Without a Care, Without a Clue
It’s the blue line for uncertainty.
At the county’s Health Care Agency clinic at 1725 W. 17th St. in Santa Ana, the entrants, a good many in their mid-teens, are told to follow the blue line to complete free testing for a variety of sexually transmitted diseases, known by the acronym STD.
More than 10,000 in this county each year seek testing to see whether they’re carrying the HIV virus that can lead to AIDS. But nearly double that number show up at the county clinic because they fear they’ve put themselves at risk for any number of sex-related diseases--herpes, gonorrhea, syphilis, maybe hepatitis B.
Concern over STDs has heightened around Southern California in recent weeks after the Los Angeles County Health Department declared an outbreak of syphilis among gay men. On Friday, officials said the number of cases had doubled to 51 in a two-week period.
No such outbreak has been reported in Orange County, but officials said they still see a steady stream of people seeking help.
“Some teens who come are afraid to even tell their parents,” said Penny C. Weismuller, the county’s division manager for disease control. “They know they have made a choice sexually that they are worried about. Their concern is great.”
And with good reason. Here’s some news about STDs that might startle a lot of sexually active people--and especially parents of teens beginning to experiment with sex.
The number of people contracting sexually transmitted viruses each year is staggering--about 1 million each year nationwide for herpes alone. And the experts, both in the federal government and in the health field, are estimating that up to 45 million Americans suffer from herpes. The American Social Health Assn., the major national group promoting STD prevention, estimates that 1 of every 4 teenagers will wind up with some kind of disease.
And many of them don’t even know it.
Few Clues
Contrary to what some may think, most STDs, especially herpes, do not include overt symptoms. So the unsuspecting plunge into a sexual relationship without even a clue as to the risk. Although many STDs are not deadly in themselves, some can lead to a higher risk of HIV. They also can lead to cancer or can cause serious complications during pregnancies.
Los Angeles gynecologist Judith Reichman says some of her patients not only are shocked to discover they have an STD such as herpes but are also surprised when she suggests ways it may have happened.
“A young woman is in a monogamous relationship, so she thinks her boyfriend must have cheated on her,” Reichman explained. “But I have to make her understand that it could be the boyfriend was carrying the virus from a previous relationship, or it could be she had caught herpes from a previous relationship herself.”
Reichman is the author of “Relax, This Won’t Hurt,” a new book on women’s health in which she argues strongly for the use of condoms. She also makes clear that both men and women owe it to their partners to tell them whether they have a sexually transmitted disease.
That’s not always easy. No question, the experts all say, that there’s a stigma to being infected with a disease like herpes.
“Most women feel like a pariah when they have it,” Reichman said. Though herpes is mostly a nuisance, so far it isn’t curable.
“A woman believes that no man will ever want to have a relationship with her if she tells him,” Reichman said. “But I try to convey a positive approach, that you can have a good relationship.”
Condoms considerably reduce the risk of transferring the disease to a sexual partner, Reichman said. But with nothing 100% safe, at some point the other party simply has to say, “I’ll take the risk. If I get it, I get it.”
Almost all her female patients with STDs have been able to have successful relationships after learning about it, she said.
Testing for STDs, especially herpes, can be expensive. But the county’s Health Care Agency eliminates that problem. Its testing service is free of charge.
Dr. Weismuller encourages anyone to be tested who feels the need.
“There’s no stigma at our clinic. Our staff is highly professional and isn’t there to embarrass anyone.”
If you plan to visit the clinic, be prepared to stay at least an hour. It doesn’t take appointments. You can call the clinic at (714) 834-8592 for details. Be forewarned that the clinic staff doesn’t offer counseling. You can get such advice, however, through the National STD hotline at (800) 227-8922.
One counselor there--rules require them not to give out their names--said the hotline receives thousands of calls each year from teenagers who feel they have nowhere else to turn.
“They’ve been to the doctor, have been shocked at the news that they have a sexually transmitted disease and don’t realize until they get home that they’ve got a hundred questions about it,” the counselor said. “We try to patiently answer everything. We know they’re scared.”
Too Complacent
Although it’s important to know you can have a sexually active life even with an STD, Weismuller worries at the complacency that she sees as a trend.
“Because we’ve got new treatments to help AIDS patients, some people think that somehow the problem of sexually transmitted diseases has died down,” Weismuller said. “We’ve seen a recent increase in risky behavior among young people.”
Here’s a final word of warning from Reichman: Though most herpes carriers have no symptoms, some do later develop lesions. That’s when you stop all sex, even with a condom.
Said Reichman: “To have intercourse when you have an open lesion, that’s just dumb.”
(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)
A Look at Sexually Transmitted Diseases (STDs)
CURABLE:
CHLAMYDIA
WHAT IS IT? Bacterial infection of the genital area.
WHO GETS IT? About 3 million Americans each year get it. The highest rates among those 15 to 19.
SYMPTOMS: Usually no symptoms, but for some women, vaginal bleeding or pain.
HOW IT’S SPREAD: Through sexual intercourse.
CONSEQUENCES: Pelvic inflammatory disease in women, infertility, increased risk of HIV infection for both men and women.
TREATMENT: Oral antibiotics. Both partners must be treated at the same time, to prevent passing the infection back and forth.
GONORRHEA
WHAT IS IT? An infection caused by small organisms.
WHO GETS IT? About 650,000 Americans a year, the highest rate among those 15 to 19.
SYMPTOMS: Usually no symptoms. For some, a burning sensation while urinating. For some women, abnormal vaginal bleeding.
HOW IT’S SPREAD: Through sexual intercourse or oral sex.
CONSEQUENCES: Increases risk of HIV, can cause pregnancy complications. Blindness or meningitis for the infant are possible.
TREATMENT: Oral antibiotics. Both partners should be treated at the same time.
SYPHILIS
WHAT IS IT? Bacterial infection of the genital area.
WHO GETS IT? About 70,000 Americans a year.
SYMPTOMS: Usually none. But for some, genital sores, or a rash on the palms of the hand or the soles of the feet.
HOW IT’S SPREAD: Through sexual intercourse or oral sex. But it can also be spread through kissing.
CONSEQUENCES: If not caught in time, can lead to brain damage, heart disease or nerve damage.
TREATMENT: Antibiotics, if caught soon enough.
TRICHOMONIASIS (TRICH)
WHAT IS IT? A parasitic genital infection.
HOW MANY GET IT: As many as 5 million Americans each year.
SYMPTOMS: Usually no symptoms. But for some, genital discomfort.
HOW IT’S SPREAD: Sexual intercourse.
CONSEQUENCES: Repetition is common even after treatment. Increased risk of HIV and can cause pregnancy complications.
TREATMENT: Antibiotics. Partners must abstain from all intercourse until the infection is gone.
INCURABLE:
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
WHAT IS IT? Retrovirus that can lead to AIDS.
HOW MANY GET IT? An estimated 650,000-900,000 are living with it now.
SYMPTOMS: Flu-like feeling eventually, but no symptoms at first.
HOW IT’S SPREAD: Through vaginal or anal intercourse, through oral sex, through sharing of needles/syringes during drug use with someone affected, through infected blood.
CONSEQUENCES: Serious health complications, can lead to AIDS-related complications, which are fatal. If a person is unaware he or she has HIV, that person may unknowingly infect his or her sexual partner.
TREATMENT: No known cure. Those infected can be treated to delay the diseases progression.
GENITAL HERPES
WHAT IS IT? A viral infection of the genital area.
HOW MANY GET IT? About 1 million Americans each year; up to 45 million in the U.S. altogether.
SYMPTOMS: Nearly two-thirds infected with genital herpes don’t even know it. Red bumps in the genital areas for some others.
HOW IT’S SPREAD: Through sexual intercourse, or oral sex, or by touching the infected area.
CONSEQUENCES: Recurrent sores and increased risk of HIV. Can cause complications during pregnancy, and can lead to an infant suffering severe illness or permanent disabilities. A cesarean section delivery can reduce this risk.
TREATMENT: No known cure. Some antiviral drugs can reduce the pain and itching and reduce the frequency of recurrent outbreaks.
HEPATITIS B
WHAT IS IT? A viral infection primarily affecting the liver.
HOW MANY GET IT? About 77,000 Americans each year.
SYMPTOMS: Most get no symptoms. Others may suffer severe fatigue, nausea and vomiting, loss of appetite, abdominal tenderness.
HOW IT’S SPREAD: Through sexual intercourse and oral sex, but also through kissing.
CONSEQUENCES: Chronic, persistent inflammation of the liver, and later cirrhosis or cancer of the liver. About 90% of the babies born to women with Hepatitis B will carry the virus unless vaccinated within an hour of birth.
TREATMENT: A vaccine is now available to prevent this STD, but some people who carry it are contagious for the rest of their lives.
Source: American Social Health Association
A Look at Sexually Transmitted Diseases (STDs), Los Angeles Times
