Students, Sex STD's and STI's

Written by Lyba Spring - Contributor Wednesday, 30 November 2005 By the time students arrive at university, the majority are having sex. Nevertheless, several students approached me at the end of my recent talk to 300 students to say that they were celibate. The women were interested in finding out if they needed to have an internal (pelvic) exam and a pap smear. What you need to know depends on what you are doing. There has been a dramatic increase in the incidence of chlamydia for people between the ages of 15 and 24, with the greatest increase for 20 to 24 year olds. There is also an increase in the percentage of heterosexual transmissions of HIV. When heterosexual couples start having intercourse, most do use condoms - at first. When the female goes on the pill and the couple feels they can trust each other, they stop using condoms. A common scenario is: One day, she goes for her check-up and finds out that she has chlamydia. She thinks her boyfriend has cheated on her. It's possible, but what's more likely is that he was already infected. Up to 50 per cent of men with chlamydia have no symptoms. Up to 80 per cent of women have no symptoms. Luckily, taking antibiotics can cure both. Suppose, however, she was having unprotected sex with a man who had HIV. He wouldn't know unless he had been tested. If she had untreated chlamydia, the HIV virus would attack the white blood cells at the site of her infection. The HIV virus would use these antibodies to gain entry to her bloodstream. A lot of couples who feel stable don't want to continue using condoms. They can both get tested for chlamydia, gonorrhea and HIV after having protected sex for three months, the "window period" for HIV infection. If neither has any of the infections they tested for, then they can decide if they want to stop using condoms to protect against infection. Of course, there is still the problem of herpes and warts. Most new cases of herpes on the genitals is caused by oral sex with a person, who has a history of cold sores on the mouth (HSV-1). It's not the end of the world, because HSV-1 on the genitals tends to break out once or twice a year. And it is difficult to pass genitally. However, genital herpes, caused by HSV-2, is most commonly spread when a person has no symptoms. Condoms really help with this asymptomatic shedding. There is treatment for herpes, which can also reduce the amount of the virus you shed.It is difficult to spread HSV-2 to the mouth with oral sex. A word of caution when dealing with genital warts: A virus called HPV causes these benign warts. After treatment, often a person's immune system clears the virus within a year. High-risk HPV types can cause changes on the cervix, which can lead to cervical cancer. There are no signs of it on a man's penis. This means that for a woman having sex with a man, it is crucial that she have her pap smear once a year. At the same time, she needs to ask her doctor to do swabs to check for things like sexually transmitted infections (STI). So, to those young women who wanted to know if they need to have a pap smear? I told them to negotiate with their family doctor. Cervical cancer is grows slowly. They are at very low risk. Nevertheless, even women who have sex with women need to have their annual pap smear. - Lyba Spring is a Sexual Health Educator for Toronto Public Health -For more information go to: www.toronto.ca/health