Our Health Topics

Sexually Transmitted Diseases (STD)

  • Sexually transmitted diseases are infectious diseases spread through sexual contact. These infections are very common, especially among young people. The United States has some of the highest rates of STDs in the industrialized world.

    • Anyone who has sex can get an STD, but young people are particularly affected. Two-thirds of STDs occur in people under 25, mostly because young people are more likely to be sexually active.
    • In a recent study by the Centers for Disease Control and Prevention (CDC), one in four girls between the ages 14 and 19 were determined to have at least one of four sexually transmitted diseases (STDs): Human Papillomavirus (HPV), chlamydia, herpes simplex virus and trichomoniasis.
    • The rates of STDs are on the rise, possible because of higher rates of sexual activity with multiple sex partners.
    • Many STDs such as AIDS, herpes and syphilis, can be passed on from mother to the baby at birth. STDs can also cause low birth weight and premature babies. Babies with infected mothers can have problems such as pneumonia, eye infections and brain damage.

    How Boston Children's Hospital approaches sexually transmitted diseases

    The prevention and treatment of sexually transmitted diseases is a top priority at Boston Children's Hospital. There are many different types of STDs with varying symptoms and severities, and Children's has different programs that provide young people and parents with the testing, treatment and counseling they need.

    At the Adolescent Medicine Clinic, we encourage parents to talk to their children about sex before they become teenagers or decide to have sex. If you think your teenage girl would benefit from doing her own research, we recommend she take a look at the Center for Young Women's Health website, which is full of guides and easy to understand information about sex, STDs and much more.

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  • Human Immunodeficiency Virus(HIV)/Acquired Immune Deficiency Syndrome (AIDS)

    • AIDS is caused by the human immunodeficiency virus (HIV), a virus that destroys the body's ability to fight off infection.
    • People who have AIDS are very susceptible to many life-threatening diseases and to certain forms of cancer. AIDS has long been considered a fatal disease. However, over the past decade, a combination of medicines has become available that turn AIDS into a chronic, though incurable, illness.
    • Transmission of the virus most often occurs during sexual activity or by the sharing of needles used to inject intravenous drugs.

    Human Papillomavirus (HPV)

    • HPV is a group of over 100 different viruses, some of which cause warts on the inside or outside of the genitals. These warts can spread to surrounding skin or to a sexual partner.
    • At least one in every two sexually active young women has HPV.
    • HPV is sometimes symptomless, so women may not know they have it and men may not know they are carrying it.
    • Women with an HPV infection are at a higher risk for developing cervical cancer, but regular Pap tests are often able to catch an infection.
    • In 2006, the FDA approved a new HPV vaccine to help prevent cervical cancer. The HPV vaccine currently targets two types of HPV that cause 70 percent of cervical cancers and two types of HPV that cause 90 percent of genital warts.
    • Smoking appears to worsen the problems of HPV infection.

    Chlamydia

    • Chlamydia, one of the most common STDs, affects four million American men and women each year.
    • Infections may cause abnormal genital discharge or a burning sensation during urination, but some people have few or no symptoms.
    • Chlamydia is treated with antibiotics.

    Gonorrhea

    • Gonorrhea is a bacterial STD, often referred to as "the clap," or "a dose," or "a drip."
    • There are over 700,000 cases of gonorrhea in the U.S. every year.
    • The infection causes a discharge from the vagina or penis and painful or difficult urination.
    • Women are much more likely to catch gonorrhea from men than men are from women but both can get it.
    • The most common and serious complications occur in women, which include pelvic inflammatory disease, ectopic (tubal) pregnancy and infertility.
    • Gonorrhea infections can be treated with antibiotic therapy.

    Genital Herpes

    • Half a million Americans are diagnosed with genital herpes each year. Many more don't know they have the virus because they have no symptoms.
    • Herpes is an infection caused by two different but closely related viruses, called Herpes Simplex Virus Type 1 (HSV-1) and Herpes Simplex Virus Type 2 (HSV-2).
    • HSV-1 commonly causes "cold sores" or "fever blisters" on the lips. However, HSV-1 can also be spread by oral sexual contact and then cause genital herpes. Ninety percent of Americans have HSV-1 at some time in their life.
    • HSV-2 is almost always spread by sexual contact and causes genital herpes or open sores around the vulva, cervix, anus and penis. A tingling or burning sensation precedes an outbreak.
    • Herpes sores usually disappear within a few weeks, but the virus remains in the body and the lesions may recur from time to time.
    • There is no cure for HSV but there are anti-viral agents an individual can take during an outbreak to decrease the length of the outbreak.

    Syphilis

    • Syphilis is an STD caused by a very small organism called a spirochete.
    • The infection needs to be treated with antibiotics early to avoid serious problems.
    • In 2006, there were over 36,000 reported cases of syphilis in the U.S.
    • The first symptom of syphilis is a painless open sore that usually appears on the penis, in the vagina or around either sexual organ.
    • It is usually passed through sexual contact, including vaginal, anal and oral sex, or other close personal contact.

    Other diseases

    How can my child prevent getting an STD?

    The only way you or your child can completely prevent an STD is to not have sex. The younger a person is when they begin to have sex for the first time, the more susceptible they become to developing an STD. As parents, you can't always control this part of your child's life, but Children's advises you to talk to him or her about sex and STDs early. Teens should read: Sexually Transmitted Diseases: A Guide for Teens from the Center for Young Women's Health.

    If sexually active, the best thing is to use a latex condom each and every time you have sex and avoid multiple sex partners. Always make sure your partner knows their STD status before having sex with him or her. Remember, gay and lesbian sexual activity can pass STDs just as easily as heterosexual sex.

    Precautionary measures, recommended by the National Institute of Allergy and Infectious Diseases, can help to reduce your risk of developing a sexually transmitted disease. These include the following:

    • have a mutually monogamous sexual relationship with an uninfected partner
    • use (consistently and correctly) a male condom
    • use a barrier method for sex between females
    • don't inject drugs, or use sterile needles if injecting intravenous drugs
    • have regular checkups for STDs
    • learn the symptoms of STDs and seek medical help as soon as possible if any symptoms develop
    • use a condom during anal sex
    • avoid douching
  • "As kids gets older, let them have private time with their healthcare provider. Recognize their need to separate from parents and give them space to develop a relationship with their healthcare provider so that they can receive appropriate care around STD evaluation, treatment and prevention."

     

    -Lydia Shrier, MD, MPH, director of Clinic-Based Research in the Division of Adolescent Medicine at Boston Children's Hospital.

    How is an STD diagnosed?

    There are easy tests to check if you have an STD. If you have any symptoms of an STD, any unexplained problems or you think you may have been exposed to an STD (even if you don't have symptoms), see your health care provider right away and get tested.

    No test for any STD is 100 percent accurate. Some STDs don't show up immediately. It could take an infection anywhere from a couple of days to a few years to show up in testing

    When should my daughter get a Pap test?

    A Pap test is usually done when you turn 21 or earlier if you have other risks for abnormal Pap tests,such as problems with your immune system. A Pap test doesn't check for STDs directly. However, problems on the Pap test may mean that you have gotten an STD. The Pap test is the only way to check the cells on your cervix for changes that can lead to cervical cancer. If you think you might have an STD, your health care provider will check you for an STD and explain to you when to begin Pap testing.

    What to do when diagnosed?

    Most STDs can be treated. Be sure to start treatment as early as you can.

    It's important that you:

    • begin treatment immediately, take the full course of medications and follow your physician's advice
    • don't breastfeed a baby or use breast milk to feed a baby
    • avoid sexual activity while under treatment for an STD
    • tell your sexual partners (or have them notified) about possible exposure
    • have a follow-up test to be sure the STD has been successfully treated

    Where can I be tested in the United States if I can't go see my physician?

    National HIV and STD Testing Resources

    This Web site has a feature where you can type in your zip code, and get the names and addresses of testing locations near you. It's sponsored by the Centers for Disease Control and Prevention (CDC).

  • STD treatment depends on the particular STD you have. For example, gonorrhea is treated with antibiotics, while herpes may need to be treated with anti-viral agents, creams, acid medicines or laser therapy. No matter the STD, it's important to get tested at the first sign and to start treatment right away to avoid more serious problems.

    STD Treatment at Boston Children's Hospital

    The Gynecology Program and the Division of Infectious Diseases offer children and parents STD testing, treatment and support.

    • At the Adolescent/Young Adult Medical Practice, physicians with special training in adolescent medicine work collaboratively with a team of nurse practitioners, nurses, nutritionists, HIV counselors and mental health professionals to meet the health care needs of adolescents and young adults, ages 10 to 23.
    • The Center for Young Women's Health offers a host of programs and health education programs for girls struggling with sexual health issues.

    Children's is also home to specialized programs that focus on groups at particular risk for STD problems:

    • The Young Parents Program (YPP), part of the Children's Hospital Primary Care Center (CHPCC) At Boston Children's Hospital, provides quality STD care and education to teen parents and their children in low-income and at-risk environments.
    • BostonHAPPENS (HIV Adolescent Provider & Peer Education Network for Services) Program at Boston Children's Hospital provides services and support to HIV infected, homeless and at-risk adolescents and young adults, 12 to 24 years old, in the Metropolitan Boston area. The program also provides free HIV counseling and testing.
  • Research & Innovation

    Handheld computers are providing new insights into adolescents' sexual behavior. Children's researcher Lydia Shrier, MD, MPH, and colleagues closely tracked 67 sexually active youth, aged 15 to 21, paging them at random four to six times a day with a series of questions about their sexual activity and emotional state. The upshot? Most adolescents feel better after sex—a finding that may not be surprising, but will help health professionals craft more effective safer-sex messages.

    HIV treatment and tuberculosis treatment
    When it comes to treating HIV patients co-infected with tuberculosis (TB), the sooner the treatment, the better. Anne Goldfeld, MD, of Children’s Hospital Boston reports about a study in Cambodia showing that HIV treatment within two weeks of TB treatment, as opposed to the current practice of waiting 2 months, increases survival by 33 percent. Read more about the HIV treatment study in Cambodia.

     

    Molecular barrier against HIV and other diseases
    Lee Adam Wheeler and Judy Lieberman, MD, PhD led research suggesting that interfering RNA could create a molecular barrier against HIV, and possible other diseases. Learn more about this research in the Children’s newsroom.
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