Trichomoniasis (Trich)

Photo of trichomoniasis courtesy of the CDC
Photo of trichomoniasis courtesy of the CDC

Trichomoniasis (trich) is a parasitic infection of the genital area. It has only minor (and often no) symptoms, and can only be diagnosed with a blood test or other bodily fluid sampling. While trich itself is a relatively benign infection, it has some serious complications.


Trich is transmitted through PiV intercourse and (more rarely) vaginal-to-vaginal contact. Based on the nature of the parasite and the way it is transmitted, I believe it might be possible to be transmitted through penis-to-penis.

Prevention basically comes down to not having sex with someone who is infected (but chances of knowing if you are infected are slip unless you get tested regularly), or using condoms/other barrier method which covers majority of genital area.


Trich is treated with a single does of antibiotics. Reinfection within 3 months is very common. Reinfection occurs when you get treated but your sexual partners (or their sexual partners) do not. If someone in your sexual network refuses or is unable to seek treatment, then your entire network can be reinfected within a year. 


Trich rarely has symptoms, and when it does the symptoms are mild. Over two-thirds of infected people don’t have symptoms.

Symptoms for people with a penis include:

  • Irritation inside the penis
  • Mild discharge
  • Slight burning after urination or ejaculation

Symptoms for people with a vagina include:

  • Greenish-yellow, frothy vaginal discharge with a strong odor
  • Painful urination
  • Vaginal itching and irritation
  • Discomfort during intercourse
  • Lower abdominal pain (rare)


Trich has two common (and serious) complications. In a pregnant person it increases the chance of premature birth.

It increases everyone’s chance of getting HIV. The inflammation and irritation of tissues make it much easier for HIV to enter the body.

STIs: Syphilis

For centuries syphilis was the bogey-man of Europe (and probably other parts of the world—but I can only speak of Europe for a certainty). In fact, it would not in anyway be an exaggeration to call syphilis the HIV of 15th century Europe.

Today, syphilis is far less of a threat. The development of effective antibiotics in the early 1900s turned what had been a horrific death sentence into, for many people, a minor annoyance. However, if left untreated the “French Disease” is just as deadly as ever.


Prevention of syphilis is brutally simple: don’t have sex with anyone who has syphilis. If you don’t know whether or not someone has syphilis either don’t have sex with them of use a condom. Using a condom reduces your risk of infection, but does not eliminate the risk. Syphilis can be transmitted through vaginal, anal, and oral sex.


Syphilis can be cured with antibiotics, no matter how long you have been infected. However, if left untreated for too long syphilis can cause permanent damage.


Syphilis occurs in several stages.

  1. In first stage syphilis an infected person develops sores in the area where they were first infected. Usually the sore will appear in or on the penis, vulva, vagina, anus or mouth, but can appear anywhere on or around the genitals and mouth. These sores are red, firm, and painless and will fade on their own after a few weeks. These sores are the primary source of contagion, but they can be hidden in vaginal folds, under foreskin, inside the anus, under the tongue, and in other areas. Lack of visible sores does not mean an infection isn’t present.
  2. Second stage syphilis occurs within six months of the infection. The most common symptom is a rash on the hands and feet, though rashes can occur on other parts of the body as well. Some people have no rashes and no symptoms. When other symptoms do occur they include:
    • fever
    • swollen lymph glands
    • sore throat
    • patchy hair loss
    • headaches
    • weight loss
    • muscle aches
    • fatigue
  3. After second stage syphilis will go latent for 10-30 years. Sometimes it stays latent, but often it develops into late stage syphilis. This is the scary one. In late stage syphilis symptoms include loss of muscle coordination, paralysis, numbness, blindness, and dementia. Additionally, the disease will attack and damage internal organs. Disfigurement can occur as the disease eats away at muscle and bones.


The biggest “complication” of syphilis is death as the internal organs shut down and your body just stops working. If the infection is treated during the first, second or latent stages, the possible complications are usually minimal. If treatment doesn’t occur until the late stages, then there are innumerable possible complications depending on the type and severity of damage done by the infection. Loss of heart or lung function, nerve damage, paralysis, muscle weakness, and a number of other complications are possible.


Syphilis may just be the post child for STI testing—easy to treat if caught, easy to miss if you aren’t looking for it, and absolutely devastating if untreated.


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STI: Scabies

Scabies is the common name for a parasitic infection, specifically this parasite:

The human itch mite. Also known as Sarcoptes scabiei var. hominis.
The human itch mite. Also known as Sarcoptes scabiei var. hominis.

These microscopic invaders not only make a meal of dead skin, like most mites, they actually burrow into human skin to create little dens for laying eggs.

Picture a field for of rabbit burrows. Now picture that field is your skin and the rabbits are these guys. This is scabies.

As you might imagine, our bodies don’t like having lots of tiny holes dug in them. The result:

ScabiesD03Those red itchy looking patches? Those are mite burrows. And this is scabies.

Like PID and a few other infections on our list, you don’t need to have sexual contact to ge scabies, but sexual contact does make it a lot easier.

Avoid prolonged skin-to-skin contact with anyone who is infected or might be infected. Thoroughly clean the bedding, clothing, etc of anyone with crusted scabies. Unless you know that it is definitely not contagious, don’t have sex (or naked cuddling) when you or your partner has a skin condition.

Symptoms usually don’t show up for 2 to 6 weeks after a first time infection, so treatment is usually recommended for all household members and all sexual partners of the infected person. Treatment consists of lotions or creams to kill the mites. While scabbies is usually only transmitted through skin-to-skin contact, it is recommended to wash all bedding, clothing, towels, etc in water 72 degrees Farenheit or hotter to prevent reinfection.

The primary symptoms are the raised red bumps caused by the scabies burrows and prolonged itching. The itching is an allergic reaction which will often last several days or weeks after treatment. If it continues more than 2 weeks after treatment you should contact your doctor.

The most complication of scabies are skin sores from frequent scratching. These sores may become infected leading to further health problems.

People who are immunocompromised, have nerve damage that prevent them from itching, and the elderly may develop crusted scabies. Per the CDC crusted scabies “is characterized by vesicles and thick crusts over the skin that can contain many mites.” Crusted scabies is highly contagious because of the extremely large number of mites present.

More information on scabies

As always, this post is provided for information purposes only and should not be considered medical advice or a replacement for getting professional medical care.

Long List of STIs

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STI: Pelvic Inflammatory Disease (PID)

(Edit: Sorry for the late post! This was supposed to go up yesterday but didn’t due to a technical glitch.)

Pelvic inflammatory disease (PID) is an infection of the cervix, uterus, Fallopian tubes and/or ovaries. PID is not a specific sexually transmitted infection, it is more like the common cold or pneumonia—a disease that can be the result of a variety of different infectious agents or other causes. PID most often develops as a complication of other STIs such as chlamydia and gonorrhea.

PID is one of the poster children for why everyone should get tested regularly. Catching other STIs early can seriously reduce your risk of getting PID, and catching PID early is critical to avoiding severe complications.

You do not need to have sex to get PID. While it is most often associated with sexual transmission, diseases that are not sexually transmitted can also cause PID. The most common non-sexual causes of PID are childbirth, abortion, insertion of an IUD, and “pelvic procedures.” Basically, if it impacts or affects the cervix it may transfer bacteria through the cervix and cause infection. A regular vaginal infection can (rarely) become PID if the cervix is weakened or damaged.


Outside of being celibate (and never getting any pelvic procedures), you can’t prevent PID. You can reduce your risk in several ways. Get tested for chlamydia and gonorrhea regularly,  don’t douche, don’t get IUDs, and (as always) be in a sexually monogamous relationship. And of course anything that prevents other STIs (like using condoms) is a good way to prevent PID.


PID is caused by bacterial infections, so it can be treated with antibiotics. It is very important to continue treatment even after symptoms go away. If you don’t finish the treatment, the PID may come back and cause further complications.

If you and your partner both have PID it is very important not to have sex during treatment or you might reinfect each other (I hope it goes without saying that you probably shouldn’t be having sex with anyone else either.)

If the disease is too far advanced, doctors may recommend surgery to remove abscesses. In extreme cases, a hysterectomy may be necessary.


PID does not always cause symptoms, and symptoms may be mild. Symptoms include

  • Pain in your lower abdomen;
  • Fever;
  • An unusual discharge with a bad odor from your vagina;
  • Pain and/or bleeding when you have sex;
  • Burning sensation when you urinate; or
  • Bleeding between periods.



Any STI where possible treatments include the word “hysterectomy” obviously has some pretty severe complications. Swelling, abscesses and scar tissue may block the Fallopian tubes leading to infertility and/or ectopic pregnancies.  Scarring of the uterus may also lead to infertility. Recurring abdominal pain is also possible.

STI List

Molluscum (Molluscum Contagiosum)

Slightly pink nodules, a few millimeters across.
Molluscum bumps

You probably haven’t heard of this one before. I never had, and I think I may have it.

Molluscum is a virus that affects the skin, creating tiny nodules where ever it colonizes. It has no real side effects, and as far as I know is not tested for in any regular STD screening (It certainly was never included in any testing I’ve had.) I seriously debated whether to include it in this list, partly because it really isn’t an STI anyone has to worry about, partly because there are a number of ways it can be transmitted other than sexual contact. I decided to include it mainly because I am tired of the hysteria over STIs, and want to clearly show that there are STIs that are not in any way dangerous or worrisome.

Transmission: Molluscum is transmitted through skin contact. If you brush up against a molluscum sore on someone else, the virus transfers to your skin. Among adults, the virus is most often transmitted through sexual contact, though it can be transmitted by sharing towels or clothes, or just sharing a bear hug. There is some evidence that hair waxing may increase the risk of viral skin infections, including molluscum.

Children usually contract molluscum from their parents, but can pick it up at public pool and other areas where people share chairs or towels and don’t wear many clothes.

Symptoms: The main (and practically only) symptom of molluscum is a small bump which can be white, pink or flesh colored and is usually slightly shiny. The bump is dry and may have a dimple or pit in the center. On average, the bumps are 3-5 mm in diameter, though size may vary. Bumps are usually painless, but may be itchy or sore.

Scratching at a bump without washing your hands may cause the virus to be transferred to other areas of your body, leading to more bumps developing. Bumps usually disappear on their own in 6 to 12 months, but have been known to remain up to four years.

Prevention: Condoms can prevent molluscum spreading in the genital regions which are covered by the condom. Watertight bandages over the bumps can prevent spread from casual contact. Don’t share towels or clothes. Wash your hands regularly, especially if you itch a lot or touch someone else near a bump.

Treatment: Bumps should only be removed by a health care professional. Prescription skin treatments and oral medicine may get rid of the bumps without scarring, though it takes longer that other methods. Treatment is recommended for bumps that are in the genital area.

Complications: Scratching at the bumps may lead to bacterial infection. Removal of the bumps may cause scarring. That’s it.

People with HIV/AIDS or other immune suppressing conditions may be at risk of serious illness from bacterial infection.


Go back to The Long List of STIs

STD/STI: Human Papilloma Virus (HPV)

HPV isn’t in the news as much as it was a few years ago when the vaccine first came out. But it is still one of the STD/STIs that most people are familiar with. It is also one that I think people make way to much fuss about. According the CDC “…almost every sexually-active person will get HPV at some time in their lives…” That said, the possible complications of HPV are real causes for concern. As always, educate yourself so you can protect yourself.

Prevention: Condoms provide some protection, but aren’t perfect. Don’t have sexual interaction with anyone who has visible warts and make sure you and your partners get tested regularly. The HPV vaccine protects against some forms of the virus, including those most likely to cause cancer. Given what the CDC says about everyone being infected at one point or another, don’t drive yourself crazy with this one.

Treatment: If warts develop, they can be treated by a doctor. Do not try to use over the counter wart treatments – they are not designed for genital warts. If you have HPV, additional tests can determine if you are infected with one of the varieties linked to cancer. Your doctor can advise you on any additional precautions you can take if those tests come back positive. Most HPV infections clear up on their own within 6 months.

Symptoms: Genital warts may look like cauliflower heads or flat, raised areas of skin. They are often microscopic. Many people don’t develop any symptoms.

Shaved base of a penis, with genital warts
Used under CC 3.0, by Rrreeewww

Complications: Some forms of HPV can cause cancers, include cervical, anal, vaginal and others. The HPV vaccine protects against some forms of HPV that cause cancer. If an expectant mother has HPV during labor and delivery, the baby may (rarely) be infected. If you are pregnant make sure your doctor is aware if you have been diagnosed with HPV, so precautions can be taken.

Back to the Long List of STD/STIs.


Today we’re tackling the big one: HIV/AIDS. This is the STI that is effectively in a class of its own, both in terms of impact and the way people react to it. The good news is that while it is still a brutal disease, great strides have been made in treating AIDS over the past decades, and what was once a death sentence is now closer to being a chronic (though still deadly) infection.

One of my jobs as a freelance writer involved researching and writing about the latest HIV/AIDS research. While I will be surprised if we see even a functional cure (a treatment that acts like a cure, even though the infection is still present) in the next ten years, based on the current research I do believe we will see on in the next quarter century. Given the current life expectancy of people with HIV, that means that many people in developed nations who are currently infected will benefit from such a cure. Unfortunately, the hardest hit parts of the world are also the areas where treatment and access to medical help is hardest to get.

Transmission: HIV is transmitted through the bodily fluids. This means the bodily fluid (semen, vaginal discharge, blood, mucus, etc) of someone who is infected, needs to enter the body of someone who is not infected. Now, let me put something in perspective. The common cold is spread through bodily fluids – that’s why you are supposed to wash your hands after you blow your nose. But where a common cold goes through a household like a storm, HIV doesn’t. Because despite the bogey-man reputation HIV has, it is actually hard to transmit HIV. One study estimated that it takes around 100 episodes of sexual contact for one person to get infected. Of course, this isn’t universal. Some strains are more infectious than others, and some people are more susceptible to infection. But it does mean that if you know someone who has HIV/AIDS, you can shake their hands, sleep in the same bed, even share a toothbrush, without worrying about getting infected. Of course, there are other reasons you really shouldn’t be sharing a toothbrush.

Prevention: Female and male condoms are some of the best and most widely available avenues of prevention. Getting tested regularly (and your partners getting tested regularly) is also very important. The FDA recently approved over-the-counter tests for HIV, so you can order a test online and take it in total anonymity if you are worried. (I believe similar tests are available in some other countries, hopefully the availability will spread over the next few years). Other barrier methods like diaphragms may provide some protection, though less than condoms. Research is ongoing into vaginal gels which can prevent transmission. Some of these have been successful in testing, but are not yet available on the market. PrEP (Pre-Exposure Prophylaxis) is becoming more available–this is taking anti-retroviral medicine before infection to prevent getting infected. If you or a partner are at high risk for HIV infection, speak with your doctor about whether or not PrEP may be right for you.

Symptoms: Immediately after infection, a person develops  flu-like symptoms for a week or two. Afterwards, there are no symptoms under HIV progresses to AIDS. The main early symptoms of AIDS are the development of certain illnesses which only appear in people with suppressed immune symptoms. If you are sexually active (and I don’t care if you are monogamous, do you REALLY know what your partner is doing?) try to get tested for HIV at least once a year, because catching the infection before symptoms develop is crucial to effective treatment. If you have multiple partners or new sexual partners, get tested more often.

Treatment: The main treatment for HIV/AIDS is HAART or Highly Active Anti-Retroviral Therapy, which consists of a combination of medications that interfere with the way HIV reproduces in the body. Other treatments are aimed at treating and preventing opportunist infections (OIs) which develop when the body’s immune system becomes too weak to fight them off.

(Update) I want to add a bit here, because lately I’ve been running into a lot of mis-information about HIV/AIDS, and some of it really pisses me off. I spent a year deunking AIDS cure scams and identifying legitimate alternative medical treatments that would actually help people with HIV/AIDS. Here the bottom line: To date only one person has been cured of HIV/AIDS, and that cure was a medical miracle that cannot be reliably repeated. The only reliable, life-extending treatment is HAART. Magic Johnson had to hold a press conference earlier this year to say what everyone should have known: he still has HIV. Thanks to HAART and a lot of luck, he remains largely healthy and can expect to live for a long time yet. But the best that medical science can do is to put HIV/AIDS into what I call a ‘remission’ status, and that remission lasts only as long as you keep taking HAART. If someone tries to tell you there is a secret pill that can cure HIV/AIDS, or that Magic Johnson is still alive so obviously there is a cure or anything like that, that are dangerously misinformed. Please get the facts, and spread the truth.

Diagnosis: Doctors really prefer to diagnose HIV through testing. If testing is not available, or if a person has not gotten tested, doctors can diagnose based on the presence of what are known as “AIDSindicator diseases” – diseases that are extremely rare and only occur when the immune system is severely depressed. By the time these diseases develop, the infection has already progressed from HIV to AIDS, and it is too late for treatments to be fully effective. I repeat: get tested early and often!

Complications: Mainly the obvious: suppressed immune system, opportunistic infections and eventually death. Wasting is a lesser known effect of AIDS, where the body loses muscle mass over time, regardless of eating habits. The nausea and diarrhea that frequently accompany both AIDS and HAART just worsens the effects of wasting.

Folks, please don’t treat HIV as a bogey-man. Don’t treat people with HIV like pariahs, and don’t let fear tactics trick you into thinking that you can get infected in ways that you can’t. But do be careful, do educate yourself, and do protect your partners. Further information on HIV/AIDS can be found at, and on the World Health Organization and websites.

Back to the Long List of STD/STIs.

STD/STI: Herpes Simplex (1 and 2)

It sometimes seems like no STD/STI causes as much upset as herpes. People I speak with never worry about getting chlamydia, HPV or granuloma, but the minute STD/STIs come up, they start on herpes.

Folks, get over it. While not entirely benign, herpes is the closest thing you can get to an STD/STI version of acne. Annoying, epidemic, and the next best thing to untreatable, but rarely a real problem.

That said, there are some complications associated with herpes, and as always, you should avoid contact with open sores.

Transmission: Herpes is transmitted through skin-to-skin contact with an infected area. Herpes 1 usually infects the mouth and herpes 2 usually infects the genital region, but they can both infect either area, and more rarely other parts of the body. Infection is most likely to be transmitted during an outbreak, but can be transmitted at other times.

Prevention: Condoms can reduce the chance of contracting herpes, but since the infection can settle outside the area covered by condoms, they are not perfect protection. Female condoms provide better protection than male condoms, because they cover a wider area. Don’t have sex during an outbreak, or any other time one of you or one or your partners has open sores.

Symptoms: Most people have no symptoms of herpes. People who do experience symptoms will develop sores that break open and heal over a period of weeks. These outbreaks happen with decreasing frequency over time.

Treatment: Antiviral medication can reduce the frequency of outbreaks and the risk of transmission. There is no cure.

Diagnosis: A test during outbreaks can confirm the presence of herpes, however tests done when there is no outbreak may return a false-negative – which means a person may test negative for infection even though they are infected. The CDC estimates that 1 in 6 people in the US have herpes 2, and most of them are unaware of it.

Complications: Herpes sores can be spread to other parts of the body by touching an open sore and then an uninfected region. This can be particularly problematic in areas such as the eyes which are highly sensitive. Always wash hands well after touching open sores. People who are infected with herpes are at higher risk of contracting HIV and other STD/STIs that can be transmitted through blood. This is because the open sores create an avenue for the virus to infect the body. People who have herpes and are not in the middle of an outbreak are not at higher risk. Again, don’t have sex or physical contact when you have open sores. Herpes 2 may create risks for a pregnant mother, if you have been diagnosed or have an outbreak, speak with your ob-gyn. It is important to avoid outbreaks during pregnancy and labor, if at all possible. People with suppressed immune systems may have additional problems caused by herpes.

Back to the Long List of STD/STIs.

STD/STI: Hepatitis (A, B and E)

Hepatitis technically refers to inflammation of the liver, which can have several possible causes. However, there are five viruses that can cause hepatitis, known as Hepatitis A, B, C, D, and E. Of these five, three can be transmitted sexually.

Hep B is the sexual infection most people are familiar with. Vaccinations for Hep B are routinely given to infants and children in the US and some other part of the world. A vaccine for Hep A was developed in the 1990s, and has been given to children in the US since 1995. Hep E is rare in the US and Europe, but common in some areas of Asia. A vaccine for Hep E has been developed in China, but as far as I know it is currently available nowhere else in the world..

Transmission: Hep A and E are both transmitting by ingesting infected feces. These versions of hep are not usually considered STD/STIs, but oral/anal contact during sex or anal sex followed by oral sex can cause infection. Hep B is transmitted through bodily fluids, so infection can occur through any sexual contact.

Prevention: Men who have sex with men, and other folks who routinely engage in anal sex are advised to speak with their doctors about getting vaccinated for Hep A, assuming they were not already vaccinated as children. Use barrier methods prevent direct skin-to-skin contact during sexual activities. Clean your hands well after coming in contact with other people’s bodily fluids or anus. All forms of hep are extremely resilient and can survive outside the body. Surfaces (including sex toys) that might be infected should be cleaned with bleach or boiled (alcohol or other standard disinfectants will not work for hep).

Symptoms: Acute infection with all three forms of Hep most often resemble a severe flu, though sometimes there are no symptoms. Symptoms from Hep A and E usually last about two months and almost always clear up within six months. Symptoms of acute Hep B usually clear up in a few weeks, through chronic infection may develop. Chronic Hep B may not have symptoms, but can cause later complications.

Treatment: Usually acute infection clear up without treatment. If signs of acute liver failure develop (which is rare but possible) treatments include dialysis and liver transplant.

Diagnosis: All forms of hep are diagnosed based on reported symptoms and a blood test.

Complications: In severe cases, hep can result in liver failure and even death. Chronic Hep B can lead to cirrhosis of the liver and other liver related illnesses as a person ages.

With the development of vaccines, hep is less of a concern now than it was twenty years ago. Still, it is a good idea to take precautions if you have not been vaccinated. If you engage in any sexual activity that may involve contact with blood, you should also learn about Hep C.

Back to the Long List of STD/STIs.

STD/STI: Gonorrhea

Colloquially know as “the Clap” or “the Drip,” Gonorrhea is a bacterial infection that is currently giving disease control official around the world nightmares. It has a disturbing ability to develop resistance to antibiotics, and some very unpleasant long-term side effects. Epidemics of gonorrhea are expected to break out eventually, if new antibiotics can’t be developed to combat it. This makes stopping the spread of gonorrhea before infection very important.

Prevention: Condoms, as always. Other barrier methods such as cervical caps will not protect against gonorrhea. Otherwise, abstinence, or only have sexual contact with people who you know are not infected. Gonorrhea can be spread through contact with infected fluids, genitals, anus or mouth. In other words, any and all forms of sexual contact. It can also be spread from mother to child during labor and delivery.

Treatment: Antibiotics. Some strain may be resistant to first-line antibiotics, so it’s important to get retested after treatment to be sure the infection is gone. If it isn’t, you will be treated with second-line antibiotics. Second-line antibiotics will usually be more expensive, take longer to work, or have more severe side effects. But because they are used less often, infections rarely develop any resistance to them.

Symptoms: Symptoms in women are either mild (and often mistaken for something else) or totally absent until complications occur. Early symptoms can include pelvic pain, vaginal discharge, burning during urination and sore throat. Early symptoms in men include penile discharge, burning during urination and sore throat. If symptoms develop, they will appear 2-30 days after infection.

Diagnosis: Gonorrhea can be diagnoses in several way, including urine test, swab test and blood test. A blood test is only effective after the infection has reached the blood stream.

Complications: Complications from gonorrhea include damage to the genitals which can lead to infertility in both men and women, meningitis, and scarring to the infected tissue.

Gonorrhea is one of the STD/STIs that makes regular testing important. The serious complications, lack of symptoms and easy of infections make it vjust plain good sense to try and avoid sexual contact with anyone who is infected, and to get yourself in treatment as early as possible if you are infection.

Back to the Long List of STD/STIs.