Sexually Transmitted Diseases

About Chlamydia

Chlamydia is a sexually transmitted disease (STD) caused by the bacteria Chlamydia trachomatis. When transmitted through sexual contact, the bacteria can infect the urinary and reproductive organs.

The term chlamydia typically refers to the STD Chlamydia trachomatis, although two other types of this bacteria also can lead to illness: Chlamydia pneumoniae, which can be spread through coughing and sneezing, and Chlamydia psittaci, which birds can pass to humans. This article refers specifically to the STD.

Chlamydia can be treated with antibiotics but often causes no symptoms, so someone can be infected without even knowing it. Untreated infections can lead to more serious health problems, such as infertility, so it’s important for sexually active teens to be screened for chlamydia at least yearly by a health care provider. It’s also important for them to take precautions to prevent chlamydia, and if they think they’ve contracted the infection, to seek treatment as soon as possible.

Symptoms

In many cases, chlamydia causes only mild symptoms or no symptoms at all. So an infection can last for weeks or months before it is discovered.

In females, chlamydia symptoms can include:

• vaginal irritation
• vaginal discharge
• lower abdominal pain
• burning feeling with urination

Untreated chlamydia also can lead to pelvic inflammatory disease (PID), which can affect the vagina, cervix, uterus, fallopian tubes, and ovaries. Sometimes, PID causes no symptoms; more often, it causes abdominal or lower back pain, painful urination, pain during intercourse, bleeding between menstrual periods, nausea, vomiting, fatigue, or fever.

Untreated chlamydia or PID infections in females can cause scarring of the fallopian tubes, which can lead to serious health problems such as chronic pelvic pain, infertility, or ectopic (tubal) pregnancy.

Just as in females, chlamydia might cause no symptoms in males. Those who do have symptoms might have discharge from the tip of the penis and a burning feeling during urination. Untreated infections can lead to epididymitis, an inflammation of the coiled tubes in the back of the testicles. This can result in testicular swelling, pain, and even infertility.

Contagiousness

Chlamydia is contagious. It can be transmitted through sexual contact via semen and vaginal secretions.

Chlamydia does not spread through casual contact such as shaking hands or using the same toilet as someone who is infected. If someone is diagnosed with chlamydia, all of that person’s sexual partners need to be notified and treated with antibiotics, even if they don’t have any symptoms, so that they don’t develop any long-term complications or spread the infection to others.

Treatment

If detected early on, chlamydia can easily be treated with antibiotics and the symptoms alleviated within 7 to 10 days. If untreated, chlamydia can lead to serious complications that can appear months or even years after the person is infected.

Medications are effective against chlamydia; however, once treated, people are encouraged to be tested again for chlamydia about 3 months later. This is because up to 20% of young women are re-exposed to chlamydia and need to be retreated. The most common reason for re-exposure is a sexual partner who hasn’t been adequately treated.

The sexual partners of anyone who has (or is thought to have) chlamydia or any other STD should be examined and treated. Those diagnosed with an STD should inform their partners as soon as possible so that they, too, can be examined and treated to prevent complications and avoid spreading the infection.

Prevention

Because chlamydia is spread through sexual contact, the best way to prevent it is to abstain from having sex. Sexual contact with more than one partner or with someone who has more than one partner increases the risk of contracting any STD.

Once sexual activity is part of a young person’s life, it is important to be screened yearly for chlamydia by a medical provider. This is important whether or not symptoms of an infection are present.

In addition, when properly and consistently used, condoms decrease the risk of STDs, including chlamydia. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Although birth control pills offer no protection against STDs, they may provide some protection against PID by causing the body to create thicker cervical mucus, making it more difficult for bacteria to reach the upper genital tract.

Using douche actually can increase a female’s risk of contracting STDs because it can change the natural flora of the vagina and may flush bacteria higher into the genital tract.

A teen who is being treated for chlamydia also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it’s important to encourage them to talk to a trusted adult who can provide the facts.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to talk about it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that they often don’t have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual health centers in your area might be able to offer some guidance.

Genital herpes is a sexually transmitted disease (STD) that’s usually caused by the herpes simplex virus type 2 (HSV2), although it  also can be caused by herpes simplex virus type 1 (HSV1), which normally causes cold sores around the mouth.

In some cases, genital herpes causes blisters and pain in the genital area, but in others, it doesn’t cause any symptoms, so someone who is infected could unknowingly pass it on to others. Sometimes people who have genital herpes only have one outbreak. Others have many outbreaks, which are less painful and shorter than the first episode.

There’s no cure for herpes. Once someone has been infected with the herpes virus, it stays in the body. Medications can alleviate the discomfort of outbreaks and limit or sometimes prevent them. But it’s better to prevent a herpes infection altogether. Anyone having sex (oral, anal, or vaginal) should take precautions against STDs and get screened for them regularly.

Symptoms

Symptoms of herpes outbreaks typically begin with pain, tenderness, or itching in the genital area and also might include fever and headache. Bumps and blisters may appear on the vagina, penis, scrotum, anus, thigh, or buttocks. Blisters soon open to form painful sores that can last up to 3 weeks.

Other symptoms may include: pain or a burning sensation during urination; muscle aches; and tender, swollen glands in the groin area. After the first herpes infection, the virus can lie dormant without causing any symptoms. But the virus might reactivate later, leading to sores that usually don’t last as long as those during the first outbreak. The virus tends to reactivate following some type of stress, like a cold, an infection, hormone changes, menstrual periods, or even before a big test at school.

After the herpes blisters disappear, a person may think the virus has gone away — but it’s actually hiding in the body. Both HSV1 and HSV2 can stay hidden away in the body until the next herpes outbreak, when the virus reactivates itself and the sores return.

Contagiousness

Herpes is contagious and can be passed from person to person through any form of unprotected sex. This can occur even when there are no sores or blisters present. So people who are infected can unknowingly spread the infection to someone else.

Treatment

To treat a genital herpes outbreak, a doctor may prescribe an antiviral medicine in the form of an ointment or pills. These medications can’t cure HSV2, but they can help make a person feel better and shorten the duration of outbreaks or prevent them.

People who know they carry the herpes virus also can take medication daily as suppressive therapy. Suppressive therapy can decrease the number of (and sometimes prevent) outbreaks and also can lessen the chance the virus will be passed on to another person during sex.

If someone is being treated for herpes, any sexual partners also should be tested and treated for any diagnosed STDs.

Prevention

Because herpes is spread through sexual contact, the best way to prevent it is to abstain from having sex. Sexual contact with more than one partner or with someone who has more than one partner further increases the risk of contracting any STD.

When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Using douche can actually increase a female’s risk of contracting STDs because it can change the natural flora (healthy bacteria) of the vagina and may flush STD pathogens higher into the genital tract.

A teen who is being treated for herpes also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it’s important to encourage them to talk to a trusted adult who can provide the facts.

Because many STDs might not cause obvious symptoms, teens often don’t know when they’re infected. It’s important for all teens who have had sex to get screened regularly for STDs so that they don’t lead to other more serious health problems.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to discuss it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don’t have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also may be able to offer some guidance.

Genital warts are warts that are on or near a person’s genital areas. They’re caused by a group of viruses called human papillomavirus (HPV), which is one of the most common sexually transmitted diseases (STDs). There are many types of HPV, and more than 40 types cause genital warts.

A vaccine for people 9 to 26 years old is approved to prevent HPV infection, which causes most genital warts and cervical cancers.

Symptoms

Some types of HPV cause the kind of warts you see on people’s hands and feet. Genital warts, though, appear on or near the vulva, vagina, cervix, or anus in females; and on or near the penis, scrotum, or anus in males.

Genital warts can be raised or flat, small or large. Sometimes they’re grouped together in a cauliflower-like shape. Some warts can be so small and flat that they’re not noticed right away.

Most of the time, genital warts are flesh-colored and painless, but some people may have itching, bleeding, burning, or pain.

Contagiousness

Genital warts can pass from person to person through intimate sexual contact (touching someone’s genitals or having vaginal, oral, or anal sex). They can appear any time from several weeks to several months later. Sometimes, it might take even longer because the virus can live in the body for a long time before showing up as warts.

When kids get genital warts, it could be a sign of sexual abuse, and parents should be aware of that possibility. However, HPV also can spread through nonsexual contact between a child and a caregiver — for instance, while giving a child a bath or changing a diaper. Kids can reinfect themselves by touching a wart somewhere else on their body and then touching their genital area.

Not everyone who’s been exposed to the virus will develop genital warts. In fact, most people don’t. Sometimes, the immune system will clear the virus, and people never even know they had it. When the HPV isn’t cleared away, though, genital warts or other problems can develop.

If not treated, genital warts may grow bigger and multiply. They may go away on their own without treatment, but this doesn’t mean they should be ignored because genital warts can be spread to other people.

Prevention and Treatment

The HPV vaccine is approved for people 9 to 26 years old:

• For kids and teens ages 9-14, the vaccine is given in two shots over a 6- to 12-month period.
• For teens and young adults ages 15-26, it is given in three shots over a 6-month period.

To be effective, the vaccine must be given before someone is exposed to HPV. It doesn’t protect people who have already been infected with certain HPV strains, and it doesn’t protect against all types of HPV. So be sure your kids have routine physical checkups and, for girls, gynecologic exams. If you have questions about the vaccine, talk with your doctor.

Because genital warts are spread through sexual contact, the best way to prevent them is to not have sex. Sexual contact with more than one partner or with someone who has more than one partner increases the risk of getting any STD.

When correctly used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective at preventing STDs. However, condoms can’t fully protect someone against genital warts because HPV can infect areas that aren’t covered by a condom.

The immune system can sometimes clear the warts with no treatment. Other times, genital warts can be treated and removed with prescription medicine or other medical procedures, such as freezing or laser treatments.

A teen who is being treated for genital warts also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens are comfortable talking with parents about these issues, so it’s important to encourage them to talk to a trusted adult who can help.

Talking to Sexually Active Teens

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to talk about it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don’t have symptoms, so a partner might have an STD without knowing it.

It can be hard to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also can offer guidance.

Gonorrhea is a sexually transmitted disease (STD) caused by a bacterium called Neisseria gonorrhoeae. It can also be transmitted from pregnant mothers to their babies at birth.

Gonorrhea most commonly affects teens and young adults. Experts believe that hundreds of thousands of cases go undetected and untreated because the infection does not always have noticeable symptoms. Many people who have gonorrhea also have another common STD, chlamydia. So when doctors diagnose or suspect a case of gonorrhea, they often screen for and treat other STDs too.

Gonorrhea is preventable — and treatable — so anyone having sex (oral, anal, or vaginal) should take precautions against STDs and get screened for them regularly.

Symptoms

Many times gonorrhea does not produce any symptoms. When there are symptoms, the infection can cause painful urination and a cloudy discharge from the penis or vagina. This discharge may be thick and may have a greenish-yellow color. Males may have swelling or pain of their testicles. Females may have lower abdominal pain, painful intercourse, and abnormal bleeding from the vagina.

Gonorrhea can cause rectal pain, especially during a bowel movement. A sore throat can result from a gonorrhea throat infection.

If gonorrhea goes undetected and untreated, it can lead to more serious health problems. In males, it can cause scars inside the urethra, which can make urination difficult. In females, untreated gonorrhea can spread upward from the vaginal area to cause acute pelvic inflammatory disease (PID) — an infection of the uterus, fallopian tubes, or ovaries. It can lead to abscesses in the fallopian tubes and even infertility.

In males and females, gonorrhea that goes undetected can spread through the blood to parts of the body that are far from the reproductive organs, and lead to inflammation in the joints, the skin, the bones, tendons, heart, or even the area around the liver.

Prevention

Because gonorrhea is spread through sexual contact, the best way to prevent it is to abstain from having sex. Sexual contact with more than one partner or with someone who has more than one partner increases the risk of contracting any STD.

When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Although birth control pills offer no protection against STDs, they may provide some protection against PID by causing the body to create thicker cervical mucus, making it more difficult for bacteria to reach the upper genital tract.

Using douche actually can increase a female’s risk of contracting STDs because it can change the natural flora of the vagina and may flush bacteria higher into the genital tract.

Treatment

If gonorrhea is suspected, the doctor will send urine or samples of fluid from the urethra (at the end of the penis) or the cervix to a laboratory for examination. If the doctor thinks it has spread, more tests may be necessary.

If gonorrhea is caught early, it can be treated with antibiotics. Because the symptoms of gonorrhea are similar to those of chlamydia, and because someone can be infected with both, people with gonorrhea are sometimes treated for both diseases. Treatments are usually very effective, but rarely someone will have a gonorrhea infection that doesn’t respond to certain antibiotics. If symptoms continue after treatment, the person should let the doctor know.

A teen being treated for gonorrhea also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it’s important to encourage them to talk to a trusted adult who can provide the facts.

All teens who have had any type of sex (vaginal, oral, or anal) should be screened regularly for STDs so that they don’t lead to other more serious health problems. It’s also important for them to notify any sexual partners if they have an STD.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to talk about it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don’t have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual health centers in your area might be able to offer some guidance.

Human immunodeficiency virus (HIV) is one of the most serious, deadly diseases in human history. It causes acquired immunodeficiency syndrome (AIDS) by infecting and damaging part of the body’s defense against infection — its lymphocytes. Lymphocytes are white blood cells in the immune system that are supposed to fight off invading germs.

HIV spreads through direct contact with the blood or body fluid of someone who is infected with the virus. That contact usually comes from sharing needles or by having unprotected sex with an infected person. An infant could get HIV from a mother who is infected.

HIV and AIDS can be treated, but there are no vaccines or cures for them.

What HIV Does to the Body

The virus attacks specific lymphocytes called T helper cells (also known as T-cells), takes them over, and multiplies. This destroys more T-cells, which damages the body’s ability to battle invading germs and disease.

When the number of T-cells falls to a very low level, people with HIV become more susceptible to other infections. They also may get certain types of cancer that a healthy body would normally be able to fight off. This weakened immunity (or immunodeficiency) is known as AIDS.

Although AIDS is always caused by an HIV infection, not everyone with HIV has AIDS.

How Common Is HIV/AIDS?

The first case of HIV was reported in 1981, but the disease might have existed unrecognized for many years before that. HIV infection leading to AIDS has been a major cause of illness and death among children, teens, and young adults worldwide.

In recent years, HIV infection rates have increased rapidly among teens and young adults:

• A quarter of all new HIV infections in the United States are in people ages 13-24.
• Thousands of teens acquire new HIV infections each year.
• Most new HIV cases in younger people are due to unprotected sex; one third are from sharing contaminated needles used to inject drugs or other substances (such as steroids), or used for tattooing and body art.
• Over half of the teens with HIV in the United States don’t know they have it.

How HIV Spreads

HIV is transmitted through direct contact with the blood or body fluid of someone who is infected with the virus.

Among children with HIV, most cases are due to a mother passing HIV to her baby during pregnancy or birth, or through breastfeeding. In rare cases, children may have been infected by being sexually abused by someone living with HIV.

Fortunately, medicines now given to HIV-positive pregnant women have greatly reduced mother-to-child HIV transmission in the United States. These drugs are also used to slow or reduce some of the effects of the disease in people who are already infected.

But these medicines aren’t yet readily available worldwide, particularly in the poorer nations hit hardest by the epidemic. Providing access to these life-saving treatments has become an issue of global importance.

In very rare cases, HIV has also been transmitted by direct contact with an open wound of an infected person (the virus may enter through a small cut or tear on the body of the healthy person) and through blood transfusions. Since 1985, the U.S. blood supply has been carefully screened for HIV, and the risk of getting HIV from a blood transfusion is extremely small. A person cannot get HIV by donating blood.

Can Kids Spread HIV?

Across the United States, only a handful of cases have been reported where HIV infection passed from a child to another person. All of those cases involved direct blood contact within a household. The typical baby secretions (urine, drool, spit up, vomit, feces, etc.) do not seem to transmit the virus, so routine care of babies with HIV is considered safe.

Despite widespread concerns, no transmissions of HIV within a school or childcare setting have been reported. Because the danger in spreading HIV involves direct contact with blood, personnel at schools and childcare programs should routinely use gloves when any child has a cut, scrape, or is bleeding.

Transmission of HIV Among Teens

Among teens, HIV is spread mostly through unprotected sex with an infected person or sharing contaminated needles to inject drugs.

Education of children and teens is vitally important to help prevent sexual transmission of HIV, as well as other sexually transmitted diseases (STDs), including chlamydia, genital herpes, gonorrhea, hepatitis B, syphilis, and HPV (which can cause genital warts or lead to various cancers).

Many STDs cause irritation, sores, or ulcers of the skin and mucous membranes that the virus can pass through. Having an STD, such as genital herpes, for example, has been proven to increase the risk of getting HIV if the person has unprotected sex with someone who is HIV-positive.

HIV is not spread through:

• casual contact, such as hugs or handshakes
• drinking glasses
• sneezes
• coughs
• mosquitoes or other insects
• towels
• toilet seats
• doorknobs

Signs and Symptoms of HIV

In Babies

A baby born with HIV infection most likely will appear healthy. But within 2 to 3 months after birth, an infected baby might begin to appear sick, with poor weight gain, mouth infections (thrush), enlarged lymph nodes, an enlarged liver or spleen, brain and nervous system problems, and numerous infections (such as pneumonia or pneumocystis pneumonia).

In Kids

Without treatment, a child with HIV also may get more severe bouts of other common childhood infections, such as Epstein-Barr virus (EBV) infection, which usually causes mild illness in most kids. In developing countries, tuberculosis has been a particularly common problem and often the cause of death of children and adults living with HIV.

In Teens and Adults

Teens and adults who contract HIV usually show no symptoms at the time of infection. In fact, it may take up to 10 years or more for symptoms to show. During this time, they can spread the virus without even knowing they have it themselves.

Once the symptoms of AIDS appear, they can include rapid weight loss, intense fatigue (tiredness), swollen lymph nodes, lasting diarrhea, night sweats, or pneumonia. They’ll also be susceptible to life-threatening opportunistic infections, which are illnesses that can develop in weakened immune systems.

Diagnosing HIV Infections and AIDS

Every pregnant woman should be tested for HIV so doctors have a better chance of preventing transmission to her unborn child.

If a woman knows she is HIV-infected and already has children, all of them be tested for HIV. Even older kids who seem healthy still could have an HIV infection if their mother was HIV-positive when they were born. A blood test is needed to know for sure.

Newer tests can help doctors to determine if a baby born to an HIV positive mother is infected in the first few months of life.

Older kids, teens, and adults are tested for HIV infection by a number of different tests that look for antibodies to the virus, proteins that coat the virus, or the presence of the virus itself. Antibodies are specific proteins that the body produces to fight infections; HIV-specific antibodies are produced in response to infection with HIV. Someone with antibodies against HIV is said to be HIV-positive.

If any one of the tests is positive, it will be repeated or confirmed with another test.

Complications of HIV/AIDS

Opportunistic Infections

Opportunistic infections (infections that take advantage of a person’s weakened immune system) are the most common complication of HIV/AIDS.

Sometimes adults with HIV/AIDS can get an infection from germs that do not normally cause illness in a healthy person (like cryptococcus). People with AIDS (especially children) can get a severe version of a more common infection, such as chickenpox.

These opportunistic infections and conditions can happen in people with HIV:

• viral infections, such as a form of chronic walking pneumonia called lymphoid interstitial pneumonia (LIP), herpes simplex virus, shingles, and the cytomegalovirus infection
• parasitic infections, such as PCP (a pneumonia caused by Pneumocystis jirovecii, a microscopic parasite that can’t be fought off due to a weakened immune system) and toxoplasmosis
• serious bacterial infections, such as bacterial meningitis, tuberculosis, and salmonellosis
• fungal infections, such as esophagitis (inflammation of the esophagus), and candidiasis or thrush (yeast infection)

Other Complications

Children with HIV are also at higher risk for some forms of cancer because of their weakened immune systems. Lymphomas associated with Epstein-Barr virus (EBV) infection are more common in older kids with HIV.

Difficult-to-treat complications in kids who have HIV/AIDS include the wasting syndrome (the inability to maintain body weight due to long-term poor appetite and other infections related to HIV disease) and HIV encephalopathy (due to HIV infection of the brain that causes swelling and then damage to the brain’s tissues over time).

HIV encephalopathy can result in dementia, especially in adults. Wasting syndrome can sometimes be helped with nutritional counseling and daily high-calorie supplements, but preventing HIV encephalopathy remains very difficult.

Treating HIV/AIDS

If they don’t receive treatment, almost all people infected with HIV will develop AIDS. Fortunately, the last 20 years have brought two major developments in the treatment of HIV/AIDS:

1. drugs that inhibit the virus’s growth, preventing or delaying the onset of AIDS and allowing people with HIV to remain free of symptoms longer
2. drugs that help reduce the transmission of the virus from an HIV-infected mother to her child

As medical understanding grows about how the virus invades the body and multiplies within cells, drugs to inhibit its growth and slow its spread are developed.

Drug treatment for HIV/AIDS is complicated and expensive, but highly effective in slowing the replication (reproduction) of the virus and preventing or reducing some effects of the disease.

Drugs to treat HIV/AIDS use several different strategies, including:

1. interfering with HIV’s reproduction of its genetic material (these drugs are called nucleoside or nucleotide anti-retrovirals)
2. interfering with the enzyme protease, which HIV needs to take over certain body cells (protease inhibitors)
3. interfering with HIV’s ability to pack its genetic material into viral code — that is, the genetic “script” HIV needs to be able to reproduce itself. These medicines are called non-nucleoside reverse transcriptase inhibitors (NNRTIs).
4. interfering with HIV’s ability to enter T helper cells (fusion inhibitors)
5. interfering with a protein on T helper cells to block HIV from entering the cells (CCR5 or entry inhibitors)
6. interfering with the enzyme integrase, which HIV needs to take over certain body cells (integrase inhibitors)

Because these drugs work in different ways, doctors generally prescribe a “combination cocktail” of them that is taken every day. This regimen is known as HAART (highly active anti-retroviral therapy) treatment. Doctors also may prescribe drugs to prevent certain opportunistic infections when a person’s immune system is very weak — for example, some antibiotics can help prevent PCP, especially in kids.

A number of medicines can treat HIV infection and slow the onset of AIDS, but they must be taken and administered properly on a round-the-clock schedule. Otherwise, the virus can quickly become resistant to that particular “cocktail.”

HIV is very adaptable and finds ways to outsmart medical treatments that are not followed properly. This means that if prescribed medicines are not taken at the correct times every day, they will soon fail to keep HIV from reproducing and taking over the body. When that happens, a new regimen must begin with different drugs. And if this new mix of medicines is not taken correctly, the virus will likely become resistant to it, too, and eventually the person will run out of treatment options.

Aside from the difficulty of getting young children to take their medication on a timed schedule, the medicines can have other problems. Some have unpleasant side effects, such as a bad flavor, while others are only available in pill form, which can be hard for kids to swallow.

Parents who need to give their child these medications can ask the doctor or pharmacist for suggestions on making them easier to take. Many pharmacies can add flavoring to bad-tasting medicines or your doctor may recommend mixing pills with applesauce or pudding.

Because drug options are still limited, doctors are concerned that if children fail to take their medicines as prescribed (even missing just a few doses), the virus could eventually develop resistance to the existing HIV drugs — making treatment difficult or impossible. So it is very important that kids take their medicines as directed.

HIV/AIDS family support groups and experienced medical providers can offer practical suggestions to help families be successful with the day-to-day challenges they face.

Paying for the medications that fight HIV infection can be a concern. In the United States, special programs can pay for medicine for all HIV-positive kids. Unfortunately, in other parts of the world (especially in developing countries), many people don’t have access to these medicines.

Preventing Mother-to-Child Transmission of HIV

When a pregnant HIV-infected woman receives good medical care early and takes antiviral medicines regularly during her pregnancy, the chance that she will pass HIV to her unborn baby is dramatically reduced.

Any pregnant woman who knows she is HIV-positive should start prenatal care as soon as possible to take full advantage of such treatments. The sooner a mother receives treatment, the greater the likelihood her baby will not get HIV.

An HIV-infected mother can receive medical treatment:

• before the birth of her baby: antiviral treatments given to the mother during pregnancy can help prevent HIV transmission to the baby
• at the time of birth: antiviral medications can be given to both the mother and the newborn to lower the risk of HIV transmission that can happen during the birth process (which exposes the newborn to the mother’s blood and fluids). In addition, the mother will be encouraged to formula-feed rather than breastfeed because HIV can spread to her baby through breast milk.
• during breastfeeding: because breastfeeding is discouraged among HIV-infected mothers, this type of transmission is rare in the United States. However, in places in the world with limited access to formula or a clean water supply to mix it, both the mother and child can be treated with medication to lower the baby’s risk of HIV infection.

Before antiviral medicines were routinely given, almost 25% of children born to HIV-infected mothers developed the disease and died by 24 months of age. Now, studies show that mothers with HIV who get good prenatal care and regularly take antiviral drugs during their pregnancy have less than a 1% chance of passing HIV to their babies. If these babies do get the HIV virus, they tend to be born with a lower viral load (less HIV virus is present in their bodies) and have a better chance of long-term, disease-free survival.

Long-Term Care of Kids With HIV/AIDS

Cases of HIV infection and AIDS in children are complicated and should be managed by experienced health care professionals. Kids will need to have their treatment schedules closely monitored and adjusted regularly. Any infections that could become life-threatening must be quickly recognized and treated.

Medicines are adjusted in relation to the child’s viral load. The child’s health is also monitored by frequent measurement of T-cell levels because these are the cells that the HIV virus destroys. A good T-cell count is a sign that medical treatments are working to keep the disease under control.

Kids should see their health care providers often for blood work, physical exams, and discussions about how they and their families are coping socially with any stress from their disease.

Some immunizations during routine visits may be slightly different for infants or children with HIV/AIDS. A child whose immune system is severely compromised will not receive live virus vaccines such as measles-mumps-rubella (MMR) and chickenpox (varicella). All other routine immunizations are given as usual, and the yearly flu (influenza) vaccine is recommended.

If a family seeks health care for their child in a hospital emergency department, parents should be sure to tell the registering nurse that the child has HIV. This will alert medical caregivers to look closely for any signs of diseases from opportunistic infections and provide the best possible treatment.

Outlook for HIV/AIDS

There is no vaccine to prevent HIV and AIDS, although researchers are working to develop one. Combinations of antiviral drugs and drugs that boost the immune system have allowed many people with HIV to resist infections, stay healthy, and live longer, and many children born with HIV who are treated early reach adulthood.

Preventing HIV and AIDS

Prevention of HIV is of worldwide importance. Despite much research, there is no vaccine that will prevent HIV infection. Infection can be prevented by never sharing needles, and abstaining from oral, vaginal, or anal sex. Since most people will eventually become sexually active at some point in their lives, always using condoms for all types of sexual intercourse can greatly reduce the risk of getting HIV.

Testing all pregnant women at least once during pregnancy also can help. If the result is positive, immediate treatment can begin before the baby is born to prevent HIV transmission.

Talking With Kids About HIV/AIDS

Talking about HIV/AIDS means talking about sex and drugs — and it’s not always easy for parents to talk about these topics with their kids. Similarly, it’s not always easy for teens to open up to parents or to believe that issues like HIV/AIDS can affect them.

Doctors and counselors suggest that parents become knowledgeable and comfortable discussing sex and other difficult issues early on, even before the teen years. After all, the issues involved — understanding the body and sexuality, adopting healthy behaviors, respecting others, and dealing with feelings — are important topics at all ages. Open communication and good listening skills are vital.

Doctors, teachers, and counselors can help. Many schools provide age-appropriate information about HIV/AIDS that has been designed to educate kids about the disease. Studies show that such education makes a tremendous difference in preventing risky behaviors in young people.

Talking to your pediatrician, adolescent medicine specialist, or family doctor can help you feel comfortable about talking to your kids. The health care professional also can talk with your child or teen about how to be safe and prevent HIV infection.

Ultimately, parents who are well-informed about how to prevent HIV and who talk with their kids regularly about healthy behaviors, feelings, and sexuality can make a huge difference in preventing HIV infection and helping kids grow up to become healthy adults.

Pelvic inflammatory disease (PID) is a serious infection of the female reproductive system that can develop from an untreated sexually transmitted disease (STD). In most cases, it occurs when bacteria from the STD in the vagina or cervix move into the uterus and upper genital tract. The most common organisms that lead to PID are gonorrhea and chlamydia, both of which are highly contagious STDs.

Untreated PID can damage the fallopian tubes, ovaries, and uterus, which can lead to chronic pelvic pain and serious damage to the reproductive system. PID is the most common, preventable cause of infertility, and can also lead to ectopic pregnancies.

The good news is that when PID causes symptoms, it can be diagnosed and treated with antibiotics. The essential part is to detect it before it leads to serious health problems. However, since symptoms can be mild, many cases of PID are unrecognized and, therefore, may be untreated if people aren’t screened for STDs. So women who are sexually active should take precautions to keep from contracting STDs, and eventually PID, and be screened for STDs regularly.

Symptoms

Signs and symptoms of PID can range from mild to severe, and can appear weeks after exposure to an STD. Sometimes, there are no symptoms at all.

When symptoms of PID occur, they may include:

• abnormal vaginal discharge, possibly with an odor
• pain during urination or more frequent urination
• aching pain in the lower abdomen
• pain in the upper abdomen
• fever or chills
• nausea and vomiting
• irregular menstrual bleeding
• pain during sex
• fatigue
• diarrhea
• back pain

If your daughter complains of any symptoms associated with PID, she should see her doctor as soon as possible. You should be especially alert to these symptoms if she has had PID before because they may signal a repeat infection.

The STDs that can lead to PID are very contagious. All sexual partners of someone who is diagnosed with chlamydia or gonorrhea should be notified and treated with antibiotics, even if they have no signs or symptoms.

Complications

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 someone who has had PID does get pregnant, scarring of the fallopian tubes may cause the fertilized egg to implant in one of the 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 that occurs in the ovary and fallopian tube. A woman 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.

Prevention

Because STDs can lead to PID, the best way to prevent it is to abstain from having sex (abstinence). Sexual contact with more than one partner or with someone who has more than one partner increases the risk of contracting any STD.

When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Although birth control pills offer no protection against STDs, they may provide some protection against PID by causing the body to create thicker cervical mucus, making it more difficult for bacteria to reach the upper genital tract.

Using douche can actually increase a female’s risk of contracting STDs and developing PID because it can change the natural flora of the vagina and flush bacteria higher into the genital tract.

A teen who is being treated for PID also should be tested for other STDs, and should have time alone with the doctor to openly discuss things like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it’s important to encourage them to talk to a trusted adult who can provide the facts.

Treatment

PID can be treated with antibiotics, which kill the bacteria that cause the disease. If damage has already occurred in the reproductive organs, antibiotics will not be able to reverse it but will stop further spread of the infection. In some cases, girls with PID do have to be hospitalized, particularly if they develop a high fever, severe nausea, and vomiting; if they need intravenous (IV) antibiotics; if they are pregnant; or if the diagnosis is uncertain.

In trying to diagnose PID, the doctor will likely ask questions about your daughter’s medical history, method of birth control, and her sexual activity and that of her partner. The doctor may then perform a pelvic exam to find out if her reproductive organs are tender or swollen and to identify the location of the infection.

It’s not always easy to diagnose PID. Some other conditions, like appendicitis, can cause symptoms similar to PID. During the pelvic exam, the doctor may take samples to look for the germs that cause gonorrhea and chlamydia infections. Blood tests also may be done. Other tests may be required to determine whether the fallopian tubes are swollen or if an abscess (collection of pus) is present.

Prompt treatment of PID and follow-up care can cure the infection and help prevent complications. Rest can help your daughter recover. Hot baths and heating pads applied to the lower back and abdomen can help relieve discomfort.

Your daughter should finish all medicines as prescribed because the PID infection may continue even after the symptoms disappear. To prevent re-infection, her partner also should be examined and treated. It’s important to abstain from sex until treatment of both partners is completed and the doctor determines that the infection is gone.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to discuss it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don’t have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also may be able to offer some guidance.

About Pubic Lice

Pubic lice (often called “crabs” because of their crab-like appearance under a microscope) are six-legged creatures that most commonly infest hair in the pubic area, although they also can infest other body hair. In most cases, pubic lice are transmitted sexually from the pubic hair of one person to another. But lice can be contracted in other ways, too — from infested clothing, towels, and bedding.

Typically, pubic lice can be treated at home. But if someone in the house has them, it’s important to take precautions so that they don’t spread.

Symptoms

Although it’s possible to be infested and have no symptoms, people with pubic lice usually experience itchiness. This can worsen at night when the lice become active and bury their heads inside pubic hair follicles to feed on a person’s blood.

Sometimes, lice bites can also cause the infested area to become inflamed and discolored because of a reaction to the proteins in the saliva of the lice. Constant itching and scratching can cause the area to become raw and lead to a secondary bacterial infection. Scratching also can help the pubic lice to spread.

If the infestation consists of many adult lice, symptoms may be noticeable immediately. But if the infestation initially involves a few lice that then lay eggs, a person may not experience any symptoms for 2 to 4 weeks until the eggs hatch.

In young children, pubic lice may also be a cause of blepharitis (irritation or infection of the eyelids). So, a child’s eyelashes should be examined with a high-powered magnifying glass if lice are suspected.

Contagiousness

Pubic lice can live 1 to 2 days away from a human body. But contrary to what some people may think, they’re rarely transmitted from furniture or toilet seats because the lice that fall from the body are usually injured or dying. Unlike fleas, lice can’t jump from person to person. And they can’t be contracted from animals.

Prevention

Because the lice can sometimes be contracted from bedding and towels used by someone who is infested, it’s important to avoid contact with any item — including clothing — that the person has used.

More commonly, pubic lice infestation is spread through sexual contact, so the best way to prevent it is to abstain from having sexual contact. Sexual contact with more than one partner or with someone who has more than one partner increases the risk of contracting any sexually transmitted disease (STD).

When properly and consistently used, condoms decrease the risk of STDs. However, because condoms don’t cover the area with pubic hair, they are not good protection against pubic lice.

A teen who is being treated for pubic lice also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it’s important to encourage them to talk to a trusted adult who can provide the facts.

Treating Pubic Lice

A teen who might have pubic lice should see a doctor right away. If the doctor diagnoses pubic lice, your child 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 may need to be repeated after 7 to 10 days to kill any lice not eliminated the first time.

Also, dry clean or use very hot water and a hot dryer cycle to wash and dry all affected bedding, towels, or recently worn clothing to properly kill the lice and their eggs. Any sexual partners from the last month should also check for pubic lice immediately. Although condoms help protect against other STDs, a partner could still get pubic lice because the condom does not cover the entire pubic area.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to discuss it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don’t have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also may be able to offer some guidance.

Sometimes it’s difficult to see your child as anything but that: a child. Yet in many ways, teens today are growing up faster than ever. They learn about violence and sex through the media and their peers, but they rarely have all the facts. That’s why it’s so important for you to talk to your kids about sex, and about sexually transmitted diseases (STDs).

Teens are one of the groups most at risk for contracting STDs (also called sexually transmitted infections, or STIs). You can help your kids stay safe by talking to them and sharing some important information about STDs and prevention.

Before you tackle this sensitive subject, though, it’s important to make sure you not only know what to say, but how and when to say it.

Timing Is Everything

It’s never too late to talk to your kids about STDs, even if they’re already teens. A late talk is better than no talk at all. But the best time to start having these discussions is during the preteen years. Of course, the exact age varies from child to child: Some kids are more aware of sex at age 9 than others are at age 11. You’ll need to read your child’s cues.

No matter how old kids are, if they start having questions about sex, it’s a good time to talk about STDs. When kids are curious, they’re often more open to hearing what their parents have to say.

But not all kids ask their parents questions about sex. One way to start a discussion is to use a media cue, like a TV show, movie, or newspaper article, and ask what your child thinks about it.

You also could use the human papillomavirus (HPV) vaccine as a conversation starting point. The HPV vaccine, recommended for all preteen girls and boys, is most effective at preventing HPV infection if the series of shots is given before someone becomes sexually active.

The surest way to have a healthy dialogue is to establish lines of communication early on. If parents aren’t open to talking about sex or other personal subjects when their kids are young, kids will be a lot less likely to seek out mom or dad when they’re older and have questions.

Spend time talking with your kids from the beginning and it’ll be much easier later to tackle topics like sex because they’ll feel more comfortable sharing their thoughts with you.

Tips for Talking

To make talking about STDs a little easier for both you and your kids:

• Be informed. STDs can be a frightening and confusing subject, so it may help to read up on STD transmission and prevention. You don’t want to add any misinformation, and being familiar with the topic will make you feel more comfortable. If kids ask for information that you’re not sure about, find out the answer from a reliable source and get back to them.
• Ask what your kids already know about STDs and what else they’d like to learn. Remember, though: Kids often already know more than you realize, although much of that information could be incorrect. Parents need to provide accurate information so their kids can make the right decisions and protect themselves.
• Ask what your kids think about sexual scenarios on TV and in movies and use those fictional situations as a way to talk about safe sex and risky behavior.
• Encourage your kids to share any fears, questions, or concerns.
• Help kids feel in charge of the talk by getting their opinions on what you discuss. If you let their questions lead the way, you’ll have a much more productive talk than if you stick to an agenda or give a lecture.
• Explain that the only sure way to remain STD-free is to not have sex or intimate contact with anyone outside of a committed, monogamous relationship, such as marriage. However, those who are having sex should use condoms to protect against STDs every time (or a dental dam when a girl is receiving oral sex). This is true even when using another method of birth control. Most condoms are made of latex, but both male and female condoms made of polyurethane are available for people with a latex allergy.

Common Questions About STDs

Depending on what your kids have heard from friends and the media, their questions will probably be fairly straightforward, such as:

• What is an STD? An STD is a sexually transmitted disease.
• How does someone catch one? These infections and diseases are spread from one individual to another during anal, oral, or vaginal sex. They also can be spread by fingers or objects after they have touched genitals or body fluids.
• What do STDs do to a person’s body? The type of STD determines what kinds of symptoms, if any, someone has. Some STDs cause virtually no symptoms, whereas others can cause the person to have discharge from the vagina or penis, sores, or pain.

  But even when there are no symptoms, untreated STDs can lead to damage to the internal organs and may cause long-term health problems, like infertility or cancer. This is why anyone who has had any type of sex (vaginal, oral, or anal) needs to be tested for STDs regularly.

• Are STDs curable or do you have them forever? Some STDs (like chlamydia and gonorrhea) can be cured with antibiotics, but some infections — like herpes or HIV — have no cure.
• Are people who catch STDs somehow bad? Getting an STD does not mean that someone is bad, just that he or she needs to learn how to prevent future infections.
• Can you tell that someone has an STD just by looking at him or her? People often don’t even know that they’re infected. Certain kinds of STDS (like genital warts and herpes) sometimes cause visible signs around the genitals, but in most cases there is no way to look at someone and know that he or she has an STD.

Answering these questions and others as openly as possible is the best approach. It’s up to you to gently correct any misinformation your kids may have learned. And always answer questions honestly without being overly dramatic.

It can be tough, but try not to be too emotional or preachy. You want your kids to know that you’re there to support and help, not judge.

Finding Reliable Information

Communicating with your kids may not be easy, but it is necessary. And if you’re always available to talk, discussions will become easier. Information from your doctor’s office or organizations like Planned Parenthood can provide answers.

And websites like TeensHealth.org discuss STDs and sex in teen-friendly language. Viewing them together can help you and your kids start talking.

Your child’s school can be another resource. Find out when sexuality will be covered in health or science class and read the texts that will be taught. The PTA may even offer sessions about talking to teens where you can share tips and experiences with other parents.

And don’t shy away from discussing STDs or sex out of fear that talking will make kids want to have sex. Informed teens are not more likely to have sex; but when they do become sexually active they are more likely to practice safe sex.

If you try these tactics and still don’t feel comfortable talking about STDs, make sure your kids can talk to someone who will have accurate information: a doctor, counselor, school nurse, teacher, or another family member.

Kids and teens need to know about STDs, and it’s better that they get the facts from someone trustworthy instead of discovering them on their own.

Syphilis is a sexually transmitted disease (STD) that, if left untreated, can lead to serious health problems and increase the risk for getting human immunodeficiency virus (HIV), the virus that causes AIDS. Syphilis also can be passed from a mother to her baby during pregnancy and cause serious complications.

A syphilis infection in its early stages can be treated with antibiotics, and can be prevented by avoiding sexual contact with someone who is infected. Unfortunately, people don’t always know that they’re infected, so anyone having sex (oral, anal, or vaginal) should take precautions against STDs and get screened for them regularly.

Symptoms

Syphilis, caused by the bacteria Treponema pallidum, often doesn’t cause any symptoms in its early stages. But if left untreated, it can progress to affect the entire body.

Syphilis typically has three stages, and there can be different symptoms in each.

Primary Syphilis

The symptoms of the first stage of the infection, primary syphilis, usually appear 10 days to 3 months after sexual contact with an infected person. A painless red sore called a chancre can appear on the genitals in the area where the infection occurred. Enlarged lymph nodes (swollen glands) also might be present in the area. Depending on the type of sexual contact, a chancre might also develop on the mouth or in the rectal area.

Chancres are the primary way that syphilis is transmitted between people, but often are unrecognized. Even without treatment, chancres will heal after 3 to 6 weeks, but if the infection isn’t treated the disease will progress to the second stage.

Secondary Syphilis

The secondary stage usually begins weeks to months after the chancre sore appears. Syphilis bacteria enter the blood and spread through the body, causing many different symptoms, including rash (small red spots), fever, headache, loss of appetite, weight loss, sore throat, muscle aches, joint pain, a generally ill feeling, and enlarged lymph nodes.

The rash of secondary syphilis can develop anywhere on the body, including on the palms and soles of the feet. Gray or white wart-like patches of skin called condylomata can appear on the moist areas around the mouth, anus, and vagina. These lesions are full of bacteria and very contagious.

The symptoms of secondary syphilis will eventually go away. But in this stage, syphilis can also affect the liver, kidneys, and eyes, or cause meningitis. The symptoms of secondary syphilis will eventually go away, but without treatment, the infection can advance to the third stage. This is true even if an infected person did not have symptoms of primary or secondary syphilis.

Late (Tertiary) Syphilis

After the secondary stage, those who haven’t been treated progress to a latent stage. People in a latent stage will not manifest symptoms but they are still infected and contagious. Some of them go on to have symptoms of late syphilis, which can appear many years later and cause damage of the eyes, large blood vessels, heart, bones, and central nervous system (called neurosyphilis).

Symptoms of this late stage of syphilis can include memory loss, problems with mental function, walking, balance, bladder control, and vision, in addition to impotence and loss of sensation, particularly in the legs.

Treatment

A doctor can test for syphilis with a physical exam and blood tests and treat it with antibiotics. The doctor also can check for other STDs, such as gonorrhea, chlamydia, and HIV.

Anyone who is sexually active should see a doctor to be screened for syphilis and other STDs. Someone who has had sexual contact with a person who has syphilis, or has any symptom of the illness, should be seen by a doctor for testing and treatment as soon as possible.

Preventing STDs

Because syphilis is an STD, the best way to prevent getting it is to abstain from having sex. Sexual activity with more than one partner or with someone who has more than one sex partner also increases the risk of contracting an STD.

When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Using douche can actually increase a woman’s risk of contracting STDs because it can change the natural flora of the vagina and may flush bacteria higher into the genital tract.

Because many STDs often don’t have obvious symptoms, people might not know when they’re infected, so sexually active teens should get screened regularly for STDs so that they don’t lead to other more serious health problems.

A teen who is being treated for syphilis also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it’s important to encourage them to talk to a trusted adult who can provide the facts.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to discuss it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don’t have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your area also might offer guidance.

Trichomoniasis, one of the most common sexually transmitted diseases (STDs), is caused by a parasite called trichomonas vaginalis. This parasite can live in the urogenital tract of males and females and infect any sexually active person, especially those who are not using protection or who have multiple partners.

Trichomoniasis (often referred to as “trich” — pronounced “trick”) is usually treated with prescription medication. An infection can be uncomfortable and can make someone who has it more susceptible to human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome (AIDS).

The only way for anyone to completely prevent infection is to abstain from sex. It’s important for sexually active teens to understand the importance of always using condoms, which can help protect against trichomoniasis and other STDs.

Symptoms

Symptoms of trich can appear as early as 5 days after sex with an infected partner. But trichomoniasis often goes undiagnosed because symptoms may not appear until later, if at all.

In females, symptoms can include:

• abundant or frothy vaginal discharge ranging in color from gray to green to yellow, with a watery to milky consistency
• foul smelling vaginal discharge
• itching and tenderness in or around the vagina
• pain during sex
• bleeding after sex
• pain during urination
• soreness or itching of the labia and inner thighs
• swollen labia

If you have a teenage daughter, it’s important for her to recognize both a normal vaginal discharge (it’s usually clear or whitish, has no bad odor, and causes no irritation) and one that might signal a problem.

Males who have trichomoniasis often don’t show any symptoms. But if they do, symptoms can include:

• mild urethral itching
• mild burning after urination or ejaculation
• painful or difficult urination
• inflammation of the prostate gland
• pain and inflammation of the scrotum

Prevention

Because trichomoniasis is an STD spread through sexual contact, the best way to prevent it is to abstain from having sex. Sexual contact with more than one partner or with someone who has more than one partner increases the risk of contracting any STD.

When properly and consistently used, condoms decrease the risk of STDs. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made of polyurethane, is also considered effective against STDs.

Using douche can actually increase a female’s risk of contracting STDs because it can change the natural flora of the vagina and may flush bacteria higher into the genital tract.

A teen who is being treated for trichomoniasis also should be tested for other STDs, and should have time alone with the doctor to openly discuss issues like sexual activity. Not all teens will be comfortable talking with parents about these issues. But it’s important to encourage them to talk to a trusted adult who can provide the facts.

Treatment

The doctor can determine whether there is a trichomoniasis infection by performing a pelvic or genital examination and by testing a sample of vaginal or urethral discharge. In females, the infection also may be detected on a Pap smear.

Trich can be treated with prescription medications. Both sexual partners should be considered infected and treated at the same time, even if one has no symptoms.

Because many STDs might not cause obvious symptoms, teens often don’t know when they’re infected. It’s important for all teens who have had sex to get screened regularly for STDs so that they don’t lead to other more serious health problems.

Getting Help

If your teen is thinking of becoming sexually active or already has started having sex, it’s important to talk about it. Make sure your teen knows how STDs can be spread (during anal, oral, or vaginal sex) and that these infections often don’t have symptoms, so a partner might have an STD without knowing it.

It can be difficult to talk about STDs, but just as with any other medical issue, teens need this information to stay safe and healthy. Provide the facts, and let your child know where you stand.

It’s also important that all teens have regular full physical exams — which can include screening for STDs. Your teen may want to see a gynecologist or a specialist in adolescent medicine to talk about sexual health issues. Community health organizations and sexual counseling centers in your local area also may be able to offer some guidance.