Module 4: STD

Love can’t make you sick … or can it? One thing is completely clear to Paolo and his friends: love is an exciting but also a difficult subject. And everybody talks about it – also in the summer camp. A competition around the subject „Love can’t make you sick … or can it?” brings out Paolo’s creative side which leaves his friends amazed. Read or hear more about Paolo’s creative ideas about how to do it your own way.

Module sexually transmitted diseases (STD)
  Episode 4
Doing it our own way
  Movie
Don’t play with your life
  Hints & Info
Hints and Information about sexually transmitted diseases (STD)


Episode 4

Doing it our own way

Slowly, the end of the summer camp is approaching. Traditionally, there is always a competition during the last week. This year’s theme is difficult and exciting at the same time: “Love can’t make you sick – or can it?”
The theme causes a lot of confusion, and the camp supervisors help the young people by telling them about the competitions of previous years. Last year’s theme had been “Don’t play with your life” – equally difficult and fascinating.

Now, what is this competition about?
The young people in the camp are supposed to invent and design creative, funny or thought-provoking posters or films.  The necessary material and technical equipment is provided. The young people are working in groups of four to six and have a week in which to prepare.. In the end, three winners are selected, and the other young people don’t come away empty-handed either at the Farewell Party.

Thelma, Natalya, Paolo and Max are racking their brains over this year’s theme. They soon agree that the subject must be sexually transmittable diseases. Natalya has overcome her “acne depression”, as Thelma calls it, long ago and offers the first idea, a song with lyrics that  make Max blush: “Bad girls are fun, but the gonococci quickly come!” “No?” Natalya looks around. “Ah, no, this is better: Everybody is anxious, about AIDS and syphilis!” Roguishly, Natalya winks  from under her hair. “Or even : Better do it with a condom, than become Mum and Dad at random!” Thelma is clutching her belly with laughter, while Max is blushing more deeply with every sentence. Paolo looks rather self-conscious, as inventing these kind of sayings are usually his role. But after a while they all laugh and rhyme around wildly. They are aware however that they won’t win the contest with these kinds of ideas. Max has no better idea than to write a modern fairy tale, and Thelma admits that she is not really creative in that direction. Paolo wraps himself in silence.

Therefore Max, Thelma and Natalya are very surprised when Paolo  arrives late for their meeting on the veranda of the old villa the next day with a roguish smile on his face, and announces: “I have something that will solve our problem!” Under the curious gaze of his friends he pulls a CD out from under his jacket. “I worked a little bit on Eva, she is  in the tent next to you girls, and the other day she showed me last year’s winner when her older sister was in the camp. And because I am such a nice guy, she lent me this until tomorrow!” Thelma tries to take the CD out of his hands, but Paolo holds it tightly. Thelma raises her eyebrows. “And now we look at it with our laser eyes and read what’s on it?” she asks mockingly. Paolo is taking a laptop out of his bag. “They also lent you this?” Natalya grins. “Of course!” Paolo puts the CD into the laptop and starts the film. When the short film ends, the four friends stay unusually quiet for a while. They are impressed. “Don’t play with your life”, Max murmurs quietly. “We could hand in this film for the contest,” suggests Paolo. “Yeah, what a super idea – the same thing twice,” Natalya looks at him sympathetically. “And what does the film want to tell us?” asks Max who is mulling over its content. This question provokes  a lively discussion, and it becomes  quite clear that they all have only a superficial knowledge of the subject.
“Did you know that AIDS can be transmitted by kissing?” Paolo asks. “Oh no, that’s nonsense,” replies Natalya. “You only get AIDS when you have unsafe sex.” And Thelma adds: “But the probability that you get infected is not very high.”

“But even if you get infected, “Max remembers, “Some medication against AIDS has been developed. So now AIDS can be cured.” Natalya does not agree. “We have never heard about this in Romania, and we have a lot of people with the HIVvirus in our country.” - “Before, in my parents’ generation, AIDS didn’t exist.”  Paolo adds, “My father told me that they didn’t know anything about condoms. And he should certainly know, because he was the greatest gigolo of Calabria!” Max is astonished: “Like father like son.” Natalya can’t suppress a giggle. Thelma looks at Paolo with big, round eyes. “But then, where does the disease come from?” Max asks and finds that everyone is looking perplexed. “We don’t seem to know very much,” says Thelma, summing up.

Paolo has had enough. “Listen, we can’t do something about AIDS again. We don’t know much about it, and besides, the subject won the first prize last year. Let’s think about other diseases that you can get, or let’s do something completely different!”
“How do you mean, something completely different?” The others don’t understand what he’s getting  at.

He explains: “Yeah, see, they do this competition every year. Everybody comes up with some nice ideas about AIDS, syphilis or other diseases, about which we should have some knowledge but haven’t, as we have just noticed. But it really gets on my nerves that we only talk about these things when someone from outside makes us, I mean, the supervisors here in the camp, or the media, the television, the newspapers. Do you understand?”

The others look confused. “Not really,” says Natalya, and Max and Thelma agree.
Paolo tries harder. “See, I don’t want to make a movie like last year. This one here is far too professional anyway, and we wouldn’t have any chance, given the fact that we are already too late anyway. Why not do something on the subject of:  we only start to think about things when the media try to make us do so? You get it now?”

Paolo looks questioningly at the small group and continues: “The message I want to send is: Let’s look at it ourselves!” Max, Thelma and Natalya stand in front of Paolo with open mouths. What he says is not complicated but turns everything upside down .Thelma is very impressed: never has she seen Paolo like this during the last weeks – so excited, so committed. Enthusiastically she agrees with him: “Yes, Let’s look at it ourselves! That’s a motto I like! If we can’t win the competition, then why not go down in history as having the best outsider idea ever?” Thelma and Max nod and immediately share their first ideas. The ice is broken, they start  work.

Movie

Don’t play with your life

Paolo is unusually excited: Today there will be the announcement if they won anything in the competition or not, and if, as Natalya says, they won a “special award for missing the point in an especially ingenious way”, or if they failed completely. Apart from that, Paolo is very happy that Thelma was so enthusiastic about his idea. Without her, he would have never had this idea, and without her he wouldn’t have cared so much and wouldn’t have put so much effort – he knows himself well enough to be sure of that. Paolo thinks about his own words and how difficult it had been to explain it to the others: "Look, I don’t want to make a film like for example the one from last year. That one is way too professional for us. We wouldn’t have the slightest chance, the more so as we are already so much behind time. If we don’t want to make a film, then let’s do something about the subject that we only start to think about something when the media want us to do so."

"Exactly," Paolo affirms again in his mind. That was the crucial point, and now it is important that the jury also gets the point: Why do we as teenagers always let ourselves be pushed on that kind of subjects only from the outside? Why do we only deal with the subjects that others set for us?

       
    Everything clear? No? Then read some helpful hints and information here. This will make it easy for you. The Hints and Info section also open in a new window, so you will have everything within your view.
Press here for the Hints & Info section about sexually transmitted diseases!

 

Hints & Info

  Skin is an important sensory organ for humans: it routes sensory perceptions to the brain. In sexual encounters, sensory perception plays an important role. Touching each other creates feelings of lust and satisfaction in various ways.

If in petting without intercourse, oral or anal sex or vaginal intercourse, sex always means skin contact between two people and usually the exchange of body fluids like semen, vaginal fluid or even blood. Sexual encounters in their different forms are exciting, but can also lead to infection with a disease. This kind of diseases is called “sexually transmitted diseases (STD)” or “sexually transmitted infections (STI)”. Among these are e. g. infections with chlamydia, gonorrhoea, syphilis, hepatitis B, herpes, genital warts and HIV / AIDS.
These diseases are caused by germs (mostly viruses or bacteria), that can be transmitted in any kind of sexual contact by the mucosa of the sexual organs or (less often) the mouth.

More information here: Definition, Transmission and Diseases.

Most sexually transmitted diseases become noticeable by unpleasant symptoms in the genital area or around the mouth: the skin changes, you may observe discharges, pain, itching or burning. Sometimes you may not notice this immediately, and thus we may have and spread an infection to other people unknowingly.
This can be rather awkward for yourself and your partner/s. In this, it is important to know that sexually transmitted diseases can cause irreparable secondary damages, like e. g. sterility (i.e. the inability to reproduce), chronic diseases or the life-threatening general immunodeficiency (AIDS), an illness that makes the body defenceless against all sorts of germs.

More Information here: Consequences and Myths.

Who knows one's body and who knows about sexually transmitted infections, how they are treated and how one can protect oneself, can enjoy sexuality without consequences for one's health and one's partner's health. Sexually transmitted diseases can be avoided through Safer Sex, above all the proper use of condoms. Also, there are vaccines against some diseases in the meanwhile.

More Information here: Protection.

But if you should catch an infection anyway, please be alert when you notice the first symptoms, take them serious, talk to your partner and see your doctor. In many of these diseases it is true that, if you notice them and have them treated early, the chance of healing is very good.

More Information here: Treatment.

Catching a sexually transmitted infection is something that can happen to everyone – it is not a reason for shame. If you look for information and protect your partner/s by practising Safer Sex, you can avoid sexually transmitted diseases and enjoy sex untroubled.

Definition

Sexually transmitted diseases have been known for centuries. They are infections that can be transmitted by sexual contact between humans.

The expression “sexually transmitted infection” is in use very often as well. Infection means that there is a germ (virus, bacterium, parasite) within the body of a person with the potential to cause a disease. 

 

A person can be infected without showing an illness. This is called an asymptomatic infection.

Symptoms
A sexually transmitted disease or infection can be identified by
various symptoms, i. e. by typical signs that show that a certain
infection has taken place:

  • pain or itching at the penis, vagina or anus
  • Reddening, spots, nodules or abscesses on the skin
  • pain in urinating or in sexual intercourse, unusual discharges from vagina or penis

    Attention! Very often the infection remains completely unnoticed
at first. But it is very important, in order to avoid the continuing
and the negative consequences of a sexually transmitted disease, to
take early symptoms serious and to see a doctor. Most sexually
transmitted diseases can be treated well, especially in an early state.
Who does not take serious early symptoms risks to transmit the
infection to other people unknowingly.
 

 

Transmission

The transmission of a sexually transmitted disease happens in sexual intercourse, through the mucosa of the sexual organs and sometimes also of the mouth.

The risk of infection increases when body fluids like semen, vaginal fluid or blood are involved.

Here, sexual intercourse is understood to include petting without penetration, oral sex, anal sex and vaginal intercourse. 

However, an infection can not only happen when body fluids are exchanged but also when one touches skin lesions caused by a disease, like e. g. spots, warts or abscesses.  

The transmission happens through various germs, among which are bacteria, viruses and parasites. In former times, humans were completely helpless against many of these germs, but today this is fortunately not the case any more. There are effective therapies against this sort of diseases.

Diseases

If you talk about sexually transmitted diseases, the first thing that will probably come to your mind is HIV/AIDS. There are many other diseases, however, that are very frequent in modern society as well and which can also be transmitted in unsafe sexual intercourse.

There are various sorts of germs that may transmit sexually transmitted diseases: there are bacteria and viruses, while other diseases are transmitted by fungi or parasites.

The table below shows the most important sexually transmitted diseases. If you would like to read more, please just click on the name and a new page will open. 

 

 

Diseases transmitted by bacteria
 
Chlamydia. More...
Chlamydia
Description
Chlamydia is one of the most frequent sexually transmitted diseases; in Germany the number of new infections is estimated to be around one million per year. The infection can be transmitted by mucosa contact in vaginal intercourse, oral or anal sex. The bacteria can form colonies in different places, e.g. in the cervix, urethra, bowels or anus, but also in the eyes or in the mouth. 

Symptoms
Symptoms like pain in urinating or slimy and pyic fluid discharging from penis or vagina usually appear one or several weeks after an infection has occurred. Men may develop painful swellings of the testicles, women may get pain in the lower belly or unclear pain and bleedings during intercourse. If the infection happens by oral sex, the infected partner may develop throat pain; following anal sex, you may notice unusual discharges from the intestines. If the germs reach the eyes, e. g. by touching them with your hands, one can also develop conjuncitivits (pinkeye).  
The tricky thing with chlamydia is that the infection is often not accompanied by symptoms at all. Because of this, the infection is often not noticed.

Consequences
An unnoticed infection with chlamydia can even lead to sterility. Actually, chlamydia is the most frequent cause for sterility in women. In men, sterility is at risk as well if a chlamydia infection with chlamydia is left untreated.
Protection
The risk to pick up chlamydia is remarkable reduced if condoms are used during sexual activity. And this is how safe sex works...
Healing
If you should have caught chlamydia, the infection can be treated with antibiotics. It is important that the partner receives treatment as well. Antibiotics can only be prescribed by a physician; thus it is very important that you see a doctor if you suspect you may have been infected.
Gonorrhoea („The Clap“). More...
Gonorrhoea („The Clap“)

Description
Another disease transmitted by bacteria is gonorrhoea, also sometimes called “the clap”. It is caused by a bacterium called Neisseria gonorrhoeae.

Symptoms
Usually the infection with gonorrhoea becomes noticeable some days later by burning while urinating or unnatural discharges. These symptoms may be very weak, but the infection can be transmitted to other people all the same. This occurs especially frequently with mouth infections (by oral sex) or infections of the intestines (by anal sex).

Consequences
Untreated gonorrhoea leads to inflammations. Women tend to develop these in the fallopian tubes, the ovaries and the mucosa of the womb (uterus). Men tend to get inflammations in the spermatic cord, the prostate and the epididymis. This can lead to sterility in women and men. In severe cases, the whole body can become affected; the patient develops fever, joint pains and rashes. 

Protection and healing
Condomes provide an effective protection against gonorrhoea. And this is how safe sex works...

If one catches an infection anyway, gonorrhoea can be treated with antibiotics. If it is treated early, it heals completely. The partner needs to be treated as well.

Syphilis (Lues). More...
Syphilis (Lues)
Description
Syphilis is another sexually transmitted disease which is transmitted by bacteria.
Symptoms and consequences. If left untreated, syphilis progresses through three stades.

Stade 1 
(about 3 weeks after infection)
At the place where the bacterium penetrated (penis, labia, mouth, anus) a painless sore called chancre develops. In the surrounding of the chancre, the lymph nodes are swelling. The chancre heals and disappears after some weeks – this is a reason why the infection is so often left unnoticed or ignored.
Stade 2 
(eight weeks to two years
after infection)
Rashes appear that don’t hurt or itch; additionally fever and swollen lymph nodes. These symptoms also disappear after a while.
Stade 3  (several years after infection) Inner organs (e. g. liver), the nervous system and the bones  deteriorate severely.

Since the end of the nineties, syphilis infections have been increasing remarkably. It is absolutely important to take symptoms serious in any case, even when they are not joined by pain or itching. Every contact with the bacteria can actually lead to an infection – if the carrier has sores in the mouth, the infection can even be transmitted during kissing.

Healing
Syphilis can be treated and healed in every stade with antibiotics. Organ damages in the third stade, however, can’t be reversed any more. Partners need to receive treatment as well.

Protection
The best way is to use condoms during sex, as they provide protection against a transmission. And this is how safe sex works...
  
Diseases transmitted by viruses
 
Hepatitis B. More...
Hepatitis B
Description 
Hepatitis B is one of the most frequent infectious diseases in the world. The virus is contained in all bodily fluids and is therefore also transmitted by semen and vaginal fluid in sexual intercourse. The virus can be transmitted as well if semen comes into the mouth. Hepatitis B can even be transmitted by saliva (spittle) during kissing.

Symptoms
One to six months after infection, a flu-like condition develops. These complaints are often very weak, and the infection is not noticed.

Consequences 
In 90% of all cases hepatitis B heals completely, and the affected persons will stay immune against the virus for the rest of their life. In the remaining 10% of the infected persons, the disease becomes chronic, the virus stays active in the body and leads to a permanent deterioration of the liver. Sometimes the result may be liver cirrhosis (liver shrinkage) or liver cancer.

Protection 
The risk of infection is reduced by using condoms, but cannot be completely excluded as there are various ways of transmission (other bodily fluids like saliva etc.).  And this is how safe sex works...

Vaccination provides the most effective protection. In Germany, it is recommended for babies, adolescents and for members of high-risk groups (medical staff, men who have sex with men) and is in these cases paid for by the health insurance in these cases. 

Healing
An infection with hepatitis B is diagnosed by blood testing. If the disease is chronic, the physician will try, by means of an antiviral therapy, to stop the multiplication of the virus and to alleviate the inflammation.
Herpes. More...
Herpes
Description 
Many of us know herpes sores on the lips. They are caused by the virus HSV I (herpes simplex virus type I). Herpes can also afflict the genital region; this is caused by another virus (herpes simplex virus type II, HSV II), but HSV I infections can be transferred to the genital region by oral sex or lack of hygiene as well.

Symptoms
Some days after the initial infection, inflammation of the mucosa and rashes appear, which may be accompanied by fever and a swelling of the lymph nodes. The skin burns, itches, reddens and blisters appear. The fluid-filled blisters burst and sores develop. These usually heal in the course of some weeks.

Consequences 
As soon as you have had a herpes infection once, you will stay carrier for the rest of your life. Most people have had a herpes infection once in their life and since then developed antibodies against the virus. But not all people who carry the virus develop the described symptoms. In some people, the sores return regularly. The outbreak can be triggered by factors like stress, UV radiation or exhaustion.
If someone has a weak immune system, the virus may spread to the whole body. Infections are especially problematic in pregnancy, as they can lead to grave diseases in the baby during pregnancy and during birth, e. g. to meningitis (brain fever).
Protection 
Condoms protect against transmission of the virus in vaginal, oral and anal sex. As the virus is so highly contagious, transmission cannot always be avoided.  And this is how safe sex works...
Healing
It is good to know the symptoms and to see a doctor after a possible infection. Herpes can then be treated with antiviral medicaments. 
Human Papilloma Virus (Genital and Anal Warts). More...
Human Papilloma Virus (Genital and Anal Warts)
Description 
The infection with HPV (Human Papilloma Virus) is one of the most frequent sexually transmitted infections. HPV may cause genital and anals warts which look like small pointed or flat warts and usually appear in the vulva, vagina, penis and anus. Some types of HPV may cause cell changes which, after some years, may develop into cancer (cervical, penile, anal cancer).

Symptoms
The virus is mostly transmitted in unsafe oral, vaginal or anal sex. After some weeks or months, the first symptoms appear (small warts that may spread quickly, sometimes joined by burning and itching, but often without symptoms). Often, there are no noticeable symptoms at all.

Consequences 
The infection with HPV may cause cancer after some years (most frequently cervical cancer in women, but also anal and penile cancer in men), and this is also the case for infections that do not cause any symptoms or visible warts at all.

Protection 
Condoms provide protection agaginst the transmission, but only insofar as they prevent skin contact with the affected skin areas, which contain the viruses. Direct contact with the warts must be absolutely avoided. And this is how safe sex works...

Annual cancer screening is especially important for women, but also men should have regular medical exams. In the so-called PAP test, the gynecologist, doctor or nurse will take some cells from the cervix mucosa and have it analyzed. Thus, the state of the mucosa can be checked and infections, cell changes and e. g. the existence of HPV can be detected. In case of treatment, the partner/s may need to receive treatment as well. 

But here is good news: a vaccination has been developed against two sorts of the Human Papilloma Virus (types 16 and 18). Since 2007 it is available and recommended for girls aged 12 to 17. The vaccination needs to be realized prior to the first sexual contacts. As there is no vaccination against all sorts of the HPV, the yearly preventive medical checkups should be continued in any case.

Healing
There is no cure for HPV, but the immune system often fights off the virus in some month’s time. In other cases, one may stay carrier of the virus for longer time or the rest of one’s life. The warts can be treated symptomatically, e. g. by removing them by medicaments and surgical or chemical treatments. Due to its chronic character, the virus may stay in the skin and the warts tend to reappear, thus the treatment may ask a lot of patience from the side of the infected person.
HIV/AIDS. More...
HIV/AIDS
Description 
The acronym AIDS means acquired immune deficiency syndrome and is acquired by infection with HIV (human immunodeficiency virus), a virus weakening the human immune system. The HI virus can be transmitted when blood, semen or vaginal fluid containing the virus get onto the mucosa of the vagina or the intestines of another person.
The HI virus is transmitted predominately through contact of bodily fluids with vaginal or anal mucosa. The mucosa of the intestines is especially sensitive and can absorb the HI virus directly. This is the reason why the transmission risk is highest with anal sex. The risk is still very high in vaginal intercourse. In oral sex, the transmission happens before all when semen enters the mouth and when the mucosa of the mouth is weakened, e. g. if one has an infection or little wounds.
If someone already has other sexually transmitted diseases, the risk to catch HIV is increased, as the virus can more easily penetrate inflamed skin as for example in an infection with chlamydia or gonorrhoea.  

Symptoms and consequences 
Initially, most people infected with HIV don’t have any symptoms for years, before the immunodeficiency starts to develop. 
In an advanced stage, one develops typical infections with germs that do not harm healthy persons at all.  In addition, rare tumor diseases may develop.

Healing
It is still not possible to cure HIV/AIDS, and there is no vaccination either.  The virus cannot be removed from the body. That is the reason why a person in whose blood the virus cannot be detected any more, can still transmit the virus.  Today, drug therapy is available: the so-called combination therapy suppresses the virus reproduction and thus delays the progression of the disease. Thus, AIDS does not lead to death as quickly as it did formerly, and infected people have the chance to lead a better life. Combination therapy means that the patient takes several drugs together, as the HI virus strains may change and may become resistant against various substances. Another name for this treatment is HAART: highly active anti-retroviral therapy.
Protection
This very positive development in the medical treatment of HIV/AIDS has unfortunately led to a less careful behaviour in terms of safer sex recently, and thus the number of new infections has increased during the last years. Safer sex is the most effective protection against HIV/AIDS.  And this is how safe sex works...
  
Other diseases 
 
Trichomoniasis. More...
Trichomoniasis
Description 
Trichomoniasis is caused by the trichomonad, an endoparasite. They bed in vagina, intestines or urethra. Trichomonads are usually transmitted in unsafe sex, especially in anal sex. The transmission can also happen by commonly used objects like towels or sextoys.

Symptoms
Symptoms appear some days to weeks after infection. Men tend to have painful urination and frequent urges to urinate, but sometimes they don’t show any clear symptoms at all. Women usually develop a white or yellowish-green foamy vaginal discharge with an accompanying unpleasant odor. Many women also experience painful sexual intercourse, lower abdominal pain, itching and burning.

Consequences 
The perfidy of an infection with trichomoniasis is that that it increases the risk to catch other sexually transmitted diseases (among which HIV). 
Protection 
Condoms provide protection against infection. And this is how safe sex works...
Healing
If the infection has already happened, trichomoniasis can be treated and healed with antibiotics. It is important that the partner receives examination and treatment as well.  
Scabies. More...
Scabies
Description 
Scabies is not a classical sexually transmitted disease, as it can be contracted in any kind of more intensive skin contact. It is transmitted by microscopic mites that burrow into the skin and lay eggs.

Symptoms and consequences
Small spot-like bumps appear on the skin (between the fingers, at the wrist, in the genital region and in the armpits). After some weeks, strong itching, especially at nighttime, comes up as a further symptom. If the bumps become infected by scratching, these places form entry routes for additional infections.

Protection 
Scabies can be avoided through careful hygiene and regular changing of clothes.
Healing
If someone has been infected, he or she can undergo external chemical treatment. All sex partners and family members need to be treated as well.
Pubic lice („crabs“). More...
Pubic lice („crabs“)
Description 
Pubic lice are small insects without wings that bed in the pubic hair and lay eggs called „nits“. In severe cases, they can also be found in armpit hair or other bodily hair.  The transmission happens through intensive bodily contact, i. e.  also through sexual contact.

Symptoms and Consequences
After some days, the infected person develops itching as well as dots and flecks on the skin, caused by lice bits.

Healing
Treatment is done with shampoos, ointments or lotions. The nits must be removed with a special comb. Clothes and mattresses should be disinfected.

Consequences

Sexually transmitted diseases can have grave consequences. Without knowing, we can infect other people, if we do not notice infections by their symptoms, or if these are so weak that we are not aware of them.

As we may transmit the infection to other people, we need to inform our partner/s if we suspect or know that we have an infection. This can be awkward and may cause conflicts in the relationship, for example if someone has to admit that he or she has been unfaithful.

    Many sexually transmitted infections can, if left untreated, lead to secondary damage that cannot be repaired any more. For example, they can cause sterility in men and women. Thus, some infections can cause chronic and lasting damage, while others, like HIV / AIDS, are even life-threatening.  

Especially an infection with HIV still usually leads to social exclusion and stigma.

Myths

  We all have some ideas about sexually transmitted infections in our heads. But they are not always correct.

One of these ideas is that AIDS and other sexually transmitted diseases exist among homosexual men only. This idea stems from the 1980s, when the AIDS epidemic began and the disease was first observed among homosexual men only. Actually every person having sex with someone whose HIV status is unknown, is at risk to become infected with HIV. It is correct that the risk of infection is higher in the group of men having sex with men, but this simply has to do with sexual practices.

History of HIV/AIDS

In 1981, suddenly a high number of infections were observed that usually only occur in humans with a weakened immune system. But these infections then hit young – homosexual – men in Los Angeles that had been completely healthy before they caught these infections.

In 1982, scientists already suspected an acquired immunodeficiency syndrome. When various cases of infection were observed among heterosexual drug addicts and people who had received a blood transfusion, it became clear that the disease had nothing to do with homosexuality. By the way, in Germany the first case was diagnosed in 1982.

After some years of investigation, science discovered that it is a certain virus that causes AIDS. In 1986, the name HIV (Human Immunodeficiency Virus) was introduced.

In 1985, the first Worldwide AIDS Conference took place.

In 1987, the first drug against HIV/AIDS was officially approved and introduced to the market. However, in the 1980s and in the first half of the 1990s, many people died of AIDS, among which some popular people like the Queen vocalist Freddy Mercury, who died in 1991.

In the 1990s, the medical science made remarkable progress, for example by developing the so-called combination therapy. This development remarkably increased the quality of life and the life-span of people infected with HIV.

Since the beginning of the 1990s, the red AIDS ribbon has been a symbol for solidarity with HIV positive and AIDS patients all over the world.

Until the end of 2004, about 73,000 people had been infected with HIV in Germany since the beginning of the epidemic. 46,500 were still alive at that time.

The annual rate of new infections has been increasing again since 2002. In 2005, it was about 2,600 new cases per year. Worlwide, nearly 33,2 millions of men, women and children are living with HIV/AIDS.
The image below from the German Robert-Koch-Institute shows an estimate of how many adults and children lived with HIV/AIDS in 2007.


Image: © Robert-Koch-Institute

Many people also believe that the number of sexually transmitted infections is decreasing. Unfortunately, this is not the case: in many countries, the rates of new infections are rising, e. g. for syphilis and HIV / AIDS.

The notion that sexually transmitted infections cannot be transmitted by petting or oral sex is also very common. This is unfortunately not true either; it rather depends on the situation and on the germ. The risk of infection may be lower with oral sex, but if you have small wounds in the mucosa of your cheeks or in the gingiva, or an infected throat, or if the penetrating partner has an infection of the urthra, then the risk of infection is increased. Should the mouth come in contact with menstrual blood or infected vaginal fluid, an infection can be transmitted as well.

Many people think that sex with a condom is not nice or not cool. That’s actually only a question of attitude, in boys as well as in girls. Women and girls may often think: „If I insist on a condom, he might not want to sleep with me any more.” There are so many kinds of condoms nowadays, however, e. g. ultrasenstitive ones. You should only decide to have sex without a condom in a stable relationship and in mutual agreement. A HIV test taken together may be the starting point.

„If I don’t feel anything, I have no infection“– that’s an attitude which is not helpful with sexually transmitted diseases. Many infections proceed for days, weeks, months or years without any symptoms. This is one of the differences to other diseases that we know. Another particularity in sexually transmitted diseases is the fact, that it is often not suffice that only the one person that shows symptoms gets treatment. Usually it is necessary that the partner gets treated as well.

 

Protection

It is impossible to protect 100% against the infection with a sexually transmitted disease. But your own behaviour can protect you so you can enjoy sex without worry. The most important measure in this is Safer Sex. For some diseases, a vaccination has been developed in the recent past. Appropriate hygiene is important as well.

    Safer Sex. In safer sex, no body fluids are exchanged between humans. Neither semen nor vaginal fluids enter the body of the partner.

The easiest way to practice Safer Sex is to wear a condom in vaginal intercourse or anal sex. Condoms can be bought nearly everywhere: in pharmacies, drugstores and supermarkets.

If you do this in the right way, condoms can provide a very good protection against infections. How to do this exactly, please read here.

How to use a condom in the right way

The first important thing is to avoid damage of the rubber of the condom (e. g. with the fingernails), when ripping open the condom package: Do not roll open the condom to check if it is okay! When you do this, it may become damaged. After that, press out the air of the reservoir of the condom with thumb and forefinger, to have space for the later ejaculation. After that, the condom can be rolled down on the stiff penis. If it doesn’t work properly of if by accident you put on the condom the wrong way (reel inside), better take a new one.


Image sequence: © German Federal Centre for Health Education (BZgA)

After orgasm, the penis should best be withdrawn from anus or vagina as long as it is still stiff. Doing this, hold the condom to avoid that it slips off in withdrawing. Please take care that no semen is pressed out – this is very important!

And please use a condom only once, and throw it away afterwards into the garbage and not in the toilet.

It is important that you only use condoms carrying a „CE“sign with a control number, and that the date of expiration is not yet exceeded. In addition, the wrapping should not be damaged. Condoms need to be safe from pressure (purse, trouser pocket) and heat. For anal sex, there are also extra tearproof condoms.

To facilitate the penetration of the penis into vagina or anus, many people use lubricants – please be aware, however, that condoms may only be used with fatfree and watersoluble lubricants. Oils and fat may affect the latex and can make a condom tear. If a woman prefers to contracept additionally with suppositories or foam, it is important to use fatfree products in this as well. In anal sex, a fatfree lubricant helps to reduce the pressure on the condom.

By the way: You can watch in detail how a condom works in a video here.

In addition, it is important to take care not to take in semen when doing oral sex – in oral sex with men you can use a condom, in oral sex with women there is a special cloth (available in pharmacies and in anti-AIDS action committees) that can be used to cover the vagina. In any case, it is very much recommended to avoid contact with visible skin changes like spots, warts or abscesses. They can be a sign for an acute infection and may be contagious.

The most important thing is that you talk about safer sex with your partner – before you start having sex. This is nothing that must be feared. Usually, both sides will be happy that the subject is discussed, and sex can be experienced without fear.

 

 

 

    Vaccinations. There are some sexually transmitted diseases against which you can protect yourself by vaccination.

The German Vaccination Committee recommends a vaccination against hepatitis B (usually administered together with Hepatitis A) and against Human Papilloma Virus (HPV) for young people, to be administered prior to the first sexual contact.

 

 

 

    Hygiene. Adequate hygiene also contributes to the protection against sexually transmitted diseases. Regular hygiene in the genital region helps to get a better feeling for your own body and to notice possible changes in an early state.

For women it is very important, however, to take care that the natural bacterial balance is not damaged, which can easily happen by using vaginal douches, deodorants etc. in the genital region. As soon as the skin of the vagina becomes dry, it becomes easy for germs to penetrate.
Many germs love a warm and humid surrounding. For this reason, it’s a good idea to wear breathable clothes if possible (e. g. cotton underwear).

Treatment

Sexually transmitted diseases need to receive treatment by a physician. Even in the case of only slight symptoms it is best to see a doctor. The treatment of sexually transmitted diseases is done by dermatologists, as well as gynecologists for women and urologists for men. In other countries, treatment is being done by general practioners or in special treatment centres (so-called genito-urinary clinic, GUM clinic)

Many people feel ashamed when they see a doctor because they noticed changes in the genital region. But for the physician, that kind of health problem is something very normal, as it is relatively frequent. In total, the number of infections with a sexually transmitted disease is increasing.

Allways remember: If you seek treatment early enough, there are very good chances for
healing. Treatment should be done after a thorough medical examination
done by a physician – self-medication can delay infections or lead to
irreparable damage.

It is very important that both partners receive treatment, otherwise the infection can see-saw between the partners (“ping-pong effect”). Also, former partners should be informed about an infection if the contact has not happened long ago. The same is true for people who have sex with more than one partner.

In principle, everyone who is affected or assumes to be affected by a sexually transmitted infection should always talk to the partner/s. This may be a bit uncomfortable, but it will help to prevent to spread the infection.

Everybody who assumes to have an infection or notices symptoms that might be a sign for one, should be aware to use condoms when having sex. And, even if it may be difficult: in such a case, it would be best to not have sex at all until healing.    

    By the way: In Germany there is an obligation for a number of infections to notify the Health Authorities, among them HIV and syphilis.

If you have several or changing sex partners, or want to have sex without condoms with one partner, you should by all means do an HIV test.  This can be done at a physician or at the Health Authorties (at a low fee or free of charge). In an HIV test it is examined if the body has formed antibodies (i. e. defence cells) against the HI virus. An infection can be excluded by test not earlier than three months after the last risk situation.