What is chlamydia?
Chlamydia (cla-mid-ee-ah) is a sexually transmitted infection (STI) caused by a bacteria called Chlamydia trachomatis. It can spread from person to person during sexual intercourse (vaginal and anal) when a person's mucous membranes come into contact with the vaginal secretions or semen of an infected person. It can be transmitted without complete insertion of a penis into the vagina or anus. It is less likely, although possible, to be transmitted to the throat during oral sex. It can also be passed from mother to newborn during childbirth. Chlamydia infections are treatable and curable with antibiotics.

Why worry about chlamydia?
Untreated chlamydia can lead to severe reproductive health problems for women, including sterility. Pelvic inflammatory disease (PID) is a common result of untreated chlamydia infection. In PID, the bacteria move from the vagina up through the cervix and into the uterus, fallopian tubes and ovaries. Blockage and scarring can damage the tubes, causing women who conceive to be more likely to have "tubal pregnancies."

In men, untreated chlamydial infections can lead to prostatitis (inflammation of the prostate gland), urethral scarring, infertility, or epididymitis (inflammation of the cord-like structure at the back of the testes).

If you are HIV positive and have chlamydia, inflamed genital tissues contain highly concentrated amounts of the virus, causing 8-10 times more HIV to be shed in your semen or vaginal secretions. If you are HIV negative and have chlamydia, your immune cells are especially susceptible to HIV if your partner is carrying the virus. Rectal chlamydia may increase chances of getting HIV ten to twenty-fold.

What are the symptoms?
Symptoms usually appear from one to three weeks after infection, but then go away, even if left untreated. Many people infected with chlamydia never have any symptoms at all.

Women may experience pain and itching of the vulva or vagina; vaginal discharge; unusual vaginal or anal bleeding; pain with urination; and/or pain when having sex. 80% of infected women have no symptoms.

Men may experience discharge from the head of the penis or the anus; pain or itching at the head of the penis; and/or pain with urination. 50% of infected men have no symptoms.

What is a chlamydia test like?
A complete examination for chlamydia includes taking a sexual history, examining any symptoms you might be having and testing a sample of your genital secretions with a swab. In addition, there is a chlamydia test that can be done on a urine sample. The exact test(s) done will depend on where you go for your exam.

Some providers recommend that you get tested for gonorrhea at the same time as your chlamydia test. Talk to your provider about the options available to you when you go to get tested.

How is chlamydia treated?
Antibiotics cure chlamydia. It is very important to take all the pills you are given even if you feel better, so the bacteria is completely wiped out.

What can I do if I have chlamydia?
Your sex partner(s) must be examined and treated too, because otherwise they can give the infection back to you and/or infect others. You need to abstain from sex for one week from when the antibiotics were started. If you still have symptoms after you've completed the treatment, it's important to go back to your provider for a check-up.

Once you are treated and cured of chlamydia, you can be re-infected if you're exposed to the bacteria again.

How do I avoid getting chlamydia?
Abstinence is the only way to completely avoid getting chlamydia or other STIs. If you're sexually active, using condoms consistently and correctly for oral, anal and vaginal sex is your best bet for staying sexually healthy. Since chlamydia can be passed even if the penis or tongue does not completely enter into the vagina or rectum, it's important to use a condom from the very beginning to end of sexual contact.

The risk for chlamydia is directly related to the number of sex partners you have: The more sex partners, the greater the risk of contracting it. Having more sex with fewer partners reduces your risk of getting chlamydia.

If you have a new partner with whom you intend to be monogamous, consider having full STI checkups together before you start having sex. If you're sexually active with more than one monogamous partner, regular STI checkups at least every six months is recommended. Chlamydia and other bacterial STDs are curable with proper diagnosis and treatment.

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What is Hepatitis?
Hepatitis is the name for inflammation of the liver caused by several different viruses. The viruses are classified by letters of the alphabet - with types A, B, and C being the most common. Each of these viruses can be transmitted in a number of ways, some sexually. Hepatitis B and C viruses can cause inflammation of the liver, liver failure, liver cancer, and death. Hepatitis B is the most common cause of liver cancer in the world. Chronic Hepatitis C (HCV) is the leading cause for liver transplants.

How many people have it?
It is estimated that there are between 125,000 and 200,000 Hepatitis A infections (HAV) per year in the United States. Approximately 1.25 million people in the United States have chronic Hepatitis B virus (HBV), with an estimated 78,000 new HBV infections each year. HCV is the most common chronic blood borne infection in the United States. It is estimated that about 4 million Americans have been infected with HCV, of whom 2.7 million have chronic infections. There are approximately 25,000 new infections in the U.S. each year.

Why worry about Hepatitis?
HAV usually runs its course without treatment. Once infected, you cannot be re-infected. Both HBV and HCV can attack in acute or chronic forms. The acute forms resemble a bad illness that can last for a few weeks, up to a few months. If the illness turns chronic (long-lasting), both Hepatitis B and C can ultimately lead to liver failure and death.

Important Note: Hepatitis B infection in someone who is HIV+ is more likely to turn into chronic HBV. It is estimated that 5,000 people die each year in the United States due to complications of cirrhosis (scarring of the liver that interferes with liver function) and liver cancer as a result of HBV.

How is Hepatitis spread?
HAV is highly contagious and is spread from person to person via contaminated food, water or stool. A person is most infectious in the two weeks after exposure, but before symptoms show up - which means people can spread the virus without even knowing they have it.

Poor hand washing and contaminated water supplies can easily transmit HAV, as well as many types of anal sex such as rimming, fisting, fingering, and anal intercourse. Contact with something that's been in contact with the anus of an infected person can also transmit the virus. This means that sharing sex toys, kissing someone who's been rimming, and sucking someone who's just topped someone else can all be risky activities for transmitting HAV.

HBV is the most common sexually-transmitted type of viral hepatitis. People can be infected through anal and vaginal sex by sharing body fluids (blood, semen and vaginal fluids). It is possible, although rare, for Hepatitis B to be transmitted solely via oral sex. People who share or use needles with contaminated blood can be infected. Currently, blood transfusions are rarely the cause of HBV infections in the United States due to the improved screening of blood supplies. Although tattoo, body piercing, and acupuncture needles may transmit HBV, they account for only a small proportion of the total reported cases in the United States.

People who share or use needles or injection drug equipment (works, cotton, cookers, spoons) contaminated with blood can be infected with HCV. Most cases of HCV in the general population today have been the result of blood transfusions in the past. The risk of HCV transmission via oral and anal sex is unknown, but likely to be very low. Currently, proper screening for Hepatitis B and C is being done on all blood supplies in the United States.

The risk of transmission via oral and anal sex is unknown, but likely to be very low.

What are the symptoms?
Within all three types of hepatitis - A, B, C - the severity and type of symptoms vary greatly. Many people do not have symptoms at all. If you do have symptoms, they could include fatigue, stomach pain, yellowing of the skin or eyes (jaundice), dark urine, light colored stool and/or fever.

In Hepatitis A, symptoms usually appear 2-6 weeks after infection. In Hepatitis B, symptoms usually appear 6 weeks to 6 months after exposure, if at all. Hepatitis C symptoms, if any, will show up 2 weeks to 6 months after exposure. Symptoms may be brief or last several weeks.

What is a Hepatitis test like?
Hepatitis is diagnosed via a blood test for hepatitis antibodies. HAV antibodies may be detected as early as the onset of symptoms. HBV usually takes between 3 weeks to 2 months to show up in the blood. The average time it takes for a person infected with Hepatitis C to develop antibodies is 8-9 weeks after exposure.

How is Hepatitis treated?
General treatment for all types of early hepatitis is bed rest and fluid intake. Fluid intake is important to prevent dehydration. Avoidance of alcohol is strongly encouraged to reduce further liver damage. Hepatitis A and acute forms of B and C will eventually run their course, although recovery may take several months.

Chronic HBV can be a fatal disease. There is no cure, although treatments are available to help stop virus replication. Interferon, an antiviral agent, has been 40 percent effective in eliminating chronic HBV infection. It is most effective for people who were infected as adults.

New prescription drugs are now also available including Lamivudine (Epivir) and Adefovir dipivoxil (Hepsera). Talk to your health care provider for more information and to see whether they may be right for you.

HCV is treatable. New studies have shown that up to nearly 50% of people who undergo one year of therapy can be cured. Treatment will differ depending on the stage of illness at the time you seek treatment. Your health care provider can help you make the best decisions about your treatment based on your personal needs and health status.

What can I do if I have Hepatitis?
The most important thing is to avoid alcohol and other drugs like acetaminophen (the active ingredient in Tylenol and Vicodin) because it can further damage your liver. In general, you want to eat healthfully, get plenty of rest, and exercise moderately. You need to see your medical provider on a regular basis to work together on your treatment plan. Don't take any new medications, including herbal or over-the-counter drugs, without talking to your provider first.

If you know you have HBV, you can protect others by using condoms during sexual activity.

If you know you have HCV, you can protect others by not donating blood, body organs, tissue or semen; covering any cuts or sores you have to prevent spreading infectious blood or secretions; not sharing personal hygiene items such as razors or toothbrushes and not sharing needles or any other works. Currently there are no recommendations for condom use with HCV infected partners, however there are many other reasons to use condoms regularly for sexual activity.

How do I avoid getting Hepatitis?
Effective vaccinations are available to protect you against Hepatitis A and B. Both are recommended for those at high-risk of infection including men who have sex with men and health workers. Currently there are no shots to protect you against Hepatitis C.

A new combination vaccine called Twinrix has been approved for protection from both HAV and HBV in people who are 18 and older. It reduces the total number of injections for vaccination from both viruses from five to three.

If you have not yet been vaccinated and you engage in anal sex activities, using condoms for intercourse and cut-up non-lubricated condoms, household plastic wrap or dams (square pieces of latex) for oral-anal sex can significantly reduce your risk of contracting hepatitis. In addition, wash your hands and sex toys as soon as possible after anal contact.

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What is Herpes?
Herpes is a sexually transmitted disease caused by two herpes simplex virus (HSV type I and type II). Herpes is transmitted from person to person via direct skin-to-skin contact during oral, anal and vaginal sex. HSV I usually causes fever blisters and cold sores on the mouth, but can also cause sores on the genitals. HSV II usually causes sores on the genitals (vagina, penis, anus) and the skin around those areas. The majority of oral herpes cases are caused by HSV I and the majority of genital herpes cases are caused by HSV II; however, since so many people are now having oral sex, type-I is increasingly appearing in the genitals. HSV is different from other common viral infections because once it is introduced into your system, it lives there forever, often with periodic symptoms or without symptoms at all.

Why worry about Herpes?
Genital herpes is seldom a severe or dangerous infection by itself, although it can cause psychological distress because of the nature of the sores and the length of time the virus stays in your system.

The open sores of herpes do play a role in the spread of HIV. A person with a herpes sore is three to five times more likely to acquire HIV if exposed to an HIV-positive sex partner. Also, people with HIV and herpes have an increased amount of HIV fluid in their open herpes sores, which increases the risk of transmitting both diseases to a partner during unprotected sex.

Pregnant women who have a first episode of genital herpes near delivery may transmit herpes to their infant, which could be a serious, even deadly, problem. Fortunately, infection of infants is rare among women with recurrent genital herpes.

What are the symptoms?
Many people have genital herpes but don't know it because they have no symptoms. Others have very mild symptoms. For the third group, who are symptomatic, the first outbreak is usually the worst. It lasts the longest, is most severe and often very uncomfortable. The initial sores can last five to ten days, first "weeping", then scabbing over, then healing. In addition to blisters or open sores, a person may have swollen glands, fever, and body aches. Women tend to have more severe symptoms than men.

Genital recurrences after the first outbreak seem to be linked to stress, fatigue, lack of sleep, menstruation, and genital friction (new sexual partner after a time of no sex), although more research is definitely needed about this subject. Usually recurrences are more frequent in the first year after the initial outbreak. Some people have tingling or itching at the site of the sores before they appear, which can help them prepare for an upcoming outbreak. For some people, the recurrences are so mild that they have been mistaken for jock itch, razor burns, insect bites, ingrown hairs, and the like. Outbreaks can appear in different locations over time.

What is a Herpes test like?
In most cases, experienced clinicians can diagnose an initial herpes outbreak by its appearance. There are also viral culture tests available that can tell if herpes is present and which type (HSV I or HSV II). These tests use fluid from an open sore and are most accurate during initial outbreaks and when blisters are present.

There are several new blood tests that can be used to confirm diagnosis but aren't reliable for screening. These tests also distinguish type (HSV I or HSV II). Speak to your medical provider about these tests if you're interested.

How is Herpes treated?
There is no cure for herpes. However there are currently three FDA-approved antiviral medications that are available to treat herpes: Zovirax (acyclovir), Famvir (famciclovir) and Valtrex (valacyclovir). Using medication to treat genital herpes can help speed the healing process of an outbreak or be used as a preventative (when taken daily) to help reduce the frequency of future outbreaks.

Valtrex have also been proven effective when taken daily to reduce the risk of transmission of herpes to sex partners. The most common short-term side effects of these drugs are nausea and headaches. Thus far, no long-term side effects have been named.

What can I do if I have Herpes?
In order to reduce outbreaks, keep your stress levels low, eat well, exercise regularly and get lots of rest. Learn to recognize the symptoms that occur during the period before the lesions appear. People often describe a tingling or burning feeling during this time. Taking medications in this time period before an outbreak can abort or reduce the duration.

In order to avoid transmission of the virus to your sex partners, we advise discussing your herpes diagnosis with a prospective partner before you have sex. A potential partner would need to understand that it's possible for him or her to become infected even if you're using condoms since not all affected areas can be covered by a condom. Most good relationships can weather the news. Your partner may want to gather information and take some time to adjust to the fact that you have herpes. If you're in a serious, long-term relationship, your partner might want to test for herpes as he or she might already be infected, but without symptoms. For more information on talking to your sex partners about herpes, click here.

How do I avoid getting Herpes?
Condoms provides some, but not complete protection, against transmission of the herpes virus. If you or your partner has herpes, abstain from sexual activities when sores are present. Communication is a wonderful tool to help you and your partner(s) make decisions about what's right for each of you at any given time.

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What are HIV and AIDS?
AIDS stands for Acquired Immune Deficiency Syndrome and is a group of health problems caused by a virus called HIV, the Human Immunodeficiency Virus. HIV is transmitted from person to person via exchange of bodily fluids - semen, blood, and vaginal fluids - during anal, vaginal, and possibly oral sex, or when sharing needles during intravenous drug use.

People who test positive for HIV do not necessarily have AIDS. Many people are HIV+ but don't show symptoms of illness for years, if at all. People who do get AIDS can get very ill and die from infectious diseases and cancers that usually don't cause problems for other people. There is currently no cure for AIDS.

Why worry about HIV/AIDS?
People with HIV show signs of AIDS when their immune system is seriously damaged. People with AIDS can suffer from what are called opportunistic infections, such as Kaposi's sarcoma (a skin cancer), PCP (a lung infection), CMV (a virus that infects the eyes), and candida (a fungal infection). AIDS-related health problems also include severe weight loss, brain tumors, and a myriad of other health problems.

AIDS shows up differently in every infected person. Some people die soon after getting infected, while others live fairly normal lives for many years after they are diagnosed with AIDS.

There are now treatments available that can slow down the replication of HIV in your body, along with any immune system damage. The treatment is called anti-retroviral therapy. However, there is currently no cure for AIDS.

What are the symptoms?
You might not know if you are infected with HIV. Some people get flu-like symptoms such as fever, headache, sore muscles and joints, stomach ache, swollen lymph glands, or a skin rash four to six weeks after exposure to the virus. However, most people have no symptoms at all.

What is an HIV test like?
If you get infected with HIV, your body tries to fight the infection. It makes antibodies, special molecules that are supposed to fight HIV. The most common HIV test is a blood test which looks for these antibodies. If you have them in your blood, it means that you are HIV positive.

If you become infected with HIV, it usually takes between three weeks and two to three months for your immune system to produce antibodies to HIV. If you think you were exposed to HIV, you should visit your doctor immediately. During your visit, speak to your doctor about the possibility of taking post-exposure prophylaxis or PEP.  PEP should be administered within 72 hours of exposure.

Newer tests can detect HIV antibodies in saliva or a scraping from inside the cheek. A rapid HIV test was approved by the FDA in November 2002. Rapid test results are available within a half an hour after a sample is taken. The home test kits on the market are designed to help you collect your own blood sample. The sample is then sent to a lab where it is tested for HIV.

Clinics and medical providers will offer either confidential or anonymous HIV testing services. Confidential antibody testing means that you and the health care provider know your results, which may be recorded in your medical file. The health care provider and any other staff in the clinic or office are bound by confidentiality not to disclose the results of your test to anyone without your permission.

Anonymous testing means that your name is never associated with your test results. Reports can be made without using your name, but instead via a unique code. Currently, a person who gets either type of HIV test is asked to participate in pre- and post-test counseling.

How is HIV/AIDS treated?
As mentioned earlier, there is no cure for AIDS. There are anti-retroviral drugs now available that can slow down the virus, and slow down the damage to your immune system. These drugs have also helped reduce the overall rates of opportunistic infections in people with AIDS. The drug regime is severe however - many expensive pills have to be taken regularly on a daily basis - and there can be side effects when the pills are taken for a long period of time. Many people who are able to, though, choose to go on anti-retroviral therapy once they are diagnosed HIV+ to stem any potential illness and keep their quality of life high as long as possible. For more detailed and current information about treatment, visit www.hivinsite.org.

What can I do if I have HIV/AIDS?
The best thing you can do is to stay healthy -- keep your stress levels low, eat well, exercise regularly, get lots of rest, and if you're sexually active, have protected sex with your partners. You also need to work closely with a medical provider to monitor your health and determine the best course of continued treatment over time. There are resources available to help HIV+ people in the U.S. get treatment and regular medical services, sometimes at low-cost or reduced fees.

In order to avoid transmission of the virus to your sex partners, as well as to protect yourself from getting other bacterial and viral STDs, we advise discussing your HIV status with a prospective partner before having sex. Communication is one of the keys to keeping our community sexually healthy.

How do I avoid getting HIV/AIDS?
The only way to be 100% sure you won't get HIV/AIDS is to abstain from sex and intravenous drug use. If you're sexually active, using condoms correctly each and every time you have anal or vaginal sex provides the best protection against HIV transmission. While there is not enough scientific evidence available yet to be certain, there are many individuals who also state that they have gotten HIV from participating in oral sex (as givers to infected men). It is advisable to consider using condoms for oral sex as well, especially because other STDs like syphilis and gonorrhea, which can increase your risk of getting HIV, can be transmitted via oral sex.

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