Sexually Transmitted Diseases

From a pamphlet by the Gay Men's Health Collective

of the

Berkeley Free Clinic
2339 Durant Ave., Berkeley, CA 94704
(510) 644-0425 or (800) 6-CLINIC

BE SAFE, GET CHECKED OUT!

If you are beginning a new relationship, if you or your partner has more than one sexual partner, if you notice burning, itching, pain or a discharge from your penis, or if you notice any new bumps, sores, or rashes around your mouth, genitals or anus---Be safe, be responsible, get checked out!

The Gay Men's Health Collective, founded in 1976, is a group of volunteer lay and professional health care workers with focussed training and experience in education, screening, diagnosis, and treatment of sexually transmitted diseases. Our goal is to provide free, quality, non-judgmental, STD-related health care to all men regardless of sexual orientation. Clients are served on a first-come-first-served bases at our drop-in clinic every Sunday evening, 4-7pm. Come early and bring something to read. You may bring someone with you for emotional support.

Gonorrhea / Chlamydia / NGU/NSU / HIV/AIDS / Hepatitis
Herpes / Syphilis / Genital Warts / Molluscum / Lice/Scabies

GONORRHEA

Clap, drip, GC, Neisseria gonorrhea

What to watch for:

Symptoms usually appear in 2-21 days.
Many people have no symptoms.
Thick yellow or white discharge from the penis, vagina, or rectum.
Burning or pain when you urinate (pee) or have a bowel movement.
Women may also have cramps, more pain than usual during periods, and pain in the lower abdomen (belly).

How do you get gonorrhea?

By having unprotected (no condom) oral, vaginal, or rectal sex with someone who has the gonorrhea bacteria.
A mother with gonorrhea can give it to her baby during childbirth.

What if you don't get treated?

You can give gonorrhea to your sexual partner.
The infection can travel to other organs and lead to more serious infections.
Reproductive organs can be damaged. Both men and women might not be able to have children.

How do you test for gonorrhea?

A positive gonorrhea culture (swab) or
A positive gram stain (slide)

How do you treat gonorrhea?

Take ALL the medication prescribed for you exactly as instructed AND
Return for a test of cure in 2 weeks. If you stop too soon, you might still have the infection and not know it. It could spread to other parts of your body or to your sexual partners.
Inform recent partners that they need to get checked to see if they also need treatment.

CHLAMYDIA

Chlamydia

What to watch for:

Symptoms usually appear in 7-21 days.
Many people have no symptoms.
Often there is a watery, white discharge from the penis, vagina or rectum.
Often there is burning or pain when you urinate (pee) or have a bowel movement.
Women may also have a fever, pain in the abdomen (belly) and bleeding from the vagina.

How do you get Chlamydia?

By having unprotected (no condom) oral, vaginal, or rectal sex with someone who has the chlamydia bacteria.
A mother with chlamydia can give it to her baby during childbirth.

What if you don't get treated?

You can give chlamydia to your sexual partners.
Chlamydia can travel to other organs and lead to more serious infections.
Reproductive organs can be damaged. Both men and women might not be able to have children.

How do you test for chlamydia?

A positive chlamydia culture (swab)

How do you treat chlamydia?

Take ALL the medication prescribed for you exactly as instructed AND
Return for a test of cure in 2 weeks. If you stop too soon, you might still have the infection and not know it. It could spread to other parts of your body or to your sexual partners.
Inform recent partners that they need to get checked to see if they also need treatment.

NGU/NSU

Nongonococcal or nonspecific urethritis

What to watch for:

Symptoms usually appear in 1-3 weeks.
Many people have no symptoms.
Often there is a yellow or white discharge from the penis, vagina, or rectum.
Often there is burning or pain when you urinate (pee) or have a bowel movement.
Women may also have cramps or pain in the abdomen (belly).

How do you get NGU or NSU?

By having unprotected (no condom) oral, vaginal, or rectal sex with someone who has NGU or NSU bacteria.
A mother with NGU or NSU can give it to her baby during childbirth.

What if you don't get treated?

You can give NGU or NSU to your sexual partners.
NGU can travel to other organs and lead to more serious infections.
Reproductive organs can be damaged. Both men and women might not be able to have children.

How do you test for NGU or NSU?

A positive urinalysis and
Other tests for gonorrhea and chlamydia are negative.

How do you treat NGU or NSU?

Take ALL the medication prescribed for you exactly as instructed AND
Return for a test of cure in 2 weeks. If you stop too soon, you might still have the infection and not know it. It could spread to other parts of your body or to your sexual partners.
Inform recent partners that they need to get checked to see if they also need treatment.

HIV (AIDS)

Acquired Immune Deficiency Syndrome caused by Human Immunodeficiency Virus

What to watch for:

Symptoms start several months to several years after contact with the virus.
Flu-like feelings that don't go away.
Unexplained weight loss.
Diarrhea
White spots in the mouth.
Purple bumps on the skin and inside mouth, nose or rectum.

How do you get HIV (AIDS)?

By having unprotected (no condom) rectal or vaginal sex and possibly oral sex with a person infected by the HIV (AIDS) virus.
By sharing needles to inject IV drugs with someone infected with the HIV virus.
A mother with the HIV (AIDS) virus can give it to her baby in the womb, during birth, or while breast feeding.

What if you don't get treated?

HIV (AIDS) cannot be cured. Most people who are infected with the HIV (AIDS) virus will eventually die of complications.
You will always be able to infect others if you have unprotected sex or share needles.

How do you test for HIV (AIDS)?

An HIV antibody blood test.

How do you treat HIV (AIDS)?

There is no cure for HIV (AIDS). But, you can learn how to strengthen your immune system, and there are medications which slow the progression of the disease. Many infected for 10 or more years still feel well.
Find out about classes, books, support groups, and clinics specializing in HIV (AIDS) information and care in your area.

HEPATITIS

Hepatitis A, B, and C

What to watch for:

Symptoms usually start in about 2-6 weeks and last as long as six months.
General feeling of ill health with fatigue, muscle and joint pain, sore throat, mild abdominal pain, fever, nausea, and vomiting.
Skin and whites of eyes turn yellow.
Dark urine and pale bowel movements.

How do you get hepatitis?

Hepatitis A (HAV): By oral-fecal contact as in poor hand washing or oral-anal sex.
Hepatitis B (HBV): By exchange of body fluids as in unprotected (no condom) oral, vaginal, or rectal sex or by sharing needles.
Hepatitis C (HCV): Mainly by sharing needles, but possibly during sex also.

What if you don't get treated?

Hepatitis A heals on its own and rarely causes serious illness or death.
Hepatitis B will usually heal on its own but serious complications may occur, leading to liver damage or cancer. (More people die from hepatitis than from AIDS.)
People with hepatitis B & C can become chronic carriers, transmitting the virus to others even though they no longer have symptoms themselves.

How do you test for hepatitis?

Blood tests for the HBsAg surface antigen in the early stages or
After 2 to 4 months, blood tests for the HBV or HCV antibodies.

How do you treat hepatitis?

Rest is the only treatment.
People with hepatitis need to eat well and to avoid drugs and alcohol which damage the liver. In most cases, recovery is complete in 3-16 weeks. In more severe cases, complete bed rest and hospitalization might be necessary.
Inform recent partners that they need to get checked to see if they also need treatment.
Get the hepatitis B vaccine if you have not already been exposed to the virus!

SYPHILIS

Treponema pallidum spirochete bacteria

What to watch for:

First Stage
Symptoms usually appear in 1-12 weeks.
A painless, reddish-brown sore usually on the mouth, hands, or sex organs.
Sore lasts 1-5 weeks, then goes away, but you still have syphilis.
Second Stage
Three to six months after the sore appeared, a generalized rash appears anywhere on the body along with flu-like feelings.
The rash and flu-like feelings go away after 1-2 weeks, but you still have syphilis.

How do you get syphilis?

By having unprotected oral, vaginal, or anal sex with a person infected with syphilis.
A mother with syphilis can give it to her baby during childbirth.

What if you don't get treated?

You can give syphilis to your sexual partners.
Syphilis can travel to other organs of the body and reappear years later, causing heart disease, brain damage, blindness, and death.

How do you test for syphilis?

A VDRL (RPR) blood test.

How do you treat syphilis?

Treatment depends on the stage of the infection, but usually some form of penicillin is required to destroy all the bacteria.
Flu-like symptoms often occur for several hours or days right after receiving penicillin.
Inform all sexual partners during the last 3 months that they need to get checked to see if they also need treatment.

HERPES

Herpes Simplex Virus

What to watch for:

Symptoms usually appear in 2-20 days.
Some people have no symptoms.
Small, painful blisters with clear fluid on the sex organs, mouth, or rectum, often in a small group of 3 to 10 blisters.
Blisters last 1-3 weeks.
Blisters often return every few weeks or months in the same place, usually preceded by itching or burning.

How do you get herpes?

By skin-to-skin contact with herpes blisters of a person infected with herpes. Condoms protect only what they cover, leaving scrotum, buttocks, and other skin surfaces exposed to the virus.
Open blisters contain high concentrations of the virus and are very contagious, but some virus can still be shed even when there are no visible blisters.
A mother with herpes can give it to her baby during childbirth.
Herpes in the eyes can lead to blindness.

What if you don't get treated?

Herpes cannot be cured. The virus remains and blisters may reappear in the same place every few weeks or months. You are always at risk of transmitting herpes to others.

How do you test for herpes?

Herpes is usually diagnosed by history, location, and appearance.
Culture a blister for the herpes virus.
In some cases, herpes antibody titers (blood tests) drawn 2 weeks apart are helpful in diagnosing herpes.

How do you treat herpes?

There is no cure for herpes.
Acyclovir can reduce the severity and frequency of outbreaks for some people.
Avoid heat and friction when blisters are present. Wear loose underwear.
Drying agents or Aspirin might help.
Call the Herpes Hotline to learn more.
Inform recent partners to get checked if they have sores or blisters appear.

GENITAL WARTS

Venereal Warts, Anogential HPV Virus

What to watch for:

Symptoms usually appear in 1-6 months.
Small painless warts with a bumpy "cauliflower" surface on the sex organs or rectum.
The warts do not go away.
Sometimes itching or burning around the sex organs.

How do you get genital warts?

By skin-to-skin contact of your genitals or rectum with the genital warts of someone else. Condoms protect only what they cover, leaving scrotum, anus, and other skin surfaces exposed to the virus.
Once infected, a person always has the virus. There is some risk of infecting others even when there are no visible warts.
Genital warts cannot spread to the hands, abdomen, feet or other places. These are caused by a different wart virus.

What if you don't get treated?

More warts can grow and then they can be harder to get rid of.
Especially for women, warts can lead to precancerous conditions.
How do you test for genital warts?
Genital warts are usually diagnosed by history, location, and appearance.

How do you treat genital warts?

Genital warts cannot be cured. Even after the wart tissue is destroyed, the virus remains and warts can reappear months or years later.
A variety of ways can be used to destroy the wart tissue: Acid, freezing, burning, and cutting are frequently used.
Usually, you will need to return for several treatments. Where tissue was destroyed, a scab will form that will fall off after a few days, occasionally leaving a small scar. While it heals, keep it clean by bathing with mild soap and warm water.
Inform recent partners that this disease is very infectious and to make sure they get checked. Women will need a cervical (vaginal) exam and possibly a pap-smear.

MOLLUSCUM

Molluscum Contagiosum Virus

What to watch for:

Symptoms usually appear in 1-5 months.
Small doughnut shaped bumps about 1-3 mm in diameter, usually on the genitals, buttocks, and thighs. The sunken center of the bumps contains a white cheesy material.
The bumps often remain unchanged for many months and then disappear.

How do you get molluscum?

By skin-to-skin contact with someone infected with molluscum or sometimes indirectly from shared towels or bedding. Condoms protect only what they cover, leaving scrotum, anus, and other skin surfaces exposed to the virus.
What if you don't get treated?
You can transmit molluscum infection to your sexual partners and physically close friends.
For most people, the bumps will eventually disappear on their own.
If scratched, the bumps can become infected with other bacteria.
If a person is immunosuppressed, the body might not be able to resist the molluscum infection and it will become increasingly severe, unsightly, and uncomfortable.

How do you test for molluscum?

There is no test. Diagnosis must be made by history, location, and appearance.
How do you treat molluscum?
For most people, the bumps will eventually disappear on their own.
For aesthetic reasons and to prevent the spread to others, a small drop of acid will destroy the center of the bump, after which the bump will soon go away by itself.
Usually, you will need to return for several treatments. Where tissue was destroyed, a scab will form that will fall off after a few days, occasionally leaving a small scar. While it heals, keep it clean by bathing with mild soap and warm water.
Inform recent partners that they need to get checked to see if they also need treatment.

LICE/SCABIES

Pthirus pubis, Sarcoptes scabei

What to watch for:

Pubic lice (crabs): Itching in the pubic hair of the crotch or buttocks, sometimes spreading to other hairy areas such as the arm pits or chest.
Scabies: Itching, particularly at night after bathing and after exercise, on hands and arms, feet and ankles, genitals, and buttocks. Sometimes there is a rash.
How do you get lice or scabies?
By close physical contact, as through shared linen or during sex. Lice can survive 24-48 hours away from their host and the eggs (nits) can survive several weeks until they hatch.
What if you don't get treated?
You can transmit lice and scabies to your sexual partners and physically close friends.

How do you test for lice and scabies?

Lice and nits can be examined under a magnifying glass to identify them.
Scabies can be identified by their burrows which can be examined further with a microscope.

How do you treat lice and scabies?

Lice: Permethin 1% (Nix) shampoo is left on for 10 minutes then thoroughly rinsed off (shower). Do not let it get in the eyes.
Scabies: Gamma benzene hexachloride 1% (Lindane) lotion is spread thinly on dry skin and left on for 8-12 hours before rinsing it off (shower).
Remove lice/nits from eyes with tweezers; no medication should be used near the eyes.
For both: Clothing and bed linen used in the past two weeks should be washed in hot water and/or dried in a hot cycle, or dry-cleaned.
Hydrocortisone cream or other soothing lotion may be used for the itching which might persist for a few days after treatment.
Treat bed partners and any housemates who also have symptoms.

©Gay Men's Health Collective, Berkeley Free Clinic, May 13, 1995. HTML version produced by Nicolas Sheon, August 31, 1997. This document may be reproduced and redistributed so long as credit is given to the Berkeley Free Clinic and the Managing Desire Web Site (www.managingdesire.org).

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