Staying Healthy and Preventing STDs

If you choose to have sex, know how to protect yourself against sexually transmitted diseases (STDs).

What are sexually transmitted diseases (STDs)?
STDs are diseases that are passed from one person to another through sexual contact. These include chlamydia, gonorrhea, genital herpes, human papillomavirus (HPV), syphilis, and HIV. Many of these STDs do not show symptoms for a long time, but they can still be harmful and passed on during sex.
How are STDs spread?
You can get an STD by having sex (vaginal, anal or oral) with someone who has an STD. Anyone who is sexually active can get an STD. You don’t even have to “go all the way” (have anal or vaginal sex) to get an STD, since some STDs, like herpes and HPV, are spread by skin-to-skin contact.
How common are STDs?
STDs are common, especially among young people. There are about 20 million new cases of STDs each year in the United States, and about half of these are in people between the ages of 15 and 24. Young people are at greater risk of getting an STD for several reasons:

  • Young women’s bodies are biologically more susceptible to STDs.
  • Some young people do not get the recommended STD tests.
  • Many young people are hesitant to talk openly and honestly with a doctor or nurse about their sex lives.
  • Not having insurance or transportation can make it more difficult for young people to access STD testing.
  • Some young people have more than one sex partner.
What can I do to protect myself?
  • The surest way to protect yourself against STDs is to not have sex. That means not having any vaginal, anal, or oral sex (“abstinence”). There are many things to consider before having sex , and it’s okay to say “no” if you don’t want to have sex.
  • If you do decide to have sex, you and your partner should get tested beforehand and make sure that you and your partner use a condom—every time you have oral, anal, or vaginal sex, from start to finish. Know where to get condoms and how to use them correctly. It is not safe to stop using condoms unless you’ve both been tested, know your status, and are in a mutually monogamous relationship.
  • Mutual monogamy means that you and your partner both agree to only have sexual contact with each other. This can help protect against STDs, as long as you’ve both been tested and know you’re STD-free.
  • Before you have sex, talk with your partner about how you will prevent STDs and pregnancy. If you think you’re ready to have sex, you need to be ready to protect your body and your future. You should also talk to your partner ahead of time about what you will and will not do sexually. Your partner should always respect your right to say no to anything that doesn’t feel right.
  • Make sure you get the health care you need. Ask a doctor or nurse about STD testing and about vaccines against HPV and hepatitis B.
  • Girls and young women may have extra needs to protect their reproductive health. Talk to your doctor or nurse about regular cervical cancer screening and chlamydia testing. You may also want to discuss unintended pregnancy and birth control.
  • Avoid using alcohol and drugs. If you use alcohol and drugs, you are more likely to take risks, like not using a condom or having sex with someone you normally wouldn’t have sex with.
If I get an STD, how will I know?
Many STDs don’t cause any symptoms that you would notice, so the only way to know for sure if you have an STD is to get tested. You can get an STD from having sex with someone who has no symptoms. Just like you, that person might not even know he or she has an STD.
Where can I get tested?
There are places that offer teen-friendly, confidential, and free STD tests. This means that no one has to find out you’ve been tested. Visit FindSTDTest.org to find an STD testing location near you.
Can STDs be treated?
Your doctor can prescribe medicines to cure some STDs, like chlamydia and gonorrhea. Other STDs, like herpes, can’t be cured, but you can take medicine to help with the symptoms.

If you are ever treated for an STD, be sure to finish all of your medicine, even if you feel better before you finish it all. Ask the doctor or nurse about testing and treatment for your partner, too. You and your partner should avoid having sex until you’ve both been treated. Otherwise, you may continue to pass the STD back and forth. It is possible to get an STD again (after you’ve been treated), if you have sex with someone who has an STD.

What happens if I don’t treat an STD?
Some curable STDs can be dangerous if they aren’t treated. For example, if left untreated, chlamydia and gonorrhea can make it difficult—or even impossible—for a woman to get pregnant. You also increase your chances of getting HIV if you have an untreated STD. Some STDs, like HIV, can be fatal if left untreated.
What if my partner or I have an incurable STD?
Some STDs- like herpes and HIV- aren’t curable, but a doctor can prescribe medicine to treat the symptoms.

If you are living with an STD, it’s important to tell your partner before you have sex. Although it may be uncomfortable to talk about your STD, open and honest conversation can help your partner make informed decisions to protect his or her health.

If I have questions, who can answer them?
If you have questions, give us a call at the Alpha Pregnancy Care Center 518-462-2188, were here to help you. Don’t be afraid to be open and honest with your concerns. If you are confused or need advice, we are here to help. Talking about sex doesn’t need to be a one-time conversation. It’s best to leave the door open for conversations in the future. It’s also important to talk honestly with a doctor or nurse. Ask which STD tests and vaccines they recommend for you.

Women who are pregnant can become infected with the same sexually transmitted diseases (STDs) as women who are not pregnant. Pregnant women should ask their doctors about getting tested for STDs, since some doctors do not routinely perform these tests.

Can pregnant women become infected with STDs?
Women who are pregnant can become infected with the same sexually-transmitted diseases (STDs) as women who are not pregnant. Pregnancy does not provide women or their babies any additional protection against STDs. Many STDs are ‘silent,’ or have no symptoms, so women may not know they are infected. A pregnant woman should be tested for STDs, including HIV (the virus that causes AIDS), as a part of her medical care during pregnancy. The results of an STD can be more serious, even life-threatening, for a woman and her baby if the woman becomes infected while pregnant. It is important that women be aware of the harmful effects of STDs and how to protect themselves and their children against infection. Sexual partners of infected women should also be tested and treated.
How do STDs affect a pregnant woman and her baby?
STDs can complicate pregnancy and may have serious effects on both a woman and her developing baby. Some of these problems may be seen at birth; others may not be discovered until months or years later. In addition, it is well known that infection with an STD can make it easier for a person to get infected with HIV1. Most of these problems can be prevented if the mother receives regular medical care during pregnancy. This includes tests for STDs starting early in pregnancy and repeated close to delivery, as needed.

Human Immunodeficiency Virus
Human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome, or AIDS. HIV destroys specific blood cells that are crucial to helping the body fight diseases. According to CDC’s 2011 HIV surveillance data, women make up 25% of all adults and adolescents living with diagnosed HIV infection in the United States2. The most common ways that HIV passes from mother to child are during pregnancy, labor and delivery, or through breastfeeding. However, when HIV is diagnosed before or during pregnancy and appropriate steps are taken, the risk of mother-to-child transmission can be lowered to less than 2%3. HIV testing is recommended for all pregnant women. A mother who knows early in her pregnancy that she is HIV-positive has more time to consult with her healthcare provider and decide on effective ways to protect her health and that of her unborn baby.

Syphilis
Syphilis is primarily a sexually transmitted disease, but may be passed to a baby by an infected mother during pregnancy. Passing syphilis to a developing baby can lead to serious health problems. Syphilis has been linked to premature births, stillbirths and, in some cases, death shortly after birth7. Untreated infants that survive tend to develop problems in multiple organs, including the brain, eyes, ears, heart, skin, teeth, and bones. Screening for syphilis should be performed in all pregnant women during their first prenatal medical visit and repeated in the third trimester, if the patient is considered to be at high risk.

Hepatitis B
Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). A mother can pass the infection to her baby during pregnancy. While the risk of an infected mother passing HBV to her baby varies depending on when she becomes infected, the greatest risk happens when mothers become infected close to the time of delivery14 Infected newborns also have a high risk (up to 90%) of becoming chronic (lifelong) HBV carriers themselves15. Infants who have a lifelong infection with HBV are at an increased risk for developing chronic liver disease or liver cancer later in life. Approximately one in four infants who develop chronic HBV infection will eventually die from chronic liver disease13. Mother-to-child transmission of HBV can be prevented by screening pregnant women for the infection and providing treatment to at-risk infants shortly after birth. Information on mother-to-child transmission of HBV can be found at http://www.cdc.gov/hepatitis/HBV/PerinatalXmtn.htm.

Hepatitis C
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV), and can be passed from an infected mother to her child during pregnancy. Overall, an infected mother will pass the infection to her baby 10% of the time, but the chances are higher in certain subgroups, such as women who are also infected with HIV16. Regular testing of pregnant women for HCV is not recommended, however, it should be considered for individuals who have risk factors known to be linked to HCV, including injection drug use. In some studies, infants born to HCV-infected women have been shown to have an increased risk for being small for gestational age, premature, and having a low birth weight15. Newborn infants with HCV infection usually do not have symptoms, and a majority will clear the infection without any medical help. Liver disease tends to move forward more slowly in children infected with hepatitis C and they respond slightly better to treatment compared to adults.

Chlamydia
Chlamydia is the most common sexually transmitted bacterium in the United States4. Although the majority of chlamydial infections do not have symptoms, pregnant women may have abnormal vaginal discharge, bleeding after sex, or itching/burning with urination. Untreated chlamydial infection has been linked to problems during pregnancy, including preterm labor, premature rupture of the membranes surrounding the baby in the uterus, and low birth weight5. The newborn may also become infected during delivery as the baby passes through the birth canal. Neonatal (newborn) infections lead primarily to eye and lung infections. All pregnant women should be tested for chlamydia at their first prenatal visit. Repeat testing in the third trimester should be done for women at high risk.

Gonorrhea
Gonorrhea is a common STD in the United States. Untreated gonococcal infection in pregnancy has been linked to miscarriages, premature birth and low birth weight, premature rupture of the membranes surrounding the baby in the uterus, and infection of the fluid that surrounds the baby during pregnancy6. Gonorrhea can also infect an infant during delivery as the infant passes through the birth canal. If untreated, infants can develop eye infections. Because gonorrhea can cause problems in both the mother and her baby, it is important to accurately identify the infection, treat with effective antibiotics, and closely follow up to make sure that the infection has been cured.

Bacterial Vaginosis
Bacterial vaginosis (BV), a common cause of vaginal discharge in women of childbearing age, is a condition in which the ‘good’ and ‘bad’ bacteria in the vagina are out of balance. BV is often not considered an STD, but it is linked to sexual activity. There may be no symptoms or a woman may complain of a foul-smelling, fishy, vaginal discharge. BV during pregnancy has been linked to serious pregnancy complications, including premature rupture of the membranes surrounding the baby in the uterus, preterm labor, premature birth, infection of the fluid that surrounds the baby, as well as infection of the mother’s uterus after delivery8. Testing all pregnant women for bacterial vaginosis is not currently recommended. However, there is some evidence to support testing and treating BV among women at high risk for preterm delivery9-11. There are no known direct effects of BV on the newborn.

Trichomoniasis
Vaginal infection due to the parasite Trichomonas vaginalis is a very common STD. Symptoms can vary widely among those women infected. Although some women report no symptoms, others complain of itching, foul odor, discharge, and bleeding after sex. Pregnant women are not usually screened for the infection. However, pregnant women with abnormal vaginal discharge should be evaluated forTrichomonas vaginalis and treated appropriately. Infection in pregnancy has been linked to premature rupture of the membranes surrounding the baby in the uterus, preterm birth, and low birth weightinfants12. Rarely, the female newborn can get the infection when passing through the birth canal during delivery and have vaginal discharge after birth.

Herpes Simplex Virus
Herpes Simplex Virus (HSV) is a virus that has two distinct types, HSV-1 and HSV-2. Infections of the newborn can be of either type, but most are caused by HSV-2. Overall the symptoms of genital herpes are similar in pregnant and non-pregnant women; however, the major concern regarding HSV infection relates to complications linked to infection of the newborn. Although transmission may occur during pregnancy and after delivery, 80 – 90% of HSV infections in newborns occur when the baby passes through the mother’s infected birth canal18. HSV infection can have very serious effects on newborns, especially if the mother’s first outbreak occurred late in pregnancy (third trimester). Women who are infected for the first time in late pregnancy have a high risk of infecting their baby. Cesarean section is recommended for all women in labor with active genital herpes lesions or early symptoms, such as vulvar pain and itching19-20.

Human Papillomavirus
Human papillomaviruses (HPV) are viruses that most commonly involve the lower genital tract, including the cervix (opening to the womb), vagina, and external genitalia. Genital warts are symptoms of HPV infection that can be seen, and they frequently increase in number and size during pregnancy. Genital warts often appear as small cauliflower-like clusters which may burn or itch. If a woman has genital warts during pregnancy, treatment may be delayed until after delivery. When large or spread out, genital warts can complicate a vaginal delivery. In cases where there are large genital warts that are blocking the birth canal, a cesarean section may be recommended. Infection of the mother may be linked to the development of laryngeal papillomatosis in the newborn. This is a rare growth in the larynx (voice box) that is not cancer.

Should pregnant women be tested for STDs?
Screening and treating pregnant women for STDs is a vital way to prevent serious health complications to both mother and baby that may otherwise happen with infection. The sooner a woman begins receiving medical care during pregnancy, the better the health outcomes will be for herself and her unborn baby. The Centers for Disease Control and Prevention’s 2010 STD Treatment Guidelines recommend screening pregnant women for STDs1. The CDC screening recommendations are incorporated into the recommendations below.

Chlamydia Screen all pregnant women at first prenatal visit; 3rd trimester rescreen if younger than 25 years of age and/or high risk group.
Gonorrhea Screen all pregnant women at risk at first prenatal visit; 3rd trimester rescreen women at continued high risk
Risk factors include: women younger than 25 years, living in a high morbidity area, previous GC infection, other STDs, new or multiple sex partners, inconsistent condom use, commercial sex work, drug use.
Syphilis Screen all pregnant women at first prenatal visit; during 3rd trimester rescreen women who are at high risk for syphilis or who live in areas with high numbers of syphilis cases, and/or those who were not previously tested or had a positive test in the first trimester.
Bacterial Vaginosis Test pregnant women who have symptoms or are at high risk for preterm labor
Trichomoniasis Test pregnant women with symptoms
Herpes (HSV) Test pregnant women with symptoms
HIV Screen all pregnant women at first prenatal visit; rescreening in the third trimester recommended for women at high risk for getting HIV infection
Hepatitis B Screen all pregnant women at first prenatal visit
Retest those who were not screened prenatally, those who engage in behaviors that put them at high risk for infection and those with signs or symptoms of hepatitis at the time of admission to the hospital for delivery
Risk factors include: having had more than one sex partner in the previous six months, evaluation or treatment for an STD, recent or current injection-drug use, and an HBsAg-positive sex partner
Human Papillomavirus There is not enough evidence to make a recommendation
Hepatitis C All pregnant women at high risk should be tested at first prenatal visit

Pregnant women should ask their doctors about getting tested for these STDs. It is also important that pregnant women discuss any symptoms they are experiencing and any high-risk sexual behavior that they engage in, since some doctors do not routinely perform these tests. Even if a woman has been tested in the past, she should be tested again when she becomes pregnant.

Can STDs be treated during pregnancy?
STDs, such as chlamydia, gonorrhea, syphilis, trichomoniasis and BV can all be treated and cured with antibiotics that are safe to take during pregnancy. STDs that are caused by viruses, like genital herpes, hepatitis B, hepatitis C, or HIV cannot be cured. However, in some cases these infections can be treated with antiviral medications or other preventive measures to reduce the risk of passing the infection to the baby. If a woman is pregnant or considering pregnancy she should be tested so she can take steps to protect herself and her baby.
How can pregnant women protect themselves against infection?
Latex male condoms, when used consistently and correctly, can reduce the risk of getting or giving STDs and HIV. The surest way to avoid STDs and HIV is to abstain from vaginal, anal, and oral sex or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.