A Brief Introduction to STDs
By Christie Vernon.
Illustration by Alexandra Roceanu.
Sexually transmitted diseases, STDs (or STIs) are diseases spread from person to person through sex. All types of sex can lead to the spread of STDs, including vaginal, anal, and oral. STDs are actually quite common, and most people who have one do not experience severe symptoms or even any symptoms at all. This is why it is important to get regularly tested as a sexually active individual, since left untreated many STDs can lead to serious health problems, including cancer. Keep in mind, pretty much all STDs can be prevented by condoms. If you get diagnosed with an STD make sure to reach out to your previous partners. In this article, we will go through some of the most common STDs, how they spread, what their symptoms are, and how they’re treated.
HPV stands for Human Papillomavirus. It is one of the most common STDs, and it is estimated that about 70-80% of people worldwide contract it at some point in their lives. While data specific to Romania is not available, in Eastern Europe about 1 in 10 women have HPV 16 or 18. There are over 200 types of HPV, and these - 16 and 18 - are the ones that cause the majority of HPV-related cancers. Around 99% of invasive cervical cancers worldwide are attributed to HPV and it can also cause cancers in men. These cancers are usually treatable if caught in time, which is why it’s so important to get regular screenings.
Being so common and with such a large potential for serious disease, how do we tackle HPV?
First, there are multiple vaccines, all proven to be highly effective. The best time to get the vaccine is between the ages of 9 and 14; the second-best time is now. If you have not been vaccinated for HPV, it is incredibly important you contact your doctor and ask about it. For women, this is essentially a vaccine against cervical cancer, the second most common female cancer in Romania.
“Low-risk” HPV can cause genital warts, while high-risk HPV does not usually have any symptoms until it becomes serious. The best way to detect it is regular screenings. A Pap test can find abnormal cells in your cervix that can turn into cancer later, but there isn’t a test for abnormal cells in the vulva, penis, or throat. While there is no cure for HPV, it normally takes several years for cancer to develop, and in that time any abnormal cells found can be treated. While scientists are not yet sure what makes HPV turn into cancer, we do know that smoking and diseases which affect your ability to stave off infection make it more likely that HPV will cause cervical cancer. The good news is most people who discover they have HPV suffer no health issues at all. Just make sure to see your doctor regularly.
Chlamydia is a bacterial infection, and it is one of the most common STDs in Europe. The disease is passed through bodily fluids such as sperm and vaginal discharge. It infects genital organs as well as the urethra, anus, eyes, and throat. It is another largely asymptomatic disease that, while easily cured with antibiotics, if left untreated can cause permanent damage, including infertility.
If symptoms do appear, they can come weeks after the original infection. They may include: pain while urinating, pain during sex, abnormal smelling or colored discharge, bleeding between periods, swollen or tender testicles, or lower abdominal pain. If you do not get treated, chlamydia may cause Pelvic Inflammatory Disease in women, which leads to infertility or ectopic pregnancies. It can also cause chronic joint pain and infertility in men. It is noteworthy that you can get reinfected with chlamydia at a later date, as one infection does not give you immunity.
Gonorrhea, similarly to chlamydia, is a usually asymptomatic bacterial infection spread through bodily fluids. You can also get gonorrhea by touching your eye with infected fluids on your fingers. Although still fairly common here, Romania has seen a steady decline in cases. Similarly to chlamydia, the consequences of leaving it untreated include infertility. If you do have symptoms, they will appear within a week of infection and may include: yellowish or bloody vaginal discharge, pain when urinating, bleeding between periods, penile discharge, or painful and swollen testicles. People with penises are more likely to show symptoms. Testing is straightforward - urine tests, discharge tests, or quick swabs are used - and should be done regularly. Once caught, gonorrhea is easily treatable with antibiotics.
Herpes is a pretty common infection, causing sores to appear on your genitals, anus, cervix, mouth, thighs, lips, throat, and sometimes even your eyes. Unfortunately, it does last for life. There are two types, HSV-1 (usually causing mouth/lip sores) and HSV-2 (usually causing genital sores). It’s estimated that about 70-80% of Romanians have HSV-1, and 17-25% have HSV-2. Outbreaks aren’t permanent, instead popping up from time to time, and less frequently as you get older. Interestingly, most people get HSV-1 in childhood, from skin-to-skin contact or a quick peck from parents with mouth herpes.
You can get herpes from skin-to-skin contact, and of course also through sex. Other areas of skin that are not mentioned above can also get infected, albeit rarely, if you have an open wound that the virus can enter through. Herpes can also be spread - either to other people or other parts of the body - by touching a sore and then touching something else without washing your hands. If you have (mouth) herpes when you have open sores you should make sure that any glasses you drink from, face towels you use, etc are not shared by other people. Do not have sex until the eruption has cleared up. And of course, always use a barrier method of protection and get regularly tested.
The symptoms of herpes, in both cases, include painful sores, pain, itchiness, tingling, burning, a slight fever, and a feeling of being run down. HSV-1 may cause enlarged lymph nodes, and HSV-2 may cause pain when urinating. There are medications available to alleviate symptoms, so if you are having a breakout see your doctor or consult a pharmacist.
Syphilis is a bacterial infection now easily cured by antibiotics but can cause great permanent damage if left untreated - such as blindness, paralysis, brain damage or death. It is a particularly nasty disease that has been around for much of history, made infamous in the 16th century for causing noses to “fall off”. It’s spread through sex and can be prevented by using condoms or other barrier methods of protection. Cases in Romania have shown a steady decrease for years.
Since the symptoms of the early stage - when you are extremely contagious - are painless sores which often go unnoticed, it is important that you always use protection. Most of the time you only have one sore, and it can hide inside your body or in skin folds, making it even harder to detect. They go away on their own after 3 to 6 weeks, but syphilis does not leave your body. Instead, it comes back in later stages, first as a rash that does not itch, along with mild flu-like symptoms, and sometimes new sores or weight/hair loss. This also goes away naturally. The final stage of syphilis comes years later, as severe damage to your nervous system, eyes, and heart, and may even lead to death in the worst cases. While the syphilis is still curable at this stage, its effects are irreversible. Syphilis is one of the STDs that really emphasizes the need for regular testing since it is so easy to miss.
HIV (human immunodeficiency virus) damages your immune system and causes AIDS (acquired immune deficiency syndrome). The National Institute of Infectious Diseases Dr. Matei Balş reported around 16,000 cases of AIDS in Romania on the 31st of December 2017. HIV related tuberculosis affected 370 people; in 2017, 19% of all TB patients had HIV. Overall, new cases of HIV have been decreasing in Romania over the last decade. For more statistics related to HIV/AIDS in Romania, visit this report written by various national health agencies:https://insp.gov.ro/sites/cnepss/wp-content/uploads/2018/11/Analiza-de-situatie-hiv-2018.pdf.
HIV/AIDS is a complex disease and hard to properly discuss in this shortened format. We are currently working on an article dedicated to HIV/AIDS in order to better inform our readers, but we’ll give you a quick overview here. HIV can be spread through sex, shared needles, breastmilk, or infected fluids entering an open wound. You can also get it from blood donations, although donated blood is now tested so this is extremely rare. Usually, HIV has few symptoms, and it can take 10 years or more to appear. Untreated HIV will eventually lead to AIDS, which ultimately causes death; however, treatment can greatly slow or even prevent the onset of AIDS and allow HIV-positive people to lead healthy lives for much longer. It also decreases the chances of spreading HIV. However, treatment must be given early on, so frequent testing is crucial.
Once AIDS develops, symptoms include opportunistic infections (such as tuberculosis), cancer, thrush (a thick, white coating in your mouth), yeast infections, a sore throat, chronic pelvic inflammatory disease, headaches, extreme weight loss, bruising easily, purplish growths on your skin, dry coughing spells, swollen or hardened glands, fevers, bleeding from the mouth, anus, vagina or nose, numbness, loss of muscle control and strength, shortness of breath and rashes. However, if you get tested and diagnosed fairly quickly after you get HIV, these symptoms can be greatly delayed or completely avoided.
There are many less common STDs not mentioned here. If you would like to know more about sexual health and STDs such as pubic lice (crabs), trichomoniasis, or scabies, visit https://www.plannedparenthood.org/learn/stds-hiv-safer-sex for a more comprehensive guide.