STI: The agony after the ecstasy

Most people are deathly afraid to go bungee jumping or skydiving. Many feel that these are dangerous sports that carry a significant amount of risk. But how come many of these people continue to practice unprotected, unsafe sex? Consider this: In the United States, for example, skydiving accounts for only about 30 deaths a year. Bungee jumping less than one. On the other hand, thousands of people die each year because of diseases passed on during sex.

There are more than 20 sexually transmitted infections or STIs. The terms venereal disease (VD) and sexually transmitted disease (STD) were once applied to such infections. In the past, the three main STIs were syphilis, gonorrhea, and non-gonococcal urethritis. During more recent years, however, it has been discovered that other disorders, among them human immunodeficiency virus (HIV) infection (AIDS) and hepatitis B, can also be transmitted either by sexual intercourse or by other forms of intimate sexual contact. With the frightening exception of AIDS, which has already claimed millions of lives worldwide, few people actually die of other STIs. Even so, they’re potentially serious and anything but rare.

According to Department of Health statistics, there were about 3.1 million chlamydia cases in the Philippines, 683,000 gonorrhea and 80,000 syphilis cases in 2001. From January to August 2003, for example, 125 new HIV cases have already been reported – an increase of 36 percent from the previous year. A local study done in 1994 showed that among female sex workers, the prevalence of gonorrhea was at 16 percent, chlamydia at 20 percent, trichomonas at 18.6 percent and syphilis at 4.6 percent. The World Health Organization (WHO) has estimated that there are 333 million STI cases each year worldwide. All this despite the fact that STIs nearly always can be avoided.

Keeping STI At Bay

Any sexual activity, including oral and anal sex, can put you at risk. STI is most common in younger and middle-age people. Statistics show that 86 percent of all STI cases occur between ages 15 and 29. The ratio of male versus female sufferers varies with each disease, and no total statistics exists. Nature appears to be on the side of males. Although the issue is still largely unresolved, traditional thought has it that a man’s body is less likely to be invaded by marauding bacteria than a woman’s. That’s because a woman’s vagina is dark, warm and moist – conditions under which bacteria thrive. Can’t say that about a penis. Plus, urination helps flush out whatever gets inside a man’s member. On the flip side, men claim to have more sexual partners over time than women, putting them at greater risk of exposure. Bottom line: Both get STI a lot. So here’s how to avoid potential dangers:

• Consider abstaining. Life offers few promises, but abstaining from sex pretty much guarantees you won’t get an STI. Unless you are in a healthy, monogamous relationship, you may want to contemplate sleeping alone until you meet that special someone you think you might have a future with. And be faithful to your partner.

• Watch the numbers. Obviously though, abstention isn’t for everyone. A 3,432-person study conducted by the US National Opinion Research Center found that more than 50 percent of men claim to have had five or more sex partners after age 18. It’s time to face up to the facts: The more sexually active you are, the greater your potential risk for contracting an STI. And you don’t have to be a Don Juan or have a new partner each week to be at risk.

• Count on prescription relief. Since the advent of antibiotics in the 1940s, many diseases that had plagued people for centuries could now be cured or controlled. So, if you do contract an STI, there’s probably no need to take a religious vow – just take medication. Do consult your doctor. And remember: Self-medication is not the way to go.

• Take the test. If you’re a sexually active adult – whether you’re 18 or 80 – get tested for STI. Not only will testing help prevent the potential long-term damage that can be caused by undetected STI, it will also help ensure you don’t inadvertently infect someone else.

• Use condom sense. It is the C in the ABCs of preventing STIs as recommended by WHO. A is for Abstaining from sex; B is for Being faithful to your partner; and C is for Consistently and correctly using condoms. While my own Catholic upbringing and belief does not allow me to condone the use of condoms, I am well aware that in the real world, condom use is fairly common – not so much as a device for contraception as for prevention of STI.

If you have to use a condom, stick with the latex variety, experts say. Skin condoms, which are made from animal intestines, are porous and may not stop STI from being passed. Lambskin condoms, for example, don’t shield you from the HIV virus as effectively as latex. Don’t use oil-based lubricants – hand lotions or petroleum jelly, for example – with condoms since they damage the latex. Remove condoms immediately after sex. Use a new condom for each sex act. And here’s Dr. Frank Pittman’s hard-and-fast rule for women on condom etiquette: Bring it up before he gets it up!

The More Common STIs

In some ways, it’s easier to guard against an STI than other infectious diseases – at least you know when you’re likely to catch it. But you also have to know what you’re looking for. Below are descriptions of some of the more common STIs, like chlamydia and gonorrhea.

• Chlamydia. It is the most common STI in most countries, including the Philippines and the United States. Hence, it is important to get tested for chlamydia. A bacterial infection, chlamydia is spread by sexual contact. It cannot be spread by sharing toilets, kissing, swimming in pools, or relaxing in hot tubs. Studies have shown that 25 percent of men with chlamydia have no symptoms at all. If symptoms do show up, it is typically about two weeks after the sexual contact. Symptoms include penile discharge (usually whitish and runny), a burning sensation during urination, and occasionally, swelling of the testicles.

Women may develop watery mucus from the vagina, burning with urination, and lower abdominal pain, about one to three weeks after infection. Some women may have no symptoms as well. It can result in sterility in both sexes, as a complication of pelvic inflammatory disease (PID) in women and epididymitis (an inflammation in the scrotum) in men. Treatment for chlamydia consists of oral antibiotics. Both partners have to be treated. A cure is achievable.

• Gonorrhea. Commonly known as clap, it is one of the most common STIs. The bacteria die easily outside the body, so it’s highly unlikely for gonorrhea to be spread by bathtubs, wet towels or by borrowing your best friend’s trunks or bathing suit. Occasionally, however, the disease is spread by objects, such as sexual aids. Gonorrhea typically appears within three to five days, although it may surface in as little as one day or as many as 30 days. Symptoms in men include penile discharge (usually greenish or yellow) and painful urination. Sometimes, the penis head swells. In women, there may be a thick yellowish discharge from the vagina and itching with burning on urination. Gonorrhea can be cured with shots of the proper antibiotics.

• Syphilis. Syphilis has been around at least since the 15th century, so you’d think we’d have learned our lesson by now. Yet, it is still very much with us today. Caused by bacteria, the infection is usually transmitted by direct contact with a sore or rash. It’s usually passed during sex, but you can also catch it from kissing if there’s a sore on the inside of the mouth, or from touching an open sore with bare hands.

Symptoms progress in three stages. The first stage typically occurs between 10 and 90 days after infection. It’s marked by the outbreak of a small, single, painless sore, called a chancre, that pops up where the bacteria entered your body. The second stage, which may last several weeks, includes a rash that rarely itches and generally appears as the chancre fades. The third stage, which may occur years later, brings the whole sad act to a close. Symptoms at this stage include paralysis, blindness, heart problems, nerve damage, insanity, and even death. Although syphilis can be treated with penicillin, the antibiotic only kills the bacteria but can’t reverse the damage already done.

So, the take-home message is this: Be forewarned. One night of unprotected ecstasy can leave you with a lifetime of agony!