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Bacterial Vaginosis (B

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Bacterial Vaginosis (B

    Appendix J. STD Fact Sheets

    Information, written in easy-to-understand layperson’s language, that educates the client on symptoms and

    treatment protocols for STDs.

    Dissemination Project Module 6, Appendix J Page J-1

    Bacterial Vaginosis (B.V.)

Bacterial Vaginosis is a condition where the normal bacteria in the vagina are replaced by a large

    number of other bacteria (not normal ones). We don't know how these bacteria get there, but lots of

    sex without condoms seems to increase the bacteria. There is a medication that can reduce the

    abnormal bacteria but sometimes it's difficult for the normal bacteria to grow back in large numbers.

    How do I know if I have B.V.? Women may have any of the following problems:

    Gray, yellow or white "fishy" smelling discharge from the vagina Itching around the vagina

    No symptoms but the clinician may find B.V. while looking at your vaginal fluid under the

    microscope. We doubt that B.V. is carried by men, and we don't usually treat them for it.

    Is B.V. a serious problem?

    ? If a woman has B.V. and is pregnant and planning to continue the pregnancy, we suggest

    treatment because the B.V. bacteria can cause early delivery.

    ? If a woman has B.V., is pregnant and planning an abortion, she should be treated before to

    prevent infection in the uterus from the B.V. bacteria.

    ? If a woman is not pregnant and does not have any complaints with B.V., it is not necessary

    to take the medicine. However, research now indicates that having B.V. may make you more

    susceptible to HIV, the virus that causes AIDS.

    How do I avoid getting B.V.? Do not douche (rinsing the vagina with water or other liquid). We think douching increases the B.V.

    bacteria in the vagina and washes away the good bacteria that help keep the vagina healthy.

    Douching has also been linked to PID (a serious infection in the uterus, tubes and ovaries.

Having lots of semen in your vagina also changes the vaginal environment and makes it easier for

    you to get BV. Using condoms will help you avoid getting BV.

What is the treatment for B.V.?

    Medicine called metronidazole or Clindamycin can be given in pill or vaginal cream form. Ask your

    clinician about special instructions for the medicine if you drink alcohol. There is research going on

    currently to see if B.V. can cause a woman to be more likely to get other STDs. There is also

    research for new medications that could help normal bacteria return to the vagina.

WARNING: HIV is also an STD. All STDs are spread by having unsafe sex. When you get infected with an STD, you could also be getting HIV. Protect yourself--use condoms (male or female).

    USE CONDOMS to keep yourself COOL.

    You’re living in the HIV and STD HOT ZONE.

    Page J-2 Module 6, Appendix J Dissemination Project

    Chlamydia

Chlamydia (cla-mid-ee-ah) is a Sexually Transmitted Disease (STD) caused by a type of bacteria

    called Chlamydia trachomatis. Chlamydia can infect men, women, and children.

    How is chlamydia spread? Chlamydia is passed from one person to another during vaginal, anal and oral sex. It can also be

    spread to the eyes by touching fluids from the vagina or penis and then touching your eyes. Babies

    of infected mothers can get eye and lung infections during delivery.

    What do I look for?

    Men:

    ? Discharge from the head of the penis, or the anus.

    ? Pain or itching of the head of the penis.

    ? Pain with urination.

    ? 50% of infected men have no symptoms.

Women:

    ? Pain and itching of the vulva or vagina.

    ? Discharge from the vagina.

    ? Unusual bleeding from the vagina, or the anus. Pain with urination.

    ? Pain when having sex.

    ? 80% of infected women have no symptoms.

Symptoms may appear within 30 days of infection but then may go away. The infected person

    remains infected and can pass chlamydia to a sex partner. If you are sexually active, see your

    doctor regularly to be tested for chlamydia and other STDs.

    Is chlamydia serious?

    Yes! If you are a woman and have chlamydia you could become sterile (unable to produce children).

    PID (pelvic inflammatory disease), a serious pelvic infection in women, is a common result of

    untreated chlamydia infection. In PID the bacteria move from the vagina up through the cervix and

    into the uterus, tubes and ovaries. Blockage and scarring can damage the tubes and make a

    woman more likely to have a "tubal pregnancy."

    How is chlamydia treated? Your doctor will give you antibiotic medicine to kill the chlamydia in your body. Take all of the pills

    you are given, even if you feel better before taking them all. Your sex partner(s) must be examined

    and treated. If not treated, they can give the infection back to you, or infect others. Don't have sex

    for one (1) full week after you are treated. Don't have sex with your partner while you are both

    taking your medicine.

    How do I avoid getting chlamydia? Plan ahead. Protect yourself. If you're thinking of having sex with a new partner: talk about STDs;

    talk about your wish to have protected, safer sex (male or female condoms); suggest an STD

    check-up for both of you before having sex.

     WARNING: HIV is also an STD. All STDs are spread by having unsafe sex. When you get infected with an STD, you could also be getting HIV. Protect yourself--use condoms (male or female).

    USE CONDOMS to keep yourself COOL.

    You’re living in the HIV and STD HOT ZONE.

    Dissemination Project Module 6, Appendix J Page J-3

    Crabs and Scabies

Crabs are very small bugs that attach themselves to the pubic hairs and bite the surrounding skin.

    Scabies are mites (bugs) that dig under the skin, where they lay their eggs. Both cause extreme

    itching in men and women.

    How are crabs and scabies spread? they are usually passed from one person to another during sex. They can also be caught by sharing

    clothes, bedding, old stuffed or padded furniture, futons, or towels that have been used by a person

    with crabs or scabies.

What do I look for?

    Crabs:

    Men and women may have any of the following symptoms.

    ? Itching in the public hair area.

    ? May see a tiny, crawling insect(s) or tiny eggs in the pubic hair.

    Scabies:

    Men and women may have any of the following symptoms.

    ? Itching in the pubic area.

    ? Bites on skin, which may itch - particularly around the fingers, armpits, waist and pubic

    hair area.

    Men may also have the following symptom: Red patches on penis.

    How do you cure crabs or scabies? The usual treatment for crabs is Pyrethrin or Permethrin (brand name RID, NIX or A-200). These

    lotions can be purchased at a drugstore. Be sure to follow your medical provider's instructions. The

    usual treatment for scabies is a lotion or cream prescribed by a clinician. (Apply the lotion to the

    entire body, starting at the neck.) Be sure to follow your medical provider's instructions to

    completely get rid of scabies. If you are pregnant tell your provider. Wash all clothing and bedding

    in hot water to avoid reinfection. You may continue to itch for a couple of weeks after you finish

    treatment but you should not develop new bites. Tell all people you have sex with, share a bed or

    clothing with to be examined and checked for symptoms or they can give the infection back to you.

    If you have items that cannot be washed (such as a leather jacket, comforter, etc.) either have them

    dry-cleaned or seal them in a plastic bag and do not open it for two weeks.

    How do I avoid getting crabs or scabies? If you buy second hand clothing or get clothing from someone else, be sure and wash it in hot water

    before wearing. You can also seal it in a plastic bag for two (2) weeks. Don't share a bed with or

    have sex with someone who has body sores or who seems to have a problem with body itching.

     WARNING: HIV is also an STD. All STDs are spread by having unsafe sex. When you get infected with an STD, you could also be getting HIV. Protect yourself--use condoms (male or female).

    USE CONDOMS to keep yourself COOL.

    You’re living in the HIV and STD HOT ZONE.

Page J-4 Module 6, Appendix J Dissemination Project

    Douching

MYTH: Douching is part of good feminine hygiene.

    FACT: Advertisers are eager to tell you that douching is the “nice” thing to do, and that

    you’ll feel better and be more attractive if you douche. But there’s really no reason to douche

    and good reason not to.

    The FACTS about douching and your vagina:

    ? The vagina cleans itself. Douching is not necessary after your period or after sex.

    ? Never use douching after sex as a method of birth control IT DOESN’T WORK!

    ? Some vaginal discharge is normal and may vary in amount and color as your hormone

    levels change during different parts of your menstrual cycle.

    ? Odor, if any, probably comes from the external part of the vagina or anus and regular

    bathing or showering should take care of it.

    ? Douching changes the environment in your vagina and makes it easier for unhealthy

    bacteria - such as sexually transmitted diseases - to grow.

    ? To keep your vagina feeling and smelling healthy and clean, use condoms.

Unless a doctor has told you that you have a special medical condition and need to douche,

    DOUCHING IS UNNECESSARY AND CAN EVEN BE DANGEROUS.

    ? Researchers have linked douching to ectopic (tubal) pregnancies, which can kill you.

    ? Researchers have also found that douching may increase the risk for pelvic inflammatory

    disease (PID), a serious infection that can cause to pain and scar tissue and is the leading

    cause of infertility (loss of the ability to have children) in women.

    ? Most of the active ingredients in douches have not been shown to be safe and effective.

    ? Some douches contain chemicals (such as boric acid) that, if absorbed, may seriously

    endanger the health of a fetus. Women who are pregnant or think they might be should not

    douche.

If you have an unusual odor, a discharge, itching or other discomfort that makes you think you

    might have and infection, see a doctor. Don’t try to douche to cure an infection, it may make it harder for the doctor to diagnose the cause of the infection!

    USE CONDOMS to keep yourself COOL.

    You’re living in the HIV and STD HOT ZONE.

    Dissemination Project Module 6, Appendix J Page J-5

    Genital Warts

Genital Warts (or condyloma) is a Sexually Transmitted Disease (STD) caused by the human

    papilloma virus (HPV). The virus may cause wart-like bumps to form on the penis, in and around

    the vagina, on the cervix (opening to the uterus), around the rectum. The virus is passed from one

    person to another during anal or vaginal sex. These are NOT the same warts commonly found on

    hands and feet.

    How do I know if I have Genital Warts? Not everyone who has the wart virus will have visible warts. Warts may appear as wart-like growths or may be

    flat and only slightly raised from the skin. Women may find out about having the wart virus if it shows up on a

    "pap smear" test.

    How are Genital Warts spread? The wart virus can be present on their penis, the vagina, anus, or on the skin around these areas. It is passed

    with skin to skin contact during sex. People that have had unprotected sex with more than two partners in

    their life have probably already been exposed to the wart virus. It’s possible to have been exposed to the wart

    virus months or years before warts appear.

    Are Genital Warts serious?

    For most people warts are only a bother, and are treated only for cosmetic reasons. There are many different

    types of wart virus. Most are harmless (especially the ones that cause visible warts). There are a few types

    which can cause changes in the cells of the cervix (opening to the uterus) or the cells of the anus. There are

    many treatments available if this develops on the cervix. For that reason all women, including women with

    visible warts on the outside of the body should have a "pap smear" test every year.

    What can I do if I have Genital Warts? Be sure you see a clinician (licensed medical provider). Keep all your return treatment appointments. Your

    sex partner(s) should also be seen and treated. If you may be pregnant, tell your clinician. If you have sex, it

    is always a good idea to use a condom to avoid getting STDs. However, condom use is not a 100% protection

    from the wart virus.

    How are Genital Warts treated? There are several different chemicals (treatments) that can be used to remove the warts, and some can be

    applied at home by the person who has the warts. It often takes several treatments for the warts to go away.

    Talk to your clinician if you have been told you have the wart virus on the cervix. There are special treatments

    available for this. Evaluation and experimental treatments are also now being offered in some settings for anal

    warts. Talk to your clinician about this. Will the warts come back?

    Warts may return, even after treatment, this is because the virus stays in the skin once you are infected. You can

    pass the virus to your sex partners during vaginal or anal sex, even when you don't have warts you can see.

    Should I tell a sex partner?

    People who have unprotected sex with more than two sex partners in their life have probably already been

    exposed to the wart virus. IT IS VERY COMMON. Your current partner can have a check-up for warts and

    other STDs, but often warts are not found. It’s up to you whether or not to tell a new sex partner that you have

    the wart virus. We do advise yearly "pap smears" for all women whose male sex partners have genital warts.

    How can I avoid getting genital warts? If you’ve never had sex you can use condoms 100% but you will only REDUCE your risk of getting warts

    because the wart virus can be on the skin near the vagina, rectum or penis and not just on the sex organs.

    Warts and the virus that causes them are generally NOT dangerous and are very common in the population

    of sexually active adults. Women are advised to have a yearly "pap smear" test and check-up for STDs. Men

    are also advised to have a yearly check-up for STDs, as many STDs do not have obvious symptoms or signs.

    WARNING: HIV is also an STD. All STDs are spread by having unsafe sex. When you get infected with an STD, you could also be getting HIV. Protect yourself--use condoms (male or female).

    USE CONDOMS to keep yourself COOL. You’re living in the HIV and STD HOT ZONE.

    Page J-6 Module 6, Appendix J Dissemination Project

    Gonorrhea

    Gonorrhea (gon-or-e-uh) is a Sexually Transmitted Disease (STD) caused by a type of bacteria N. gonorrhea. Gonorrhea can infect men and women. It is passed from one person to another during vaginal, anal and oral sex. It can be found in the throat, vagina, urethra and anus. Babies can be infected during birth, causing eye infections.

What are the symptoms of gonorrhea?

    Symptoms usually appear within 10 days after being exposed.

    Men:

    ? Discharge from the head of the penis, or the anus.

    ? Pain or itching of the head of the penis.

    ? Occasionally, swelling of the penis.

    ? Pain with urination.

    ? Occasionally, discharge may have appeared and then gone away without treatment. You

    are still infected. Women:

    ? Discharge from the vagina.

    ? Lower belly pain, especially with sex.

    ? Unusual bleeding with cramping. Pain with urination.

    ? Often, women have no symptoms at all but are still infected. Throat:

    If gonorrhea infects the throat usually there are no symptoms although it may cause a "sore throat." Gonorrhea is more efficiently spread to the throat by penis/mouth sex than by mouth/vagina sex. Studies have shown that gonorrhea in the throat disappears on its own within 3 months without treatment.

    Rectum:

    If gonorrhea infects the rectum, there may be white discharge on stools, pain, spasm, and rectal itching. As in the throat, there may be no symptoms at all.

    Is gonorrhea serious?

    YES! Men can occasionally develop epididymitis, an infection of the testicles which is painful and can cause sterility (blockage of sperm). If you are a woman and have gonorrhea you could become sterile (unable to produce children). PID (pelvic inflammatory disease), a serious pelvic infection in women, is a common result of untreated gonorrhea infection. In PID the bacteria move from the vagina up through the cervix and into the uterus, tubes and ovaries. Blockage and scarring can damage the tubes and make a woman more likely to have a "tubal pregnancy."

    How is gonorrhea treated?

    Your clinician will give you medicine to kill the gonorrhea in your body. Take all of the pills you are given, even if you feel better. Avoid having sex (you and your partner) for one full week after your treatment. Your sex partner(s) must be examined and treated. If not treated, they can give the infection back to you, or infect others.

    How do I avoid getting gonorrhea?

    Plan ahead. Protect yourself. If you're thinking of having sex with a new partner: talk about STDs; talk about your wish to have protected, safer sex (male or female condoms); suggest an STD check-up for both of you before having sex.

    WARNING: HIV is also an STD. All STDs are spread by having unsafe sex. When you get infected with an STD, you could also be getting HIV. Protect yourself--use condoms (male or female).

    Dissemination Project Module 6, Appendix J Page J-7

    Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) is a serious infection usually caused by gonorrhea, chlamydia or

    other sexually transmitted bacteria. The bacteria are passed during vaginal sex, and go from the

    vagina through the cervix (opening to the uterus), into the uterus, tubes or ovaries. They cause

    infection, pain and scar tissue. PID is the leading cause of infertility (loss of the ability to have

    children) in women.

How is PID spread?

    The bacteria that cause PID are passed from a man to a woman during vaginal sex. Men can have an

    infection and not know it because they may not have any symptoms (discharge or burning on urination).

    Women may have gonorrhea or chlamydia without symptoms for many months, even years.

    How do I know if I have PID?

    ? A woman can have any of the following problems:

    ? Pain in the belly during sex

    ? Mild or severe pain in the lower belly

    ? Unusual bleeding or discharge from the vagina

    ? Pain in the lower back

    ? Fever, chills or vomiting.

    ? There may be no signs of PID.

    Is PID a serious problem? Yes! Once bacteria get into the vagina they can travel up through the cervix, uterus, and then out into the

    tubes and ovaries. This may cause many long-term problems.

    ? Scarring and blockage in the tubes (can't get pregnant in the uterus).

    ? Scarring around uterus, tubes, and ovaries (vaginal sex can be painful).

    ? Pregnancy in the tubes, instead of the uterus ("ectopic" or "tubal" pregnancy). If this happens

    emergency surgery is needed and tube may be removed.

    ? Each time a woman has PID her chance of normal pregnancy lowers by 15 to 30%.

How is PID treated?

    Antiobiotic medicine is given that would treat gonorrhea or chlamydia (most common infections that cause

    PID) You may need to go to the hospital for treatment. Be sure to return to the clinic or hospital for all your

    follow-up appointments, to make certain the infection is getting better. Do not have sexual intercourse for at

    least 2 weeks, to allow healing and to prevent spreading the infection in your body. Stop all vigorous exercise

    for 2 weeks, and try hot baths while being treated to encourage your body to heal. Finish all your medications,

    even if you feel better. Your sex partners (and their partners) must get checked and treated also, or you can

    be infected again.

    What can I do to avoid PID? Get an STD check-up if you have had sex without using a condom. Try to get a check-up before your next

    menstrual period (we think it's easier for bacteria to get up through the cervix at this time). Use condoms

    every time you have vaginal sex, even if you are using birth control pills or the birth control shot to prevent

    pregnancy. They will not protect you from STD infections, including HIV. Barrier birth control methods: foam,

    condoms (male and female), diaphragm and suppositories for birth control can help because they keep

    bacteria and semen from getting into the cervix (opening to the uterus). Plan ahead. Protect yourself. If you're

    thinking of having sex with a new partner: talk about STDs; talk about your wish to have protected, safer sex

    (male or female condoms); suggest an STD check-up for both of you before having sex.

WARNING: HIV is also an STD. All STDs are spread by having unsafe sex. When you get infected with an STD, you could also be getting HIV. Protect yourself--use condoms (male or female).

    Page J-8 Module 6, Appendix J Dissemination Project

    Syphilis

Syphilis is a Sexually Transmitted Disease caused by a type of bacteria called T. pallidum. It can

    spread from person to person by physical contact during vaginal, anal, or oral sex.

    What are the symptoms of syphilis? Usually, symptoms show up 2-12 weeks after being exposed to syphilis.

    ? Possible early symptoms (2-12 weeks after becoming infected): Skin sore called chancre

    (shank-er). There may be more than one. They are usually not painful. They may be on the

    penis, scrotum, vaginal lips, anus, or mouth. Infected women may not be aware of any

    symptoms because sores may be inside the vagina. Even without treatment these sores will

    go away after several weeks. You are still infected. Lymph glands near the sore may be

    swollen, and also are not painful.

    ? Possible later symptoms (4-12 weeks after becoming infected): Flu-like illness with sore

    throat, headache, and fever. Skin rash all over the body, in the mouth, on the palms of the

    hands and soles of the feet (not itchy). Warty-like growths may appear in the mouth, on the

    genitals or around the anus. Patchy hair loss may be noticed. Nervous system symptoms:

    neck stiffness, nausea, vomiting, seizures, hearing loss and loss of speech.

    These symptoms will go away even without treatment. You are still infected.

    How would I know if I have syphilis? If you have a sore on your genitals, have an STD check. There are special tests available at City

    Clinic to diagnose syphilis from sores. A blood test for syphilis can be done. You could have syphilis

    and not know it. Anytime you have tests for STDs be sure and ask for a syphilis blood test also.

    Is syphilis dangerous? Yes! If not treated, syphilis can cause brain damage, heart disease, and other long-term health

    problems. A pregnant woman can pass syphilis to her baby which could cause permanent damage.

    The chancre also makes it easier to get HIV.

    How is syphilis treated?

    Penicillin shots cure syphilis. Other medicine can be used if you are allergic to penicillin. We

    sometimes find a positive test for syphilis in an older person who is no longer sexual. They could

    have been infected many years ago. We recommend treatment for them because some people with

    long term, untreated syphilis can develop brain, heart, and nervous system damage. At this late

    stage of syphilis a person is not contagious to sex partners.

    What can I do if I have syphilis? Your sex partner(s) must be examined and treated. If not treated they can give the infection back to

    you, or infect others. Your syphilis blood test may stay positive (not normal) even after treatment.

    We will give you a card that shows proper treatment was given to cure your syphilis once your

    treatment is completed. You are no longer contagious once treatment is completed. You will need a

    repeat blood test one week after treatment, and then regularly during the first year of your diagnosis

    and treatment.

    How do I avoid getting syphilis? Plan ahead. Protect yourself. If you're thinking of having sex with a new partner: talk about STDs;

    talk about your wish to have protected, safer sex (male or female condoms); suggest an STD

    check-up for both of you before having sex.

     WARNING: HIV is also an STD. All STDs are spread by having unsafe sex. When you get infected with an STD, you could also be getting HIV. Protect yourself--use condoms (male or female).

    Dissemination Project Module 6, Appendix J Page J-9

    Trichomonas

Trichomonas is a Sexually Transmitted Disease (STD) caused by a protozoa. It infects both men

    and women, but causes more symptoms in women.

    How is trichomonas spread? Trichomonas, or "trich," is passed from one person to another during vaginal sex. We do not think

    that trichomonas can be passed through oral or anal sex. There are no good tests to look for

    trichomonas in the throat or in the rectum. There are also no good tests to look for trichomonas in

    men.

How do I know if I have it?

    Women:

    ? A yellow-green or gray, bubbly fluid from the vagina, that may have an unpleasant odor.

    Itching or burning on or around the vagina.

    ? Pain or burning with urination.

    ? Vaginal secretions (fluids) are examined under the microscope by a clinician to make the

    diagnosis.

    Men:

    ? Often men don't have any signs or problems and would not know they are infected.

    ? May have discomfort and itching in the penis, rarely discharge.

    ? Rarely, pain or burning with urination.

What can I do if I have trichomonas?

Your clinician will give you pills called metronidazole that will cure trichomonas. Your male partner(s)

    must be treated even though they may not have any symptoms. If you may be pregnant, tell your

    doctor. DO NOT drink any alcohol for 24 hours before and after taking metronidazole. It can cause

    nausea and vomiting. Avoid having vaginal sex for one week after you have completed treatment. If

    you do have sex, use a condom to avoid re-infection.

    How do I avoid getting trichomonas?

    Plan ahead. Protect yourself. If you're thinking of having sex with a new partner: talk about STDs;

    talk about your wish to have protected, safer sex (male or female condoms); suggest an STD

    check-up for both of you before having sex.

     WARNING: HIV is also an STD. All STDs are spread by having unsafe sex. When you get infected with an STD, you could also be getting HIV. Protect yourself--use condoms (male or female).

    USE CONDOMS to keep yourself COOL.

    You’re living in the HIV and STD HOT ZONE.

Page J-10 Module 6, Appendix J Dissemination Project

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