Although some of these diseases are less well-known in the United
States than other STDs, they are still important some are
especially significant for pregnant women. Many of these
infections are of serious concern for people in other parts of
the world, particularly in developing countries.
Chancroid
Chancroid ("shan-kroid") is an important bacterial
infection caused by Haemophilus ducreyi, which is spread by
sexual contact. Periodic outbreaks of chancroid have occurred in
the United States, the last one being in the late 1980s. These
outbreaks are usually seen in minority populations in the inner
cities, especially in the southern and eastern portion of the
country. Globally, this disease is common in sub-Saharan Africa
among men who have frequent contact with prostitutes.
The infection begins with the appearance of painful open sores on
the genitals, sometimes accompanied by swollen, tender lymph
nodes in the groin. These symptoms occur within a week after
exposure. Symptoms in women are often less noticeable and may be
limited to painful urination or defecation, painful intercourse,
rectal bleeding, or vaginal discharge. Chancroid lesions may be
difficult to distinguish from ulcers caused by genital herpes or
syphilis. A physician must therefore diagnose the infection by
excluding other diseases with similar symptoms. People with
chancroid can be treated effectively with one of several
antibiotics. Chancroid is one of the genital ulcer diseases that
may be associated with an increased risk of transmission of the
human immunodeficiency virus (HIV), the cause of AIDS.
Cytomegalovirus Infections
Cytomegalovirus (CMV) is a very common virus that infects
approximately one-half of all young adults in the United States.
It rarely causes serious consequences except in people with
suppressed or impaired immune systems or in infants, whose immune
systems are still developing. The virus, a member of the
herpesvirus family, is found in saliva, urine, and other bodily
fluids. Because it is often found in semen as well as in cervical
secretions, the virus can be spread by sexual contact; it also
can be easily spread by other forms of physical contact such as
kissing. Day-care center staff for children under the age of 3
are at increased risk of CMV infection and should carefully wash
their hands after changing diapers. Like other herpesvirus
infections, CMV is incurable; people are infected with it for
life. Although the virus usually remains in an inactive state, it
can reactivate from time to time.
Symptoms: In healthy adults, CMV usually produces no symptoms of
infection. Occasionally, however, mild symptoms of swollen lymph
glands, fever, and fatigue may occur. These symptoms may be
similar to those of infectious mononucleosis.
Diagnosis: The ELISA (enzyme-linked immunosorbent assay) test is
commonly used to detect levels of antibodies (disease-fighting
proteins of the immune system) in the blood. A number of other
blood tests can suggest a diagnosis of CMV infection, but no
blood test can reliably diagnose it. Although CMV can be isolated
from urine or other body fluids, it may be excreted months or
years after an infection; therefore, isolation of the virus from
these fluids is not a reliable method of diagnosing recent
infection.
Complications: Babies can be infected with CMV in the uterus if
their mothers become infected with the virus or develop a
recurrence of a previous infection during pregnancy. Although
most babies infected with CMV before birth do not develop any
symptoms, CMV is the leading cause of congenital infection in the
United States. An estimated 6,000 babies each year develop
life-threatening complications of congenital CMV infection at
birth or suffer serious consequences later in life, including
mental retardation, blindness, deafness, or epilepsy.
Investigators supported by NIAID are currently studying how the
virus interferes with normal fetal development and at which
stages the fetus is most susceptible to infection. Congenital CMV
is the most common cause of progressive deafness in children.
When CMV is acquired after birth, or if it reactivates, it can be
life-threatening for persons with suppressed immune systems, such
as those receiving chemotherapy or persons who have received
immunosuppressant drugs for organ transplantation. Persons with
HIV infection or AIDS may develop severe CMV infections,
including CMV retinitis, an eye disease that can lead to
blindness.
Treatment: NIAID scientists are testing new antiviral drugs that
might be effective against CMV infections. The antiviral drugs
foscarnet and ganciclovir have been approved for treating people
with AIDS-associated CMV retinitis.
Prevention: There is no intervention to prevent CMV. Use of the
male condom may reduce risk although virus in the saliva would be
transmitted by kissing or oral intercourse. Some experts believe
that primary or first-time exposure during pregnancy is a major
cause of CMV infection in newborns. Infants infected before or
just after birth are likely to be shedding CMV in saliva and
urine, which can infect others. Hand washing and proper handling
of diapers may reduce risk. Scientists are working to develop a
vaccine and other methods to provide immunity to CMV and offer
protection against severe disease.
Molluscum Contagiosum
This common viral infection most often affects young children,
who pass it to each other through saliva. In adults, however, the
virus is transmitted sexually, resulting in lesions on the
genitals, lower abdomen, buttocks, or inner thighs. Most people
with the infection do not have noticeable symptoms, although
sometimes the lesions, which are painless wart-like bumps, may
itch or become irritated. The lesions often heal without
treatment, although physicians may sometimes scrape them off or
treat them with chemical irritants.
Pubic Lice
Pubic lice (pediculosis pubis or crab lice) are very tiny insects
that infest the pubic hair and survive by feeding on human blood.
These parasites are most often spread by sexual contact; in a few
cases, they may be picked up through contact with infested
bedding or clothing. An estimated 3 million people with new cases
of the infestation are treated each year in the United States.
Symptoms: The primary symptom of infestation is itching in the
pubic area. Scratching may spread the lice to other parts of the
body; thus, every effort should be made to avoid touching the
infected area, although this may be difficult.
Diagnosis: Pubic lice are diagnosed easily because they are
visible to the naked eye. They are pinhead size, oval in shape,
and grayish, but appear reddish-brown when full of blood from
their host. Nits, the tiny white eggs, also are visible and
usually are observed clinging to the base of pubic hair.
Treatment: Lotions and shampoos that will kill pubic lice are
available both over the counter and by prescription. Creams or
lotions containing lindane, a powerful pesticide, are most
frequently prescribed for the treatment of pubic lice. Pregnant
women may be advised not to use this drug, and a physician's
recommendations for use in infants and small children should be
followed carefully. Itching may persist even after the lice have
been eradicated. This is because the skin has been irritated and
requires time to heal. A soothing lotion such as calamine may
offer temporary relief.
Prevention: All persons with whom an infested individual has come
into close contact, including family and close friends as well as
sex partners, should be treated to ensure that the lice have been
eliminated. In addition, all clothing and bedding should be
dry-cleaned or washed in very hot water (125¡ F), dried at a
high setting, and ironed to rid them of any lice. Pubic lice die
within 24 hours of being separated from the body. Because the
eggs may live up to six days, it is important to apply the
treatment for the full time recommended.
Scabies
Scabies is a skin infestation with a tiny mite, Sarcoptes
scabiei. Scabies has become relatively common throughout the
general population. It is highly contagious and is spread
primarily through sexual contact, although it also is commonly
transmitted by contact with skin, infested sheets, towels, or
even furniture.
Symptoms: Scabies causes intense itching, which often becomes
worse at night. Small red bumps or lines appear on the body at
sites where the female scabies mite has burrowed into the skin to
lay her eggs. The areas most commonly affected include the hands
(especially between the fingers), wrists, elbows, lower abdomen,
and genitals. The skin reaction may not develop until a month or
more after infestation. During this time, a person may pass the
disease unknowingly to a sex partner or to another person with
whom he or she has close contact.
Diagnosis: Scabies may be confused with other skin irritations
such as poison ivy or eczema. To make an accurate diagnosis, a
doctor takes a scraping of the irritated area and examines it
under a microscope, to reveal the presence of the mite.
Treatment: As with pubic lice, lindane is an effective treatment
for scabies. Pregnant women should consult a doctor before using
this product. Nonprescription remedies such as sulfur ointment
also are available. Sulfur is fairly effective but may be
objectionable because of its odor and messiness. Itching can
persist even after the infestation has been eliminated because of
lingering skin irritation. A hydrocortisone cream or ointment or
a soothing lotion may provide relief from itching.
Prevention: Family members and sex partners of a person with
scabies are advised to undergo treatment. Twenty-four hours after
drug therapy, a person with scabies infestation is no longer
contagious to others, even though the skin irritation may persist
for some time. As with pubic lice, special care must be taken to
rid clothing and bedding of any mites.
Human T-Cell Lymphotropic Virus
The human T-cell lymphotropic viruses (retroviruses), HTLV-I and
HTLV-II, are uncommon in the general U.S. population. They appear
to be most prevalent among IV drug users and persons who have
multiple sex partners, genital ulcers, or a history of syphilis.
The virus can be transmitted by blood or intimate sexual contact,
and can be passed from mother to child during pregnancy and
through breast milk.
Most infected persons remain healthy carriers of the virus. In
rare cases, however, HTLV-I can cause adult T-cell
leukemia/lymphoma (ATL), a rare and aggressive cancer of the
blood. Infected persons also may develop myelopathy, a neurologic
disorder that affects the muscles in the legs. In addition,
researchers think that HTLV-I plays a role in the development of
B-cell chronic lymphocytic leukemia. HTLV-II can cause another
rare cancer called hairy-cell leukemia. Because the chances of
curing ATL rely on early detection, scientists are studying
protein in the blood of HTLV-I-infected persons that may help
predict who will develop the disease.
Blood donations are screened routinely for HTLV-I. Because lab
tests cannot easily distinguish between HTLV-I and HTLV-II,
experts believe many cases of HTLV-II are eliminated from the
blood supply as well.
Keeping It Casual Sex at Sacramento State University
I'm 23 and I've been using the Net for over two years now to meet guys. It's a lot better than the bar scene, and it's very convenient. I just sit at my computer and surf profiles until I find someone I like. Usually it doesn't take much longer than an hour. I haven't found anyone for a long-term relationship yet, but I haven't been looking. Most of the time I go out on dates because I need to unwind. Sex is the best stress reliever. I'm a graduate student in Political Science at Sac State and it's not easy. Sometimes I just have to get laid, there's no way to get around it.
My poli sci classes typically have a lot of guys, but I won't go out with anyone in my faculty. When I was an undergraduate it was a different story, but as a graduate student the class sizes are smaller and there's a lot of gossip. I'd imagine it's like living in a small town. Everybody knows everyone else's business, including the professors, and when you're doing a thesis, reputation is everything.
Dating through the Internet has been a lifesaver. I don't have to worry about how many guys I go out with or wonder what people say about me. If I want to have a one-night stand, I just do it. It's great.
Last night I had a wonderful time with a guy I'd only spent half an hour talking to online. His name was Danny and we had a mutual understanding from the moment we said hello in a chat room. I had such a good feeling about him we skipped the usual formalities and met for coffee not far from where I live. The first face-to-face introduction is usually awkward, but this time it was pure pleasure. Danny was gorgeous (as I suspected) and we were both so horny we got our coffees to go and went back to his place after only a little small talk.
When we got to his condo in College Greens off Folsom Blvd he lit some incense and we curled up on a couch in front of his TV. I can't remember what was on KCRA, but I wasn't paying much attention to Walt Gray. I think only ten minutes passed by before I had him sucking on my nipples. His mouth was really hot and I made sure to lose my clothes first so he would continue working his tongue all over my body. He didn't even have his shirt off before I came. It was a good thing the couch was leather, I was very wet and I made quite a mess.
The night was just starting though. After my orgasm he climbed up my body and pulled out his cock in front of my face. When it touched my lips he moaned and I took some pride in taking all of it to the back of my throat in one quick motion. I usually don't give head on one-night stands, but Danny had done such a good job licking my pussy it would just seem wrong not to do it for him. His penis was thick and beautiful and I gave him the best blowjob as I could.
I didn't expect him to come, but once he started pumping jizz in my mouth I actually ended up swallowing it all. It was bitter, but I loved his reaction. I had big plans for this stud and I knew it would be appreciated.
We fucked on his Breuners couch for what must have been an hour and then when we were both exhausted we went to his bedroom. I slept over and in the morning we made love very slow and sensual. It was awesome. He asked if he could see me again but I had to tell him I'd think about it. He's the sort of guy I worry about falling in love with. I've worked very hard to get where I am right now and I don't need any emotional baggage.
I usually never go back a second time with guys like Danny, but I find that I'm thinking about him a lot more than I thought I would. I thought writing this letter might help but it only seems to be making things worse. I might give Danny a call right now, but then, I might just go online and see if I can satisfy my cravings somewhere else.
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