Sexually Transmitted Infections (STIs)

by Helen Smith and Dr. Patricia Robertson

Who can get Sexually Transmitted Infections (STIs)? Anyone who has sexual relations with an infected person can get STIs. Many lesbians are under the illusion that they cannot contract STIs from another woman. The truth is, STIs are easily spread from woman to woman via unprotected sex. Another misconception is the belief that only bisexual women bring STIs into the lesbian community. STIs can be transmitted from woman to woman as well as from man to woman. Bisexual women are not the cause of STIs among lesbians.

We are not going to use scare tactics for you to abstain from sex, or insist that have protected sex all the time. It is your decision, but we want to prepare you with information so you can make the best decisions for your health and well being.

We also would like you to consider the health of your sexual partner(s). If you have a sexually transmitted infection, it is best to take precautions and inform sexual partners before you have sex. This will give your partner(s) a choice. If you have any STIs and do not know how to speak to your partner(s) about it, or are having difficulty dealing with it, you may want to seek help from health professionals or from others who have STIs. You may feel alienated or embarrassed, but you are not alone. There are many others who have STIs, and you are entitled to a sexual life and intimate relationships.

Sexually Transmitted Diseases (STIS)
The following STIS can be transmitted sexually from woman to woman.
 
For the most recent information on Lesbian and STIs, go to LesbianSTD.com.

Chlamydia
Caused by bacteria, chlamydia can do damage to reproductive organs such as the uterus, ovaries, fallopian tubes. It often has mild to no symptoms and is known as a silent infection. Chlamydia is transmitted through vaginal, oral, or anal sex. Since it it hard to detect, chlamydia is often passed from one person to the next without the infected person even knowing he/she has it. This sexually transmitted infection can also be passed from mother to child during childbirth. Often times it is found in those who have also contracted Gonorrhea.

Note: Young women (who have been occasionally been sexually active with men) should routinely get chlamydia and gonorrhea cultures with their annual exams because women carry these two STIs without symptoms.

Gonorrhea
Gonorrhea, also known as "the clap", is caused by a bacteria that is often present in the vagina, penis, eyes, throat, and rectum. When one comes in contacted with the bacteria, infection can occur. It is possible to spread this sexually transmitted infection from one part of the body to another via touch. Symptoms are different in men and women. Women may have abnormal bleeding, irritability in outer portions of vagina, vaginal discharge, and burring during urination. Men may may experience pus-like discharge from penis, painful urination, blood in their urine, reddening of the penis head, and a swelling of the groin. Read more on gonorrhea through the National Institute of Allergy and Infectious diseases.

Hepatitis
There are many types of hepatitis, and some are spread via sexual contact with an infected person. This STI may be passed from person to person through the sexual exchange of blood, vaginal or seminal fluids. It can also be spread through anal sex. Hepatitis leads to liver damage, and possibly progresses into some types of cancer.

Herpes
Herpes is transmitted by oral, anal, or genital contact. It can be spread by kissing or any skin-to-skin contact in which there is an exchange of bodily fluids. Herpes is considered most contagious when the symptoms are present, but may also be contagious when no symptoms are visible. The symptoms are open sores, blisters, itching, and pain/irritation in the infected area. Read more about herpes through information provided by the National Institute of Allergy and Infectious Diseases.

HIV/AIDS
AIDS stands for Acquired Immune Deficiency Syndrome. One does not get AIDS right away. First one contracts HIV (Human Immunodeficiency Virus) through an exchange of bodily fluids (blood, vaginal fluid, semen, or breast milk) with an infected person. It can be spread through sex or sharing needles with an infected person. HIV can also be passed from mother to child during pregnancy, birth, or breast feeding. The HIV virus weakens the immune system and once the immune system is severely damaged, HIV becomes AIDS. This process may take years, or it could occur rapidly. To learn more about HIV/AIDS visit The Body, an HIV and AIDS information source. Also, visit the HIV/AIDS Question/Answer on our LHRC site.

HPV/Genital warts
Human Papillomavirus (HPV), more commonly known as genital warts, can be spread orally, genitally, or anally during sex with an infected partner. Genital warts can be seen on the outer and inner vagina, on the cervix, around the anus, in the throat, on the penis (usually the tip) and scrotum. It often appears and/or spreads in clusters resembling cauliflower. The symptoms do not have to be noticeable for an infected person to pass it to another. To learn more on genital warts review the National Institute of Allergy and Infectious Diseases web pages.

Pelvic Inflammatory Disease (PID)
Pelvic Inflammatory Disease (PID) refers to a group of sexually transmitted diseases/infections caused by bacteria or viruses. It is an infection of the internal reproductive organs: uterus, fallopian tubes, ovaries, and surrounding pelvic tissues. These areas may become inflamed, irritated, and/or swollen. If untreated infertility may result. Two common types of PID are chlamydia and and gonorrhea. PID can be passed via sex, but may also occur after surgery to the genital area, abortions, pap smears, and insertion of IUDs. To review more on PID visit the National Institute of Allergy and Infectious Diseases Web site.

Pubic lice/Crabs
Pubic Lice, also known as crabs, consist of small parasitic insects that live in the genital areas and/or areas of coarse hair (eyebrows, mustache, arm pit hair and leg hair) of humans. Pubic Lice is transmitted through direct contact with the genitals; however, it can also be spread via sheets, towels, or clothes. You can get rid of pubic lice by purchasing a cream or shampoo at your pharmacy. Learn more about pubic lice through the Center for Disease Control and Prevention's Web site.

Scabies
When tiny microscopic mites burrows in the skin and lays eggs, one is said tohave scabies. Upon hatching the mites come to the surface of the skin. Scabies is contracted through close skin-to-skin contact. Sexual contact is a way scabies can be spread, but one does not have to have sexual intercourse to spread it to another person. It often causes red bumps and itching around the infected areas which are often the feet, fingers, and genitalia. To learn more about scabies check out the American Academy of Dermatology's Web pages.

Syphilis    
Syphilis is transmitted through direct contact with a sore. Syphilis is found in areas of the anus, genitals, rectum, vagina, cervix, and mouth. It is sometimes hard to detect because the sores that appear seem to clear up on its own; however it stays in the body damaging internal organs. To learn more about syphilis review information supplied by the Center for Disease Control and Prevention.

Trich/Trichomoniasis
Trich (Trichomoniasis) is caused by a single-celled protozoan parasite called Trichomonas Vaginitis, which commonly infects the urgently tract. It can be transmitted via sexual contact. Trich occurs in the vagina of the woman and the urethra of the man. It often has no symptoms, appears to cause irritation, vaginal discharge, odor, and/or itching. It is transmitted via sexual contact. It can easily be ransmitted between lesbians, and if one lesbians is diagnosed with it, her partner needs to be treated at the same time she is being treated, so re-infection does not occur.If untreated vaginal discharge could cause skin irritation around genitals and inner thighs, and inflammation of the fallopian tubes. To learn more about trich visit the Trich Question/Answer on our LHRC site.

Vaginitis
There are three common types of vaginitis. Allergic Vaginitis is often a reaction to spermicides or latex. Atrophic Vaginitis is often a result of low amounts of estrogen, often during times of menopause, breast feeding. Bacterial Vaginitis is type of vaginitis that results when there is an overgrowth of naturally occurring vaginal bacteria. Bacterial Vaginosis is when certain bacteria which do not require oxygen (anaerobic) over-grow in the vagina, often creating a yellow or green stain on the underwear, with an odor. Vaginitis most often is detected through laboratory tests of vaginal fluid and not based primarily on physical examination and symptoms. There are numerous organisms that may cause vaginitis, and can be caused by products that cause a reaction. It may be transmitted sexually, but may have other causes. For example the risk factors of bacterial vaginitis are: a new sexual partner, multiple sexual partners, oral sex, and douching. It can also occur from reactions to spermacides and detergent. To read more about vaginitis visit Planned Parenthood's Web site.

Yeast Infections (Candidiasis)
Most yeast infections, also known as candidiasis, are caused by a fungus called Candida albicans. A yeast infection occurs when there is an overgrowth of naturally occurring yeast in the vagina, or when the immune system is weakened allowing for the yeast to proliferate. Some symptoms are: vaginal itching, white vaginal discharge, painful sexual intercourse, and vaginal swelling. Most women will experience a yeast infection in their lifetime. Sex can aid in the development of yeast infections, however they most often occur due to other reasons. For example many yeast infections occur as a result of pregnancy, poor nutrition, stress, diabetes mellitus, AIDS, antibiotic use, and the use of birth control pills or immunosuppressive drugs. To learn more about yeast infections visit the Family Doctor.org online.

Ways to Avoid STIs:

The following are suggestions to help prevent the spread of sexually transmitted infections.

• If you are in a consensual situation where you want to use protection, but can not, you may want to rethink why and how you got into that situation. For example, if you are with a partner who refuses to use protection at your request, you may want to look at the type of relationship you have.

• Be sure to get your first pap smear about three years after the onset of sexual activity, or at the age of 21. After your first pap smear, you should receive one every year, unless advised differently by the health care practitioner. Visit the American College of Obstetrics and Gynecology (ACOG) Web site for the most recent statement (July 31st 2003) on Cervical Cancer Screening.

• Use condoms, condoms cut to form a rectangle, and latex gloves when you have sex. Saran wrap and dental dams are often suggested as safe-sex barrier methods, but there have been no studies proving they are effective. Also, it is possible that some saran wraps are porous to the HIV virus.
  - If you share toys like vibrators and dildos, cover them with condoms. STIs can be spread from woman to woman through the use of sex toys.
  - Wash sex toys, the point is to keep them clean.
  - Keep bodily fluids from entering each others bodies. STIs can be transmitted through the vagina, anus, mouth, or any open cuts or sores.
  - Recognize that condoms are not foolproof. They can break and may not be 100% effective in preventing the spread of STIs by skin-to-skin contact.

• Get checked for STIs.

• Ask your sexual partner if she/he has any STIs and about her/his sexual history.

• Tell your sexual partner if you have any STIs and about your sexual history.

• Know that drugs and alcohol can cause you make unsafe choices. Drug and alcohol use can blur decisions, and put you at risk of having unprotected sex, or having unwanted sex with people.

• If you use lubricants with condoms make sure they are water-based. Oil-based lubricants can cause condoms to break.

• Be aware that having sex with an infected woman while she is menstruating is an easy way to contract many STIs.

• Unprotected sex with an opposite sex partner can lead to pregnancy. There is emergency contraception available if desired. Up to 120 hours after intercourse, a woman can take pills that makes it unlikely she will become pregnant that cycle. However the pills work best if use within 72 hours after unprotected intercourse. Some pharmacists can dispense them without a doctors prescription. The two on the market are: Prevent and Plan B.

Links

Lesbian Safer Sex/STIs

• Avert.org

• The Body

• LesbianSTD.com

• Planned Parenthood

• SaferSex.org

• Superdyke

STI Information

• American Academy of Dermatology

• Center for Disease Control and Prevention

• EngenderHealth

• National Institute of Allergy and Infectious Diseases

• Planned Parenthood

• San Francisco Sex Information

• Yeast Infection Resource

• SaferSex.org