Viral STI (Sexually Transmitted Infection) Update

Andrew Siegel MD   1/27/2018

Sadly, there exist many “creatures” out there that enjoy cohabiting our genitals and bodies. Today’s entry is on the topic of viral STIs– an important subject, since several viral STIs are highly prevalent and many of those who are infected are unaware that they are infected. Viral STIs consist of the four “H’s”: HPV, HIV, herpes and hepatitis as opposed to bacterial STIs (gonorrhea, syphilis, chlamydia), protozoan STIs (trichomoniasis) and other-organism STIs (pubic lice and scabies). This is the 4-H club that you would rather not be a member of. 

The format of today’s entry will be a 10-question multiple-choice quiz to test your basic knowledge.  Please try to answer all questions before proceeding to the answers and explanations at the end.

Abbreviation Glossary:

STI: sexually transmitted infections

HAV: hepatitis A virus

HBV: hepatitis B virus

HPV: human papilloma virus

HSV-1: herpes simplex 1

HSV-2: herpes simplex 2

HIV: human immunodeficiency virus

AIDS: acquired immune deficiency syndrome

1. Which of the following STIs can be prevented by means of vaccination?

a) hepatitis A virus

b) hepatitis B virus

c) human papilloma virus (HPV)

d) all of the above

2. Natural membrane condoms (lambskins) are effective in preventing STIs.

a) true

b) false

3. Which of the following is the most common ulcerative STI?

a) genital herpes

b) chancroid

c) syphilis

d) lymphogranuloma venereum

4. Most genital herpes infections are transmitted by people who are unaware they are infected.

a) true

b) false

5. What is the most common STI in the United States?

a) chlamydia

b) HPV

c) herpes

d) gonorrhea

6. Most cases of HPV infections are characterized by which of the following?

a) self-limited

b) asymptomatic

c) unrecognized

d) all of the above

7.   What areas of the body may HPV infect?

a) genital and anal areas

b) mouth and throat

c) respiratory tract

d) all of the above

8. Hepatitis B infections can cause which the following problems?

a) permanent liver scarring

b) liver failure

c) liver cancer

d) all of the above

9. Hepatitis A infections, although usually spread by contaminated food or water can also be spread sexually by the following means:

a) oral-anal contact

b) digital-anal contact

c) penetrative anal sex

d) all of the above

10. Approximately what percent of persons living with HIV are unaware of their infection?

a) 15%

b) 25%

c) 35%

d) 45%

Answers:

1. All of the above. There are effective vaccinations available for hepatitis A virus, hepatitis B virus and human papilloma virus (HPV).  These are the only STIs for which vaccination is available for prevention.
2. False. Natural membrane condoms (lambskins) are NOT effective in preventing STIs. They are made from lamb intestine and have pores that block passage of sperm, but the pores are more than 10 times the diameter of HIV and 25 times the diameter of HBV. Sexual transmission of hepatitis B, HIV and herpes simplex can occur with natural membrane condoms. However, latex condoms are capable of preventing the transmission of these viruses
3. Genital herpes is the most common STI that can cause ulcerations.  When symptomatic it causes painful, watery blisters that usually erode to form ulcers.
4. True. Most genital herpes infections are transmitted by people who are unaware that they are infected. In the USA, one in six persons age 15-50 is infected with HSV-2. Most people infected have not been diagnosed and as such, most genital herpes infections are transmitted by people who are unaware they are infected or are asymptomatic. Lesions recur in 80% of those with HSV-2 and 50% of those with HSV-1.
5. The most common STI in the United States is HPV. The prevalence of genital HPV in adults is approximately 45% in men and 40% in women. All boys and girls 11 to 12 years of age are currently recommended to receive HPV vaccines, prior to the onset of sexual activity and initial exposure to the virus.
6. All of the above. Most cases of HPV infections are self-limited, asymptomatic and go unrecognized.  When symptomatic, HPV is characterized by genital warts (condyloma) in the anogenital regions.
7. All of the above. HPV can infect the genital and anal areas, the mouth and throat, and even the respiratory tract.
8.  All of the above. Hepatitis B infections if left untreated can cause serious liver diseases: permanent liver scarring (cirrhosis), liver failure, liver cancer and death.  HBV is transmitted by exposure to infected blood or body fluids.
9. All of the above. Hepatitis A infections, although usually spread by contaminated food or water, can also be spread sexually by oral-anal contact, digital-anal contact, and penetrative anal sex. A combined HAV/HBV vaccine is available.
10. About 15% percent of persons living with HIV are unaware of their infection. It is estimated that in the United States about 1.2 million individuals are living with HIV or acquired immune deficiency syndrome (AIDS). Fortunately, there are effective medications utilized for prevention of HIV infection as well as treatment of HIV infection.  

Bottom Line:  Be smart when choosing your sex partner and practice safe sex. There are many infections that are caused by pathogens (bacteria, viruses, protozoa, etc.) spread person to person by intimate contact. Although some are merely annoying and are easily treated, others can cause significant morbidity; some are associated with the development of cancer, and others, including HIV, are responsible for an epidemic of death. The viral STIs are the 4 “H’s”: HPV (human papilloma virus, responsible for genital warts), HIV (human immunodeficiency virus), hepatitis, and herpes.  Latex condoms are the only widely available proven method for reducing the risk of transmission of HIV and other STIs, but they are certainly not infallible. Strongly consider getting vaccinated to protect against HPV and hepatitis.

Wishing you the best of health!

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (the female version is in the works): PelvicRx

 

 

 

Tags: acquired immune deficiency syndrome, Andrew Siegel MD, hepatitis A, hepatitis B, herpes simplex 1, herpes simplex 2, human immunodeficiency virus, human papilloma virus, viral sexual transmitted infections