Herbal Health

An infant born to a mother who is HIV positive has a 12-13 percent risk of being born infected, with a higher risk if the mother is at an advanced stage in her illness. If the mother has a large amount of circulating virus (which can be the case briefly during the initial infection and for a longer period later in the course of her illness), then an infant runs a 30 percent or greater chance of being infected. Babies born prematurely also seem to have a higher risk of infection, and the use of fetal scalp monitors also makes transmission of HIV easier. (These devices use tiny electrodes placed on the infant’s head while in the womb to monitor the infant’s condition,- the tiny cuts they create in the scalp can facilitate the transmission of HIV and herpes virus from the mother to the infant.) Trauma to the scalp from forceps may also facilitate transmission. Having a delivery via cesarean section may decrease the risk of transmission of HIV to a child.

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Several medications are now recommended as first-line choices for treating gonorrhea of the genital and anal areas. A person who is diagnosed with gonorrhea is usually treated for NGU and chlamydia as well, because the likelihood of co-infection with the bacteria that cause these infections is high. Some gonorrhea treatments are given as an injection, some are available as a week-long course of oral medication, and some are available as a single pill—which is the easiest way to treat any infection.

A shot of ceftriaxone or a single dose of such oral medications as ofloxacin, cefixime, and ciprofloxacin will treat gonorrhea. Recently some gonorrheal resistance to ofloxacin has been reported in certain areas of the country. Other treatments are available if these are not well tolerated.

If more extensive infection—such as epididymitis, prostatitis, or PID—is suspected, then a longer course of antibiotics is necessary (see the sections on epididymitis and prostatitis and on pelvic inflammatory disease). For gonorrhea of the throat, either ceftriaxone or ciprofloxacin is usually given, since these antibiotics are more effective than the other choices. Talk with your health care provider about which treatment is best for you.

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To protect a woman’s fertility for the future, safer sex practices are mandatory. One episode of chlamydia-induced pelvic inflammatory disease (PID) decreases a woman’s likelihood of becoming pregnant in the future by 20 percent, and each episode of PID makes a repeat episode more likely because of the scarring that occurs.

Unfortunately, many women experimenting with their first sexual experiences in young adulthood are not adequately informed about STDs and how to keep safe. It is young people, and young women in particular, who suffer the brunt of the consequences of the STD epidemic. Young women are more vulnerable to becoming infected with bacterial STDs such as gonorrhea and chlamydia because of the anatomy of the cervix, which makes it more susceptible to infection in adolescence and the twenties than later in adulthood. Even though women may not be thinking about pregnancy at that point in their lives (in fact, they may be trying their best not to get pregnant), what about five or ten or twenty years later? The actions taken by a young woman now could affect her chances of getting pregnant later, when she wants to.

Many women are becoming sexually active at earlier ages but are delaying marriage and childbirth until later—a life choice that leaves them with more time for sexual activity, and more opportunity to acquire a sexually transmitted infection. Education can equip young people with the tools to protect their fertility for later in life, and getting regular STD screens will help to detect most infections early, while they are still treatable and reversible.

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Usually the first thing that happens when you visit a health care provider is that he or she takes a medical history by asking a lot of questions about your health, your behavior (for instance, “Do you smoke?”), and your family’s health. When you are seeking advice about sexual health, some of the questions you will be asked may seem embarrassing. It may seem that a health care provider is prying, but that is usually not the case. These questions help the health care provider assess or religion on patients. To be effective, the health care environment must be supportive and nonjudgmental. If it is not, you your risk for a sexually transmitted infection. Remember that what you discuss is confidential. Here are a few of the questions you may be asked:

1. When was your last sexual contact with a partner? With your steady partner? With a casual partner?

2. What kind of sexual contact have you had? Oral? Anal? Genital? (Knowing where on the body you have had sexual contact will help the health care provider know where to look for evidence of infection.)

3. How many sexual partners have you had in the last two months? In the last twelve months? In your lifetime?

4. For heterosexual persons: Do you use any type of birth control, such as a condom, diaphragm or cervical cap, or birth control pills? For all sexually active persons: What method do you use to prevent STD transmission, such as condoms, spermicides, or dental dams? Did you use this method during your last sexual contact?

5. Are your partners male, female, or both? (Certain health care providers may use terms that label people in terms of their sexual orientation, such as gay or homosexual for those who have sex with same-sex partners, straight or heterosexual for those who have sex with opposite-sex partners, or bisexual for those who have sex with both male and female partners. This approach may make some people less willing to answer this question. Certain health care providers make assumptions; in other words, they may assume that if you are male, you only have sex with females. You must make clear what type of sexual practice you have engaged in, so that your health care provider will have accurate information.)

6. Are you concerned that your partner may be having sex with other partners?

7. Are you having any symptoms in the genital area?

8. Have you had a history of a sexually transmitted infection in the past, and if so, when? Have you ever been tested for STDs?

9. Do you use injection drugs? Do you have a sexual partner who uses injection drugs?

10. Have you ever had a blood transfusion?

11. Do your partners (or partner) have a history of sexually transmitted infections? Are they having symptoms now?

You will also usually be asked about your understanding of sexually transmitted infections—what causes them, how they are transmitted, and so on—and be given a chance to have all your questions answered.

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The urethra is the tube that carries urine from the bladder to the outside. The opening of the urethra is located below the clitoris, and it can sometimes be difficult to see when a woman examines herself. The urethra can be the site of sexually transmitted infections, such as chlamydia and gonorrhea, which can cause burning with urination. Bladder infections (which, unlike in men, are very common in women) can also cause irritation of the urethra.

Glands on each side of the urethra, called Skene’s glands, supply lubricating fluid to the vaginal area during sexual stimulation. These can sometimes become the site of sexually transmitted bacterial infections. BARTHOLIN’S GLANDS

Bartholin’s glands sit on each side of the lower part of the vaginal opening and secrete lubricating fluids during sexual stimulation. They can also become infected (in particular with gonorrhea and chlamydia), and this would make them enlarged and painful. They are not usually noticeable.

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