“I caught an STD?“
Sexually transmitted diseases are on the rise, especially in Nevada. How do you know if you have one, and how do you deal with it?
“It started with tiny bumps near my crotch,” Shawna, a University of Nevada, Reno, student said. “Then, it started itching a few weeks later and just erupted into these crusty lesions.”
The 21-year-old college junior, who described her sex life as “monogamous and quite tame,” got tested and diagnosed with the most common sexually transmitted disease, human papillomavirus (HPV), more commonly known as genital warts. She was confused with the diagnosis because her boyfriend didn’t have any warts.
“The scary part is that most people have HPV and don’t know it,” said Kamin Van Guilder, a certified medical assistant at Student Health Services. “Seventy to 90 percent of sexually active adults carry it around.”
Unlike Shawna, most people are unaware that they are carriers of HPV because the warts lie dormant in the body and rarely make an appearance. Though sometimes treatable with wart-removing prescription drugs, the virus never leaves your system and nests within for life.
The warts vary in size and shape, ranging from small, brownish growths to large reddish clusters.
“Let’s put it this way,” Shawna said. “Genital warts equals cauliflower. And I had to get the warts frozen off with liquid nitrogen.”
Teenagers and young adults account for nearly half the cases of STDs reported in the United States though they make up just a quarter of the sexually active population, according to research done by the federal Center for Disease Control and Prevention. Young people are more likely than older folks to have multiple partners and alcohol-induced one-night stands.
The most common STDs among college-age students are HPV, genital herpes and chlamydia.
With the number of STDs being as varied as the colors and textures of condoms available, the array of diseases can be confusing. STDs are divided into three categories: bacterial (chlamydia, gonorrhea and syphilis), viral (HPV, hepatitis B, herpes and HIV/AIDS) and parasitic (trichomoniasis and pubic lice).
Consequences range from disgusting to deadly.
“You can also get genital warts in your throat through oral sex,” Van Guilder said. “Even more seriously, HPV can lead to cervical cancer in women if left untreated.”
Many STDs are also hard to detect.
“A lot of STDs, especially HPV, are hard to detect because the general symptoms are so similar to any viral infection,” Van Guilder said. “Many people, especially women, have no symptoms even when infected.
Chlamydia is a biggie when it comes to rate of infection. It is the most commonly reported STD both nationally and in Washoe County. With a total of 973 Washoe County cases in 2002, young women aged 15-24 make up the largest chunk of those diagnosed.
“Women are just more likely to display the symptoms of chlamydia,” Van Guilder said.
Chlamydia is a bacterial infection, transferred through vaginal and seminal fluids and may have symptoms of painful urination and discharge from the penis or vagina. (You can get chlamydia from oral sex.) The majority of people infected with chlamydia have no symptoms. The biggest danger of chlamydia for women is that it can result in pelvic inflammatory disease, which can lead to infertility.
Gonorrhea, or “the clap” in old-school terms, is another contagious bacterial infection. It affects an estimated 2.5 million Americans annually. The symptoms usually appear within one to three weeks after infection. In men, these include a white to yellow-green penile discharge, burning pain while urinating and deep, aching pain or pressure in the genitals. In women, there may be painful urination, abdominal pain and, rarely, vaginal discharge. Gonorrhea, like chlamydia, is curable with antibiotics.
And if you thought you’d heard enough, syphilis is making a national comeback, especially in the gay community. It is highly contagious, and it’s transmitted through blood, semen, vaginal fluids and contact with infected blood, sores and skin-to-skin genital contact. A potentially deadly bacterial disease, syphilis has three stages. In the final stage, there is tissue damage in the brain, nervous system, heart, liver, bone and skin. In as many as one-third of untreated individuals, this damage may result in death.
“It’s pretty nasty,” Van Guilder said.
Syphilis is diagnosed with a blood test and is curable with penicillin and other antibiotics.
Bacterial STDs have moved increasingly to the sidelines over the years as viral STDs have become more common. That shift from bacterial to viral STDs should give students great incentive to avoid getting one because there’s currently no cure for viral STDs; the viruses nest in your body for life.
Herpes, for example, is a virus. Its symptoms are visually obvious: sores and blister-like lesions around the mouth and face (Type I) or with similar symptoms in the genital area (Type II). Painful urination, rash and flulike feelings are other symptoms of herpes. It sets up a lifelong presence in the body called latency, meaning that it sleeps in the body’s nerve roots. You get herpes not from blood or body fluids but from exposure to open sores and skin-to-skin contact with affected areas.
Hepatitis B is another virus transmitted through sexual and blood-to-blood contact, including sharing needles. Hepatitis A is spread by feces, while hepatitis C is spread from blood. Hepatitis is not only more contagious than HIV, it is, oftentimes, asymptomatic, rendering its hosts ignorant to its presence.
The STD most familiar to young adults is the human immunodeficiency virus (HIV), which is transmitted through blood and vaginal or seminal fluids. It’s the scariest and deadliest of uncurable STDs. Nevada is tied with Texas as having the highest rate of new AIDS cases in the Western United States. Even scarier is that other STDs serve as a sort of gateway to HIV.
“People with pre-existing STDs have a three-to-five times higher chance of getting HIV than those who don’t,” said Jennifer Howell, a health educator for Washoe County Health Department’s HIV program. “STDs cause irritation, abrasions and lesions that serve as ports of entry for HIV.”
A national increase in HIV in people under 30, however, suggests that younger adults are not as aware of the dangers of the disease as youths were in the 1990s. Howell said that it is because the media has loosened its focus on STDs and also because the younger generation has not seen the devastation of AIDS.
Far less serious than viral infections are the parasitic ones. Pubic lice, or “crabs,” are less serious and easier to detect than other STDs because, well, you really itch down there. The lice, which can be found attached to pubic hair, are yellow-gray in color and become dark after they are engorged with blood. The intense itching is a reaction to the parasites’ bites. It is readily cured by applying a special prescription cream, lotion or shampoo.
STDs can hide in your system, but a few basic symptoms should alert you that something is askew: abnormal discharge from the penis/vagina, redness or soreness of the genitals, rash or bumps on the genitals or excessive itchiness of genitals, painful urination or urine that is cloudy or smells bad, sores or blisters on or around the genitals and/or anus, mouth or throat, abdominal cramps or pelvic pain, fever, swollen glands or an overall sick feeling.
Preventing STDs in young adults, Howell said, requires a straightforward approach.
“There’s a lot of bullshit from conservatives that try to scare young people out of having sex,” Howell said. “They’ve even gone so far as to say that condoms don’t really work.”
The Bush administration is proposing to double the money it spends on “abstinence only” programs. Even though the surest way to prevent STDs is to abstain from sexual intercourse, the “just say no” virginal attitude is hardly realistic and is sneered at by the majority of hormone-laden youths.
Condoms, following abstinence, are the best protection against STDs. Students say that although they know condoms work, the message is usually forgotten after a few drinks or in the heat of the moment.
“If you’re out drinking and having a good time, you’re not going to care about limiting yourself with booze and sex,” said UNR senior Veronika Makhina.
But still better to use condoms than rely on vows of chastity. As former Surgeon General Jocelyn Elders said: “The bonds of latex are stronger than the bonds of abstinence.”
Large bowls of free, colored condoms offer latex protection from STDs to students visiting UNR’s Student Health Center. They are apparently popular with the clinic’s patrons, going like latex hotcakes—about 10,000 every three months.
Other precautions for preventing STDs include washing the genital area and urinating after intercourse, using condoms and spermicidal vaginal foams, jellies or creams and being tested frequently.
Many people, especially men, are hesitant about getting tested for STDs. Embarrassment, having no symptoms or just plain distaste for the testing process hold people back. But getting tested for chlamydia and gonorrhea is less of an ordeal these days for men and women. Whereas before, a Q-tip was very uncomfortably inserted into the urinary tract, a simple urinalysis now does the trick.
For women, a routine Pap smear detects chlamydia, gonorrhea and genital warts. Blood tests are required to diagnose herpes, HIV, syphilis and hepatitis B.
Health professionals emphasize never letting fear or embarrassment stand in the way of receiving prompt care.
“A lot of the women who are diagnosed don’t sleep around,” Van Guilder of Student Health Services said. “They say ‘I only had sex one time and I got it.’ So you see, it takes just one. These diseases don’t discriminate.”