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What It Is

The primary goal of the Kentucky Sexually Transmitted Disease/Human Immunodeficiency Virus Counseling and Testing (STD/HIVCT) program is to prevent the spread and resulting effects of sexually transmitted diseases, including HIV infection.

What are STDs?

Sexually Transmitted Diseases are serious, sometimes painful illnesses that can cause damage to the human body. Initially, STDs infect your sexual and reproductive organs and later can destroy other organs. Other STDs such as HIV, hepatitis B and syphilis can cause general body infections.

Sometimes you can have an STD with no signs or symptoms. Other times, the symptoms go away on their own. Either way, you still will have the STD until you get treated. A few STDs cannot be cured, but most STDs can be cured if you get treated.

How are STDs Spread?

STDs are spread during close, sexual activity and during vaginal, anal and oral sex. Some STDs (HIV and hepatitis B) are also spread by contact with infected blood.

Most STD germs need to live in warm, moist areas. That's why they infect the mouth, rectum and sex organs (vaginal vulva, penis and scrotum).

What To Do If You Think You Have An STD

If you think you might have an STD, get checked out. Don't just hope the STD will go away. Chances are it won't. All county health departments test for and treat STDs. Private doctors also treat STDs. If you don't know where to get help, call your local health department or private health care provider for information. All information you give will be private and confidential.

You may feel embarrassed about having an STD, but you must get treatment. That's the only way you will get well. So, no matter how difficult it may be, see a health care professional for treatment.

Most STDs can be treated with antibiotics. Follow your doctor's instructions and be sure to take all of your medicine. You also must tell your sexual partner(s). If they aren't treated, they can spread the STD and they might even reinject you.

Symptoms To Watch For

Women

  • Unusual vaginal discharge or odor
  • Pain in your pelvic area - the area between your belly button and sex organs
  • Vaginal area burning or itching
  • Bleeding from your vagina that is not your regular period
  • Pain deep inside your vagina when you have sex

Men

  • A drip or discharge from your penis.

Women and Men

  • Sores, bumps or blisters near your sex organs, rectum or mouth
  • Burning and pain when you urinate (pee) or have a bowel movement
  • Need to urinate often
  • Itching around your sex organs
  • Swelling or redness in your throat
  • Flu-like feelings with fever, chills and aches
  • Swelling in your groin - the area around your sex organs

If you have any of these symptoms, go to an STD clinic or your health care provider. Don't put it off - get checked out right away.

How to protect yourself from STDs 

Who To Contact For Help

Local health departments offer patients tests for gonorrhea, chlamydia and syphilis and provide treatment for patients diagnosed with, exposed to or suspected of having these diseases. Services received at local health departments are confidential. A service fee may be charged, but no one will be refused testing or treatment because they are unable to pay. Patients with other STD infections will receive counseling about the infection and probably will be referred to a health care provider who can test for and treat these diseases.

All local health departments in Kentucky offer free HIV counseling and testing. Patients can choose to be tested confidentially or anonymously. It is usually necessary to call the local health department for an appointment to be tested for HIV and to receive STD services.

Local Health Department Listing

Health providers and the general public are encouraged to call the Kentucky STD program at (502) 564-4804 for information and statistical data.

What To Do To Protect Yourself From STD's

  • Not having sex is the best way to protect yourself from STD.
  • Having sex with only one uninfected partner who only has sex with you is also safe.
  • Talking to your partner about past sex partners and about needle drug use.  Don't have sex with someone who you think may have STD.
  • Before you have sex, look closely at your partner for any signs of STD - a rash, a sore, redness or discharge.  If you see anything you are worried about don't have sex!
  • Use a latex condom (rubber) for vaginal, anal or oral sex.  Condoms will help protect you from STD much of the time.  Both men and women should carry condoms.
  • In addition to condoms, use birth control foam, cream or jelly.   These kill many STD germs.
  • Get checked for STD every time you have a health exam.  If you have more than one sex partner, get an STD check any time you think you might be at risk, even if you don't have symptoms.
  • Know the signs and symptoms of STD.  If you notice a symptom that worries you, get checked out!
  • If you have an STD, your partner(s) must get treated when you do.
  • If you have an STD, don't have sex until your treatment is complete.

Sexually Transmitted Diseases

Sexually transmitted diseases (including HIV-AIDS)

  • Are most common in people who begin sexual activity at a young age, have had more than one sex partner in a lifetime, use drugs, have sex without a condom, or have a partner with one or more of the risk factors.
  • Some sexually transmitted infections such as HIV, human papilloma viruses (HPV), and herpes are not curable.
  • Gonorrhea and chlamydia can cause sterility in both males and females. A pregnant woman may pass an untreated infection to her baby.
  • Safer sex practices such as using a condom and limiting the number of sex partners will decrease the risk of contacting a sexually transmitted infection.

Chlamydia or NGU

What to Watch for:

Symptoms show up 7-21 days after having sex. Most women and some men have no symptoms.

Women:

  • Discharge from the vagina.
  • Bleeding from the vagina between periods.
  • Burning or pain when you urinate (pee).
  • Pain in abdomen, sometimes with fever and nausea.

Men:

  • Watery, white or yellow drip from the penis.
  • Burning or pain when you urinate (pee).

How Do You Get this STD:

  • Spread during vaginal, anal or oral sex with someone who has chlamydia or NGU.

What Happens If You Don't Get Treated:

  • You can give chlamydia or NGU to your sexual partner(s). 
  • Can lead to more serious infection. Reproductive organs can be damaged.
  • Both men and women may no longer be able to have children.
  • A mother with chlamydia can give it to her baby during childbirth.

Genital Warts

What to Watch for:

  • Symptoms show up 1-8 months after having sex.
  • Small bumpy warts on the sex organs and anus.
  • Itching or burning around the sex organs.
  • After warts go away, the virus stays in the body. The warts can come back. 

How Do You Get This STD:

  • Spread during vaginal, anal or oral sex with someone who has genital warts.

What Happens If You Don't Get Treated:

  • You can give genital warts to your sexual partner(s).
  • Warts cannot be cured.
  • More warts grow and are harder to get rid of.
  • A mother with warts can give them to her baby during childbirth.
  • May lead to precancerous conditions.

Gonorrhea

What to Watch for:

  • Symptoms show up 2-21 days after having sex. Most women and some men have no symptoms.

Women:

  • Thick yellow or white discharge from the vagina.
  • Burning or pain when you urinate (pee) or have a bowel movement.
  • Abnormal periods or bleeding between periods.
  • Bleeding from the vagina between periods.
  • Cramps and pain in the lower abdomen (belly).

Men:

  • Thick yellow or white drip from the penis.
  • Burning or pain when you urinate (pee) or have a bowel movement.
  • Need to urinate (pee) more often..

How Do You Get This STD:

  • Spread during vaginal, anal or oral sex with someone who has gonorrhea.

What Happens If You Don't Get Treated:

  • You can give gonorrhea to your sexual partner(s).
  • Can lead to more serious infection. Reproductive organs can be damaged.
  • Both men and women may no longer be able to have children.
  • A mother with gonorrhea can give it to her baby during childbirth.
  • Can cause heart trouble, skin disease, arthritis and blindness.

Hepatitis B

What to Watch for:

  • Symptoms show up 1-9 months after contact with the hepatitis B virus.
  • Many people have no symptoms or mild symptoms.
  • Flu-like feelings that don't go away.
  • Tiredness.
  • Jaundice (yellow skin).
  • Dark urine, light-colored bowel movements.

How Do You Get This STD:

  • Spread during vaginal, anal or oral sex with someone who has hepatitis B.
  • Spread by sharing needles to inject drugs, or for any other reason.
  • Spread by contact with infected blood.

What Happens If You Don't Get Treated:

  • You can give hepatitis B to your sexual partner(s) or someone you share a needle with.
  • Some people recover completely.
  • Some people cannot be cured.  Symptoms go away, but they can still give hepatitis B to others.
  • Can cause permanent liver damage.
  • A mother with hepatitis B can give it to her baby during childbirth.

Herpes

What to Watch for:

  • Symptoms show up 1-30 days after having sex.
  • Some people have no symptoms.
  • Flu-like feelings.
  • Small, painful blisters on the sex organs or mouth.
  • Itching or burning before the blisters appear.
  • Blisters last 1-3 weeks.
  • Blisters go away, but you still have herpes.  Blisters can come back. 

How Do You Get This STD:

  • Spread during vaginal, anal or oral sex with someone who has herpes.

What Happens If You Don't Get Treated:

  • You can give herpes to your sexual partner(s).
  • Herpes cannot be cured.
  • A mother with herpes can give it to her baby during childbirth.

HIV/AIDS

What to Watch for:

  • Symptoms show up several months to several years after contact with HIV, the virus that causes AIDS.
  • Can be present for many years with no symptoms.
  • Unexplained weight loss or tiredness.
  • Flu-like feelings that don't go away.
  • Diarrhea.
  • White spots in mouth.
  • In women, yeast infections that don't go away.

How Do You Get This STD:

  • Spread during vaginal, anal or oral sex with someone who has HIV.
  • Spread by sharing needles to inject drugs, or for any other reason.
  • Spread by contact with infected blood. 

What Happens If You Don't Get Treated:

  • You can give HIV to your sexual partner(s) or someone you share a needle with.
  • HIV cannot be cured.  Most people die from the disease.
  • A mother with HIV can give it to her baby in the womb, during birth or while breastfeeding.

Syphilis

What to Watch for:

1st Stage:

  • Symptoms show up 3-12 weeks after having sex.
  • A painless sore or sores on the mouth, sex organs, breast or fingers.
  • Sore lasts 1-5 weeks.
  • Sore goes away, but you still have syphilis.

2nd Stage:

  • Symptoms show up 1 week-6 months after sore heals.
  • A rash anywhere on the body.
  • Flu-like feelings.
  • Rash and flu-like feelings go away, but you still have syphilis. 

How Do You Get This STD:

  • Spread during vaginal, anal or oral sex with someone who has syphilis.

What Happens If You Don't Get Treated:

  • You can give syphilis to your sexual partner(s).
  • A mother with syphilis can give it to her baby during childbirth or have a miscarriage.
  • Can cause heart disease, brain damage, blindness and death.

Vaginitis

What to Watch for:

  • Some women have no symptoms.
  • Itching, burning or pain in the vagina.
  • More discharge from the vagina than normal.
  • Discharge smells and/or looks different.

How Do You Get This STD:

  • Spread during vaginal, anal or oral sex.  Men can carry vaginitis infections without symptoms.

What Happens If You Don't Get Treated:

  • Uncomfortable symptoms will continue.
  • Having vaginitis while pregnant may put a woman at increased risk for some complications of pregnancy, such as preterm delivery.
  • Men can get infections in the penis, prostate gland or urethra.

Genital Warts

(Venereal Warts, Condylomata)

Genital warts are light pink, cauliflower-like growths that appear on the external genitalia (sex organs) of the male and female. The usual locations are the penis, scrotum, vagina, and anus. In the female, warts may be found inside the vagina or on the cervix (mouth of the uterus). In the male the warts may be inside the penis and may not be noticeable. There may be only 1, 2 or several warts present. Sometimes the warts cause itching or may bleed. Anal warts may be mistaken for hemorrhoids. The warts generally will appear 3 weeks to 6 months after direct exposure to the virus.

Genital warts may grow larger or even leave without any treatment. Since this is a sexually transmitted infection, you can give the genital warts to your sex partner during intercourse. It is very important to use condoms (male or female) each time you have intercourse. People may also spread the virus to other parts of the body with their hands. A pregnant woman with genital warts can pass them on to her baby during childbirth, however this is rare. Women with a history of genital warts are at increased risk for cervical cancer.

There are several different treatments for genital warts, which your health care provider can discuss with you. These treatments include medications, freezing, laser, or surgical removal. Sometimes warts can be stubborn to treat and they may grow back. The HPV virus always remains in the body; there is not currently a "cure" for this virus. You should keep the infected area clean and dry, wear cotton underwear, avoid sexual contact while the warts are present, limit the number of sex partners, tell your partner(s) that you have HPV, and make sure to get regular Pap Smears if you are a female. Condom usage with every intercourse helps to lower the chance of infections in the future.

Subclinical HPV Infection

Most HPV infections are in this category. Although the HPV virus is present, it cannot be seen with the naked eye. Subclinical HPV infections are likely the most common cause for cells on the female cervix to grow abnormally resulting in an abnormal Pap Smear. This abnormal growth is called DYSPLASIA. Dysplasia may range from mild to severe, and may go on to become cervical cancer. If a woman has an abnormal Pap Smear, it is very important that she have checkups according to her health care provider’s advice. Women who smoke and have HPV are at high risk for developing cervical cancer.

Like genital warts, subclinical HPV is not "curable"; the virus remains in the body. However, there are certain things you can do to improve your health and keep the virus from causing problems. Your immune system helps to fight off all kinds of infections including HPV. To have a healthy immune system eat a well-balanced diet daily, exercise regularly, and avoid alcohol, drugs, and smoking. Keep the number of lifetime sex partners limited and use condoms regularly with sexual activity. Females should have a yearly Pap Smear and follow-up on all abnormal results as directed by her health care provider.

Crabs and Scabies

What Are They?

Crabs are lice found mostly in the pubic hair, but can move to the hair on other parts of the body, such as the beard, mustache, and underarms. Crabs are very small but can be seen because they attach themselves to the hair. They live by feeding on human blood.

Scabies is caused by mites that burrow (push) under the skin to lay their eggs. They are usually found between the fingers, around the wrists, under the arms, or around the genital area including the buttocks.

How Do You Get Them?

Infestation occurs by direct contact with someone that has them; either with sexual contact or close personal contact like sharing a bed, towels, or clothing. Infestations can affect an entire household and all family members, not just the sexual contacts, may need to be examined.

What Can An Infestation Do to You?

The first sign of Crabs (Pubic Lice) is usually severe itching in the genital or anal area. You may see eggs or the crabs. The burrows of mites (Scabies) also cause intense itching that is usually worse at night. Scratching the affected areas may make it worse and lead to a more severe infection caused by bacteria entering the skin.

Medications and Other Necessary Measures

Scabies should not be treated at home unless a health care provider has diagnosed the condition and tells you to do so. Crabs (Pubic Lice) may be treated at home with over-the-counter medication that your health care provider or pharmacist recommends. Pregnant, breastfeeding women, and infants cannot use some of these medications. Follow the directions correctly; do not over treat.

For Scabies or Pubic Lice (Crabs), clean your clothing very well. Either dry clean or machine wash and dry (hot setting) all clothing that has been in contact with lice or mites. Wash all bed linens including blankets, comforters, and bedspreads. Items that cannot be laundered should be sealed in a plastic bag for 14 days. Vacuum upholstered furniture, carpets, and car seats. Your health care provider or pharmacist can recommend a spray to disinfect furniture and other household items infested with lice or mites. All treatments must be done the same day to be effective. Infestations are stubborn and can be difficult to treat. If repeat treatment is necessary, consult with your pharmacist or health care provider. Persons infected with scabies should not attend school or work until the day after treatment. Persons infected with crabs should remove the nits and must have their sexual contacts treated to avoid re-infection.

Herpes

What Is Herpes?

Herpes is a viral infection that causes blisters on the mouth ("cold sores," "fever blisters," "oral herpes") or sores in the genital area ("genital herpes"). The virus that causes herpes is different from most viruses in that a person with herpes stays infected all of his/her life. The sores or blisters come and go but the virus never leaves the body. There is no known "cure" for herpes at this time.

How Do You Get Herpes?

Herpes is passed through close contact with a person infected with the virus. Herpes is transmitted through oral or sexual contact. You can get genital herpes if your partner has "cold sores" (oral herpes) and performs oral sex on you. It is possible to spread the virus to other parts of the body with UNWASHED hands that have been in contact with a sore or blister. A mother with active herpes at the time of delivery can transmit the virus to her baby. Although rare, it can result in serious complications for the infant.

How Common Is Herpes?  Is There A Test For Herpes?

About 80% of American adults have oral herpes ("cold sores") and more than 20% have genital herpes. Some people with genital herpes don’t know they are infected because the symptoms are too mild to notice; but they can still pass the herpes virus to others without even knowing they are infected.

If you have symptoms, the best test is a viral culture. Your health care provider can take a swab of fluid from the sore soon after it appears for a viral culture. This test is very reliable and accurate.

If you don’t have symptoms but have a partner with herpes, a blood test can tell whether you have the virus that causes genital herpes. This test (HSV-2) is not one hundred percent accurate in detecting herpes and may be expensive.

How Often Do "Outbreaks" Occur With Genital Herpes?

Symptoms are usually the worst with the first outbreak of herpes and generally occur within two weeks of contacting the virus. A person experiencing their first outbreak may have a cluster of blisters in the genital area that last for up to 4 weeks. Some people may also have flu-like symptoms during the first outbreak that includes fever, swollen glands, and tiredness. The blisters tend to be painful and may cause burning with urination. Some people may have itching and irritation in the genital area.

Recurrent outbreaks of herpes may occur after the first episode and symptoms vary greatly from person to person. Some people never have another outbreak while others may experience frequent recurrent episodes. Repeat episodes tend to be less severe than the first outbreak. Many people have "warning signs" that they are going to have an outbreak. These may include itching or burning in the genital area or leg/hip pains.

What Causes Recurrent Outbreaks?

Herpes "triggers" are medically poorly understood since they vary from person to person. Research does show that prolonged exposure to sunlight can trigger oral herpes (cold sores) and mental stress tend to trigger recurrent outbreaks of genital herpes.

Medications are available to help reduce the number of outbreaks in people who tend to have severe or frequent bouts of outbreaks.

What Can You Do To Feel Better During An Outbreak?

  • Keep the area clean and dry since this helps the sores to heal faster.
  • Soaking in a shallow tub of salt water may ease the pain of genital blisters (sores). It is important to clean the tub thoroughly afterwards.
  • Wear cotton underwear since synthetic material holds in moisture and slows the healing process.
  • Wash your hands well with soap and water after touching a sore or using the bathroom. This will help prevent the spread of the virus.
  • DO NOT have sex while genital blisters (sores) are present.
  • DO NOT perform oral sex on your partner if you have a cold sore (oral herpes).
  • Your health care provider may prescribe medication that can help make the sores heal quicker but the medicine does not stop the sores from coming back and it is not a "cure.
  • Tell your partner you have herpes so he/she can be examined and counseled.
  • If you are planning a pregnancy or are already pregnant, TELL YOUR HEALTH CARE PROVIDER. You may need special care around the time of your delivery to protect your baby from getting herpes.
  • Take good care of yourself and avoid stress. Get plenty of exercise and maintain a healthy diet and lifestyle.
  • Women should make sure to have a yearly Pap Smear.
  • Use condoms when sexually active and limit the number of sex partners to help lower the chance of sexually transmitted infections in the future.

Common Vaginal Infections

BACTERIAL (also called BVor Gardnerella) vaginal infections are the most common of all vaginal infections. Bacterial Vaginosis is caused by an over-growth of the bacteria normally found in the vagina. This type of infection is associated with sexual activity --the more partners you have the greater your risk of getting By. Symptoms may include a fishy-smelling discharge (especially after sex), frothy clear or white discharge, itching and/or burning. About half of the women with this type of infection do not have any symptoms. Treatment consists of an antibiotic given either by mouth or as a cream in the vagina. Untreated, BV can cause Premature labor/delivery, Pelvic Inflammatory Disease (PID), and Infertility. Typically, sex partners do not need treatment; however condoms are highly recommended.

YEAST (also called Candida or Monilia) infections are the second most common type of vaginal infections. Pregnancy, HIV/AIDS, Birth control pills, Diabetes, and Antibiotic medications can be contributing factors. Symptoms may include itching and/or a burning sensation in and around the vagina that ranges from mild to severe. Burning may increase with urination. The vaginal discharge tends to be white, clumped and cottage cheese like in appearance. Since yeast infections are not considered sexually transmitted infections; the sex partner usually does not require treatment. Treatment consists of an Anti-fungal medication used in the vagina or a pill taken by mouth.

TRICHOMONAS (also called Trich) is the third most common vaginal infection. It is sexually transmitted by a parasite and causes heavy, sometimes foul smelling vaginal discharge that is greenish, gray or yellow in color. Burning or itching may also occur. Treatment consists of a medication called Metronidazole (Flagyl). Women should not take this medicine in the first 3 months of a pregnancy. To be effective, the medicine must be taken by the woman and her sex partner(s) during the same time period. Untreated Trichomonas infections may make a woman more likely to get other sexually transmitted infections and/or contribute to premature labor/delivery if the she is pregnant.

CHLAMYDIA is one of the most common; curable sexually transmitted infections (STD). This infection is spread by sexual contact with another person or from the mother to the child during birth. Chiamydia CANNOT be caused by casual contact (toilet seats, hot tubs, saunas, or swimming pools). Chlamydia infections are often overlooked because the symptoms are very mild or are totally absent. If symptoms are present they may include irregular vaginal bleeding, pain or burning with urination or sex, vaginal discharge, or lower abdominal pain and fever. Males may experience swelling of the testicles, have a discharge from the penis and/or pain with urination. A person can have the infection, not have symptoms, and transmit it to someone else without knowing it. The diagnosis of Chlamydia is made by a culture, and treatment is oral or intramuscular antibiotics. Untreated Chlamydia can cause Pelvic Inflammatory Disease (PID) in the female and Epididymitis (inflammation in the scrotum) in the male; leading to infertility (sterility). Pregnant women with untreated Chlamydia are at risk for premature labor. Babies born to mothers with this infection can get pneumonia and a severe infection of the eyes.

GONORRHEA (also called the Clap or Drip) is another infection that is transmitted by sexual contact. Gonorrhea can also be spread from the mother to the baby during birth. Men infected with gonorrhea may have burning with urination and/or a yellowish-white discharge from the penis. Most women DO NOT have symptoms or only very mild symptoms like a heavier vaginal discharge with or without burning. A person with Gonorrhea can spread the disease even without having symptoms. This infection is treated with either oral or intramuscular antibiotics. If left untreated, Gonorrhea can cause Sterility (infertility), Arthritis, Skin problems, and other organ infections caused by the spread of infection in the body. Pregnant women can pass the infection to their baby during delivery causing severe infection of the eyes. Gonorrhea can be diagnosed by a culture.

ALLERGIC VAGINITIS is a reaction to chemical irritants, soaps, perfumes, spermicides, or less commonly latex. Symptoms include burning, itching, redness, and swelling in and around the vagina. Diagnosis is based on history and ruling out other causes. Treatment consists of avoidance of the product causing the reaction, cool compresses, and or sits baths. Rarely, a steroid cream may be prescribed by your clinician. If the allergy is due to spermicides or latex, an alternate method of contraceptive may be needed. Non-latex condoms are available that are made from polyurethane and can safely be used.

PREVENTION AND TREATMENT OF VAGINAL INFECTIONS

Regardless of which of the vaginal infections you have been diagnosed with, it is essential to follow your health care provider’s advice and COMPLETE the prescribed treatment!

  • Faithfully use condoms with sexual intercourse (male and female condoms are available) to prevent sexually transmitted infections. Pregnant women at risk for infection should use condoms during intercourse for the remainder of the pregnancy.
  • Limit your number of sex partners: The more partners you have the greater the risk of all infections
  • AVOID DOUCHING as it disrupts the normal vaginal environment and may lead to infections.
  • After using the bathroom, always wipe from FRONT to BACK and wash your hands afterwards.
  • Avoid feminine hygiene sprays, deodorant pads and tampons, perfumed soaps, bubble baths, and talc.
  • Wear clean, cotton panties and don’t forget basic hygiene (bathe or shower daily).
  • Report all symptoms of an abnormal vaginal discharge to your health care provider.
  • If you think you may be at risk for a sexually transmitted infection (STD), tell your provider.
  • Ask questions if you are concerned over your symptoms and/or risk of infection.


Documentation