Hi everyone!  Welcome to the A to Z of Sex.  I’m Dr Lori Beth and I am your host.  We are working our way through the erotic alphabet one letter at a time.  Just a reminder this podcast deals with adult content, so if you don’t have total privacy, you might want to put on your headphones. Today the letter is H and H is for HIV, Herpes and other Sexually Transmitted Infections.

So often information about sexually transmitted infections and sexual health is accessed only once.    Many people never really learn much about the types of problems that can arise as a result of sex.  We don’t make learning about it sexy and people often prefer to avoid things that are unpleasant, awkward or might cause conflict.

Today I am taking you through a grand tour of sexually transmitted infections and diseases.   I will describe the disease, how you transmit it/catch it and any treatment available as well as how you can prevent it.    Since we started doing this for the letter H, I will start with all the diseases that begin with H.

H is for Hepatitis (A,B,C,D, E).  Hepatitis comes in at least 5 forms.  Hepatitis is an inflammation and/or infection of the liver.   Your liver is the organ responsible for cleaning your blood, detoxifies chemicals, metabolizes drugs and makes proteins that are needed for clotting.   Acute hepatitis either resolves on its own, progresses to chronic forms.  Chronic hepatitis can lead to liver scarring or liver cancer.  The most common causes of hepatitis are viruses.  But some can be caused by alcohol abuse and autoimmune disease.  Types A and E are spread primarily through contaminated food and water.  Types B and C are blood born viruses and spread through needle sharing and sexual activity where there is access to the blood stream.  Type D only infects those who are already infected with type B.   There are vaccines for Hepatitis A and B but not for the rest.    Prevention is having safe sex (using barrier methods for all sexual activity).

There are a variety of treatments for hepatitis C now and some can be quite successful.  Because hepatitis can lead to liver failure and liver cancer, screening is essential and treatment as early on give the best chance of recovery.    If you are diagnosed with hepatitis, you must abstain completely from alcohol and limit your drug intake (including prescriptions and over the counter medication) to decrease the stress on the liver.

H is for Herpes:  Herpes comes in a variety of forms.  There is a family of 9 herpes viruses that attacks humans and that includes herpes simplex 1 and 2, varicella zoster, Epstein-Barr and cytomegalovirus.  Herpes simplex 1 and 2 are the ones that cause oral and genital herpes.   The viruses are caught via skin to skin contact when the virus is active (from when the tingling first appears until new skin has grown).  You can catch it in more than one place but will rarely spread it through your body.  First outbreaks can involve flu like symptoms as well as blisters and sores at the infected area.  Some people have repeated outbreaks and others have only one. 

6 out of 10 people in the UK have type 1 by age 25 and 1 out of 10 have type 2.  Most people who have herpes have mild or no symptoms and so do not know they have it.  Antiviral medication can prevent outbreaks and make them resolve more quickly.

H is for HIV: HIV is a virus that attacks the immune system and weakens the body’s ability to fight other viruses.  There is no cure but there are many treatments that help people to live a long and healthy life.    AIDS is the last stage of HIV infection.     Early diagnosis and treatment of HIV prevents things moving on to become AIDS.

HIV is contained in body fluids of infected people.  You can contract it from having sex without a condom or from sharing needles or there is transmission from mother to child during pregnancy, birth or breast feeding.  For the most part, HIV is spread through anal or vaginal sex but it is possible for it to be spread through oral sex and sharing sex toys though this is much rarer.

There is medication that can prevent you contracting the virus if you were exposed.  You must take that medication within three days for it to be effective.  This is called PEP medication (Post-exposure prophalaxis).

You should be tested as soon as you believe you may have been eposed and then again one to three months after as it can take this long for the antibodies to show up in the blood.    Antiretroviral treatment can be extremely effective in bringing the viral load to undetectable.   To prevent HIV transmission: abstain from sex or use a barrier method of prevention (condom, femidom).

Current NHS statistics for HIV in the UK: 1 in every 620 people has HIV.  Two groups have the highest incidence: Gay and bisexual men (approximately 1 in 20) and Black African heterosexual (approximately 1 in 56 men and 1 in 22 women).    Of course these statistics don’t include those who are not yet diagnosed and don’t know they are infected.

The estimate for world wide prevalence is 35 million people are living with HIV and the majority of these cases are in sub-Saharan Africa.  There are currently clinical vaccine trials going on in the United Kingdom.

H is for Human Papillomavirus: Most infections cause no symptoms and resolve spontaneously.  In some they produce warts or precancerous lesions.  Nearly all cervical cancer is linked to HPV.  This is the most common sexually transmitted infection globally.  Most people are infected at some point in their lives.  There is now a vaccine that is very effective if given before infection. 

Gonorrhea  can infect men and women.  The infection is very common in 15-24 year olds.    It can affect genitals, rectum and throat. Most women with gonorrhoea have no symptoms.  Men may have burning when peeing and a discharge from the penis.  Gonorrhea can be cured with antibiotics although there are now some serious drug-resistant strains.    If you do not get treatment, women can contract Pelvic Inflammatory Disease which can lead to infertility.  Men can get a painful condition in the tubes attached to the testicles and this can lead to infertility.  Rarely untreated gonorrhoea can spread to blood or joints and this can be life-threatening.

Syphyllis: This STD is easily treated with antibiotics (primarily penicillin).  If it is untreated, it can lead to neurological or heart symptoms an eventually death. 

It causes non-cancerous growths that cause symptoms that look like many other diseases because of where they grow.    Syphyllis can be prevented by using condoms as long as the chancre (sore) is covered.   Syphyllis also increases the rate of transmission of HIV.

Chlamydia: This is a bacterial infection.  Many people who are infected have no symptoms.  This is one of the most common sexually transmitted infections.  It effects 4.2% of women and 2.7% of men worldwide.  In women the infection untreated can cause ectopic pregnancies or pelvic inflammatory disease leading to infertility.  The infection can be cured by antibiotics.  Women who are sexually active should be screened yearly.   Prevention is by abstinence or condom use.

Trichomoniasis is an infection caused by a single cell organisam.  Women are more likely to have it than men.  It is easily treated.  Women who havr the infection are more likely to become infected with HIV if exposed to HIV.

Crabs (pubic lice) are contracted by close contact with someone who has them or their bedding or clothing  (just as with other forms of lice).  They can be treated in the same way other lice is treated. 

Scabies is a contagious skin condition caused by a mite.  It can be caught from skin to skin contact or contact with clothing or bedding of the infected person.  It can be cured through the use of chemicals like lice.

Bacterial vaginosis is caused by too much of a certain bacteria in the vagina.  It is unclear how this imbalance occurs but it rarely happens in women who are not sexually active.  Having a new sexual partner or multiple partners as well as douching raises the incidence of an imbalance making the risk higher.    It can resolve without treatment but treatment is fairly easy and as there are risks that go with leaving it untreated (higher risk of contracting HIV if exposed, risk of Pelvic Inflammatory Disease, higher risk of contracting chlamydia and gonorrhoea, higher risk of delivering a baby early) it makes sense to treat it as soon as possible.

The best way to prevent infections is of course abstinence but this no fun.  The second best way is to have only one sexual partner who has been tested and found clear of all infections.   If you are having more than one partner, using barrier methods (condoms, femidoms) is the best protection though it won’t be perfect protection.  If you want to go without barrier methods, get regularly tested and recognise that you will be running a higher risk of contracting infections.   Make sure that the decisions you make factor in the risks.    There is nothing in life that does not contain risks.  Balancing risks and accepting responsibility for your choices is the job of the adult and leads to a more joy filled life.

Thanks for joining me this week for the A to Z of Sex.  Write in with your questions to drloribeth@atozofsex.com and visit both websites www.atozofsex.com and www.the-intimacy-coach.com to learn about alternative sexual choices, types of sexual relationships and to learn to sizzle and create that ideal lasting intimate relationship.   For a free 30 minute session with me, head over to www.atozofsex.com and click on the button that says ‘book now’.   If you have enjoyed this podcast, please leave a review on iTunes and/or Stitcher and please subscribe! Join me next week when the letter will be I and I is for Infidelity.