STDs, or STIs, remain a risky social concern

February 15, 2011

By Laura Geggel

Students typically learn about sexually transmitted infections starting in fifth grade, but many people, post-graduation, get no such reminder unless they get one.

Of course, the best way to avoid what people commonly call an STD, or STI, is to skip sex.

“Abstinence is the only 100 percent way to avoid an STI,” Victoria Fletcher, director of clinician services for Planned Parenthood, said. “Abstinence, or being in a long-term monogamous relationship, definitely has a place in preventing STIs.”

The sexually active can reduce the spread of a virus by using condoms, Overlake Medical Center Issaquah family medicine doctor Christy Gibson said. Receive free condoms this week, and any week, from Planned Parenthood in Issaquah, 75 N.W. Dogwood St., Suite B. The clinic is open on Monday, Wednesday and Thursday.

Many times, people will visit their doctor and asked to be tested for everything, Planned Parenthood Health Center Manager Annelise Ring said. Instead of going that route, she suggested patients talk about their risks with their physician.

“We try to whittle it down to what they really need, so they’re not paying for a bunch of stuff they don’t really need,” Ring said.

Human papilloma virus or HPV

The human papilloma virus is the most common type of STI in the country, with 20 million Americans already affected and 6 million more people infected annually, according to the Centers for Disease Control and Prevention.

HPV affects both men and women. The virus is passed through vigorous skin-to-skin contact and, “it can’t just be a gentle graze. It has to be prolonged contact,” Gibson said.

It usually affects the genital areas, but it can also affect other areas, including the mouth and throat.

In men and women, HPV can lead to warts, which doctors can freeze off or treat with medication.

“Genital warts are spread from skin-to-skin contact, so you can’t get it from the toilet seat,” Gibson said.

In women, HPV can also lead to cervical cancer, “and it is the first cancer that we actually have a prevention for,” Fletcher said.

There are more than 40 strains of HPV, and the vaccines target the most frequent. Gardasil, FDA approved for both men and women, protects against four strains, and Cervarix, approved for only for women, shields against two strains.

Women and men ages 11 to 26 are eligible for the vaccines. The one vaccine prevents against genital warts for men, and it also prevents them from passing the virus onto their female partners. For women, the vaccines prevent against the most common strains that cause warts and cervical cancer.

About 10,000 women develop cervical cancer annually, and 3,700 die from it.

Women can get tested for HPV by having pap smears, though 90 percent of the time the immune system naturally clears the virus within two years, Fletcher said. For more serious cases, doctors can do a colposcopy — using a microscope to look for visual abnormalities on the cervix. Treatments vary depending on the case.

In most instances, “men don’t know they’re carrying it and women don’t know they have it until they get that abnormal pap smear,” Gibson said.

Chlamydia

Chlamydia, the most common STI caused by bacterium, often has no symptoms, but can damage a woman’s reproductive system. It is spread through bodily fluids.

In 2008, 1.2 million cases in the country were reported to the CDC, with most of them affecting people ages 14 to 39. Young girls are more susceptible to the bacterium because the tissue in their cervix is immature and still developing, Fletcher said, recommending that sexually active people ages 14 to 25 get a Chlamydia test at least once per year.

In women, Chlamydia can cause chronic pelvic pain, or infertility if the bacterium travels into the cervix, uterus and fallopian tubes.

Doctors can test for the bacterium with a genital swab or a urine test.

In men, it can cause rectal pain, a burning sensation during urination, discharge or bleeding.

“The good news for Chlamydia — and this is why screening and testing is recommended — is that it’s easily treated with antibiotics,” Fletcher said.

Herpes

There are two types of herpes, and both of them are viruses that stay in the body forever.

Both types can cause blisters or cold sores on the genitals or elsewhere on the body.

Herpes is more contagious during outbreaks, but can be spread at any time. Some people take suppression therapy when they feel an outbreak approaching — they may feel itchy, for example — with the treatment reducing the length of the outbreak and the transmission of the virus.

With herpes, especially type 2, “what typically happens is you get a blister, and the blisters break open and ulcerate,” Fletcher said. “It’s usually quite painful.”

People with open herpes sores who are sexually active are more susceptible to other STIs, including HIV.

Doctors can take a sample of a blister during an outbreak. If a patient is between outbreaks, the physician can do a blood test to determine if a patient has type 2 herpes. About one in six people has herpes nationwide, according to the CDC.

Though the virus stays with people their whole lives, the body does get better at fighting it.

“You can have outbreaks of herpes over and over again over your whole lifetime,” Fletcher said, but “the frequency of outbreaks usually decreases.”

Other STIs are found in Issaquah, including gonorrhea, HIV, or Hepatitis B or C, but HPV, Chlamydia and herpes appear to be the most common.

Most major insurance companies will cover STI tests and treatment, but call your provider to learn more. Planned Parenthood can also give financial help for qualifying patients.

“Everybody has the opportunity to have an STI, so be careful and protect yourself and get tested,” Ring said.

Laura Geggel: 392-6434, ext. 241, or lgeggel@isspress.com. Comment at www.issaquahpress.com.

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