Know your enemy: a guide to sexually transmitted infections
I was having a conversation with one of my male friends during which he announced that he was planning on getting tested for HIV. He was starting a new relationship and just wanted to take a “precautionary measures.”
That was great, I told him. But what about the other sexually transmitted infections: chlamydia, gonorrhea, syphilis and herpes?
“Oh, I’d know if I had one of those,” he said confidently.
I was a little appalled. Having spent the greater part of middle school sex ed looking at slides of people’s infested nether regions, I know that there are definite signs and symptoms of STIs — but not always. Yeah, if it burns when you pee, you’ve probably got a problem. But there’s a reason that chlamydia has been called the “silent epidemic.”
I already wrote about the reasons why testing is a good idea, but I wrote that under the assumption that most college students have had some STI education. Well, thanks to abstinence-only education, that assumption has been blown to bits. When questioned, very few college students can name the common STIs, let alone their symptoms.
Maybe that’s why our age group is the most highly infected. Sixty percent of STI infections occur in people younger than 25. STIs are not things that happen to “other people.” Knowing your STI status and that of your partner will help you to protect yourself.
Searle and Evanston Hospital offer testing for STIs. While many tests are free, some cost a lot. Check to see if your or your parent’s insurance covers the expense or you could end up with one whopper of a bill. You can also get tested by your health provider at home, or go to a free clinic in Chicago.
That said, I’m providing the following user-friendly STI guide: how they’re transmitted, how to protect yourself, what the symptoms are, how to test for them and treatment options.
Viral STIs
HIV/AIDS
How it’s transmitted: Any contaminated body fluid — including blood, semen, preseminal fluid, vaginal fluid and breast milk — coming into contact with a mucous membrane or the bloodstream. You cannot get HIV from saliva, but you can get it from oral sex.
How to prevent it: Use a condom or dental dam every time, including oral sex. Don’t use an oil-based lube, like Vaseline, as this will break down the latex. Use a water-based one, instead. Don’t floss your teeth before a date, either.
Symptoms: Since HIV attacks your immune system, early signs are fevers, night sweats, swollen lymph nodes, weakness and weight loss.
How to test for it: HIV antibodies don’t actually show up until three to six months after infection, so you have to wait until after this window period to be tested. A sample of your blood, saliva, or urine will be taken and run through the ELISA test, a highly accurate and commonly used test.
Treatment options: There is currently no known cure for HIV/AIDS. There is anti-retroviral medication available, but most people don’t live longer than ten years after being infected.
Herpes
How it’s transmitted: There are two types of herpes: Type One, which is oral herpes, and Type Two, which is genital herpes. Oral herpes manifests as common cold sores, and most people — 80-90% of adults over 50 — have Type One herpes. You can get Type One from any kind of oral contact. Genital herpes, on the other hand, is transmitted through any kind of skin-to-skin contact. That means if you give oral sex to someone with genital herpes, you can get genital herpes in your mouth. Someone who has genital herpes in their mouth can then also pass that on to someone during oral sex. Genital to genital contact can also spread genital herpes.
How to prevent it: Although condoms can help prevent transmission, they do not cover the entire infected area. Not having sex with someone with a herpes outbreak can also diminish chances of transmission, but someone with no visible signs of herpes can be close to having an outbreak and pass the virus on. Always use a condom or dental dam for oral sex. Using lots of lube to prevent skin abrasions can help, too.
Symptoms: After infection, outbreak usually occurs within two weeks. An outbreak starts with itching, then sores break out which ooze clear fluid before scabbing over. The outbreak usually clears up within a month, but recurrences can happen several times a year, especially during the first year of infection.
How to Test for It: A swab can be taken directly from a suspected herpes sore, or a person can have a antibody blood test done. Some blood tests can determine the difference between Type One and Type Two, but some cannot. Consult with your doctor to make sure you’re getting the right test.
Treatment: There is no cure for herpes, but there are anti-viral medications available. Outbreaks will gradually become less frequent over the years, but a person can still spread the virus throughout their lifetime.
Human Papillomavirus
How it’s transmitted: There are over a hundred types of HPV, most of which cause common body warts. There are two strains that cause genital warts, and twelve that can cause cervical cancer. HPV is highly contagious and is transmitted through any kind of skin-to-skin contact. Nearly half of women — 44.8 percent — aged 20 to 24 years old will have some strain of HPV infection.
How to prevent it: Although condoms have been shown to be helpful in preventing transmission, it does not cover the entire infected area. You can still pass on HPV while using condoms. There is, however, a new vaccine available, Gardasil, which vaccinates against both strains that cause genital warts and the two strains of HPV that cause 70 percent of cervical cancer. The vaccine is recommended for women ages nine through 26, but men can also be vaccinated. The vaccine does not work against those strains of HPV already present, but can prevent the others. The vaccine is given in three parts over six months, and, while expensive, is covered through many health plans.
Symptoms: Genital warts usually appear within one to three months of infection, but it is possible to be carrying the virus and show no signs of infection. Cervical cancer strains often have no symptoms in either men or women.
How to Test for It: A diagnosis of genital warts can usually be made visually. For cancer-causing strains, women should get an annual pap smear to detect any cell changes on their cervix. HPV tests are only recommended for women over thirty, as most HPV strains will clear the body on their own before then. There is no HPV test for men.
Treatment: Most HPV strains will leave the body within a few years and no additional treatment is need unless the virus causes warts or cervical cancer. Warts can be burned off, and cervical cancer can treated with surgery, radiation, and chemotherapy.
Bacterial STIs
Chlamydia
How it’s transmitted: This bacterial infection is transmitted through vaginal, anal or oral sex. Yes, you can get chlamydia in your throat. Wrap that sucker up. Vaginal infections, if left untreated, can cause pelvic inflammatory disease in women and sterility in both men and women. In men, untreated chlamydia can cause sterility in as little as little as six weeks.
How to prevent it: Using a condom or dental dam every time you have sex will help to prevent transmission.
Symptoms: Chlamydia often has no symptoms. In women, possible symptoms include unusual discharge, abdominal pain, fever, and pain while urinating. In men, unusual discharge and pain while urinating are symptoms.
How to Test for it: A cervical or urethral swab is taken and tested. Yes, that means that something gets inserted. No easy blood test, here, kids.
Treatment: There are several oral antibiotics that treat chlamydia. Most don’t need to be taken for more than a week.
Gonorrhea
How it’s transmitted: Through vaginal, anal and oral sex. Yes, again, you can get this in your throat. Very nasty.
How to prevent it: Again, use a condom. And a dental dam, when necessary.
Symptoms: Both women and men can have no symptoms. In woman, gonorrhea can cause unusual discharge or bleeding and difficulty urinating. In men, symptoms include an unusual discharge. Both men and women can have oral gonorrhea, which is usually just mistaken for a sore throat. Symptoms, when they do appear, usually happen within one to two weeks after infection.
How to Test for it: By looking for the bacteria from a swab of discharge under a microscope (which is only really an accurate test for men) or doing a culture test from a cervical swab.
Treatment: Single dose oral antibiotic.
Syphilis
How it’s transmitted: Through vaginal, anal, and oral sex. It can also be transmitted through mucous membranes and broken skin.
How to prevent it: Use a goddamn condom (am I starting to sound like a broken record yet?).
Symptoms: First a sore appears near the point of contact, usually ten to 90 days after infection. About one to six months later, a rash appears, especially on the hands and feet. This can come with sore throat, fatigue, lymph-node swelling and weight loss. If left untreated, syphilis eventually causes tumor-like growths on the skin and mucous membranes, and insanity. Famous people who allegedly contracted syphilis include John F. Kennedy, Adolf Hitler, Frederich Nietzsche and Al Capone.
How to Test for it: A simple blood test can detect syphilis antibodies.
Treatment: If you catch it early, a quick dose of penicillin should do the trick.
While there are other sexually transmitted infections — like scabies, trichomoniasis, pubic lice and Hepatitis B — these are not commonly looked for in routine STI testing. Scabies, “trich,” and public lice are usually diagnosed visually by a doctor, while there is a common vaccine for Hepatitis B that most college students are required to have.
The bottom line? Get tested and encourage your partners to do the same. It’s the only way to protect yourself from ending up on one of those grotesque slides in middle-school sex ed classrooms.
Find out why more women don't get vaccinated for HPV. Or you can return home.

New information on life expectancy for people with HIV: The estimate has changed from 10 years to 24 years since the late 1990s. For more info, check out this website: http://www.gay.com/news/article.html?2006/11/13/4
Thanks to Alec Thorne for the update!
Jessi Knowles
May 25, 2007 at 4:36 pm
There are a couple of inaccuracies here in your info about HPV. First off, there are more than two kinds of HPV that cause genital warts. The Gardasil vaccine simply protects against the two most common strains which cause about 70% of genital warts cases. Also, there are over 30 strains of genital HPV. Many of them are low-risk, which means they do not cause cancer, but as you mentioned, doctors only test women over 21 or 30 to find out if they have low grade or high grade HPV. Also, the Gardasil vaccine is NOT approved for men. Men cannot get the vaccine. That’s important, because it’s very clear that the medical community does almost nothing to address HPV infection in men. Most men who contract HPV never have any symptoms at all, since they don’t have cervixes to get lesions on. Therefore, doctors don’t see a reason to pour money into testing, vaccinating, and treating men for HPV. Sad but true. As someone who recently was diagnosed with HPV through an abnormal PAP smear (get them regularly, everyone!), I thought these things were important enough to mention. It’s good that you are trying to inform people though.
A. W.
June 28, 2007 at 3:33 am
I’m sorry – I should have been more clear. Gardasil protects against the two kinds of HPV, Types 6 and 11, which cause 90% of genital warts. It also protects against Types 16 and 18, which cause 70% of HPV-related cervical cancer.
There is no HPV test for men, and Gardasil is still only approved by the Food and Drug administration for women. But there seems to be a growing movement to have it approved for men in the U.S., and some doctors are vaccinating men, especially in the UK (http://info.cancerresearchuk.org/news/newsarchive/2007/february/18070574).
It was recently discovered that oral sex can transmit HPV and can put you at risk for throat cancer. Many men have also contracted anal cancer from HPV, and so it seems that it makes just as much sense for men to be vaccinated as women. While obviously only women can get cervical cancer, everyone is at risk for throat and anal cancer.
Like you said, women should get an PAP smear annually. Getting the vaccine is not a replacement for getting regular PAP smears.
Also! The scary number that most govenment agencies are producing that put the HPV infection rate at close to or over 50% doens’t specify if it’s only for genital HPV strains. Many people have hand warts or other kinds of HPV and might be included in this number. I read a report that actually put the genital HPV infection at a much lower rate, but now I can’t find it…does anybody have any information on this?
A.W., I’m kudos to you for getting regular tests. I hope that the HPV didn’t cause any serious problems, and thanks so much for your input!
Jessi Knowles
June 28, 2007 at 2:26 pm
One more HPV update:
New Hampshire is currently the only state that provides girls the vaccine free of charge. A bill was passed and will go into effect next year in Virgnia requiring all girls in 6th grade to get the vaccine (parents could opt out). A similar bill has passed the House in Kentucky and is going on to the Senate.
There are currenlty 15 other states with similar bills pending. Check out your state’s status:
http://en.wikipedia.org/wiki/Gardasil#Government_Mandates
Jessi Knowles
June 28, 2007 at 2:38 pm
Just one more! Australia has approved Gardasil for boys aged 9-15 years. Hooray Aussies!
Jessi Knowles
June 28, 2007 at 2:41 pm
I was just this week diagnosed with herpes. Awaiting results from a swab. Will going my whole life (30) without anything I have a flings my my ex hs sweetheart. 3 days later I’m sick with flu symptoms, worst flu ever. And A sore. So off to the doc. Herpes it is. So I’ve been searching everywhere for info.
2 questions,
1#during an outbreak of “shedding” can just touching or kissing my kids spread to them, I feel like I need to be in complete body armor.
2# I gave oral the same night we had sex. Strange thing is, we used a condom, but had brief contact before. So if I developed herpes from that brief moment, why don’t I also have sores on my mouth. I now have 3 on my genital, and doc said I had them on my cervix. So why didn’t my mouth break out?
I don’t know how to confront this guy about this.
And I’m taking an antiviral. 3 days now…..I hope relief soon. I’m dieing… and is 3 sores a bad outbreak? Will my next be easier? The flu is what killed me.
Thank u!
newlydiagnosed
June 30, 2008 at 12:47 am
Great educational post on protecting yourself against STD. The stats are still on the rise and its shocking to see how many people still have unprotected sex with multiple partners.
Watrol Guy
September 3, 2008 at 5:41 pm
Great post and very informative. While your friend should be congratulated for getting tested before he began his new relationship he is not alone when it comes to his disregard to other STDs. I guess that’s why there are over 6 million new cases of HPV a year. Like Watrol guy I too am shocked and amazed that people still have unprotected sex.
BD
October 6, 2008 at 1:53 pm
What type of sores are created when someone contracts genital herpes through oral sex? Are the mouth herpes located both inside and outside of the mouth? With the growing prevalence of oral sex in youth culture, it’s a truly scary thought that many young people could grow up with genital herpes in their mouth!
HSV
November 17, 2008 at 9:25 pm
i have so many questions. is Hpv cureable?
ali
May 4, 2009 at 2:26 pm