Resources for Best Choices in Relating to Kids About Sex

The Facts About Hepatitis C

What is hepatitis C?

Hepatitis C is an extremely contagious bloodborne disease that can also be sexually transmitted.

How does someone get hepatitis C?

Hepatitis C is primarily transmitted from people sharing needles when shooting drugs. Transmission can also occur if needles used for tattooing or body piercing are not properly sterilized and are then reused. Before 1992, when widespread screening of blood products became the norm, transfusions were a common mode of transmission. In the early 1960s, as many as one in every five transfused blood products was contaminated with Hepatitis C; now the risk is about one in 100,000.² One of every 30 infants born to mothers with hepatitis C is infected during the birth process.³ Hepatitis C can also be sexually transmitted. Multiple sex partners increase the risk for infection. Hepatitis C is not transmitted through the type of casual contact that occurs in a workplace.

What are the symptoms?

About three out of four infected people show no signs or symptoms of infection. Due to liver damage, an infected person may experience jaundice (yellowing of the skin and eyes), severe fatigue, loss of appetite, abdominal pain, nausea and vomiting.

What are some of the long-term effects of a hepatitis C infection?

A significant number of people with hepatitis C have lifelong infections that can cause liver failure, cancer and death.

How does someone find out s(he) has hepatitis C?

Hepatitis C can be diagnosed through a variety of simple blood tests.

How is hepatitis C treated?

There is no vaccine to prevent hepatitis C, although vaccination against hepatitis A and B is recommended to prevent any further damage to the liver. For the same reason, consumption of alcohol is not recommended for people infected with hepatitis C. There are a couple of drug therapies available, but they tend to be expensive, have to be used for extended periods of time and can cause serious side effects, including depression. Even when taken diligently, the drugs are not always effective.

Am I safe if I consistently use a condom?

Studies are lacking, but given the way hepatitis C is transmitted, condoms would not be expected to eliminate your risk of infection, though they might reduce it some.

How can I avoid getting hepatitis C?

Don’t shoot drugs. Never get a tattoo or body piercing from a place that does not have a current inspection certificate from your local health department. If you haven’t had sex and don't shoot drugs, your chances of getting hepatitis C are considerably reduced. If you’ve already been sexually active outside a lifelong mutually faithful relationship (as in marriage), talk to your healthcare provider about getting you and your partner tested for STDs. Abstinence from sexual activity or lifetime faithfulness to one uninfected partner is the only certain way to avoid being infected sexually.

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1 Centers for Disease Control and Prevention. Viral Hepatitis C Fact Sheet. Available at http://www.cdc.gov/ncidod/diseases/hepatitis/c/fact.htm. Accessed July 22, 2003.

2 American Red Cross. Hepatitis C Lookback. Available at: http://chapters.redcross.org/ca/norcal/phys/transfus/hepatitis.htm. Accessed July 21, 2003.

The Facts About Hepatitis B

What is hepatitis B?

Hepatitis B is a common viral bloodborne infection that can also be sexually transmitted.

How does someone get hepatitis B?

About half of all hepatitis B infections are transmitted through sexual activity. People who share needles when shooting drugs are at high risk for infection as well. Transmission can also occur if needles used for tattooing or body piercing are not properly sterilized and are then reused. Most newborns will become infected during the birth process if the mother is infected and the baby is not vaccinated. Hepatitis B is not transmitted through the type of casual contact that occurs in the workplace.

What are the symptoms?

Nearly 30 percent of infected people have no signs or symptoms of infection. Due to liver damage, an infected person may experience jaundice (yellowing of the skin and eyes), severe fatigue, loss of appetite, abdominal pain, nausea and vomiting. Rash, joint pain and fever may also occur.

What are some of the long-term effects of a hepatitis B infection?

A significant number of people with hepatitis B have lifelong infections that can cause liver failure, cancer and death.

How does someone find out s(he) has hepatitis B?

Hepatitis B can be diagnosed through a variety of simple blood tests.

How is hepatitis B treated?

There are numerous drug therapies available that can be used to treat hepatitis B, but they tend to be expensive, have to be used for extended periods of time and can cause serious side effects, including depression. Even when taken diligently, the drugs are not always effective.

Am I safe if I consistently use a condom?

Studies are lacking, but given the way hepatitis B is transmitted, condoms would not be expected to eliminate your risk of infection, though they might reduce it some.

How can I avoid getting hepatitis B?

The Facts About Syphilis

What is syphilis?

Treponema pallidum is a centuries-old, highly infectious bacterium that causes syphilis.

How does someone get syphilis?

Syphilis transmission usually occurs during vaginal, anal or oral sex when syphilitic sores or patches come into contact with slightly abraded skin or mucous membranes. Women who catch syphilis within a few years before they get pregnant and who fail to get treated often (70 percent) pass syphilis on to their infants. Forty percent of women who acquire syphilis during pregnancy and who go without treatment will lose the child.

What are the symptoms?

Syphilis has been called “The Great Imitator” because so many of the signs and symptoms resemble other diseases. The primary stage of syphilis is usually marked by the appearance of a single sore (chancre), although multiple sores may develop. The chancre is usually firm, round and painless and appears about three weeks after exposure at the spot where the syphilis bacteria entered the body. Left untreated, the chancre heals in 3-6 weeks, but the infection may progress to the secondary stage of syphilis. The secondary stage starts when one or more areas of the skin break into an itch-less rash. Additional symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue. Tertiary symptoms include incoordination, paralysis, numbness, gradual blindness and severe confusion.

What are some of the long-term effects of a syphilis infection?

Left untreated, secondary syphilis may develop into the tertiary stage resulting in damage to internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. The damage can be serious enough to cause death.

How does someone find out s(he) has syphilis?

Primary and secondary syphilis are generally diagnosed with a blood test. The diagnosis of tertiary syphilis usually requires a test on cerebrospinal fluid (ie, fluid that normally surrounds the brain and spinal cord).

How is syphilis treated?

There are no home remedies or over-the-counter treatments for syphilis; however, a single dose of an antibiotic (usually penicillin) can cure a person who has been infected for less than a year. Larger doses are needed to cure someone who has had it for more than a year. While antibiotics are extremely effective at killing the syphilis bacterium, they will not repair or reverse the damage already caused by the disease.

Am I safe if I consistently use a condom or switch to oral sex?

Not really. Even if you use a condom exactly as directed 100 percent of the time when you have sex, you only reduce your chance of getting syphilis from an infected partner by about 30 to 50 percent.^{3, 4, 5} Syphilis is also easy to transmit through oral sex. In fact, oral sex appears to have played a significant role in syphilis transmission in a number of recent outbreaks.^{6, 7, 8}

How can I avoid getting syphilis?

Because most infected individuals are unaware that they have syphilis, having a sexual partner who has no symptoms offers no guarantee. If you’ve already been sexually active outside a lifelong mutually faithful relationship (as in marriage), talk to your healthcare provider about getting you and your partner tested for STDs. Abstinence from sexual activity—including oral sex—or lifetime faithfulness to one uninfected partner is the only certain way to avoid being infected.

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1 Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2001. Atlanta, GA: U.S. Dept. of Health and Human Services; September 2002.

2 Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2001 Supplement. Syphilis Surveillance Report. Atlanta, GA: U.S. Dept. of Health and Human Services; February 2003.

3 Ahmed S, Lutalo T, Wawer M, et al. HIV incidence and sexually transmitted disease prevalence associated with condom use: A population study in Rakai, Uganda. AIDS. 2001;15:2171-2179.

4 Baeten JM, Nyange PM, Richardson BA, et al. Hormonal contraception and risk of sexually transmitted acquisition: Results from a prospective study. Am J Obstet Gynecol. 2001;185:380-385.

5 Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention. July 20, 2001. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services. Available at: http://www.niaid.nih.gov/dmid/stds/condomreport.pdf.

6 Cook PA, Clark P, Bellis MA, et al. Re-emerging syphilis in the UK: A behavioural analysis of infected individuals. Commun Dis Public Health. 2001;4:253-258.

7 Poulton M, Dean GL, Williams DI, Carter P, Iversen A, Fisher M. Surfing with spirochaetes: An ongoing syphilis outbreak in Brighton. Sex Transm Infect. 2001;77:319-321.

8 Lacey HB, Higgins SP, Graham D. An outbreak of early syphilis: Cases from North Manchester General Hospital, UK. Sex Transm Infect. 2001;77:311-313.

The Facts About HIV and AIDS

What are HIV and AIDS?

HIV (human immunodeficiency virus) is a virus that invades the immune system and destroys it over time. The destruction of the immune system reduces a person’s ability to fight off infections and cancer. The majority of people infected with HIV eventually develop AIDS (acquired immune deficiency syndrome), which is often fatal.

How does someone get HIV?

Exposure to infected blood or other body fluids is required for HIV transmission to occur; the highest HIV concentrations are in blood, semen and vaginal secretions. Intravenous drug users and men who have sex with men are at the highest risk for HIV, followed by those who have sex with multiple partners. People who have untreated sexually transmitted diseases (particularly those that cause sores—such as syphilis) have an increased risk of acquiring HIV infection. HIV is not transmitted through the type of casual contact that occurs in the workplace. 

What are the symptoms?

Infected individuals may have short-lived, flu-like symptoms (fatigue, fever, aches). Others have no symptoms with the initial infection or for many years thereafter. AIDS typically appears about 10 years after the initial HIV infection (although new therapies may further delay the development of AIDS).

What are some of the long-term effects of an HIV infection?

HIV usually develops into AIDS, which is often painful and deadly. More than a dozen “opportunistic” infections (ie, infections that are fought off by normal immune systems) and several types of cancer are common in AIDS patients. These infections include tuberculosis, pneumocystis pneumonia, certain types of fungal and yeast infections, and persistent and unusual intestinal infections. Common cancers include lymphomas and Kaposi’s sarcoma.

Due to the severe nature of HIV, people with HIV infections should seriously consider abstaining from future sexual activity, as it poses a considerable risk to any uninfected partner. Because HIV can be passed from a mother to child, it is important for every pregnant woman and her doctor to know the woman’s HIV status. Prompt treatment of the mother and newborn significantly decreases the infant’s risk of HIV infection.

How does someone find out s(he) has HIV?

Blood tests are available to diagnose HIV infections. When a person is first infected with HIV, a few months (1-6) may need to go by before the blood tests become positive.

How is HIV treated?

A complex regimen of medicine can prolong the lives of those infected with HIV for many years. These drugs are expensive, often have considerable side effects and great care must be taken to take them consistently. Though a great deal of energy and financial resources have been devoted to finding an effective vaccine, these efforts have yet to prove successful.

Am I safe if I consistently use a condom or switch to oral sex?

Using condoms exactly as directed every time you have sex can reduce your risk of getting HIV by about 85 percent.^3,4 However, this still leaves a significant chance of getting a deadly disease. It is also possible for HIV to be passed during oral sex.

How can I avoid getting HIV?

The Facts About Trichomonas

What is trichomonas?

Trichomonas vaginalis is a protozoan (a single-celled organism that is bigger and more complex than a bacterium) that infects the genital tracts of both women and men.

How does someone get trichomonas?

Trichomonas is almost always a sexually transmitted infection.

What are the symptoms?

The majority (50-80 percent) of women and some men infected with trichomonas do not know that they are infected.⁴ In women, trichomonas causes vaginitis (inflammation of the vagina) and cervicitis (inflammation of the cervix). Symptoms of trichomonas vaginitis/ cervicitis frequently include vaginal discharge, abnormal vaginal bleeding (typically after intercourse) due to cervical irritation, swelling and irritation of the genitals, itching of the vulva and abdominal pain. In men, the urethra (tube carrying fluid from the bladder out the penis) is the most common location of infection. Symptoms of urethritis (infection of the urethra) include discharge from the penis and burning with urination.