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Comprehensive Sexually Transmitted Disease (STD) Panel

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HealthCheckUSA has packages that make it simple for consumers to measure, monitor, and improve their health by being able to order their own lab tests without a doctor’s order. HealthCheckUSA serves customers without insurance, have high deductible insurance plans, and taking control of their health because their doctor won’t order the test.

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Posted by David | Posted on 26-08-2009

HealthCheckUSA Health Alert: STD Testing Recommendations Part 2

Category : std testing

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STD Lab Testing Recommendations: Part 2

By Mayo Clinic staff

Testing for a disease in someone who doesn’t have symptoms is called screening. Most of the time, STD screening is not a routine part of health care. But there are exceptions:

Everyone:
The one STD screening test suggested for everyone between the ages of 13 and 65 is a blood test or saliva test for human immunodeficiency virus (HIV), the virus that causes AIDS. Most health care settings in the United States offer a rapid HIV test with same-day results.

STD Screening for HIV, hepatitis B, Chlamydia, gonorrhea and syphilis generally takes place at the first prenatal visit. A blood test to detect HSV type 2 infections is recommended for pregnant women with current or past partners who have genital herpes.

Comprehensive Sexually Transmitted Disease (STD) Panel

Young Women who are Sexually Active:
All sexually active women under age 25 should be tested for Chlamydia infection. The Chlamydia STD test uses a sample of urine or vaginal fluid you can collect yourself. Some experts recommend repeating the Chlamydia STD test three months after you’ve had a positive test and been treated. The second STD test is needed to confirm that the infection is cured, as reinfection by an untreated or undertreated partner is common. A bout of Chlamydia doesn’t protect you from future exposures. You can catch the infection again and again, so you should get retested when you have a new partner.

Women ages 21 to 66:
The Pap test screens for cervical abnormalities, including inflammation, precancerous changes and cancer, which is caused by certain strains of human papillomavirus (HPV). From ages 21 to 66, women should have a Pap test at least every three years. Women who start having sex before age 21 should have a Pap test within three years of first intercourse.

Men who have sex with men:
Compared with other groups, men who have sex with men run a much higher risk of catching STDs. Many public health groups recommend annual or more frequent STD testing for these men. Regular tests for HIV, herpes, gonorrhea, Chlamydia and syphilis are particularly important.

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People with HIV:
If you have HIV, it dramatically raises your risk of catching other STDs. Experts recommend frequent syphilis, gonorrhea, Chlamydia and herpes STD tests for people with HIV. Women with HIV may develop aggressive cervical cancer, so they should have Pap tests twice a year to screen for HPV. Some experts also recommend regular HPV STD screening of HIV-infected men who risk anal cancer from HPV contracted anally.

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Vaccination for STDs
Vaccines are available to prevent two viral STDs that can cause cancer — human papillomavirus (HPV) and hepatitis B. The HPV vaccine is recommended for all girls between ages 9 and 26, and the hepatitis B vaccine is usually given to newborns.

Partner notification and preventive treatment
If STD lab tests show that you have an STD, your sex partners — including your current partners and any other partners you’ve had over the last three months to one year — need to be informed so that they can get STD lab tested and treated if infected. Public health regulations require doctors to report all cases of syphilis and HIV to the local or state health department, which employs trained disease intervention specialists who will work with you — and sometimes with your doctor — to identify your partners, inform them of their exposure and get them tested and treated. In some states and counties, the health department also notifies partners exposed to gonorrhea and Chlamydia.

Official, confidential partner notification effectively limits the spread of STDs, particularly syphilis and HIV. The practice also steers those at risk toward appropriate counseling and treatment. Finally, since you can contract some STDs more than once, partner notification reduces your risk of getting reinfected.

Depending on your circumstances, you might prefer to be the one who breaks the bad news to your partner, and that’s certainly an option. Your disease intervention specialist may help you prepare and make a contract with you to go through with the conversation within a set amount of time. If your partner hasn’t been treated by that time, the health department picks up with its usual partner notification procedure.

In an approach called expedited partner treatment, the staff at an STD clinic will treat an exposed partner without doing a full medical evaluation. When you’re diagnosed with Chlamydia, gonorrhea or trichomoniasis, your doctor may prescribe enough medication to treat both you and your partner. This approach is called patient-delivered partner treatment.

Safer sex
Thanks to improved STD lab testing and treatment, most people with access to health care no longer face all the dreadful consequences of STDs. Still, there is no room for complacency. One risky encounter is unlikely to cost you your life, but it could really mess up your future. These guidelines offer the greatest possible margin of safety.
• Don’t have sex in any way that puts you and your partner in direct contact with each other’s blood, semen or other body fluids.
• Avoid vaginal and anal intercourse with new partners until you have both been tested for STDs. Oral sex is less risky, but use a latex condom or dental dam to prevent direct contact between the oral and genital mucosa.
• Use a latex condom every time you have intercourse.
• Never use an oil-based lubricant, such as petroleum jelly, with a latex condom.
• Don’t drink alcohol or use drugs. If you’re under the influence, you’re more likely to take sexual risks.
• Don’t look for sex partners online or in bars or other pickup places.
• Before any serious sexual contact, communicate with your partner about practicing safer sex. Reach an explicit agreement about what activities will and won’t be OK.
• Stay with one sex partner who doesn’t have any STDs and who won’t have sex with anyone but you.

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Posted by David | Posted on 25-08-2009

HealthCheckUSA STD Alert: STDs and Common Symptoms

Category : std testing

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STD Testing Recommendations: 7 STDs and Common Symptoms

By Mayo Clinic staff

If you’re having sex, you may also be experiencing STD symptoms. STD symptoms can occur regardless of what type of sex — vaginal, oral or anal — you’re having, or whether you use condoms. Although condoms when correctly and consistently used are highly effective for reducing transmission of STDs, no method (other than abstinence) is 100 percent effective. This is particularly true with certain STDs, such as genital warts and genital herpes.

STD symptoms can range from subtle to obvious. If you think you’re experiencing STD symptoms, see a doctor to get tested for STDs. Some STD symptoms can be treated easily and eliminated. Other STD symptoms require more involved and long-term treatment.

Either way, it’s essential to be STD tested via blood or urine, and — if diagnosed with an STD — be treated. It’s also essential to inform any partners so that they can be evaluated and treated. If untreated, STDs can increase your risk of acquiring another STD such as HIV. This happens because an STD can stimulate an immune response in the genital area or cause sores, either of which might make HIV transmission more likely. Some untreated STDs can also lead to infertility.

Common STDs and their Symptoms

Chlamydia
Chlamydia is a bacterial infection of your genital tract. Chlamydia may be difficult for you to detect because early-stage infections often cause few or no signs and symptoms. When they do occur, they usually start one to three weeks after you’ve been exposed to Chlamydia. Even when signs and symptoms do occur, they’re often mild and passing, making them easy to overlook.

Signs and symptoms may include:
• Painful urination
• Lower abdominal pain
• Vaginal discharge in women
• Discharge from the penis in men
• Painful sexual intercourse in women
• Testicular pain in men

Gonorrhea
Gonorrhea is a bacterial infection of your genital tract. The first gonorrhea symptoms generally appear within two to 10 days after exposure. However, some people may be infected for months before signs or symptoms occur. Signs and symptoms of gonorrhea may include:
• Thick, cloudy or bloody discharge from the penis or vagina
• Pain or burning sensation when urinating
• Frequent urination
• Pain during sexual intercourse

HIV
HIV is an infection with the human immunodeficiency virus. HIV interferes with your body’s ability to effectively fight off viruses, bacteria and fungi that cause disease, and it can lead to AIDS, a chronic, life-threatening disease.

When first infected with HIV, you may have no symptoms at all. Some people develop a flu-like illness, usually two to six weeks after being infected. Early HIV symptoms may include:
• Fever
• Headache
• Fatigue
• Swollen lymph glands
• Rash

These early symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection. During this period, you are very infectious. More persistent or severe symptoms of HIV infection may not appear for 10 years or more after the initial infection.

As the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic symptoms such as:
• Swollen lymph nodes — often one of the first signs of HIV infection
• Diarrhea
• Weight loss
• Fever
• Cough and shortness of breath

Signs and symptoms of later stage HIV infection include:
• Persistent, unexplained fatigue
• Soaking night sweats
• Shaking chills or fever higher than 100 F (38 C) for several weeks
• Swelling of lymph nodes for more than three months
• Chronic diarrhea
• Persistent headaches

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Genital herpes
Genital herpes is highly contagious and caused by a type of the herpes simplex virus (HSV). HSV enters your body through small breaks in your skin or mucous membranes. Most people with HSV never know they have it, because they have no signs or symptoms. The signs and symptoms of HSV can be so mild they go unnoticed. When signs and symptoms are noticeable, the first episode is generally the worst. Some people never experience a second episode. Other people, however, can experience episodes over a period of decades.

When present, genital herpes symptoms may include:
• Small, red bumps, blisters (vesicles) or open sores (ulcers) in the genital, anal and nearby areas
• Pain or itching around your genital area, buttocks or inner thighs

The initial symptom of genital herpes usually is pain or itching, beginning within a few weeks after exposure to an infected sexual partner. After several days, small, red bumps may appear. They then rupture, becoming ulcers that ooze or bleed. Eventually, scabs form and the ulcers heal.

In women, sores can erupt in the vaginal area, external genitals, buttocks, anus or cervix. In men, sores can appear on the penis, scrotum, buttocks, anus or thighs, or inside the urethra, the tube from the bladder through the penis.

While you have ulcers, it may be painful to urinate. You may also experience pain and tenderness in your genital area until the infection clears. During an initial episode, you may have flu-like signs and symptoms, such as headache, muscle aches and fever, as well as swollen lymph nodes in your groin.
In some cases, the infection can be active and contagious even when sores aren’t present.

Genital warts (HPV infection)
Genital warts, caused by the human papillomavirus (HPV), are one of the most common types of STDs. The signs and symptoms of genital warts include:
• Small, flesh-colored or gray swellings in your genital area
• Several warts close together that take on a cauliflower shape
• Itching or discomfort in your genital area
• Bleeding with intercourse
Often, however, genital warts cause no symptoms. Genital warts may be as small as 1 millimeter in diameter or may multiply into large clusters.
In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum or the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sex with an infected person.

Hepatitis
Hepatitis A, hepatitis B and hepatitis C are all contagious viral infections that affect your liver. Hepatitis B and C are the most serious of the three, but each can cause your liver to become inflamed.

Some people never develop signs or symptoms. But for those who do, symptoms may occur after several weeks and may include:
• Fatigue
• Nausea and vomiting
• Abdominal pain or discomfort, especially in the area of your liver on your right side beneath your lower ribs
• Loss of appetite
• Fever
• Dark urine
• Muscle or joint pain
• Itching
• Yellowing of your skin and the whites of your eyes (jaundice)

Syphilis
Syphilis is a bacterial infection. The disease affects your genitals, skin and mucous membranes, but it may also involve many other parts of your body, including your brain and your heart.

The signs and symptoms of syphilis may occur in four stages — primary, secondary, latent and tertiary.

Primary
These signs may occur from 10 days to three months after exposure:
• A small, painless sore (chancre) on the part of your body where the infection was transmitted, usually your genitals, rectum, tongue or lips. A single chancre is typical, but there may be multiple sores.
• Enlarged lymph nodes.
Signs and symptoms of primary syphilis typically disappear without treatment, but the underlying disease remains and may reappear in the secondary or third (tertiary) stage.

Secondary
The signs and symptoms of secondary syphilis may begin two to 10 weeks after the chancre appears, and may include:
• Rash marked by red or reddish-brown, penny-sized sores over any area of your body, including your palms and soles
• Fever
• Fatigue and a vague feeling of discomfort
• Soreness and aching
These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year.

Latent
In some people, a period called latent syphilis — in which no symptoms are present — may follow the secondary stage. Signs and symptoms may never return, or the disease may progress to the tertiary stage.

Tertiary
Without treatment, syphilis bacteria may spread, leading to serious internal organ damage and death years after the original infection.
Some of the signs and symptoms of tertiary syphilis include:
• Neurological problems. These may include stroke and infection and inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis). Other problems may include poor muscle coordination, numbness, paralysis, deafness or visual problems. Personality changes and dementia also are possible.
• Cardiovascular problems. These may include bulging (aneurysm) and inflammation of the aorta — your body’s major artery — and of other blood vessels. Syphilis may also cause valvular heart disease, such as aortic valve problems.
If you suspect you have an STD, see your doctor.

If you suspect you have these or other STDs or that you may have been exposed to one, see your doctor for STD testing. Timely diagnosis and treatment are important to avoid or delay more severe, potentially life-threatening health problems and to avoid infecting others.

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Posted by David | Posted on 19-08-2009

HealthCheckUSA Health Alert: STD Testing Recommendations

Category : Blood Testing, std testing

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STD Testing Recommendations: Part 1

By Mayo Clinic staff , Mary Gallenberg, M.D.

STD testing: What to know before your appointment
Not all doctors perform the same lab tests for sexually transmitted diseases, known as STD testing. Learn which STD lab tests you may need, which you might have to ask for and the limitations of STD testing.

If you’re sexually active, particularly with multiple partners, you’ve probably heard the following advice many times — use protection and make sure you and your partners receive routine STD testing. But what’s included in routine STD testing? Not all doctors test for the same STDs. And some STDs — some of which can’t be fully prevented by condom use — can’t be tested for. So even if you ask your doctor to test you for everything, this doesn’t mean that you or your partner will be screened for or clear of all STDs.

The only way to fully protect yourself against STDs is to abstain from sex. However, if you’ve decided to be sexually active, routine STD testing is important to managing your health. Mary Gallenberg, M.D., a specialist in obstetrics and gynecology at Mayo Clinic, Rochester, Minn., helps clarify what kinds of STD tests are important and how to ensure you get them.

If you’re sexually active, what routine STD lab tests are most important?

STD Lab Testing For Women:
At a minimum, get a Pap smear — a simple procedure that collects cells from your cervix to test for cancer or precancerous changes. This type of cancer can arise as a result of a human papillomavirus (HPV) infection — a common STD. Pap smears are recommended for women who are age 21 and older or no later than three years after a woman’s first intercourse. If you’re a woman between age 30 and 69, you may only need a Pap smear every two to three years if you’ve had three normal Pap smears in a row and have had no new sexual partners.

STD Lab Testing For Men:
Centers for Disease Control and Prevention (CDC) guidelines don’t suggest routine STD screening if you don’t have any symptoms, unless your sexual practices include having sex with men.

If you are a man who has sex with men, annual screening for HIV, syphilis, Chlamydia and gonorrhea is recommended. HIV and syphilis can be life-threatening if untreated, and Chlamydia and gonorrhea can put you at greater risk of acquiring HIV and other STDs.

STD Lab Testing For Men and Women:
Also see your doctor for STD testing if you have any signs such as genital sores, including fluid-filled blisters, ulcerations or warts, or if you have unusual discharge from your penis or vagina. If you’re a woman, abdominal pain or fever along with unusual discharge may indicate pelvic inflammatory disease (PID) — an STD-related condition that can cause infertility.

The CDC also encourages voluntary HIV testing, at least once, as a routine part of medical care if you are an adolescent or adult between the ages of 13 to 64. The CDC advises yearly HIV testing if you are at high risk of infection, for example if you’ve had unprotected sex with more than one sexual partner since your last screening.

What other STD testing do you recommend?
First, don’t assume that during an annual exam or Pap smear that you’re also receiving STD testing. This may not be the case. If you think you need STD testing, you must request it from your doctor. Talk to your doctor about your concerns and what tests you’d like or need.

Gonorrhea and Chlamydia STD Testing
If you are a sexually active girl or woman under age 24, or a woman older than 24 and at risk of STDs — for example you are having sex with a new partner or multiple partners — get screened annually for gonorrhea and Chlamydia. If untreated, these infections can cause PID in women. Gonorrhea and Chlamydia can also significantly increase your risk of acquiring other STDs like HIV. If you are a man who has sex with men, get tested for these infections at least annually.
Gonorrhea and Chlamydia screening is either done through a urine test or through a swab inside the penis in men or from the inside of the cervix in women. The sample is then analyzed in a laboratory. Screening is important, because you can be unaware that you have either infection. For example, approximately 80 percent of women and 50 percent of men diagnosed with Chlamydia don’t have symptoms at the time of diagnosis.

Syphilis, hepatitis and HIV STD Testing
If you test positive for gonorrhea or Chlamydia, you’re at greater risk of other STDs such as syphilis, HIV and hepatitis and should get tested for these infections.

In addition, request HIV, syphilis and hepatitis testing if you:
• Have had more than one sexual partner since your last screening
• Use IV drugs
• Are a man who has sex with men
• Are concerned you’ve been exposed

Your doctor tests you for syphilis by taking either a blood sample or a swab from any genital sores you might have. The sample is examined in a laboratory. A blood sample is taken to test for HIV and hepatitis A and B.

It’s possible that you may test negative for syphilis or HIV if you’ve only just recently acquired the infection. If you or your doctor suspects this is the case, you may need to be rescreened at a later date. Talk with your doctor if you have concerns about this.
Consider vaccination for hepatitis A and B. You can prevent these infections by receiving the vaccines.

What about other common STDs like genital herpes and human papillomavirus (HPV) infection?

Genital herpes and STD Testing
Unfortunately, no good screening STD test exists for herpes, a viral infection that can be transmitted even when a person doesn’t have symptoms. Your doctor may take a tissue scraping or culture of blisters or early ulcers, if you have them, for examination in a laboratory. But a negative test doesn’t rule out herpes as a cause for genital ulcerations.

A blood test may also help detect a herpes infection, but, again, results aren’t always conclusive, particularly if you’re not experiencing signs and symptoms of an active stage. Some blood tests don’t distinguish between types 1 and 2 of the herpes virus. Type 1 is the virus that more typically causes cold sores, although it can also cause genital sores. Type 2 is the virus that more typically causes genital sores. You may ask for a “type-specific” IgG blood test, which differentiates between the two, measuring antibodies to the viruses in your blood. Still, the results may not be totally clear, depending on the sensitivity of the test and the stage of the infection. False-positive and false-negative results are possible.

HPV STD Testing
HPV, an infection that can be transmitted even when a person doesn’t have symptoms, is a condition contracted from one of a group of more than 100 related human papillomaviruses (HPVs). Some of the viruses cause cervical cancer, others cause genital warts. Some never cause any problems. At least 50 percent of sexually active men and women will acquire an HPV infection within their lives, and that number jumps to 80 percent of women by age 50.

Being infected with certain types of HPV is the most important risk factor for developing cervical cancer. Women over age 30 may choose to receive a Pap test (to test for cervical cancer) every three years along with a human papillomavirus (HPV) DNA test. The HPV test is collected with a brushing from the cervical canal. Women with both a negative Pap test and a negative HPV DNA test are at low risk of developing significant precancerous changes of the cervix over the next three years. The combination of Pap smear and HPV DNA testing is not Food and Drug Administration (FDA) approved for screening women younger than 30 because HPV infections that will ultimately clear up on their own are more common in this age group, and a positive test result may lead to unnecessary additional testing and treatment.

The HPV DNA test can test for both low-risk types of HPV, which may cause genital warts, and high-risk types that may cause cervical cancer. Your doctor may recommend testing only for the high-risk types because of their threat to your health. Since no treatments exist for HPV itself — although treatments do exist for genital wart outbreaks caused by HPV — paying for a test to find the low-risk types may be of little use to you.

No HPV test is available for men with the exception of visual inspection or biopsy of genital warts if they are present.
Girls and women ages 9 to 26 can help prevent HPV infection by receiving the HPV vaccine. This vaccine protects against the two strains that cause 70 percent of cervical cancers and the two strains that cause 90 percent of genital warts.
STD testing: What to know before your appointment

Are all STD tests always done?
No, as mentioned earlier, men should receive STD testing if they have symptoms, have sex with other men, or if a partner tests positive for an STD. In women, HIV, syphilis and hepatitis testing may be done if other STDs are present. Testing for herpes is only usually done if symptoms are present. And HPV testing isn’t available for men, and only sometimes done for women older than 30.
Ask to be tested for other STDs if you’re concerned. Some tests may be expensive and your insurance may not cover them.

What STD tests are commonly covered by insurance?
Insurance companies differ in what services are covered. Check with your insurer, and if STD testing isn’t covered and you can’t afford to pay, consider testing through HealthCheckUSA. HealthCheckUSA provides affordable STD lab testing that is totally anonymous, confidential and convenient. HealthCheckUSA has over 5,000 locations nationwide for STD Lab Testing Services.

What do you suggest to someone considering having sex with a new partner or who may be at risk of an STD?
If you can’t trust a partner not to give you an STD, you may not want to have sex with that person. You can ask them to be tested for gonorrhea, Chlamydia, HIV, syphilis and hepatitis, but negative tests for these may mean the infection is just in too early of a stage to detect. Also, there are no good screening tests for herpes, and HPV testing is limited — men can’t be tested unless they have visible warts, and HPV testing generally isn’t recommended for women younger than 30.

If you decide to have sex, use condoms. Condoms help protect you against life-threatening infections like HIV. However, condoms don’t fully protect you against every STD. For example, condoms may not cover all of the skin that might contain an HPV or herpes virus, so the condoms may reduce, but not eliminate, the chance of such a virus being transmitted to you. In fact, you can be exposed to these viruses through genital to genital or mouth to genital contact, not just through intercourse.

If you have sex, you put yourself at some risk even with the most thorough STD testing and condom use, and you have to accept that risk.

If a person tests positive for an STD, what’s the next step?
If you test positive for an STD, the next step is to consider further testing and then to get treatment as recommended by your doctor. In addition, inform any partners. Your partners need to be evaluated and treated, because you can pass some infections back and forth.

Expect to feel various emotions. You may feel ashamed, angry or afraid. These are all normal feelings. Some STDs are very common so you aren’t alone. You’ve done the right thing by getting tested and you can now discuss treatment and how this might affect current or future relationships. Talk with your doctor about your concerns.

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Posted by David | Posted on 19-08-2009

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What you don’t know can hurt you. Ventura County’s lesser-known and most popular STDs

By Kit Stolz, 07/30/2009

The most feared of all sexually transmitted diseases (STDs) is the potentially deadly AIDS/HIV virus, which in 2005 struck 30 people in Ventura County, according to the Department of Public Health.

That, ironically, is the good news. The rate of AIDS/HIV infection has stabilized in recent years, and even declined slightly from that of five years ago.

The bad news is that more than 50 times as common as the HIV/AIDS virus is a sexually transmitted bacteriological disease called chlamydia. Chlamydia is epidemic in the United States, and the rate of infection in Ventura County has doubled in the last 10 years.

Chlamydia was diagnosed in 1,570 people in Ventura County in 2005, the most recent year for which there are official statistics. Most of those who contracted the disease were young. Nearly one-quarter of those who came down with the sexually transmitted disease (STD) were teenagers, and almost one-half of those who contracted the STD disease were between the ages of 20 and 24.

It’s the most frequently reported of all sexually transmitted diseases (STDs), both nationwide and in Ventura County. Although it’s not the most common of sexually transmitted diseases (STDs), it’s one of the most likely to cause problems if not treated.

The real hazard of chlamydia is not that so many people have it and know it, but that a far larger number of people have it and don’t know it.

“It’s one of the most common infections we see,” said Dr. Kirk Cook, who works as a family doctor and serves as a public information official for the county, “but the number of cases we see is just a fraction, because most people who contract this disease do not have symptoms.”

According to the U.S. Centers for Disease Control, about three-quarters of infected women and about one-half of infected men do not show signs of chlamydia.

If symptoms do appear, they show up within one to three weeks after infection.

In women, medical experts say that the most common symptom is a vaginal discharge, pain during urination, pelvic pain or pain during sex.

In men, the most likely symptom is a burning experienced during urination. Because men’s sexual organs are simpler, the disease is more likely to be seen, but symptoms can vary. One Ventura County patient, who wished to keep his identity private, found a sore on his penis after a sexual adventure overseas.

“It didn’t hurt, but it was gross,” he said. “I couldn’t believe it. I never saw anything like it. It looked like a crater on my dick. It just got bigger and bigger. I had to go to the doctor.”

Easy to cure and easy to contract, again Chlamydia is one of the easiest of all sexually transmitted diseases to treat. A single dose of an antibiotic pill named azithromycin can cure the disease, although doctors typically ask patients to return to take a second dose of the medicine, because one-quarter or more of those who are initially diagnosed with the disease are reinfected within months, usually by the same partner who passed on the disease in the first place.

“In California, the largest population affected by this disease are in the ages of 15-25,” said Cook. “I think that’s partly because these are people who are not mature adults, and also because chlamydia is not a disease that kills people, the way the HIV/AIDS virus can, so it’s easy to get complacent. But if this disease goes untreated in women, it can lead to pelvic inflammation and scarring of the fallopian tubes. This is a disease with bad long-term consequences for fertility.”

If a woman has no symptoms, or overlooks cramping, pain or a bloody discharge, the chlamydia infection can spread, often resulting in PID, or pelvic inflammatory disease, which can damage a woman’s reproductive organs. According to the Guttacher Institute, an international nonprofit organization focused on sexual health, about 20 percent of women who contract PID will lose their fertility permanently.

Why patients often don’t know who gave them the STD Disease
According to Dr. Adina Nack, a sexual health educator at Cal Lutheran University who published a book last year about women’s experiences with sexually transmitted diseases such as HPV, the human papillomavirus, STDs can remain hidden in the body and without symptoms for so long that a patient often isn’t sure who gave him or her the disease.

“One of my interviewees had been married once, gotten divorced, and then when she was with her second husband came down with symptoms of a sexually transmitted infection,” Nack said. “We tend to think that if we are exposed to one of these diseases, that we will get the symptoms within a short period of time, but it’s very possible to be exposed to an STD and not see your first symptoms for upwards of 18 months.”

This was the case of one young Ventura County woman, “Helen,” who had gotten engaged to be married when she suffered her first outbreak of genital herpes. She assumed at the time that her fiance had given her the disease, despite his denials, but now realizes that she probably picked it up when she was an undergraduate in college.

“It was horribly painful, and I blamed him,” she said. “I had no idea what was happening to me — I didn’t know anybody who had had herpes. It caused a lot of stress in the relationship, and we eventually broke up.”

Genital herpes is not on the list of sexually transmitted diseases reported to government medical authorities because, according to the Centers for Disease Control, blood tests for genital herpes can be “difficult to interpret.”

Blood tests can detect the presence of antibodies to herpes, but cannot reliably distinguish between herpes simplex type 1, which is more likely to cause fever blisters around the mouth, and herpes simplex type 2, the virus which usually causes genital herpes.

The virus is the most common sexually transmitted disease, infecting an estimated 45 million to 60 million Americans, according to the CDC.

Herpes can be passed on even if no symptoms are present. Although antiviral prescription drugs such as Valtrex can make the disease less painful and contagious, it’s still a disease profoundly damaging to what Nack, in her book Damaged

Goods, calls a woman’s “sexual self.”

An older woman in the San Fernando Valley, “Jamie,” wrote in an e-mail interview how she was devastated by a diagnosis of herpes simplex type 2 from a lover who died before she found out that he gave her the sexually transmitted disease.

“I was so wounded that I shut down socially. I had no social life for many years and did not even think about dating. I could not begin to imagine the misery and humiliation of having to have that infamous ‘talk’ that we, who know we have herpes, are supposed to have with a potential mate or lover. It is ironic because those who are spreading it are those who do not know they have it, which is most people with herpes,” she said.

Recovering from a sexually transmitted disease (STD)
According to Nack, the emotional devastation “Jamie” experienced when she caught a sexually transmitted disease is often what happens to women who contract STDs. Nack thinks this reflects the way we as a people have decided to look at sexual health.

“In this country, we consistently want to hold women responsible for sexual health, but not their male partners,” she said. “You can see this attitude play out with the Gardasil vaccine, which can protect against HPV (human papilloma virus, aka genital warts) in both men and women, but which has been marketed only to young women, and not as an HPV vaccine, but as a cancer vaccine. I don’t think we’re doing men any favors by letting them off the hook when it comes to taking care of their sexual health. They won’t get cervical cancer, but I have seen some seriously bad cases of genital warts on men.”

Nack points out that more than 6 million new cases of HPV are diagnosed each year, making it the second most common sexually transmitted disease after herpes. Complicating matters is the fact that the test for cervical cancer, the Pap smear, can detect the presence of abnormal HPV-altered cells around the cervix, but cannot detect the genital wart virus on external sex organs. A doctor who isn’t careful can give a patient the impression she doesn’t have HPV when she does, or can lead a patient to fear cervical cancer, when in fact she may only have contracted the virus that can sometimes develop years later into cervical cancer.

All too often, according to Nack’s research, doctors stumble over the complexities and uncertainties of diagnosis of sexually transmitted disease, especially in women. Two-thirds of the more than 40 women she interviewed at length complained that their doctors misdiagnosed their STDs, failed to explain them clearly, or even hurt them unnecessarily in treatment, adding to the pain and confusion.

Patients often go into “diagnostic shock” when they learn they have a sexually transmitted disease, Dr. Cook confirms.

“If a patient has symptoms, sometimes the diagnosis comes as a relief, especially with chlamydia, which is easy to treat,” he said. “But sometimes a patient will say, ‘I don’t even know what you’re talking about,’ or, ‘I never heard of it.’ Part of a doctor’s job is education, and with STDs, that means encouraging patients to contact sexual partners and encourage them to come in for treatment.”

Christine Lyon, of Planned Parenthood in Santa Barbara, points out that young patients are often reluctant to go to their family doctors for tests or treatments, knowing that this will likely spark questions from parents. She encourages young people who suspect they have an STD, or who want to know how to protect themselves, to visit Planned Parenthood or a county health clinic if a visit to a family doctor sounds intimidating.

“One in four young women in this country have an STD,” she said. “A lot of those cases are chlamydia. The known rate of chlamydia is higher in women than in men, but that’s probably because they are more likely to receive routine screening. Our goal is to treat anyone who comes through the door and wants reproductive health services.”

The good news about STDs
Contracting a sexually transmitted disease (STD) often turns out to be a strengthening experience in the long run, according to Dr. Nack. Many of the women she interviewed look back on themselves before they were infected as naive and passive, too compliant to the wishes of men.

“Once you decide you might want to be intimate with someone, you have to have ‘The Talk.’ You have to get your partner to be as honest as possible about their sexual health,” Nack said. “Because there’s a heavy moral stigma against being sexually active, it’s difficult for young girls to take an assertive role, but it’s really necessary. Condoms are great for preventing fluid-borne STDs, such as HIV, chlamydia, and gonorrhea, but skin-to-skin contact still takes place in sex, and that can pass other STDs, such as HPV and herpes.”

“Jamie” completely agrees that women must protect themselves, and objects fiercely to victims of sexually transmitted diseases being blamed for their misfortune.

“The herpes social stigma really makes me mad because it is the only serious harm it does to most people who contract, it,” she wrote. “It is not fair to make us lepers. I hate the stereotype ‘herpes whore.’ I got it while being faithful to a man I loved, a guy who should have gotten a special Oscar for Performance in a Personal Life. If you have sex with anyone — and at some point nearly everyone does — you risk contracting the herpes simplex virus. We are not bad people. We are unlucky.”

“Jamie” has taken to wearing confrontational T-shirts in public places, with slogans such as “VALTREX” or “HERPES DISCLOSURE.” She watches the expressions on the faces of people she passes, curious to see if they’re shocked, horrified or understanding, and gives out information on herpes if they’re curious.

She writes that she has mostly taken this one-woman personal sexual education campaign to places such as Venice Beach, but this summer plans to go to more conservative places.

If you see her, she hopes you will say “hi” and be accepting. She says she is only trying to protect you from the pain and heartbreak of coming down with an STD.

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