As well, anyone who is sexually active should take steps to avoid sexually transmitted diseases (STDs). This is important for your health as well as the health of any future partner you may have. It is important to find out about the types of STDs and to learn about and use effective protection.

Chlamydia

Chlamydia is a common STD. It is spread by sexual contact and can spread to a baby passing through the birth canal of an infected mother. Chlamydia is serious because it may cause damage to the tubes which carry the ovum (egg) from the ovary to the uterus.

Scarring of these tubes can make it difficult to get pregnant later. Surgery to unblock the tubes may be required. Unfortunately, a woman can have a chlamydia infection resulting in complications without any symptoms. At the other extreme, there can be severe illness requiring surgery and then treatment for several weeks with antibiotics.

Symptoms may include an increased vaginal discharge, irregular spotting of blood, low abdominal or pelvic pain or cramping, spotting of blood after sexual intercourse, or pain with intercourse. If you have any of these symptoms, you should see your doctor.

A pelvic examination may reveal pain or tenderness and will also show the cervix (lower part of the uterus), which is examined by inserting a speculum gently into the vagina. With a chlamydia infection the cervix may look irritated and bleed easily. The test for chlamydia is done by taking a swab from the cervix and sending it to the lab.

If you are seeing a doctor for a checkup and Pap smear, the test for chlamydia can easily be done at the same time. That is, if you ever had sexual intercourse without using a condom, you could be at risk and should request this test. It would be a particularly good idea to request an STD check if you have had a new partner within the previous few months.

If the test comes back positive for chlamydia, your doctor will prescribe treatment with antibiotics and ask for your co-operation in filling out the STD contact tracing form. Because women often have no symptoms from chlamydia and because it can be serious, the government has taken steps to try to prevent spread of this infection.

Your doctor is legally required to fill in a report for any positive test result. The person with the positive test will be asked to provide the names of any recent sexual contacts. There is a person in each health region whose job it is to find these people, because they may have chlamydia without knowing it.

Contacts are notified and treated. This may protect them from complications and prevent the infection from spreading to others. If preferred, arrangements for treatment of the partner can be made at the time of the visit, but the form must still be filled out. A person who is named as a contact and has not already been treated will be told about having been identified as having had possible exposure to chlamydia. This is confidential information and the identity of the person who provided the name will not be revealed.

Males often will have symptoms if they have chlamydia. They may notice a burning sensation when passing urine or a discharge from the end of the penis. The slang name for this discharge is a 'drip.' To test a male for chlamydia, a thin swab is inserted a short distance into the urethra or a urine specimen may be collected.

The usual treatment given for chlamydia is a high dose of an antibiotic with all the capsules being given at once. The STD program provides free medication. The success rate of treatment is higher with a single-dose treatment because if people are supposed to take medications for a number of days, doses may be missed.
Usually, a second antibiotic is given as well to treat another STD, gonorrhea, which may be transmitted at the same time as chlamydia. Gonorrhea is sometimes called a 'dose.' Gonorrhea fortunately is not nearly as common now as in the past.

HIV - a life threatening STD

Talking, shaking hands or hugging cannot spread HIV infection. The human immuno-deficiency virus (HIV) is spread by contact with blood or body fluids. Sexual intercourse, either heterosexual or homosexual, can spread HIV. Use of condoms dramatically reduces the chance of becoming infected with HIV. Intravenous drug users may transmit HIV to each other by use of contaminated needles.

The chance that you could be in contact with HIV depends on whether your partner or your partner’s partner have ever been in contact with it. The more partners they have all had, the greater the chance of HIV infection. If any of these people ever used intravenous drugs the chance increases considerably.

If you always use condoms yourself and if your partner has always used condoms when sexually active in the past, your chance of developing HIV is very much reduced.

If you have had unprotected sex, it would be wise to get an HIV test done. The blood test for HIV detects antibodies to the virus. It can take up to six months for these antibodies to develop and for the HIV test to turn positive. Usually, it will be positive sooner than that. If you have a new partner and either of you has been sexually active before, you should use condoms consistently for at least the first six months and then have an HIV test done. In a long-term relationship, if each partner is confident that the other is not having sexual contact with anybody else, you may decide to stop using condoms.

Someone might tell you that he or she had an HIV test and it was negative, and so it is not necessary for you to use a condom. You should still use a condom unless you know that he or she has not had any risk behaviours in the previous six months.

Hepatitis B - easier to get than HIV

Hepatitis B, like HIV, can be spread by contact with blood or body fluids (by sexual intercourse). Infection with this virus can result in liver damage which may be mild or severe and can even be life threatening. Children are now being immunized against Hepatitis B when they are in grade five or six. This should reduce the incidence of this disease in the future.

The chance of infection with this virus is much higher among intravenous drug users because they have contact with someone else’s blood by sharing needles. This is similar to HIV, but the number of virus particles in the blood is much higher with Hepatitis B and a smaller amount of blood may be enough to spread the virus. If your partner has had unprotected sex with someone who has used intravenous drugs or with someone whose previous partner had used intravenous drugs, you could be at risk and should request a blood test for Hepatitis B.

Herpes

Herpes II is a virus which causes tiny blisters in the genital area. These blisters are very similar to cold sores which are usually caused by a related virus, Herpes I. The first time Herpes blisters appear can be very painful. This is particularly so when urinating because the urine will touch the open sores and sting. There are usually swollen glands in the groin and the person may feel somewhat ill. To confirm that the lesion is caused by Herpes, a swab of fluid from inside the blister may be sent to the laboratory for the virus to be grown in a tissue culture.

Just as there is no cure for cold sores, Herpes II cannot be 'cured.' The virus stays within the body.

Visible blisters or outbreaks can occur often in some people; rarely in others. They seem to be triggered by fatigue, other illness or may occur before menstrual periods. Herpes II can be passed to a sexual partner whether or not blisters are visible. Therefore condoms should be used at all times to prevent transferring the infection.

An anti-viral medication can be prescribed for Herpes II, particularly for the first outbreak which tends to be the longest lasting and most painful. Medication can also be taken on a long-term basis to decrease the frequency of episodes.

If Herpes II blisters are present in the mother when a baby is about to be born, a caesarean section is usually done to protect the baby from infection. Women who have had Herpes II should have regular pap smears because they have an increased chance of cancer of the cervix.

Warts

Warts are caused by particular viruses, which have the ability to get inside cells and cause them to grow more rapidly than normal. The human papilloma virus (HPV) can infect the genital area. In research studies it has been shown that 20 to 30 per cent of those who are sexually active are infected with HPV. Only one to three per cent of the same group will have visible warts, called condylomata accuminata. If a visible wart develops, it is usually three months after contact with the virus.

Some of the more than 70 types of HPV are associated with pre-cancer or cancer of the cervix. Women who have had intercourse should be sure to have regular testing.

Visible warts can be treated by application of a chemical solution in a doctor’s office. This may need to be done a number of times. The treatment may remove the visible wart but the virus will likely still be present in some cells.

Pre-cancer or cancer of the cervix

Pre-cancer of the cervix is detected by having a Pap smear done by your doctor. This should be done once a year after you become sexually active. The chance of developing pre-cancer of the cervix is higher in a woman who has had several sexual partners and also is related to the number of other female partners the male partner has had. One reason for this is that the chance of acquiring an infection with HPV is greater with increased number of partners and some types of HPV cause abnormalities of the cells of the cervix. Herpes II is also a risk factor for cancer of the cervix.

Fortunately, cancer of the cervix is now usually identified at a pre-cancer stage when it can be cured.

The abnormal cells can often by removed by cryotherapy (freezing) or laser treatment. If the disease is more advanced, an operation called a cone biopsy is done. Usually, this treatment does not cause any problem with pregnancy or childbirth. Since HPV and Herpes II infection are decreased by the use of condoms, those who use them have a lower risk of developing pre-cancer or cancer of the cervix.

How NOT to get an STD

As you can see, there are many diseases that can be spread by unprotected sex. Some are painful or embarrassing and some are life threatening or can reduce fertility. You can avoid STDs. There are several choices.

One option is to delay having sexual intercourse. There are many ways of showing love and affection. Many couples choose to get to know each other better first and to develop their relationship through doing other things together.

The other option is to use condoms. The use of condoms dramatically cuts down the chance of getting an STD. You are more likely to stay healthy and have a pregnancy when you want it.

In order to use condoms, you need to:
1. Have some.
2. Use them.

Many teenagers have relationships that last for months or years and may not be concerned about STDs. However, if either partner has ever had another partner, there is a risk. For this reason, it is much safer to use a condom. After all, you know what you are doing and have done in the past. However, you do not know for sure what sexual relationships your partner may have had in the past. Also, you do not have control over whether your partner may decide to be sexually active with someone else while in a relationship with you.

This is more likely to happen if you talk about it in advance. Talk to your partner about your wishes about how far to go. You may want to spend longer getting to know each other before having sex. Talk to your partner about condoms. This is about personal health, not whether you trust the other person.

Being a teenager involves many big changes. One of the biggest is that you make more of your own decisions. Then you have to live with the results of your decisions. Wise decisions can keep you safe from STDs.

Sexually Transmitted Diseases Protecting yourself and your partner

There are many things to think about when you are deciding whether, or when, to become sexually active, and with whom. You must decide whether you are ready to become pregnant or to become a father. If not, you need to find out about birth control and use an effective method.