain from having sex until they and their partner have been treated.
If a sexual partner has chlamydia, quick treatment will reduce his or her risk of complications and will lower your chances of being reinfected if you have sex with that partner again. (You can become infected with chlamydia again even after you have been treated — having chlamydia once does not make you immune to it.)
It’s better to prevent chlamydia than to treat it, and the best way to prevent the infection is to abstain from all types of sexual intercourse. If you do have sex, use a latex condom every time. This is the only birth control method that will help prevent chlamydia.
Genital Herpes
What Is It?
Genital herpes is caused by a virus called herpes simplex (HSV). There are two different types of herpes virus that cause genital herpes — HSV-1 and HSV-2. Most forms of genital herpes are HSV-2. But a person with HSV-1 (the type of virus that causes cold sores or fever blisters around the mouth) can transmit the virus through oral sex to another person’s genitals.
Genital herpes is a sexually transmitted disease (STD). It can cause sores in the genital area and is spread through vaginal, oral, or anal sex — especially during unprotected sex when infected skin touches the vaginal, oral, or anal area. Occasionally, it can cause sores in the mouth, and can be spread through saliva (spit). Because the virus does not live outside the body for long, you cannot catch genital herpes from an object, such as a toilet seat.
Symptoms of an Outbreak
Someone who has been exposed to the genital herpes virus might not be aware of being infected and might never have an outbreak of sores. However, if a person does have an outbreak, the symptoms can cause a lot of discomfort.
Someone with genital herpes may first notice itching or pain, followed by sores that appear a few hours to a few days later. The sores, which may appear on the vagina, penis, scrotum, buttocks, or anus, start out as red bumps that soon turn into red, watery blisters. The sores might make it very painful to urinate (pee). The sores may open up, ooze fluid, or bleed; during a first herpes outbreak, they can take from a week to several weeks to heal. The entire genital area may feel very tender or painful, and the person may have flu-like symptoms (such as fever; a headache; and tender, swollen lymph nodes in the groin area).
If future outbreaks happen, they tend to be less severe and don’t last as long, with sores healing faster.
How Long Until Symptoms Appear?
Someone who has been exposed to genital herpes will notice genital itching and/or pain about 2 to 20 days after being infected with the virus. The sores usually appear within days afterward.
What Can Happen?
After the herpes blisters disappear, a person may think the virus has gone away — but it’s actually hiding in the body. Both HSV-1 and HSV-2 can stay hidden away in the body until the next herpes outbreak, when the virus reactivates itself and the sores return, usually in the same area.
Over time, the herpes virus can reactivate itself again and again, causing discomfort and episodes of sores each time. The number of future outbreaks can vary (some people might have four or five a year; others might have one or none) and usually lessen over time.
At this time there is no cure for herpes; it remains in the body and can be passed to another person with any form of unprotected sex. This is the case even if blisters aren’t present, but more likely if they are. A person can lessen the chance of spreading the infection to someone else by taking an antiviral medicine. This is a medication that must be prescribed by a doctor.
Genital herpes also increases a person’s risk of HIV infection because HIV can enter the body more easily whenever there’s a break in the skin (such as a sore) during unprotected sexual contact.
If a pregnant woman with genital herpes has an active infection during childbirth, the newborn baby is at risk for getting it. To prevent this, she may have a C-section to avoid passing the infection to the baby. Herpes infection in a newborn can cause meningitis (an inflammation of the membranes that surround the brain and spinal cord), seizures, and brain damage.
How Is It Prevented?
The best way to prevent genital herpes is abstinence. Teens who do have sex must properly use a latex condom every time they have any form of sexual intercourse (vaginal, oral, or anal sex). Girls receiving oral sex should have their partners use dental dams as protection. These sheets of thin latex can be purchased online or from many pharmacies.
If one partner has a herpes outbreak, avoid sex — even with a condom or dental dam — until all sores have healed. Herpes can be passed sexually even if a partner has no sores or other signs and symptoms of an outbreak. Finally, one way to lessen this risk is to take antiviral medication even when no sores are present if you know you have genital herpes.
How Is It Treated?
If you think you may have genital herpes or if you have had a partner who may have genital herpes, see your family doctor, adolescent doctor, gynecologist, or health clinic for a diagnosis.
Right now, there is no cure for genital herpes, but a doctor can prescribe antiviral medication to help control recurring HSV-2 and clear up the painful sores. The doctor can also tell you how to keep the sores clean and dry and suggest other methods to ease the discomfort if the virus reappears.
Genital Warts (HPV)
What Are They?
Genital warts are warts that are near or on a person’s genital areas. For a girl, that means on or near the vulva (the outside genital area), vagina, cervix, or anus. For a guy, that means near or on the penis, scrotum, or anus.
Warts appear as bumps or growths. They can be flat or raised, single or many, small or large. They tend to be whitish or flesh colored. They are not always easy to see, so people who have genital warts often don’t know they have them.
Genital warts are caused by a group of viruses called HPV (short for human papillomavirus). There are more than 100 types of HPV. Some of them cause the kind of warts you see on people’s hands and feet. Genital warts and the kinds of warts on hands and feet are usually caused by different types of HPV.
More than 40 types of HPV cause genital warts. Genital warts can be passed from person to person through intimate sexual contact (touching someone’s genitals or having vaginal, oral, or anal sex). In some rare cases, genital warts are transmitted from a mother to her baby during childbirth.
HPV infections are common in teens and young adults. The more sexual partners someone has, the more likely it is that the person will get an HPV infection.
How Do People Know They Have HPV?
Most HPV infections have no signs or symptoms. So someone can be infected and pass the disease on to another person without knowing.
Some people do get visible warts. Although warts might hurt, itch, or feel uncomfortable, most of the time they don’t. This is one reason why people may not know they have genital warts.
Doctors can diagnose warts by examining the skin closely (sometimes with a magnifying glass) and using a special solution to make them easier to see. Tests like Pap smears can help doctors find out if someone has an HPV infection.
Experts believe that when a wart is present, the virus may be more contagious. But HPV can still spread even if you can’t see warts.
When Do Symptoms Start?
Warts can appear any time from several weeks to several months after a person has been exposed to them. Sometimes they might take even longer to appear because the virus can live in the body for a very long time before showing up as warts.
When to See a Doctor
See your doctor, gynecologist, or visit a health clinic if:
- you are having sex or have had sex in the past or have touched someone’s genitals
- you have a bump or lump “down there”
- you think you might have genital warts
- you have had a partner who might have genital warts
Because many people who are infected with HPV don’t show any symptoms, everyone having sex should get regular medical checkups and tell their doctor about their sexual history.
Not all bumps on a person’s genitals are warts. Some can be pimples, other infections, or growths. Turn to your doctor for help — he or she can help figure out what a bump is and what you can do.
What Can Happen?
If a person doesn’t get treated, genital warts can sometimes grow bigger and multiply. Even if warts go away on their own, the virus is still in the body. That means warts can come back or the virus can spread to other people.
How Are They Prevented?
The best way to avoid genital warts is not having sex of any kind (abstinence). That means not having vaginal, oral, or anal sex. Preventing HPV infection also means not touching the genitals of someone who is infected with HPV.
People who have sex should use a condom every time to protect against STDs. Condoms are a good defense against warts, but they can’t completely protect against them. That’s because the virus can spread from or to the parts of the genitals not covered by a condom.
Doctors recommend that girls ages 11 through 26 and guys 11 through 21 get the HPV vaccine. The vaccine protects against some types of HPV that cause genital warts and certain types of cancer.
How Are Warts Treated?
There is no cure that gets rid of the human papillomavirus completely. But treatments can reduce the number of warts — or help them go away faster. When the warts go away, the virus is still there. It could still spread to someone else.
A doctor will do an examination, make a diagnosis, and then provide treatment, if necessary. A number of different treatments might be used depending on where the warts are, how big they are, and how many there are. The doctor might put special medications on the warts or remove them with treatments like laser therapy or chemical “freezing.”
Sometimes warts can come back, so you might need to visit the doctor again. Anyone you’ve had sex with also should be checked for genital warts.
Gonorrhea
What Is Gonorrhea?
Gonorrhea (pronounced: gah-nuh-REE-uh) is a sexually transmitted disease (STD) caused by bacteria called Neisseria gonorrhoeae. The bacteria can be passed from one person to another through vaginal, oral, or anal sex, even when the person who is infected has no symptoms.
Gonorrhea also can be passed from a mother to her baby during birth. You can’t catch it from a towel, a doorknob, or a toilet seat.
What Are the Signs of Gonorrhea in Girls?
A girl who has gonorrhea may have no symptoms at all or her symptoms may be so mild that she doesn’t notice them until they become more severe. In some cases, girls will feel a burning sensation when they pee, or they will have a yellow-green vaginal discharge. Girls also may have vaginal bleeding between menstrual periods.
If the infection spreads and moves into the uterus or fallopian tubes, it may cause an infection called pelvic inflammatory disease (PID). PID can cause abdominal pain, fever, and pain during sex, as well as the symptoms above.
What Are the Signs of Gonorrhea in Guys?
Guys who have gonorrhea are much more likely to notice symptoms, although a guy can have gonorrhea and not know it. Guys often feel a burning sensation when they pee, and yellowish-white discharge may ooze out of the urethra (at the tip of the penis).
How Long Until There Are Symptoms?
Symptoms usually start 2 to 7 days after a person is exposed to gonorrhea. In girls, they might start even later.
What Problems Can Happen?
Gonorrhea can be very dangerous if it’s not treated, even in someone who has mild or no symptoms:
- In girls, the infection can move into the uterus, fallopian tubes, and ovaries (causing PID) and can lead to scarring and infertility (the inability to have a baby). Gonorrhea infection during pregnacy can cause problems for the newborn baby, including meningitis(an inflammation of the membranes around the brain and spinal cord) and an eye infection that can result in blindness if it is not treated.
- In guys, gonorrhea can spread to the epididymis (the structure attached to the testicle that helps transport sperm), causing pain and swelling in the testicular area. This can create scar tissue that might make a guy infertile.
In both guys and girls, untreated gonorrhea can affect other organs and parts of the body, including the throat, eyes, heart, brain, skin, and joints, although this is less common.
How Is Gonorrhea Diagnosed?
Doctors now test teens 15 and older for STDs as part of annual checkups, regardless of whether the teens disclose they are having oral, anal, or vaginal sex. This is to make sure that everyone who needs treatment gets it. All teens who are having oral, vaginal, or anal sex should get tested at least once a year for gonorrhea.
If you think you may have gonorrhea or if you have had a partner who may have gonorrhea, you need to see your doctor or gynecologist. He or she will do an exam that may include checking a urine (pee) sample. In some cases, testing may require swabbing of opening of the penis or the vagina or cervix for discharge. Talk to your doctor about which test is best for you.
The doctor also may test for other STDs, such as HIV, syphilis, and chlamydia. Let the doctor know the best way to reach you confidentially with any test results.
How Is Gonorrhea Treated?
If you have gonorrhea, your doctor will prescribe antibiotics to treat the infection. Any sexual partners should also be tested and treated for gonorrhea immediately. This includes any partners in the last 2 months, or your last sexual partner if it has been more than 2 months since you last had sex.
If a sexual partner has gonorrhea, quick treatment will reduce the risk of complications for that person and will lower your chances of being reinfected if you have sex with that partner again. (You can become infected with gonorrhea again even after treatment — having it once doesn’t make you immune to it.)
Don’t have sex for at least 7 days after you and your partner have both finished taking your antibiotics. If you have sex earlier than that, you could be reinfected.
Can Gonorrhea Be Prevented?
It’s better to prevent gonorrhea than to treat it, and the best way to completely prevent the infection is to not have sex (oral, vaginal, or anal).
If you do have sex, use a latex condom every time. This is the only birth control method that will help prevent gonorrhea.
Hepatitis B
What Is Hepatitis B?
Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). In some people, HBV stays in the body, causing chronic disease and long-term liver problems.
How Do People Get Hepatitis B?
Most commonly, HBV spreads through:
- sexual activity with an HBV-infected person
- shared contaminated needles or syringes for injecting drugs
- transmission from HBV-infected mothers to their newborn babies
Who Is at Risk for Hepatitis B?
In the United States, the most common way people get infected with HBV is through unprotected sex with someone who has the disease. People who share needles also are at risk of becoming infected because it’s likely that the needles they use will not have been sterilized.
What Is Chronic Hepatitis B?
Doctors refer to hepatitis B infections as either acute or chronic:
- An acute HBV infection is a short-term illness that clears within 6 months of when a person is exposed to the virus.
- A person who still has HBV after 6 months is said to have a chronic hepatitis B infection. This is a long-term illness, meaning the virus stays in the body and causes lifelong illness. An estimated 850,000 to more than 2 million people in the U.S. have chronic HBV.
The younger someone is when infected, the greater the chances for chronic hepatitis B.
What Are the Signs & Symptoms of HBV Infection?
HBV can cause a wide range of symptoms, from a mild illness and general feeling of being unwell to more serious chronic liver disease that can lead to liver cancer.
Someone with hepatitis B may have symptoms similar to those caused by other viral infections, like the flu. The person might:
- be extra tired
- feel like throwing up or actually throw up
- not feel like eating
- have a mild fever
HBV also can cause darker than usual urine (pee), jaundice (when the skin and whites of the eyes look yellow), and abdominal (belly) pain.
Someone who has been exposed to hepatitis B may start to have symptoms from 1 to 6 months later. Symptoms can last for weeks to months.
In some people, hepatitis B causes few or no symptoms. But even someone who doesn’t have any symptoms can still spread the disease to others.
What Problems Can Hepatitis B Cause?
Hepatitis B (also called serum hepatitis) is a serious infection. It can lead to cirrhosis (permanent scarring) of the liver, liver failure, or liver cancer, which can cause severe illness and even death.
If a pregnant woman has the hepatitis B virus, her baby has a very high chance of having it unless the baby gets a special immune injection and the first dose of hepatitis B vaccine at birth.
Sometimes, HBV doesn’t cause symptoms until a person has had the infection for a while. At that stage, the person already might have more serious complications, such as liver damage.
How Is Hepatitis B Diagnosed?
If you think you may have hepatitis B or you might have been exposed to the virus through sex or drug use, see your doctor or gynecologist to get tested(they can test you for other infections as well). The blood test also can tell whether someone has an acute infection or a chronic infection. Let the doctor know the best way to reach you confidentially with test results.
How Is Hepatitis B Treated?
There’s no cure for HBV. Doctors will advise someone with a hepatitis B infection on how to manage symptoms — like getting plenty of rest or drinking fluids. A person who is too sick to eat or drink will need treatment in a hospital.
In most cases, teens who get hepatitis B recover and may develop a natural immunity to future hepatitis B infections. Most feel better within 6 months. Health care providers will keep a close eye on patients who develop chronic hepatitis B.
What Happens After a Hepatitis B Infection?
Some people carry the virus in their bodies and are contagious for the rest of their lives. They should not drink alcohol, and should check with their doctor before taking any medicines (prescription, over the counter, or supplements) to make sure these won’t cause further liver damage.
Anyone who has ever tested positive for hepatitis B cannot be a blood donor.
Can Hepatitis B Be Prevented?
Yes. Newborn babies in the United States now routinely get the hepatitis B vaccine as a series of three shots over a 6-month period. There’s been a big drop in the number of cases of hepatitis B over the past 25 years thanks to immunization.
Doctors also recommend “catch-up” vaccination for all kids and teens younger than 19 years old who didn’t get the vaccine as babies or didn’t get all three doses. Anyone who is at risk for hepatitis B (including health care and public safety workers, people with chronic liver disease, people who inject drugs, and others) also should be vaccinated.
If someone who hasn’t been vaccinated is exposed to HBV, doctors may give the vaccine and/or a shot of immune globulin containing antibodies against the virus to try to prevent the person from becoming infected. That’s why it’s very important to see a doctor immediately after any possible exposure to the virus.
To prevent transmission of hepatitis B through infected blood and other body fluids, teens should:
- abstain from sex (oral, vaginal, or anal)
- if sexually active, always use latex condoms when having sex (oral, vaginal, or anal)
- avoid contact with an infected person’s blood
- not use intravenous drugs or share needles or other drug tools
- not share things like toothbrushes or razors
- research tattoo and piercing places carefully to be sure they don’t reuse needles without properly sterilizing them
HIV and AIDS
What Is It?
The human immunodeficiency virus (HIV) is one of the most serious, deadly diseases in human history. HIV causes a condition called acquired immunodeficiency syndrome — better known as AIDS.
HIV destroys a type of defense cell in the body called a CD4 helper lymphocyte (pronounced: LIM-foe-site). These lymphocytes are part of the body’s immune system, the defense system that fights infections. When HIV destroys these lymphocytes, the immune system becomes weak and people can get serious infections that they normally wouldn’t.
As the medical community learns more about how HIV works, they’ve been able to develop medications to inhibit it (meaning they interfere with its growth). These medicines have been successful in slowing the progress of the disease.
If people with HIV get treated, they can live long, relatively healthy lives — just as people who have other chronic diseases like diabetes can. But, as with diabetes or asthma, there is still no cure for HIV and AIDS.
How Do People Get It?
Thousands of U.S. teens and young adults get infected with HIV each year. HIV can be transmitted from an infected person to another person through body fluids like blood, semen, vaginal fluids, and breast milk.
The virus is spread through things like:
- having unprotected oral, vaginal, or anal sex (“unprotected” means not using a condom)
- sharing needles, such as needles used to inject drugs, steroids, and other substances, or sharing needles used for tattooing
Other risk factors:
- People who have another sexually transmitted disease (STD) (such as syphilis, genital herpes, chlamydia, gonorrhea, or bacterial vaginosis) are at greater risk for getting HIV during sex with infected partners.
- If a woman with HIV is pregnant, her newborn baby can catch the virus from her before birth, during the birthing process, or from breastfeeding.
When doctors know a mom-to-be has HIV, they can do things to try to stop the virus from spreading to the baby. That’s why all pregnant women should be tested for HIV so they can begin treatment if necessary.
How Does HIV Affect the Body?
A healthy body has CD4 helper lymphocyte cells (CD4 cells). These cells help the immune system function normally and fight off certain kinds of infections. They do this by acting as messengers to other types of immune system cells, telling them to become active and fight against an invading germ.
HIV attaches to these CD4 cells. The virus then infects the cells and uses them as a place to multiply. In doing so, the virus destroys the ability of the infected cells to do their job in the immune system. The body then loses the ability to fight many infections.
When a person with HIV has an extremely low number of CD4 cells or certain rare infections, doctors call this stage of disease AIDS. People who have AIDS are unable to fight off many infections because their immune systems are weakened. They are more likely to get infections like tuberculosis and some rare infections of the lungs (such as certain types of pneumonia), infections of the surface covering of the brain (meningitis), or the brain itself (encephalitis). People who have AIDS tend to keep getting sicker, especially if they are not taking antiviral medications properly.
AIDS can affect every body system. The immune defect caused by having too few CD4 cells also permits some cancers that are stimulated by viral illness to happen — some people with AIDS get forms of lymphoma and a rare tumor of blood vessels in the skin called Kaposi’s sarcoma.
Because AIDS is fatal, it’s important that doctors detect HIV infection as early as possible so a person can take medicine to delay the onset of AIDS.
How Do People Know They Have HIV?
How long it takes for symptoms of HIV/AIDS to appear varies from person to person. Some people may feel and look healthy for years while they are infected with HIV. It is still possible to infect others with HIV, even if the person with the virus has absolutely no symptoms. You cannot tell simply by looking at someone whether he or she is infected.
When a person’s immune system is overwhelmed by AIDS, he or she might notice:
- extreme weakness or fatigue
- rapid weight loss
- frequent fevers that last for several weeks with no explanation
- heavy sweating at night
- swollen lymph glands
- minor infections that cause skin rashes and mouth, genital, and anal sores
- white spots in the mouth or throat
- chronic diarrhea
- a cough that won’t go away
- trouble remembering things
- in girls, severe vaginal yeast infections that don’t respond to usual treatment
How Can It Be Prevented?
One of the reasons that HIV is so dangerous is that a person can have the virus for a long time without knowing it. So making smart choices about sex and not using drugs is the best way to avoid HIV/AIDS.
HIV transmission can be prevented by:
- not having oral, vaginal, or anal sex (abstinence)
- always using latex condoms when having oral, anal, or vaginal sex
- avoiding contact with the body fluids through which HIV is transmitted
- never sharing needles
How Do Doctors Test for and Treat HIV?
Doctors now recommend that all people have at least one HIV test by the time they are teens. If you are having sex, have had sex in the past, or shared needles with someone else, your doctor will probably recommend that you get tested at least once a year.
If you have questions about HIV and want to get tested, you can talk to your family doctor, pediatrician, adolescent doctor, or gynecologist.
People also can get tested for HIV/AIDS at pretty much any clinic or hospital in the country. Clinics offer both anonymous testing (meaning the clinic doesn’t know a person’s name) and confidential testing (meaning they know who a person is but keep it private). Most clinics will ask you to follow up for counseling to get your results, whether the test is negative or positive.
The HIV test can be either a blood test or a swab of the inside of your cheek. Depending on what type of test is done, results may take from a few minutes to several days. Let the doctor know the best way to reach you confidentially with any test results.
If you had unprotected sex with someone you know has HIV or if you were raped or forced to have sex by someone, see your doctor or go to the emergency room right away. They might be able to give you medications to prevent HIV infection (within 72 hours), and do the appropriate follow-up testing.
If you’re not sure how to find a doctor or get an HIV test, you can contact the National AIDS Hotlines at 800-448-0440 (Monday-Friday 1pm-4pm EST). A specialist there will explain what you should do next.
There is no cure for HIV. That’s why prevention is so important. Combinations of antiviral drugs and drugs that boost the immune system have allowed many people with HIV to resist infections, stay healthy, and prolong their lives, but these medications are not a cure. Right now there is no vaccine to prevent HIV and AIDS, although researchers are working on developing one.
Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease (PID) is an infection of the fallopian tubes, uterus, or ovaries. Most girls with PID develop it after getting a sexually transmitted disease (STD), such as chlamydia or gonorrhea.
Girls who have sex with different partners or don’t use condoms are most likely to get STDs and be at risk for PID. If PID is not treated, it can lead to internal scarring that might cause ongoing pelvic pain, infertility, or an ectopic pregnancy.
What Are the Symptoms of PID?
PID can cause severe symptoms or very mild to no symptoms. Girls who do have symptoms may notice:
- pain and tenderness in the lower abdomen
- bad-smelling or abnormally colored discharge
- pain during sex
- spotting (small amounts of bleeding) between periods
- chills or fever
- nausea, vomiting, or diarrhea
- loss of appetite
- backache and perhaps even difficulty walking
- pain while peeing or peeing more often than usual
- pain in the upper abdomen on the right
What Can Happen?
Any girl who has signs of an STD should get medical care as soon as possible. An untreated STD has a greater chance of becoming PID.
If PID is not treated or goes unrecognized, it can continue to spread through a girl’s reproductive organs. Untreated PID may lead to long-term reproductive problems, including:
- Scarring in the ovaries, fallopian tubes, and uterus. Widespread scarring may lead to infertility (the inability to have a baby) and chronic pelvic pain. A teen girl or woman who has had PID multiple times has more of a chance of being infertile.
- Ectopic pregnancy. If a girl who has had PID does get pregnant, scarring of the fallopian tubes may cause the fertilized egg to implant in one of the fallopian tubes rather than in the uterus. The fetus would then begin to develop in the tube, where there is no room for it to keep growing. This is called an ectopic pregnancy. An untreated ectopic pregnancy could cause the fallopian tube to burst suddenly, which might lead to life-threatening bleeding.
- Tubo-ovarian abscess (TOA). A TOA is a collection of bacteria, pus, and fluid in the ovary and fallopian tube. Someone with a TOA often looks sick and has a fever and pain that makes it difficult to walk. The abscess will be treated in the hospital with antibiotics, and surgery may be needed to remove it.
How Is PID Diagnosed and Treated?
If you think you may have PID, see your gynecological health care provider (your family doctor or nurse practitioner, gynecologist, or adolescent doctor) right away. The longer a girl waits before getting treatment, the more likely it is that she will have problems.
If a doctor thinks a girl has PID, he or she will do a physical exam, including a pelvic exam. The exam can show if a girl has a painful cervix, abnormal discharge from the cervix, or pain over one or both ovaries.
The doctor may also take swabs of fluid from the cervix and vagina, and this fluid will be tested for STDs. He or she may also do a pregnancy test. Sometimes health providers take blood or do urine tests to look for signs of infection, including STDs like chlamydia and gonorrhea.
Sometimes doctors need an ultrasound or CAT scan of the lower abdomen to see what’s going on with a girl’s reproductive organs. Ultrasounds are often used to diagnose a TOA or ectopic pregnancy.
If doctors find that a girl has PID, they will prescribe antibiotics to take for a couple of weeks. It’s vital to take every dose of the medicine to completely treat the infection, even if a girl’s symptoms go away before she finishes the medicine. It’s also important that girls with PID get rechecked 2–3 days after beginning treatment to make sure that they are improving. A girl who has taken all her medicine for PID but still isn’t feeling better should follow up with her doctor.
Girls with more severe cases of PID might have a fever or vomiting, and not respond to medicines by mouth. They, and girls with PID who are pregnant, often are treated in the hospital for a few days with antibiotics given directly into a vein through an IV. Surgery is sometimes needed if a girl has an abscess. Ectopic pregnancies can require emergency surgery.
If a girl has PID, her sexual partners should be checked for STDs right away so they can get treatment. And, a couple should hold off on having sex again until at least 7 days after both partners have finished treatment. An untreated partner is likely to reinfect a girl with the same STD again.
Can PID Be Prevented?
The best way to prevent STDs or PID is to not have sex (abstinence). For those who choose to have sex, it’s important to use protection and to have as few sexual partners as possible. Using latex condoms properly and every time you have sex helps protect against most STDs. However, it’s also very important to have regular checkups with your doctor. And if either partner has any symptoms of STDs, both partners should be tested and treated as soon as possible.
So when you’re making choices about sex, be smart and be safe.
Pubic Lice (Crabs)
What Are They?
Pubic lice are tiny insects that can crawl from the pubic hair of one person to the pubic hair of another person during sexual contact. People also can catch pubic lice from infested clothing, towels, and bedding.
Once they are on a person’s body, the insects live by sucking blood from their host. Pubic lice are sometimes called “crabs” because when seen under a microscope they look like tiny crabs.
What Are the Symptoms?
Pubic lice can cause intense itching. A person who has been exposed to pubic lice may notice tiny tan to grayish-white insects crawling in their pubic hair. He or she may also see tiny oval-shaped, yellow to white blobs called nits clinging to the hair. Nits are about the size of a pinhead, and are the louse eggs. Nits can’t be easily removed from the hair with the fingers — “nit combs” made especially to remove the eggs are sold at drugstores and many grocery stores.
Someone who has been exposed to pubic lice may not notice symptoms for a few weeks. The primary symptom of pubic lice is itching, especially at night, but lice can also leave bluish-grayish marks on the thighs and pubic area from bites.
What Can Happen?
It’s unusual for pubic lice to create any serious health problems, but the itching can be very uncomfortable, and it’s easy to transmit pubic lice to others. The female louse survives an average of 25 to 30 days and each can lay 20 to 30 eggs. Lice can also live away from the body for 1 to 2 days. So it’s important to get properly diagnosed and treated, or it can take a while to get rid of them.
How Is It Treated?
If you think you may have pubic lice or if you have had a partner who may have pubic lice, see a doctor or gynecologist right away. If the doctor diagnoses pubic lice, you may be prescribed medication or told to buy an over-the-counter medicine that kills the lice and their eggs.
The important thing to remember is that the treatment you use may need to be repeated after 7 to 10 days to kill any lice you didn’t get the first time. And anyone who is treated for pubic lice should be tested for other STDs as well.
You will also need to dry clean or use very hot water and a hot dryer cycle to wash and dry all your bedding, towels, and recently worn clothing to properly kill the lice and their eggs.
Anyone with whom you’ve had sexual contact (oral, anal, or vaginal) in the last month should check for pubic lice immediately. Properly using condoms every time you have sex is always important. But while condoms help protect against other STDs, they do not cover the entire pubic area, so someone who has pubic lice can still pass them to a partner.
Syphilis
What Is It?
Syphilis (pronounced: SIFF-ill-iss) is a sexually transmitted disease (STD) caused by a type of bacteria known as a spirochete (through a microscope, it looks like a corkscrew or spiral). It is extremely small and can live almost anywhere in the body.
The spirochetes that cause syphilis can be passed from one person to another through direct contact with a syphilis sore during sexual intercourse (vaginal, anal, or oral sex). A person also can get syphilis by kissing or touching someone who has sores on the breasts, or on or inside the mouth or genitals. A mother can pass the infection to her baby during pregnancy. You cannot catch syphilis from a towel, doorknob, or toilet seat.
In the 1990s, there was a decrease in the number of people infected with syphilis. More recently, though, there has been a steady increase in reported cases of syphilis, especially in young adults and in men who have male sexual partners.
In its early stages, syphilis is easily treatable. But if left untreated, it can cause serious problems — even death. So it’s important to understand as much as you can about this disease.
What Are the Symptoms?
Syphilis happens in several different stages:
Primary Syphilis
In the first stage of syphilis, red, firm, painless and sometimes wet sores appear on the vagina, rectum, penis, or mouth. There is often just one sore, but there may be several. This type of sore is called a chancre (pronounced: SHANG-ker). Chancres appear on the part of the body where the spirochetes moved from one person to another. Someone with syphilis also may have swollen glands during this first stage.
After a few weeks, the chancre will disappear, but the disease doesn’t go away. In fact, if the infection hasn’t been treated, the disease will get worse.
Syphilis is highly contagious during this first stage. Unfortunately, it can be easy to miss because the chancres are painless and can appear in areas that may not be easy to see, like in the mouth, under the foreskin, on the cervix, or on the anus. This means that people may not know that they are infected, and can pass the disease to others without realizing it.
Secondary Syphilis
If syphilis hasn’t been treated yet, the person will often break out in a rash (including on the soles of the feet and palms of the hands). The infected person might get flu-like symptoms, such as fever and achiness. This can happen weeks to months after the chancre first appears. Sometimes the rashes can be very faint or look like rashes from other infections and, therefore, may be ignored or not even noticed. Sores sometimes appear on the lips, mouth, throat, vagina, and anus — but many people with secondary syphilis don’t have sores at all.
The symptoms of this secondary stage will go away with or without treatment. But if the infection hasn’t been treated, the disease can continue to get worse. Syphilis is still contagious during the secondary stage.
Latent Syphilis
If syphilis still hasn’t been treated yet, the person will have a period of the illness called latent (hidden) syphilis. This means that all the signs of the disease go away, but the disease is still very much there. Even though the disease is “hiding,” the spirochetes are still in the body. Syphilis can remain latent for many years.
Tertiary Syphilis
If the disease still hasn’t been treated at this point, some develop tertiary (or late-stage) syphilis. This means the spirochetes have spread all over the body and can affect the brain, the eyes, the heart, the spinal cord, and bones. Symptoms of late syphilis can include difficulty walking, numbness, gradual blindness, and possibly even death.
How Long Until Symptoms Appear?
A person who has been exposed to the spirochetes that cause syphilis may notice a chancre from 10 days to 3 months later, though the average is 3 weeks. If it’s not treated, the second stage of the disease may happen anywhere from about 2 to 10 weeks after the original sore (chancre).
Remember, many people never notice any symptoms of syphilis. This means it is important to let your doctor know that you are having sex, so that he or she can test you for syphilis even if you don’t have any symptoms.
What Can Happen?
Syphilis can be very dangerous if left untreated. In both guys and girls, the spirochetes can spread throughout the whole body, infecting major organs. Brain damage and other serious health problems can happen, many of which can’t be treated.
A woman who is pregnant and hasn’t been effectively treated is at great risk of putting her baby in danger. Untreated syphilis also can cause major birth defects. Syphilis also increases the risk of HIV infection because HIV can enter the body more easily when there’s a sore present.
How Is It Treated?
If you think you may have syphilis or if you have had sexual contact with someone who might have syphilis, see your doctor or gynecologist right away. It can sometimes be difficult to spot chancres. So it’s important to get checked on a regular basis, especially if you have had unprotected sex and/or more than one sex partner.
Depending on the stage, the doctor can make a diagnosis by examining the discharge from chancres under a special microscope or by doing a blood test to look for signs of infection. Let the doctor know the best way to reach you confidentially with any test results.
Early stages of syphilis are easily cured with antibiotics. Someone who has been infected for a while will need treatment for a longer period of time. Unfortunately, damage to the body from the late stage of syphilis cannot be cured. However, even in the late stage, it is important to get treatment to prevent further damage. Anyone with whom you’ve had sex also should be checked for syphilis immediately.
How Is Syphilis Prevented?
The best way to prevent any STD is to not have sex. However, for people who decide to have sex, it’s important to use protection and to have as few sexual partners as possible. Latex condoms are effective against most STDs; however, if there are any sores or rashes, avoid sex until the person has seen a doctor for treatment.
Trichomoniasis
What Is It?
Trichomoniasis is one of the most common sexually transmitted diseases (STDs). The germ that causes trichomoniasis can be passed from one person to another during sexual intercourse. The good news is that trichomoniasis can be prevented and is curable.
How Does a Girl Know She Has It?
A girl with trichomoniasis can get vaginitis, which is the medical term for irritation of the vagina. A girl who has trichomoniasis may have vaginal discharge that can be gray, yellow, or green, and may be foamy. This discharge may have a foul odor, and a girl’s vagina may feel very itchy.
A girl with trichomoniasis may find it very painful to urinate (pee). Trichomoniasis also can cause an achy abdomen and pain or bleeding during sexual intercourse.
Some girls do not have any symptoms.
How Does a Guy Know He Has It?
In most cases, guys won’t notice any symptoms. However, a guy who has trichomoniasis may notice some temporary irritation inside his penis or a mild burning feeling when he pees or after sex.
When Do Symptoms Appear?
Symptoms usually appear 5 to 28 days after a person has been exposed.
What Can Happen?
Untreated trichomoniasis can turn into an infection of the urethra or bladder. Trichomoniasis can make someone more susceptible to getting HIV. In pregnant women, trichomoniasis can cause the baby to be born early or to be born with a low birth weight.
If a patient has trichomoniasis, a doctor usually will also test for other STDs like gonorrhea and chlamydia because these STDs sometimes happen together.
How Is It Treated?
If you think you may have trichomoniasis or if you have had a partner who may have trichomoniasis, you need to see your family doctor, adolescent doctor, or gynecologist. He or she will do an exam and swab the vagina or penis for secretions, which will then be tested.
Doctors usually prescribe antibiotics for people who are diagnosed with trichomoniasis. Sexual partners should be treated at the same time, and people being treated should not have sex until they have finished their treatment and no longer have symptoms.
It’s better to prevent trichomoniasis than to treat it, of course. The only way to completely prevent infection is to not have oral, anal, or vaginal sex (this is called abstinence). People who choose to have sex should use a latex condom every time, and limit their number of sexual partners. Condoms are the only birth control method that will help prevent trichomoniasis.