Sexually Transmitted Infections, Part 2: Incurable STIs
Last month, we detailed the specifics of curable sexually transmitted infections (STIs) that are prevalent worldwide and in the United States. To recap, there are more than 30 identified types of bacteria, viruses, and parasites that can spread through vaginal, oral, or anal sex. Of these 30+ infections, we covered the four most common STIs that are fully treatable:
- Chlamydia
- Gonorrhea
- Syphilis
- Trichomoniasis
Because of these and so many additional widespread STIs you can contract, it is important to stay on top of your health through STI testing, especially after changing sexual partners. Those who have reason to believe their current partner has contracted an infection should also undergo testing for complete understanding or peace of mind.
As we mentioned, many STIs can lead to serious health complications, but not all infections are harmful or threatening to your health. Whether curable or incurable, STIs usually come with lots of stigma, misunderstanding, and misinformation, so we want to provide thorough details about these infections for a clearer understanding.
This month, we are covering the most common incurable STIs, including genital herpes, hepatitis B, human immunodeficiency virus (HIV), and human papillomavirus (HPV).
Genital Herpes (HSV-1 & HSV-2)
The herpes virus is an extremely common infection, estimated to affect nearly two thirds of the global population, and is one of the more misunderstood STIs because of the nature of its strains and how it can be contracted.
In its simplest terms, there are two strains of the herpes virus:
Herpes simplex virus type 1 (HSV-1), which is often referred to as oral herpes.
- HSV-1 most commonly causes cold sores or fever blisters in or around the mouth.
- HSV-1 is highly contagious during an outbreak and can be passed via kissing, sharing cups and utensils, and engaging in oral sex.
- Infected persons may not show signs of an outbreak, so it is possible to spread HSV-1 even if there are no warning signs that the person is currently shedding the virus.
- HSV-1 can be transmitted to the genitals through oral sex with an infected person experiencing an outbreak.
Herpes simplex virus type 2 (HSV-2), which is often referred to as genital herpes.
- HSV-2 can infect the areas around the genitals and rectum.
- HSV-2 is highly contagious during an outbreak and can be passed via vaginal, anal, or oral sex.
- Infected persons may not show signs of an outbreak, so it is possible to spread HSV-2 even if there are no warning signs that the person is currently shedding the virus.
- HSV-2 can be transmitted to the mouth or throat through oral sex with an infected person experiencing an outbreak.
Part of the misunderstanding with the herpes virus is because the lines between each strain continue to blur. Even though each strain has its own genetic markup, both lead to the same symptoms, can infect the same areas, and will respond to the same antiviral drugs. Plus, the strains continue to recombine with each other in various ways to create additional recombinant versions, making vaccination and medical protection against herpes a difficult endeavor for researchers.
Symptoms of Herpes
Herpes symptoms are usually mild, and most infected people are asymptomatic. Even though symptoms of an outbreak are rare, they can include:
- Painful, blistering sores that appear around the mouth or genitals, depending on the infection site
- Fever, body aches, or swollen glands, especially during the first outbreak
The sores can vary in pain and usually last one to two weeks before healing. Symptomatic patients usually experience a painful first outbreak but will see a decrease in outbreak severity and frequency over time.
How to Treat Herpes
Herpes is a virus that lives inside your body permanently after infection. However, the virus can be suppressed through prescription antiviral medications. While herpes can activate at any time, a daily medicine regimen can severely decrease its likelihood of activation, lowering your risk of spreading the infection or experiencing an outbreak.
Hepatitis B
Hepatitis B (HBV) is an STI that targets the liver and can wreak havoc on it. While many young people born in the early 90s or later have received a vaccine against this infection, adults born before 1991 are likely not to have received the vaccine and are vulnerable to contracting the virus.
HBV can be acute or chronic, and the virus is spread through bodily fluids, including those shared during unprotected sexual intercourse, like blood, semen, and vaginal discharge. Infected mothers can also spread HBV to their children during birth.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, roughly 0.5% of the US population suffers from HBV infection, making it a virus that is rare but still possible to contract.
Symptoms of HBV
Many people do not show signs of HBV, but those who do tend to experience:
- Fever
- Headaches
- Body aches
- Excessive tiredness
- Poor appetite
- Nausea, vomiting, and diarrhea
Because HBV affects the liver, patients with chronic HBV can also experience symptoms of liver cancer or cirrhosis, which can include:
- Dark urine
- Pain in the abdomen
- Skin or eye yellowing
How to Treat HBV
Not every patient with HBV requires treatment. However, your provider will likely prescribe antiviral medication if you develop chronic HBV. The length of treatment can vary from patient to patient; it depends on your liver’s response to the prescribed medicine.
In cases where the patient develops liver cancer or cirrhosis, the patient may require a liver transplant.
Human Immunodeficiency Virus
Human immunodeficiency virus (HIV) is an STI that weakens the immune system, making it harder for your body to ward off additional infections. The virus spreads through contact with infected bodily fluids, which is most commonly achieved through unprotected sexual intercourse or by sharing needles. It can also pass from a mother to her baby via pregnancy, birth, or breastfeeding.
If not caught early or left untreated, HIV leads to the development of acquired immune deficiency syndrome (AIDS). It can take roughly ten years for an HIV infection to reach this stage.
Symptoms of HIV
While some patients do not experience symptoms after infection, others may feel as if they contracted the flu shortly after infection. They can experience:
- Fever
- Headaches
- Skin rash
- Fatigue
The virus will continue targeting the immune system, and patients will eventually experience:
- Diarrhea
- Extreme fatigue
- Nighttime sweating
- Sudden weight loss
- Swelling of the glands
If ignored, the immune system will become even more fragile and highly vulnerable to developing AIDS.
HIV Treatment
HIV can be managed via a consistent regimen of antiviral medication, or antiretroviral therapy (ART), which suppresses the virus, allowing the infected person to live a healthy life. ART aims to significantly reduce the viral load in the bloodstream to slow its progression and minimize levels to an undetectable amount.
It is crucial to stay on top of your medication regimen every day for ART to be fully effective. Inconsistent medication use can allow the virus to begin multiplying and mutating again, causing the ART to become ineffective.
Human Papillomavirus
Human papillomavirus (HPV) is one of the more confusing STIs because of how many strains there are, how it is spread, and how it can affect your body. It is also the most common STI in the US, affecting both men and women. In fact, the CDC estimates that nearly all sexually active individuals will contract some form of HPV at some point if they are not yet vaccinated. While vaccination is available as a preventative measure against HPV infection, you cannot protect yourself with vaccination if you have already contracted HPV.
There are more than 100 HPV strains, 30+ of which affect the genitals. Most strains are considered “low risk” and do not threaten your overall health, but others are considered “high risk” and can lead to cervical cancer and, in rarer cases, other forms of cancers affecting the anus, penis, throat, vagina, or vulva.
How Is HPV Spread?
The HPV strains that affect the genitals are highly contagious and can be transferred through contact with the skin. Genital areas, including the vulva, vagina, cervix, penis, scrotum, anus, and rectum, can become infected. If a person without HPV touches HPV-infected skin, they are likely to contract HPV at the site of contact, even if no bodily fluids are present or involved. Condoms are not always effective at preventing the spread of HPV, but they can lower your chances of spreading or contracting the infection.
Symptoms of HPV
In most cases, the HPV strains transferred via sexual intercourse do not cause signs or symptoms. However, signs of infection can appear in the form of genital warts or cancer development.
Genital Warts
Those exhibiting symptoms most commonly develop genital warts, which are contagious but harmless. Genital warts are cauliflower-like lumps that can appear within weeks or years after infection. Most of the time, genital warts are painless but can cause itching. Patients can have their warts removed, but wart regrowth is possible because the infection is permanent. Many patients who undergo wart removal will likely have to do so more than once.
HPV-Related Cancer
High-risk HPV strains can lead to certain cancers, the most common of which is cervical cancer. While an HPV diagnosis can be frightening and cause anxiety, it is important to remember that contracting high-risk HPV does not mean cancer is inevitable; it only means cancer is more likely to develop.
Pap Smears & HPV Testing
There are often no signs of high-risk HPV until cancer develops, but infection or cancer development can be detected and caught early through HPV testing and routine pap smears. Patients can receive HPV testing to check for high-risk strains that could lead to cervical cancer. Pap smears will also inform your provider if cancerous or precancerous cells have developed in the cervix.
HPV Treatment
HPV is an incurable infection if contracted, but healthy immune systems can fight many strains and eradicate them within two years of infection.
Ways to protect yourself now and in the future are to:
- Get vaccinated before becoming sexually active
- Get screened and tested regularly
- Practice safe sex
- Inform your partner of any infection
- Request your partner get tested before engaging in sexual activity
This advice can apply to any of the STIs covered in this article.
If you suspect you have contracted a sexually transmitted infection or want to get screened for peace of mind, Women’s Clinic of Atlanta offers STI testing and treatments.
Our providers will thoroughly test for STIs like genital herpes, HBV, HIV, and HPV. If your test results are positive, we’ll inform you of your treatment or management options and provide educational information about your infection.
Schedule an STI screening by texting “appointment” to 404-777-4771 today.
Women’s Clinic of Atlanta is HIPAA compliant and AAAHC accredited.
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