Sexually Transmitted Infections

Symptoms in women 

Even when chlamydia has no symptoms, it can damage a woman’s reproductive system. Women with symptoms may notice: 

• An abnormal vaginal discharge 
• A burning sensation when peeing 

Symptoms in men 

Men with symptoms may notice: 

• Penis discharge 
• A burning sensation when peeing 
• Pain and swelling in one or both testicles (although this is less common) 

Symptoms from rectal infections 

Men and women can also get chlamydia in their rectum. This happens either by having receptive anal sex, or by spread from another infected site (such as the vagina). While these infections often cause no symptoms, they can cause: 

• Rectal pain 
• Discharge 
• Bleeding 

See your healthcare provider if you notice any of these symptoms. You should also see a provider if your partner has an STI or symptoms of one. Symptoms can include an unusual sore, a smelly discharge, burning when peeing, and bleeding between periods. 

You can get chlamydia by having vaginal, anal, or oral sex without a condom with someone who has the infection. A pregnant woman with chlamydia can give the infection to her baby during childbirth. 

How can I reduce my risk of getting chlamydia?

The only way to completely avoid STIs is to not have vaginal, anal, or oral sex.

If you are sexually active, the following things can lower your chances of getting chlamydia:

• Being in a long-term mutually monogamous relationship with a partner who has been tested and does not have chlamydia
• Using condoms the right way every time you have sex

I’m pregnant. If I have chlamydia, how can I protect my baby from getting it?

If you are pregnant and have chlamydia, you can give the infection to your baby during delivery. This can cause serious health problems for your baby. If you are pregnant, talk to your healthcare provider about getting the correct examination, testing, and treatment. Treating chlamydia as soon as possible will make health problems for your baby less likely.

If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for chlamydia or other STIs.

If you are a sexually active gay or bisexual man, you should get tested for chlamydia every year. If you are a sexually active woman, you should get tested for chlamydia every year if you are:

• Younger than 25 years
• 25 years and older with risk factors, such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection Testing is also recommended during pregnancy in some cases.

How will my healthcare provider know if I have chlamydia?

Laboratory tests can diagnose chlamydia. Your healthcare provider may ask you to provide a urine sample for testing, or they might use (or ask you to use) a cotton swab to get a vaginal sample.

Is there a cure for chlamydia?

Yes, the right treatment can cure chlamydia. It is important that you take all of the medicine your healthcare provider gives you to cure your infection. Do not share medicine for chlamydia with anyone. When taken properly it will stop the infection and could decrease your chances of having problems later. Although medicine will stop the infection, it will not undo any permanent damage caused by the disease.

Repeat infection with chlamydia is common. You should receive testing again about three months after your treatment, even if your sex partner(s) receives treatment.

When can I have sex again after my chlamydia treatment?

You should not have sex again until you and your sex partner(s) complete treatment. If given a single dose of medicine, you should wait seven days after taking the medicine before having sex. If given medicine to take for seven days, wait until you finish all the doses before having sex.

If you’ve had chlamydia and took medicine in the past, you can still get it again. This can happen if you have sex without a condom with a person who has chlamydia.

What happens if I don’t get treated?

The initial damage that chlamydia causes often goes unnoticed. However, chlamydia can lead to serious health problems.

In women, untreated chlamydia can cause pelvic inflammatory disease (PID). Some of the complications of PID are:

• Formation of scar tissue that blocks Fallopian tubes
• Ectopic pregnancy (pregnancy outside the womb)
• Infertility (not being able to get pregnant)
• Long-term pelvic/abdominal pain

Men rarely have health problems from chlamydia. The infection can cause a fever and pain in the tubes attached to the testicles. This can, in rare cases, lead to infertility.

Untreated chlamydia may also increase your chances of getting or giving HIV.

Gonorrhea often has no symptoms, but it can cause serious health problems, even without symptoms.

Symptoms in women

Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Symptoms in women can include:

• Painful or burning sensation when peeing
• Increased vaginal discharge
• Vaginal bleeding between periods

Symptoms in men

Men who do have symptoms may have:

• A burning sensation when peeing
• A white, yellow, or green discharge from the penis
• Painful or swollen testicles (although this is less common)

Symptoms from rectal infections

Rectal infections may either cause no symptoms or cause symptoms in both men and women that may include:

• Discharge
• Anal itching
• Soreness
• Bleeding
• Painful bowel movements

See your healthcare provider if you notice any of these symptoms. You should also see a provider if your partner has an STI or symptoms of one. Symptoms can include an unusual sore, a smelly discharge, burning when peeing, or bleeding between periods.

You can get gonorrhea by having vaginal, anal, or oral sex without a condom with someone who has the infection. A pregnant woman with gonorrhea can give the infection to her baby during childbirth.

Am I at risk for gonorrhea?

Sexually active people can get gonorrhea through vaginal, anal, or oral sex without a condom with a partner who has gonorrhea.

If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for gonorrhea or other STIs.

How can I reduce my risk of getting gonorrhea?

The only way to completely avoid STIs is to not have vaginal, anal, or oral sex.

If you are sexually active, the following things can lower your chances of getting gonorrhea:

• Being in a long-term mutually monogamous relationship with a partner who has been tested and does not have gonorrhea.
• Using condoms the right way every time you have sex.

I’m pregnant. If I have gonorrhea, how can I protect my baby from getting it?

If you are pregnant and have gonorrhea, you can give the infection to your baby during delivery. This can cause serious health problems for your baby. If you are pregnant, talk to your healthcare provider about getting the correct examination, testing, and treatment. Treating gonorrhea as soon as possible will make health problems for your baby less likely.

If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for gonorrhea or other STIs.

If you are a sexually active gay or bisexual man, you should get tested for gonorrhea every year. If you are a sexually active woman, you should get tested for gonorrhea every year if you are:

• Younger than 25 years
• 25 years and older with risk factors, such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection Testing is also recommended during pregnancy in some cases.

How will my healthcare provider know if I have gonorrhea?

Most of the time, a healthcare provider will use a a urine sample to diagnose gonorrhea. However, if you have had oral and/or anal sex, your healthcare provider may use swabs to collect samples from your throat and/or rectum. In some cases, a healthcare provider may also use a swab to collect a sample from a man’s urethra (urine canal) or a woman’s cervix (opening to the womb).

Is there a cure for gonorrhea?

Yes, the right treatment can cure gonorrhea. It is important that you take all of the medicine your healthcare provider gives you to cure your infection. Do not share medicine for gonorrhea with anyone. Although medicine will stop the infection, it will not undo any permanent damage caused by the disease.

It is becoming harder to treat some gonorrhea, as drug-resistant strains of gonorrhea are increasing. Return to a healthcare provider if your symptoms continue for more than a few days after receiving treatment.

When can I have sex again after my gonorrhea treatment?

Wait seven days after finishing all medicine before having sex. You and your sex partner(s) should avoid having sex until you have each completed treatment and your symptoms are gone. This will help prevent you and your partner(s) from giving or getting gonorrhea again. Those with gonorrhea should be retested about three months after treatment of an initial infection, even if their partners received successful treatment.

If you’ve had gonorrhea and took medicine in the past, you can still get it again. This happens if you have sex without a condom with a person who has gonorrhea.

What happens if I don’t get treated?

Untreated gonorrhea can cause serious and permanent health problems. In women, untreated gonorrhea can cause pelvic inflammatory disease (PID). Some of the complications of PID are:

• Formation of scar tissue that blocks Fallopian tubes
• Ectopic pregnancy (pregnancy outside the womb)
• Infertility (not being able to get pregnant)
• Long-term pelvic/abdominal pain

In men, gonorrhea can cause a painful condition in the tubes attached to the testicles, which can, in rare cases, lead to infertility.

Rarely, untreated gonorrhea can also spread to your blood or joints. This condition can be life-threatening.

Untreated gonorrhea may also increase your chances of getting or giving HIV.

Primary infection, also called acute HIV

Some people infected by HIV get a flu-like illness within 2 to 4 weeks after the virus enters the body. This stage may last a few days to several weeks. Some people have no symptoms during this stage.

Possible symptoms include:

• Fever.
• Headache.
• Muscle aches and joint pain.
• Rash.
• Sore throat and painful mouth sores.
• Swollen lymph glands, also called nodes, mainly on the neck.
• Diarrhea.
• Weight loss.
• Cough.
• Night sweats.

These symptoms can be so mild that you might not notice them. However, the amount of virus in your bloodstream, called viral load, is high at this time. As a result, the infection spreads to others more easily during primary infection than during the next stage.

Clinical latent infection, also called chronic HIV

In this stage of infection, HIV is still in the body and cells of the immune system, called white blood cells. But during this time, many people don’t have symptoms or the infections that HIV can cause.

This stage can last for many years for people who aren’t getting antiretroviral therapy, also called ART. Some people get more-severe disease much sooner.

Symptomatic HIV infection

As the virus continues to multiply and destroy immune cells, you may get mild infections or long-term symptoms such as:

• Fever.
• Fatigue.
• Swollen lymph glands, which are often one of the first symptoms of HIV infection.
• Diarrhea.
• Weight loss.
• Oral yeast infection, also called thrush.
• Shingles, also called herpes zoster.
• Pneumonia

Progression to AIDS

Better antiviral treatments have greatly decreased deaths from AIDS worldwide. Thanks to these lifesaving treatments, most people with HIV in the U.S. today don’t get AIDS. Untreated, HIV most often turns into AIDS in about 8 to 10 years.

Having AIDS means your immune system is very damaged. People with AIDS are more likely to develop diseases they wouldn’t get if they had healthy immune systems. These are called opportunistic infections or opportunistic cancers. Some people get opportunistic infections during the acute stage of the disease.

The symptoms of some of these infections may include:

• Sweats.
• Chills.
• Fever that keeps coming back.
• Ongoing diarrhea.
• Swollen lymph glands.
• Constant white spots or lesions on the tongue or in the mouth.
• Constant fatigue.
• Weakness.
• Rapid weight loss.
• Skin rashes or bumps.

When to see a doctor

If you think you may have been infected with HIV or are at risk of contracting the virus, see a healthcare professional as soon as you can.

You can get infected with HIV if infected blood, semen or fluids from a vagina enter your body. This can happen when you:

• Have sex. You may become infected if you have vaginal or anal sex with an infected partner. Oral sex carries less risk. The virus can enter your body through mouth sores or small tears that can happen in the rectum or vagina during sex.
• Share needles to inject illicit drugs. Sharing needles and syringes that have been infected puts you at high risk of HIV and other infectious diseases, such as hepatitis.
• Have a blood transfusion. Sometimes the virus may be transmitted through blood from a donor. Hospitals and blood banks screen the blood supply for HIV. So this risk is small in places where these precautions are taken. The risk may be higher in resource-poor countries that are not able to screen all donated blood.
• Have a pregnancy, give birth or breastfeed. Pregnant people who have HIV can pass the virus to their babies. People who are HIV positive and get treatment for the infection during pregnancy can greatly lower the risk to their babies.

You can’t become infected with HIV through casual contact. That means you can’t catch HIV or get AIDS by hugging, kissing, dancing or shaking hands with someone who has the infection.

HIV isn’t spread through air, water or insect bites. You can’t get HIV by donating blood.

What are the risk factors for HIV?

Anyone of any age, race, sex or sexual orientation can have HIV/AIDS. However, you’re at greatest risk of HIV/AIDS if you:

• Have unprotected sex. Use a new latex or polyurethane condom every time you have sex. Anal sex is riskier than is vaginal sex. Your risk of HIV increases if you have more than one sexual partner.
• Have an STI. Many STIs cause open sores on the genitals. These sores allow HIV to enter the body.
• Inject illicit drugs. If you share needles and syringes, you can be exposed to infected blood.

What can I do to prevent HIV?

There’s no vaccine to prevent HIV infection and no cure for HIV/AIDS. But you can protect yourself and others from infection.

To help prevent the spread of HIV:

• Consider preexposure prophylaxis, also called PrEP. There are two PrEP medicines taken by mouth, also called oral, and one PrEP medicine given in the form of a shot, called injectable. The oral medicines are emtricitabine-tenofovir disoproxil fumarate (Truvada) and emtricitabine-tenofovir alafenamide fumarate (Descovy). The injectable medicine is called cabotegravir (Apretude). PrEP can reduce the risk of sexually transmitted HIV infection in people at very high risk.
  • PrEP can reduce the risk of getting HIV from sex by about 99% and from injecting drugs by at least 74%, according to the Centers for Disease Control and Prevention. Descovy hasn’t been studied in people who have sex by having a penis put into their vaginas, called receptive vaginal sex.
  • Cabotegravir (Apretude) is the first U.S. Food and Drug Administration-approved PrEP that can be given as a shot to reduce the risk of sexually transmitted HIV infection in people at very high risk. A healthcare professional gives the shot. After two once-monthly shots, Apretude is given every two months. The shot is an option in place of a daily PrEP pill.
  • Your healthcare professional prescribes these medicines to prevent HIV only to people who don’t already have HIV infection. You need an HIV test before you start taking any PrEP. You need to take the test every three months for the pills or before each shot for as long as you take PrEP.
  • You need to take the pills every day or closely follow the shot schedule. You still need to practice safe sex to protect against other STIs. If you have hepatitis B, you should see an infectious disease or liver specialist before beginning PrEP therapy.
• Use treatment as prevention, also called TasP. If you have HIV, taking HIV medicines can keep your partner from getting infected with the virus. If your blood tests show no virus, that means your viral load can’t be detected. Then you won’t transmit the virus to anyone else through sex.
  • If you use TasP, you must take your medicines exactly as prescribed and get regular checkups.
• Use post-exposure prophylaxis, also called PEP, if you’ve been exposed to HIV. If you think you’ve been exposed through sex, through needles or in the workplace, contact your healthcare professional or go to an emergency room. Taking PEP as soon as you can within the first 72 hours can greatly reduce your risk of getting HIV. You need to take the medicine for 28 days.
• Use a new condom every time you have anal or vaginal sex. Both male and female condoms are available. If you use a lubricant, make sure it’s water based. Oil-based lubricants can weaken condoms and cause them to break.
  • During oral sex, use a cut-open condom or a piece of medical-grade latex called a dental dam without a lubricant.
• Tell your sexual partners you have HIV. It’s important to tell all your current and past sexual partners that you’re HIV positive. They need to be tested.
• Use clean needles. If you use needles to inject illicit drugs, make sure the needles are sterile. Don’t share them. Use needle-exchange programs in your community. Seek he
• If you’re pregnant, get medical care right away. You can pass HIV to your baby. But if you get treatment during pregnancy, you can lessen your baby’s risk greatly.
• Consider male circumcision. Studies show that removing the foreskin from the penis, called circumcision, can help reduce the risk of getting HIV infection.

If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for gonorrhea or other STIs.

If you are a sexually active gay or bisexual man, you should get tested for gonorrhea every year. If you are a sexually active woman, you should get tested for gonorrhea every year if you are:

• Younger than 25 years
• 25 years and older with risk factors, such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection Testing is also recommended during pregnancy in some cases.

How will my healthcare provider know if I have gonorrhea?

Most of the time, a healthcare provider will use a a urine sample to diagnose gonorrhea. However, if you have had oral and/or anal sex, your healthcare provider may use swabs to collect samples from your throat and/or rectum. In some cases, a healthcare provider may also use a swab to collect a sample from a man’s urethra (urine canal) or a woman’s cervix (opening to the womb).

How do I know if I have syphilis?

Each stage of syphilis has different signs and symptoms. There are four stages of syphilis (primary, secondary, latent, and tertiary).

Primary stage

During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is the location where syphilis entered your body. These sores usually occur in, on, or around the

• Penis
• Vagina
• Anus
• Rectum
• Lips or in the mouth

Sores are usually (but not always) firm, round, and painless. Because the sore is painless, you may not notice it. The sore usually lasts 3 to 6 weeks and heals regardless of whether you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.

Secondary stage

During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet and look

• Rough
• Red
• Reddish-brown

The rash usually won’t itch, and it is sometimes so faint that you won’t notice it. Other symptoms may include

• Fever
• Swollen lymph glands
• Sore throat
• Patchy hair loss
• Headaches
• Weight loss
• Muscle aches
• Fatigue (feeling very tired)

The symptoms from this stage will go away whether you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.

Latent stage

The latent stage of syphilis is a period when there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years.

Tertiary stage

Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen, it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death. A healthcare provider can usually diagnose tertiary syphilis with the help of multiple tests.

Neurosyphilis, ocular syphilis, and otosyphilis

Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can happen during any of the stages described above.

Signs and symptoms of neurosyphilis can include

• Severe headache
• Muscle weakness and/or trouble with muscle movements
• Changes to your mental state (trouble focusing, confusion, personality change) and/or dementia (problems with memory, thinking, and/or decision making).

Signs and symptoms of ocular syphilis can include

• Eye pain and/or redness
• Changes in your vision or even blindness

Signs and symptoms of otosyphilis may include

• Hearing loss
• Ringing, buzzing, roaring, or hissing in the ears (“tinnitus”)
• Dizziness or vertigo (feeling like you or your surroundings are moving or spinning)

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex.

Women can also pass syphilis to their baby during pregnancy.

You cannot get syphilis through casual contact with objects, such as

• Toilet seats
• Doorknobs
• Swimming pools
• Hot tubs
• Bathtubs
• Sharing clothing, or eating utensils

Am I at risk for syphilis?

Sexually active people can get syphilis through vaginal, anal, or oral sex without a condom with a partner who has syphilis.

If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for syphilis or other STIs.

Syphilis may be more common in some racial/ethnic and sexual minority groups. For instance, gay and bisexual men are disproportionately impacted by syphilis. In addition, people from racial and ethnic minority groups are experiencing the brunt of the congenital syphilis epidemic. These disparities are due to social, cultural, and economic conditions that make it difficult for sexually active people to stay healthy.

How can I reduce my risk of getting syphilis?

The only way to completely avoid STIs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting syphilis:

• Being in a long-term mutually monogamous relationship with a partner who has been tested and does not have syphilis.
• Using condoms the right way every time you have sex.

Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

I’m pregnant. If I have syphilis, how can I protect my baby from getting it?

If you are pregnant and have syphilis, you can give the infection to your baby. Having syphilis can lead to a low-birth-weight-baby. It can make it more likely you will deliver your baby too early or stillborn (a baby born dead). To protect your baby, you should receive syphilis testing at least once during your pregnancy. Receive treatment right away if you test positive.

At birth, a baby with a syphilis infection may not have signs or symptoms of disease. However, if the baby does not receive treatment right away, the baby may develop serious problems within a few weeks. These babies can have health problems, such as cataracts, deafness, or seizures, and can die.

What is the link between syphilis and HIV?

Having a sore or break in the skin from an STI such as syphilis may allow HIV to more easily enter your body. You may also be more likely to get HIV because the same behaviors and circumstances that put you at risk for getting other STIs can also put you at greater risk for getting HIV.

You should get tested regularly for syphilis if you are sexually active and

• Are a gay or bisexual man
• Have HIV
• Are taking pre-exposure prophylaxis (PrEP) for HIV prevention
• Have partner(s) who have tested positive for syphilis · Have certain risk factors for syphilis, like living in a community with high rates of syphilis

All pregnant women should receive syphilis testing at their first prenatal visit. Some pregnant women need to receive syphilis testing again during the third trimester at 28 weeks and at delivery.

How will my healthcare provider know if I have syphilis?

Most of the time, healthcare providers will use a blood test to test for syphilis. Some will diagnose syphilis by testing fluid from a syphilis sore.

Is there a cure for syphilis?

Yes, syphilis is curable with the right antibiotics from your healthcare provider. However, treatment might not undo any damage the infection can cause.

Can I get syphilis again, after receiving treatment?

Having syphilis once does not protect you from getting it again. Even after successful treatment, you can get syphilis again. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your healthcare provider is necessary to make sure your treatment was successful.

It may not be obvious that a sex partner has syphilis. Syphilis sores in the vagina, anus, mouth, or under the foreskin of the penis, can be hard to see. You may get syphilis again, if your sex partner(s) does not receive testing and treatment.