Recent studies have found a continual upward trend in infection rates amongst Young Men of Color who have Sex with Men (YMCSM) and Sexually Transmitted Diseases (STD) and Infections (STI). Compared to whites, men of color are twenty-four (24) times more likely to have gonorrhea and eight (8) times more likely to have syphilis.
Recent research has also highlighted increases in unprotected sex among some groups of men who have sex with men (MSM), as well as high rates of HIV co-infection among men diagnosed with syphilis (averaging about 50 percent).1 These findings, plus HIV surveillance data from a recent CDC 25-state study showing a 17.7% increase in HIV diagnoses among men who have sex with men between 1999 and 2002, have raised concerns about a resurgence of HIV in this population. Also noted are the physical changes caused by STDs, including genital lesions that can serve as an entry point for HIV and the presence of certain STDs can increase the chances of contracting HIV by three- to five-fold.2 Similarly, because co-infection with HIV and another STD can cause increased HIV shedding, a person who is co-infected has a greater chance of spreading HIV to others.
“Prevention challenges for gay and bisexual men of color may include a low level of concern about other STDs, as well as the belief that treatment advances mean HIV is no longer a deadly illness, resulting in relaxed attitudes toward safer sex practices,” said Dr. John Douglas, director of CDC’s STD prevention programs.
So in order to combat this resurgence and assist with the spreading of knowledge amongst the community of Young Men of Color who have Sex with men (YMCSM), People of Color in Crisis has compiled information on the following Sexually Transmitted Diseases and Infections:
• Chancroid
• Chlamydia
• Crabs (Pubic Lice)
• Giardiasis (Parasites)
• Genital Warts (HPV)
• Gonorrhea
• Hepatitis A, B, and C
• Herpes
• Scabies
• Syphilis
• Trichomoniasis (Trich)
Chancroid
What is Chancroid?
Chancroid is a bacterial infection that both men and women can get.
How is Chancroid Spread?
Chancroid is spread through contact with another person's chancroid sore during vaginal, anal, or oral sex.
What are the symptoms of chancroid?
Symptoms may include painful, draining, open sores on the skin and painful, swollen lymph nodes in the groin. Sores usually begin as tender red bumps 4 to 7 days after sexual contact with an infected person. These sores grow and deepen and may become very painful or bleed. If sores are in the rectum, there may be pain or bleeding with a bowel movement.
How will I know if I have chancroid?
Your doctor or other health-care provider will collect a sample of fluid from the sore with a small swab and have it tested at a laboratory.
How is chancroid treated?
Antibiotics can cure chancroid. After you've taken all your medication, you should see your doctor again to make sure the sores have healed and that the infection is completely cleared.
What happens if chancroid is left untreated?
Left untreated, chancroid can cause serious damage to the skin and genitals. Like other STDs, if left untreated, chancroid can also increase a person's chance of getting or spreading HIV. If you have symptoms or think you've been exposed to chancroid, get examined and treated immediately to avoid any complications.
Do sex partners have to be treated?
Yes. If you're diagnosed with chancroid, it's important to tell everyone you've had sex with over the past 10 days, so they can be examined and treated, too. Take all your medication as directed, even if you feel better before the medicine is finished. Don't have sex until you and the people you've had sex with have been completely treated and all symptoms have disappeared, or you could infect each other again.
How can I avoid chancroid?
Latex condoms may be helpful in preventing the spread of chancroid, but only when the infected area is covered or protected by the condom. If there is contact with an open sore, chancroid can be transmitted to areas not protected by a condom.
Chlamydia
What is Chlamydia?
Chlamydia is a bacterial infection. It is one of the most common sexually transmitted diseases (STDs) in New York City and around the country. Both men and women can get Chlamydia. Most cases occur in women, especially women aged 24 and younger. A young woman's cervix is more vulnerable to Chlamydia than an older woman's.
What causes Chlamydia?
Chlamydia is spread through contact with an infected person during vaginal, anal, or oral sex.
What are the symptoms of Chlamydia?
Many people with Chlamydia do not have symptoms. If symptoms ARE experienced, a woman may notice unusual vaginal discharge (drip), pain or bleeding during or after sex, and pain or burning during urination. A man may experience a clear, watery discharge from the penis that comes and goes, and pain or burning during urination. Chlamydial infection of the rectum can cause pain, rectal bleeding, pus or mucous discharge from the rectum or constipation. If you think you've been exposed to Chlamydia, your provider can do tests to see if you're infected, whether you have symptoms or not.
(Giving your doctor a chance to find infections that don't have symptoms is one reason it's so important to get regular check-ups, even when you're not feeling sick!)
How will I know if I have Chlamydia?
Your doctor or other health-care provider will collect a sample of fluid from the cervix, penis, rectum or mouth with a small swab and have it tested in the laboratory. Chlamydia can also be detected using a urine sample. Sexually active people aged 24 and younger should be tested at least once a year for Chlamydia, even if they have no symptoms.
How is Chlamydia treated?
Antibiotics can cure Chlamydia, often in a single dose. Because the risk of re-infection is high, women who have been treated for Chlamydia should be tested again 3 to 4 months after treatment is complete. A person can become re-infected after treatment if exposed to Chlamydia again.
What happens if Chlamydia goes untreated?
If left untreated, Chlamydia can spread and cause severe pain and permanent damage to the reproductive system. It may make both women and men infertile. In women, Chlamydia can lead to pelvic inflammatory disease (PID). PID may have no symptoms. When symptoms are experienced, they may include lower belly pain; cramping; burning during urination; pain or bleeding during or after vaginal sex; unusual vaginal discharge; nausea and vomiting, and fever. If left untreated, PID can make it difficult or impossible to get or stay pregnant. It can also lead to "tubal" (ectopic) pregnancies and long-term pelvic pain. Like other STDs, if left untreated, Chlamydia can increase a person's chance of getting or spreading HIV. If you have symptoms or think you've been exposed to Chlamydia, get examined and treated immediately to avoid any complications.
Do sex partners have to be treated?
Yes. If you're diagnosed with Chlamydia, it's important to tell everyone you've had sex with over the past 2 months, so they can be examined and treated, too. Take all your medication as directed, even if you feel better before the medicine is finished. Don't have sex until you and the people you've had sex with have been completely treated and all symptoms have disappeared, or you could infect each other again.
How can I avoid Chlamydia?
Sexually transmitted infections can be avoided by not having sex. If you are sexually active, you can reduce your risk of getting Chlamydia and most other sexually transmitted diseases (STDs), including HIV, by having sex only in a mutually monogamous relationship with a partner you are sure is not infected. If you are having sex outside of such a relationship, you can reduce your risk of STDs by:
1. Always using a latex condom (or other type of latex barrier) whenever you have
sex-vaginal, anal, or oral. Condoms made of "natural" materials, such as lambskin,
protect against pregnancy, but not against STDs. If you are allergic to latex, you can
use condoms made of polyurethane or other synthetic materials.
2. Limiting the number of people you have sex with. The more partners you have,
the higher your risk.
Crabs (Pubic Lice)
What are crabs?
Crabs (also called pubic lice) are small, wingless insects that infest pubic hair. Both men and women can get crabs.
What causes crabs?
Crabs are usually spread through sexual contact. They can also be spread through contaminated clothing and bedding.
What are the symptoms of crabs?
Symptoms; which usually appear within 5 days of being exposed, include itching in the groin area. The crabs look like small flakes of skin to the naked eye, but you can actually see the insects with a magnifying glass. You may also see white or gray dots in your pubic hair; those are louse eggs.
How will I know if I have crabs?
Your doctor or other health-care provider can tell if you have crabs by examining the infested area.
How are crabs treated?
Medicated creams and shampoos can cure crabs. Some of these treatments are available without a prescription at the drug store. Follow directions carefully. You do not need to shave your pubic hair to remove crabs.
Clothes, bedding, towels, and other items that may contain the lice should be machine washed and dried on a hot cycle setting, or dry-cleaned. Articles that cannot be washed can be sealed in a plastic bag for 72 hours. Fumigation of living areas is not necessary. A person can become re-infested after treatment if exposed to crabs again.
What happens if crabs go untreated?
In addition to the discomfort of the infestation, repeated scratching of the infested area can result in a serious skin infection. If you have symptoms or think you've been exposed to crabs, get examined and treated immediately to avoid any complications and continued transmission.
Do sex partners have to be treated?
Yes. If you're diagnosed with crabs, it's important to tell everyone you've had sex with recently, so they can be examined and treated, too. Take all your medication as directed, even if you feel better before the medicine is finished. Don't have sex until you and the people you've had sex with have been completely treated and all of your symptoms have disappeared, or you could infest each other again.
Household members, including children, should also be examined, even if they have no symptoms.
How can I avoid crabs?
Latex condoms may be helpful in preventing the sexual transmission of crabs, but only when the infestation is covered or protected by the condom. Infections that are sexually transmitted can be avoided by not having sex. If you are sexually active, you can reduce your risk of getting crabs and most other sexually transmitted diseases (STDs), including HIV, by having sex only in a mutually monogamous relationship with a partner you are sure is not infected. If you are having sex outside of such a relationship, you can reduce your risk of STDs by:
1. Always using a latex condom (or other type of latex barrier) whenever you
have sex-vaginal, anal, or oral. Condoms made of "natural" materials, such as
lambskin, protect against pregnancy, but not against STDs. If you are allergic to
latex, you can use condoms made of polyurethane or other synthetic materials.
2. Limiting the number of people you have sex with. The more partners you have,
the higher your risk.
Giardiasis (Parasites)
What is giardiasis?
Giardiasis, an intestinal illness, is caused by a microscopic parasite called Giardia lamblia. In 2001, there were 1,525 cases reported among New York City residents. (Rate of 19.0 cases per 100,000 persons.)
Who gets giardiasis?
Anyone can get giardiasis, but it tends to occur more often in people residing in institutional settings, diaper-aged children in day care centers, child care workers, foreign travelers, and individuals who drink improperly treated surface water (such as from lakes, rivers, or streams). Men who have sex with men may also be at increased risk of contracting giardiasis.
How is giardiasis spread?
The parasite is passed in the stool (feces) of an infected person or animal, and may contaminate soil, water, food or surfaces. Person-to-person transmission may occur in day care centers or other settings where hand washing practices are poor. Sexual practices which allow oral or hand contact with stool (feces) may result in spread.
Where are the Giardia parasites found?
Giardia has been found in infected people (with or without symptoms) and wild and domestic animals. The beaver has gained attention as a potential source of Giardia contamination of lakes, reservoirs, and streams, but human fecal wastes may just be as equal to blame.
What are the symptoms of giardiasis?
People exposed to giardia may experience mild or severe diarrhea, abdominal cramps, bloating, and fatigue. In some instances, infection may be completely asymptomatic, Fever is rarely present. Occasionally, chronic diarrhea may develop over several weeks or months, with significant weight loss. In otherwise healthy persons, symptoms may last for 2-6 weeks.
How soon after infection do symptoms appear?
The symptoms may appear from 3 to 25 days after exposure, but usually within 10 days.
How long can an infected person carry Giardia?
The carrier stage generally lasts from a few weeks to a few months. Treatment with specific antibiotics may shorten the carrier stage.
How is giardiasis diagnosed?
Examination of stool (feces) under a microscope is the most common way for a doctor to diagnose giardiasis. Sometimes, several stool samples obtained on different days are necessary, since the number of Giardia parasites shed in the stool (feces) vary from day to day.
What is the treatment for giardiasis?
Anti-infective drugs, such as metronidazole, quinacrine, or furazolidone are often prescribed by doctors to treat giardiasis. Drug resistance or relapse may occur with any drug. Some individuals may recover on their own without medications. Although giardia can infect all people, young children and pregnant women may be more susceptible to the dehydration caused by diarrhea and should drink plenty of fluids while ill.
Should an infected person be excluded from work or school?
Since the giardia parasite is passed in the stool (feces), only people with active diarrhea who are unable to control their bowel habits (e.g., infants, young children, and certain handicapped individuals) should be isolated. Most infected people may return to work or school when their stools become formed as long as they wash their hands thoroughly after using the toilet. Food handlers, children in day care, and health care workers must obtain approval from the Health Department before returning to their routine activities. This requires follow-up stool testing to be sure that they are no longer infectious.
How can giardiasis be prevented?
Avoid sexual practices that may result in hand or mouth contact with stool (feces), such as anal sex or oral-anal contact. Individuals who are infected with giardia should refrain from anal sex or oral-anal contact until effectively treated. If you have giardiasis, avoid swimming in recreational waters while experiencing diarrhea and for at least 2 weeks after the diarrhea stops. Giardia in your stool (Feces) can contaminate water for several weeks after your symptoms have ended.
Genital Warts (HPV)
What are genital warts?
Genital and anal warts are caused by a virus called human papillomavirus (HPV). HPV is the most common sexually transmitted disease in the United States, causing more than 5 million new infections each year. There are nearly 100 different strains of HPV. Some strains have been associated with cancers of the cervix, anus, and genital skin. The strains that cause cancer are generally different than the strains that cause genital warts. Both men and women can get HPV.
What causes genital warts?
HPV, the virus that causes genital warts, is spread through direct contact with an infected person during vaginal, anal, (and perhaps oral) sex. Many people infected with HPV have warts that are very small and hard to see, or they may have no warts at all. You can still pass HPV to your sex partners even if you have no visible warts.
What are the symptoms of genital warts?
Most people infected with HPV do not have warts or other symptoms. If symptoms are experienced, they may include warts in the genital or anal areas, which appear as fleshy bumps. Warts may also be hidden on the cervix, in the vagina, or in the rectum. Warts usually appear 1 to 3 months after contact with an infected person, but may take up to a year to appear.
How will I know if I have genital warts?
If you have genital warts, your doctor or other health-care provider can tell by examining the area visually. If you are infected with HPV but don't have warts, the diagnosis requires laboratory testing (such as a Pap test).
How are genital warts treated?
There is no single treatment that is best for all patients or all warts. Treatment depends partly on the size, number, and location of the warts. They can be removed from the skin with medicated creams and liquids, by freezing with liquid nitrogen, through surgery, or by laser treatment. Your provider will give you advice on the best treatment for you. Medications used to treat warts on the hands or feet should not be used to treat genital warts because they can be harmful to the genital skin. Warts may be more difficult to treat in persons with a weakened immune system, such as those with advanced HIV infection. Although warts can be removed, there is no cure for HPV infection.
What happens if genital warts go untreated?
Left untreated, genital warts can grow larger, bleed, and cause pain or itching. Rarely, genital warts result in cancer.
Do sex partners have to be treated?
If you're diagnosed with genital warts, it's important to tell everyone you've had sex with recently, so they can be evaluated for HPV and other STDS and treated appropriately. There is currently no widely available test to tell whether someone without visible warts or other symptoms is infected with HPV.
How can I avoid genital warts?
We do not know exactly how effective latex condoms are in preventing the spread of HPV. Sexually transmitted infections, including HPV, can be avoided by not having sex. If you are sexually active, you can reduce your risk of getting HPV and most other sexually transmitted diseases (STDs), including HIV, by having sex only in a mutually monogamous relationship with a partner you are sure is not infected. If you are having sex outside of such a relationship, you can reduce your risk of STDs by:
1. Always using a latex condom (or other type of latex barrier) whenever you have
sex-vaginal, anal, or oral. Condoms made of "natural" materials, such as lambskin,
protect against pregnancy, but not against STDs. If you are allergic to latex, you
can use condoms made of polyurethane or other synthetic materials.
2. Limiting the number of people you have sex with. The more partners you have,
the higher your risk.
Gonorrhea
What is gonorrhea?
Gonorrhea is a bacterial infection that both men and women can get.
What causes gonorrhea?
Gonorrhea is spread through contact with an infected person during vaginal, anal, or oral sex.
What are the symptoms of gonorrhea?
Many women with gonorrhea do not have symptoms. If symptoms ARE experienced, they may include inflammation of the reproductive system, rectum, or mouth, depending on where the infection is located. A woman may experience unusual vaginal discharge (drip), pain or bleeding during or after sex, and pain or burning during urination. A man may experience a thick, yellow or greenish discharge or pus from the penis, and pain or burning during urination. Gonorrhea infection of the rectum can cause pain, rectal bleeding, pus or mucous discharge from the rectum, or constipation. If you think you've been exposed to gonorrhea, your provider can do tests to see if you're infected, whether you have symptoms or not.
(Giving your doctor a chance to find infections that don't have symptoms is one reason it's so important to get regular check-ups, even when you're not feeling sick!)
How will I know if I have gonorrhea?
Your doctor or other health-care provider will collect a sample of fluid from the cervix, penis, rectum, or mouth with a small swab and have it tested at a laboratory. Gonorrhea can also be detected using a urine sample.
How is gonorrhea treated?
Antibiotics can cure gonorrhea, often in a single dose. A person can become re-infected after treatment if exposed to gonorrhea again.
What happens if gonorrhea goes untreated?
If left untreated, gonorrhea can spread and cause severe pain and permanent damage to the reproductive system or serious blood infection. It may make both women and men infertile. In women, gonorrhea can lead to pelvic inflammatory disease (PID). PID often has no symptoms, but when symptoms are experienced, they may include lower belly pain; cramping; burning during urination; pain or bleeding during or after intercourse; unusual vaginal discharge; nausea and vomiting, and fever. If left untreated, PID can make it difficult or impossible to get or to stay pregnant. It can also lead to "tubal" (ectopic) pregnancies and long-term pelvic pain. Like other STDs, if left untreated, gonorrhea can increase a person's chance of getting or spreading HIV. If you have symptoms or think you've been exposed to gonorrhea, get tested and treated immediately to avoid complications.
Do sex partners have to be treated?
Yes. If you're diagnosed with gonorrhea, it's important to tell everyone you've had sex with over past 2 months, so they can be examined and treated, too. Take all your medication as directed, even if you feel better before the medicine is finished. Don’t have sex until you and the people you've had sex with have been completely treated and all symptoms have disappeared, or you could infect each other again.
How can I avoid gonorrhea?
Sexually transmitted infections can be avoided by not having sex. If you are sexually active, you can reduce your risk of getting gonorrhea and most other sexually transmitted diseases (STDs), including HIV, by having sex only in a mutually monogamous relationship with a partner you are sure is not infected. If you are having sex outside of such a relationship, you can reduce your risk of STDs by:
1. Always using a latex condom (or other type of latex barrier) whenever you have
sex-vaginal, anal, or oral. Condoms made of "natural" materials, such as lambskin,
protect against pregnancy, but not against STDs. If you are allergic to latex, you can
use condoms made of polyurethane or other synthetic materials.
2. Limiting the number of people you have sex with. The more partners you have,
the higher your risk.
Hepatitis A (infectious hepatitis)
What is hepatitis A?
Hepatitis A (formerly known as infectious hepatitis) is a liver disease caused by the hepatitis A virus. The disease is fairly common, with 410 cases reported among New York City residents in 1999 (rate of 5.6 cases per 100,000 persons).
Who gets hepatitis A?
Anyone can get hepatitis A, but it occurs more frequently in children.
How is hepatitis A virus spread?
The hepatitis A virus enters through the mouth, multiplies in the body, and is passed in the stool (feces). The virus can then be carried on an infected person's hands and can be spread by direct contact, or by consuming food or drink that has been handled by the individual. In some cases, it can be spread by consuming water contaminated with improperly treated sewage. Sexual practices that allow oral or hand contact with stool (feces) may result in person to person transmission.
What are the symptoms of hepatitis A?
The symptoms of hepatitis A may include fatigue, poor appetite, fever and vomiting. Urine may become dark in color, and then jaundice ( yellowing of the skin and whites of the eyes) may appear. The disease is rarely fatal and most people recover in a few weeks without any complications. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults. Not everyone who is infected will have all of these symptoms.
How soon after infection do symptoms appear?
The symptoms may appear two to six weeks after exposure, but usually within three to four weeks.
For how long is an infected person able to spread the virus?
The contagious period begins about a week or so before the symptoms appear, and ends when the person develops jaundice.
Does past infection with hepatitis A make a person immune?
Once an individual recovers from hepatitis A, he or she is immune for life and does not continue to carry the virus.
How is hepatitis A diagnosed?
The diagnosis is based on a positive blood test for hepatitis A antibody.
What is the treatment for hepatitis A?
There are no special medicines or antibiotics that can be used to treat a person once the symptoms appear. Generally, bed rest is all that is needed.
How can hepatitis A be prevented?
To prevent person-to-person spread, careful hand washing after visiting the toilet or changing diapers is the single most important means of prevention. Avoid sexual practices that may result in hand or mouth exposure to stool (feces), such as anal sex or oral-anal contact. For close household or personal contacts of a patient with acute hepatitis A, a dose of immune globulin is recommended to minimize the risk of disease. For long term protection, immunization is recommended; the hepatitis A vaccine has been available since 1995.
Who should obtain the new hepatitis A vaccine?
The U.S. Centers for Disease Control and Prevention (CDC) recommends hepatitis A vaccine for:
• travelers to countries with high rates of hepatitis A;
• people living in communities with high rates of hepatitis A;
• people in certain outbreak settings;
• laboratory personnel who work with hepatitis A virus;
• sexually active homosexual/bisexual men;
• people with existing chronic liver disease;
• Injecting drug users.
The hepatitis A vaccine may also be used in certain outbreak situations where ongoing transmission is occurring. Although studies of certain occupational groups (for example, food service workers, health care workers, child care workers, sewage workers) have not shown an increased risk, such people may consider vaccination if they wish to further reduce their risk or are in communities where ongoing outbreaks are occurring.
Hepatitis B (serum hepatitis)
What is hepatitis B?
Hepatitis B (formerly known as serum hepatitis) is an infection of the liver caused by a blood borne virus. The disease is fairly common. In 2001, there were 661 acute cases reported among New York City residents (rate of 8.3 cases per 100,000 persons).
Who gets hepatitis B?
Anyone can get hepatitis B, but those at increased risk include:
• injecting drug users who share needles;
• health care workers who have contact with infected blood;
• persons having sexual contact (vaginal, oral, or anal) with a persons who is infected;
• homosexual or bisexual males, particularly those with multiple partners;
• people with multiple sexual partners;
• travelers to area of the world where hepatitis B is endemic if they are staying for
more than 6 months;
• people in custodial care (in settings such as developmental centers) or staff of
these facilities;
• hemodialysis patients;
• certain household contacts of an infected persons
(especially if they share personal items, such as razors or toothbrushes); and
• infants born to mothers who are hepatitis B carriers.
How is hepatitis B virus spread?
Hepatitis B virus can be found in the blood and, to a lesser extent, saliva, semen and other body fluids of an infected person. It is spread by direct contact with infected body fluids; usually by needle stick injury or sexual contact. Hepatitis B virus is not spread by casual contact.
What are the symptoms of hepatitis B?
The symptoms of hepatitis B include fatigue, poor appetite, fever, nausea, vomiting, diarrhea, joint pain, hives or rash. Urine may become darker in color, and then jaundice (a yellowing of the skin and whites of the eyes) may appear. Some people experience few or no symptoms.
How soon after infection do symptoms appear?
The symptoms appear two to six months after exposure, but usually within three months.
For how long is a person able to spread the hepatitis B virus?
The virus can be found in blood and other body fluids several weeks before symptoms appear and generally persists for several months afterward. Approximately 10 percent of infected people may become long-term carriers of the virus. Carriers may remain infectious for hepatitis B for years.
How is hepatitis B diagnosed?
Hepatitis B is diagnosed by a positive blood test for hepatitis B viral antigen or antibody.
What is the treatment for hepatitis B?
There are no special medicines or antibiotics that can be used to treat a person once the acute symptoms appear. Generally, bed rest is all that is needed. Chronic carriers of hepatitis B should seek consultation from a physician for medical follow-up.
What precautions should hepatitis B carriers take?
Hepatitis B carriers should follow standard hygienic practices to ensure that close contacts are not directly contaminated by his or her blood or other body fluids. Carriers must not share razors, toothbrushes, or any other object that could potentially become contaminated with blood. In addition, susceptible household members, particularly sexual partners, should be immunized with hepatitis B vaccine. It is important for carriers to inform their dentist and health care providers.
How can hepatitis B be prevented?
A vaccine to prevent Hepatitis B has been available for several years. The vaccine is given in 3 separate shots (you must have all 3 to be protected). It is safe, effective and is recommended for people in high-risk settings:
• injecting drug users who share needles;
• health care workers who have contact with infected blood;
• persons having sexual contact (vaginal, oral, or anal) with a persons who is infected;
• homosexual or bisexual males, particularly those with multiple partners;
• people with multiple sexual partners;
• travelers to area of the world where hepatitis B is endemic if they are staying for
more than 6 months;
• people in custodial care (in settings such as developmental centers) or staff of
these facilities;
• hemodialysis patients;
• certain household contacts of an infected persons
(especially if they share personal items, such as razors or toothbrushes); and
• infants born to mothers who are hepatitis B carriers.
It is also recommended that hepatitis B vaccine be universally administered to all children, along with their routine childhood immunizations beginning at birth or two months of age. A special hepatitis B immune globulin is also available for people who are exposed to the virus. In the event of exposure to hepatitis B, consult a doctor or the health department.
Hepatitis C
What is hepatitis C?
Hepatitis C (HCV), formerly called non-A, non-B hepatitis, is a blood-borne RNA virus that may lead to acute or chronic liver disease. The most common blood-borne infection in the United States, it is estimated that over 4 million persons in the United States (1.8% of the population) have been infected with hepatitis C, and between 8,000 - 10,000 American's will die this year from HCV-related complications.
Who gets hepatitis C?
Hepatitis C commonly occurs in people who have shared needles to inject drugs and in people who received a blood transfusion before 1992. People who are HIV positive may be at risk because of common risk factors for HCV and HIV.
How is hepatitis C virus spread?
Like hepatitis B, hepatitis C is spread by direct exposure to blood from an infected person, such as through sharing injection drug equipment. The risk of sexual transmission appears to be small. There is no evidence that the hepatitis C virus can be transmitted by casual contact, through foods or by coughing or sneezing. Transmission from mother to child appears to be uncommon.
What are the symptoms of hepatitis C?
Most people have no symptoms and don't feel sick until their liver disease is advanced, which can be 20 to 30 years after infection. However, some people experience appetite loss, fatigue, nausea and vomiting, vague stomach pain, and jaundice (a yellowing of the skin and whites of the eyes).
How soon after infection do symptoms occur?
Symptoms may occur from two weeks to six months after exposure but usually within two months. Because many people infected with hepatitis C do not feel sick, it is recommended that everyone who is at risk get tested. Everyone who has hepatitis C should seek medical care even if they don't have symptoms.
When and for how long is a person able to spread hepatitis C?
Some people carry the virus in their bloodstream and may remain contagious for years. The disease may be followed by complete recovery or it may become chronic and cause symptoms for years.
How is hepatitis C diagnosed?
Hepatitis C is diagnosed by a positive blood test for hepatitis C antibody. Testing is readily available and recommended for anyone at risk for infection.
What is the treatment for hepatitis C?
There are no special medicines or antibiotics that can be used to treat people with the acute form of hepatitis C. However, the FDA has approved a drug called recombinant alpha-interferon for treating people with chronic hepatitis C.
Is donated blood tested for the virus?
Since May 1990, blood donation centers throughout the United States have routinely used a blood donor screening test for hepatitis C. Widespread use of this test has significantly reduced the number of post-transfusion hepatitis C cases.
What are the possible consequences of hepatitis C?
Only one out of four of the people infected with hepatitis C virus will become sick with jaundice or other symptoms of hepatitis. 75% to 85% of all people infected may go on to develop chronic liver disease. Up to 20% of those may develop cirrhosis (serious scarring of the liver), and some may eventually die.
Does hepatitis C have anything to do with HIV?
In New York, 78% of people with HIV who report injecting drug use are also infected with HCV. Both HIV and HCV can be transmitted by blood-to-blood contact, and HCV is 10 times more infectious than HIV through contact such at sharing needles used for injecting drugs. People infected with both HIV and HCV can progress faster to cirrhosis and more liver damage than people who are infected with only hepatitis C, and it appears that HCV may accelerate HIV disease, although this is still being studied.
How can hepatitis C be prevented?
People who have had hepatitis C should be aware that their blood and possibly other body fluids are potentially infectious. Therefore, infected persons should avoid sharing toothbrushes, razors, needles, etc. In addition, infected people must not donate blood and should inform their dental or medical care providers so that proper precautions can be followed. The risk of sexual transmission of hepatitis C virus has not been thoroughly investigated but appears to be minimal. Several studies suggest that spread seldom occurs from people with chronic hepatitis C disease to their steady sexual partners. Therefore, limitations on sexual activity with steady partners may not be needed. However, people with acute illness and multiple sexual partners may be at greater risk and should use condoms to reduce the risk of acquiring or transmitting the hepatitis C virus, as well as other sexually transmitted infections.
Is there a vaccine for hepatitis C?
At the present time, there is NO vaccine for hepatitis C.
Herpes
What is herpes?
Genital herpes is caused by sexually transmitted viruses called herpes simplex. Herpes is extremely common: as many as 1 out of every 5 people in the United States is infected with the virus that causes ano-genital herpes, and only about 20% of those who are infected know they have it. Both men and women can get herpes.
How is herpes spread?
Herpes is spread through direct, skin-to-skin contact with an infected person. Often the contact occurs during vaginal, anal, or oral sex. A person with a cold sore can pass herpes to the mouth of a sex partner by kissing or to the genitals of a sex partner during oral sex. Herpes virus may be shed from the skin even without blisters or sores; therefore it may be passed even when the skin looks normal. It is especially easy to contract the virus if there is direct contact with sores, but it is also possible to become infected even if no sores are present on an infected partner.
What are the symptoms of herpes sores?
When experienced, symptoms of herpes may include repeated outbreaks of painful blisters or sores on the skin that scab over and heal without scars. Blisters may also be hidden in the vagina. During your first herpes outbreak, you may also experience swollen glands, muscle aches, headache, fever, and pain or difficulty during urination. This first outbreak usually occurs 2 to 12 days after infection. Blisters or sores may return periodically but are usually less severe and heal more quickly than the first outbreak. Recurrent outbreaks may begin with itching or burning on the skin in the area where blisters or sores are about to appear.
How will I know if I have herpes?
Your doctor or other health-care provider will collect a sample of fluid with a small swab or take a scraping from a blister or sore during an exam and have it tested at a laboratory. Some facilities may be able to diagnose herpes using blood tests.
How is herpes treated?
There are medications that can shorten herpes outbreaks, relieve discomfort, and make transmission less likely. Medication can also be taken on a daily basis to decrease the number of outbreaks a person has. Although herpes outbreaks are treatable, there is no cure for the herpes virus infection.
What happens if herpes is left untreated?
Discomfort and inconvenience are usually the worst problems associated with herpes. People with a weakened immune system, such as those with advanced HIV infection, may have more severe outbreaks and complications. Like other STDs, if left untreated, herpes can increase a person's chance of getting or spreading HIV. If you have symptoms, get examined as soon as possible to avoid any complications and discuss treatment options.
Do I need to tell my sex partners?
Yes. If you're diagnosed with herpes, it's important to tell everyone you've recently had sex with, so they can be examined for signs of herpes.
How can I avoid herpes?
Latex condoms may be helpful in preventing the spread of genital herpes, but only when the infected area is covered or protected by the condom. If there is contact with an open sore, herpes can be transmitted to areas not protected by a condom. A person with herpes should not have sex when a herpes sore is present on the mouth, genitals, anus, or buttocks.
Scabies
What is scabies?
Scabies is an itchy skin condition caused by mites, tiny insects that burrow their way under the skin. The mite feeds on human blood and lays eggs under the skin. Both men and women can get scabies.
How is scabies spread?
Scabies is spread through close person-to-person contact between sex partners or among people who live in the same household. Scabies mites can also be spread through contaminated clothing and bedding.
What are the symptoms of scabies?
Symptoms may include itching in the infested area, especially at night. This is the result of the body's allergic reaction to the mites, their eggs, and their waste products. The first time a person is ever infested, symptoms usually begin 3 to 4 weeks after exposure. People who have been infested with scabies in the past may develop symptoms much more quickly when re-infested, usually within 24 hours after exposure. Bumps may appear on the external genitals, between the fingers, and in skin folds such as the inside of the wrist and elbow, the buttocks, and in the creases of the groin. The bumps may become inflamed, crusty, or hard.
How will I know if I have scabies?
Your doctor or other health-care provider can tell if you have scabies by examining the infested area.
When and for how long is a person able to spread scabies?
A person is able to spread scabies until mites and eggs are destroyed by treatment.
How is scabies treated?
Medicated creams and lotions can cure scabies. Although the mites themselves will be dead at the end of treatment, itching may continue for a few more weeks because of the body's continuing allergic reaction. If symptoms continue for more than 2 weeks after being treated, you should see your provider again. Clothes, bedding, towels, and other items that may contain the mites should be machine-washed and dried on a hot cycle setting, or dry-cleaned. Articles that cannot be washed can be sealed in a plastic bag for 72 hours. Fumigation of living areas is not necessary.
A person can become re-infested after treatment if exposed to scabies again.
What happens if scabies is left untreated?
In addition to the discomfort of the infestation, repeated scratching of the infested area can result in a serious skin infection. If you have symptoms or think you've been exposed to scabies, get examined and treated immediately to avoid any complications. People with a weakened immune system, such as persons with advanced HIV infection, are at higher risk for crusted scabies, a serious skin infection that is more difficult to treat.
Do sex partners have to be treated?
Yes. If you're diagnosed with scabies, it's important to tell everyone you've had sex with during the past 6-weeks, so they can be examined and treated, too. Take all your medication as directed, even if you feel better before the medicine is finished. Don't have sex until you and the people you've had sex with have been completely treated and all of your symptoms have disappeared, or you could infest each other again.
Household members, including children, should also be examined, even if they have no symptoms.
How can I avoid scabies?
Latex condoms may be helpful in preventing the sexual transmission of scabies, but only when the infested area is covered or protected by the condom.
Infections that are sexually transmitted can be avoided by not having sex. If you are sexually active, you can reduce your risk of getting sexually transmitted diseases (STDs), including HIV, by having sex only in a mutually monogamous relationship with a partner you are sure is not infected. If you are having sex outside of such a relationship, you can reduce your risk of STDs by:
1. Always using a latex condom (or other type of latex barrier) whenever you
have sex-vaginal, anal, or oral. Condoms made of "natural" materials, such as
lambskin, protect against pregnancy, but not against STDs. If you are allergic
to latex, you can use condoms made of polyurethane or other synthetic materials.
2. Limiting the number of people you have sex with. The more partners you have,
the higher your risk.
Syphilis
What is syphilis?
Syphilis is a bacterial infection that both men and women can get. In New York and other cities, syphilis cases have increased recently among men, especially men who have sex with men, many of whom are HIV-infected. For this reason, it is recommended that men who have sex with men and men who are HIV -infected be tested for syphilis and other sexually transmitted diseases (STDs) regularly. Women engaging in high-risk sexual behavior should also be screened for syphilis.
How is syphilis spread?
Syphilis is spread through direct, skin-to-skin contact with a syphilis sore, lesion, or moist rash. Usually the contact occurs during vaginal, anal, or oral sex. Other intimate contact, such as kissing, can spread syphilis if syphilis sores are present in the mouth or on the lips. Syphilis can also be passed from a woman to her unborn baby.
What are the symptoms of syphilis?
Most people with syphilis infection have no recognizable symptoms. If symptoms ARE experienced, they can include rashes (especially on the palms of the hands and soles of the feet). Painless, open sores called chancres (pronounced "shankers") can appear on the penis, the anus, inside or outside the vagina, on the mouth or lips, or on any skin exposed during sex. Other symptoms include patchy hair loss, fever, swollen lymph glands, muscle aches, and fatigue. Symptoms (when they are noticed) usually last several weeks and disappear, even without treatment. Although the symptoms go away, syphilis infection remains in the body. If left untreated, over the years, syphilis can permanently and seriously damage the heart, brain, and nervous system.
How will I know if I have syphilis?
Since most people with syphilis don't have symptoms, the best way to find out is to get a blood test. (Giving your doctor a chance to find infections that don't have symptoms is one reason it's so important to get regular check-ups, even when you're not feeling sick!) If you have a sore or a rash, your doctor or other health-care provider may also collect a sample of fluid from the skin or sore with a small swab during an exam and have it tested at a laboratory.
How is syphilis treated?
Antibiotics can cure syphilis, often in a single dose. To be cured, however, syphilis must be treated early, before permanent damage occurs. Long-term damage caused by syphilis (years after exposure) cannot be cured. A person can become re-infected after treatment if exposed to syphilis again.
What happens if syphilis is left untreated?
Even though the outward symptoms of syphilis disappear without treatment, the infection itself remains in the body. Left untreated, syphilis can cause very serious and permanent damage to the heart, brain, and nervous system. The results of this damage may not show up for many years. The final result may be death.
Like other STDs, if left untreated, syphilis can increase a person's chance of getting or spreading HIV. If you have symptoms or think you've been exposed to syphilis, get examined and treated immediately to avoid any complications.
Do sex partners have to be treated?
Yes, if you're diagnosed with syphilis, it's important to tell everyone you've had sex with over the past year, so they can be examined and treated, too. Take all your medication as directed, even if you feel better before the medicine is finished. Don't have sex until you and the people you've had sex with have been completely treated and all of your symptoms have disappeared, or you could infect each other again.
How can I avoid syphilis?
Latex condoms may be helpful in preventing the spread of syphilis, but only when the infectious area is covered or protected by the condom. Anytime a person has skin-to-skin contact with a syphilis sore or rash on the penis, in the rectum, in the vagina, in the mouth or elsewhere on the body, it is possible to get syphilis.
Trichomoniasis (Trich)
What is trichomoniasis?
Trichomoniasis, sometimes referred to as "trich," is a common sexually transmitted disease (STD) that affects 2 to 3 million Americans yearly. It is caused by a single-celled protozoan parasite called Trichomonas vaginalis. Trichomoniasis is primarily an infection of the urogenital tract; the urethra is the most common site of infection in man, and the vagina is the most common site of infection in women.
How is trichomoniasis spread?
Trichomoniasis is a bacterial infection that both men and women can get during vaginal, anal, or oral sex. Women engaging in high-risk sexual behavior should also be screened for trichomoniasis.
What are the symptoms of trichomoniasis?
Trichomoniasis, like many other STDs, often occurs without any symptoms. Men almost never have symptoms. When women have symptoms, they usually appear within four to 20 days of exposure. The symptoms in women include a heavy, yellow-green or gray vaginal discharge, discomfort during intercourse, vaginal odor, and painful urination. Irritation and itching of the female genital area, and on rare occasions, lower abdominal pain also can be present. The symptoms in men, if present, include a thin, whitish discharge from the penis and painful or difficult urination.
How will I know if I have trichomoniasis?
Diagnosis is made by collecting specimens from the urethra. No diagnostic test is 100% accurate; mistakes can be made. Your health care provider may order additional testing to confirm the diagnosis.
How is trichomoniasis treated?
Because men can transmit the disease to their sex partners even when symptoms are not present, it is preferable to treat both partners to eliminate the parasite. Metronidazole is the drug used to treat people with trichomoniasis. It usually is administered in a single dose. People taking this drug should not drink alcohol because mixing the two substances occasionally can cause severe nausea and vomiting.
Do sex partners have to be treated?
All sexual partners should be treated at the same time. Use a latex condom or avoid having sexual intercourse to prevent re-infection during treatment.
How can I avoid trichomoniasis?
Use of male condoms may help prevent the spread of trichomoniasis, although careful studies have never been done that focus on how to prevent this infection.
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