Herald & Review (Decatur, IL)

April 27, 1997
Section: Life
Page: F1
THINK AGAIN
Although most people believe they'll never get a sexually transmitted disease, one in five Americans is affected
By STEPHANIE ERICKSON

H&R Staff Writer

They are teens -- and pre-teens -- wanting, or feeling pressured, to have unprotected sex. They are prostitutes and intravenous drug users.

They are people in a committed relationship -- who let their guard down.

They are wives, husbands, boyfriends, girlfriends -- having one-night stands.

Some don't even know the name of their sexual partner.

But they all have one thing in common: a sexually transmitted disease.

Some know they have one. Others do not.

Some will learn their lesson. Others will get reinfected. Again and again and again.

``We see them all in here,'' said Michelle Henkelman, health educator at Planned Parenthood in Decatur. ``We see drug users. We see married couples. Most people don't think it will happen to them.''

By 1992, 12 years into its epidemic, AIDS had claimed the lives of more than 170,000 Americans. And while AIDS is the deadliest STD of all -- and one without a cure -- a myriad of other STDs should not be forgotten, health officials say.

At least 56 million people -- more than one in five Americans -- are believed to be infected with a viral STD other than AIDS. For people under age 20, the ratio drops to one in four.

And while statistics vary, it is clear that Illinois and Macon County are not sheltered from what some health officials call an ``STD epidemic.''

Illinois ranks fifth in the United States for chlamydia, seventh for syphilis and 14th for gonorrhea.

According to Illinois Department of Public Health data, the number of syphilis cases in Macon County dropped in 1995. But the number of gonorrhea and chlamydia incidents climbed. Meanwhile, Macon County topped Champaign and Sangamon counties for all three diseases.

Ed Renier attributes the rise in number of chlamydia cases to more chlamydia testing.

``More testing equals more positive results,'' said Renier, assistant chief of the STD section at the state health department.

Dr. Michael Pacyga, a Decatur obstetrician, said the main contributor to the rise in STD cases is irresponsible teen-age behavior.

``Teen-agers tend to be less selective in choosing their sexual partners,'' he said. ``They tend to use their emotions, rather than their heads. They wind up with one, two or three cases of gonorrhea or chlamydia and then wind up being infertile for the rest of their lives.''

All STDs first became prevalent during World War II but declined with the introduction of penicillin, which provided a cure for syphilis and gonorrhea.

In the 1960s and 1970s, however, STDs increased again with the introduction of birth-control pills. Use of barrier contraceptives, which provide some protection against STD infection, declined.

Today, according to the Centers for Disease Control and Prevention in Atlanta, STDs are on the rise, with more than 12 million new cases diagnosed each year.

Of the top 10 infections reported for women, 91 percent are STD-related. And the situation is worse than it appears. Several of the most common STDs -- like genital herpes and genital warts -- aren't accounted for in statistics because they are not tracked by the government.

CDC National STD Hotline counselors answered 213,767 calls during the last 12 months. Most of the callers sought information about herpes, HPV (genital warts) and chlamydia.

While syphilis and gonorrhea have nearly disappeared in most industrialized countries, syphilis in the United States is at its highest level in 40 years, and gonorrhea is the country's most commonly reported contagious disease.

Henkelman said part of the problem with syphilis and gonorrhea is that they are treatable.

``So people keep getting reinfected,'' she said. ``And it spreads wild.''

For many people, problems do not end with an STD diagnosis. More than 1 million women suffer an episode of pelvic inflammatory disease each year, most as a consequence of an undetected STD. As many as 150,000 women may become infertile, and 45,000 may experience a life-endangering ectopic pregnancy.

``The consequences of STDs and pregnancy can also be quite severe,'' Pacyga said. ``It can lead to infection of the bag of water around the baby. It can lead to pre-term labor.''

The most prevalent STD in the United States is chlamydia, which strikes between 3 million and 10 million people each year. ``Chlamydia right now is almost at epidemic proportions,'' Pacyga said.

Left untreated, chlamydia can spread throughout the reproductive system, causing infertility and pregnancy complications.

Untreated gonorrhea can also cause pelvic inflammatory disease, infertility and ectopic pregnancy, as well as urethral stricture and erection problems in men, and blindness in newborns.

Untreated syphilis lapses into a latent stage -- which is not contagious and has no symptoms -- then develops into a late stage that can result in mental illness, blindness, heart disease and death.

Some strains of untreated genital warts may lead to cervical cancer. And untreated hepatitis B can result in liver disease, cancer and death.

About 45 percent to 50 percent of STD patients are between 14 and 25 years old. State health department data shows that in 1994, 45 percent of Macon County cases of chlamydia and gonorrhea were among 10- to 19-year-olds.

While Pacyga said he treats many teen-agers with STDs, he also sees a fair number of married couples who test positive.

``Even though their partner has said they've been faithful,'' he said. ``Sometimes though, it's just that they've been harboring an organism for a while. And it slowly, gradually, causes damage to the fallopian tubes and a lot of pelvic pain and other problems.''

While women are more prone to becoming infected with any STD, they are also less likely to show symptoms.

``The symptoms may be completely minimal until they have seriously advanced problems,'' Pacyga said.

The most common STD symptoms are burning, abdominal pain and abnormal discharge.

``There can be a lot of pain for a short time,'' Henkelman said. ``But then they get treated, and by the time the next night (of sexual activity) comes, they've forgotten how painful it is.''

Common sexually transmitted diseases

HIV

-- Damages the immune system's ability to fight disease, eventually developing into AIDS.

Transmitted sexually or though infected blood.

Early symptoms include chronic fever, diarrhea, weight loss, swollen lymph nodes, night sweats, fatigue, fungal infection.

There is no cure. Antiviral medications can slow the spread of infection and delay the onset of symptoms.

Herpes Simplex Virus (genital herpes)

-- A viral infection that lies dormant in the nervous system between flare-ups.

Transmitted by skin-to-skin contact with someone who has open herpes sores.

Symptoms include itching and flulike symptoms and painful sores in the genital or anal region.

There is no cure. Antiviral drugs can reduce the severity and frequency of attacks.

Gonorrhea

-- A bacterial infection.

Transmitted sexually.

Symptoms include abnormal discharge and burning during urination, pain during sex, abdominal pain.

Cured with antibiotics.

Trichomoniasis

-- A parasitic infection.

Transmitted sexually.

Symptoms include discharge, itching, an unpleasant odor.

Cured with antibiotics.

Syphilis

-- A bacterial infection.

Transmitted sexually or by contact with infected blood.

In the primary stage, painless pimplelike sores appear where germs entered the body. About six to 12 weeks later, an infected person may experience flulike symptoms, a sore throat, a rash on palms of hands or soles of feet, reappearance of sores.

Cured with antibiotics. Late-stage syphilis, however, cannot be treated or cured.

Chlamydia

-- A bacterial infection.

Transmitted sexually.

Symptoms include discharge, genital itching, burning during urination.

Cured by antibiotics.

Human Papilloma Virus

-- A viral infection that causes genital warts.

Transmitted by skin-to-skin contact with an infected partner.

Symptoms include painless warts.

There is no cure, but there are treatments to remove the warts.

Hepatitis B

-- A viral infection that causes liver inflammation.

Transmitted sexually, through infected blood and saliva, and can be spread by casual contact such as sharing a toothbrush or razor blade. About 100 times more infectious than HIV.

Symptoms include a low-grade fever, headaches, fatigue, muscle aches, diarrhea, pain in the finger joints, rashes, vomiting, abdominal pain, jaundice (yellowing of the skin and whites of the eyes, and darker urine).

There is no cure. The only treatment is rest, combined with a high-protein diet to repair damaged cells and a high-carbohydrate diet to protect the liver.

Hepatitis B is the only STD for which there is a vaccine. Treatment includes an antiviral drug, bed rest, good nutrition and abstaining from alcohol.

NOTE: Sexual transmission includes vaginal, anal or oral sex with an infected partner. Some carriers of these STDs may not have symptoms.

SIDEBAR: Latex condoms provide best protection

DECATUR -- Condoms of every color outline her bulletin board.

A necktie dotted with smiling cartoon condoms and a Frisbee that reads ``Real men use condoms'' hang nearby.

An ``I love carefully'' poster full of hearts adorns the wall.

Most methods of contraception cannot protect against sexually transmitted diseases. Birth-control pills cannot. Neither can hormonal implants like Norplant. Nor can an IUD.

But the theme of Michelle Henkelman's office at Planned Parenthood in Decatur makes one thing clear: condoms can.

Abstinence from sexual intercourse is the only 100 percent effective means of preventing STDs. But for the 80 percent of people who have intercourse at least once by age 20, condoms are the next best preventative measure.

When used correctly, latex condoms approved by the U.S. Food and Drug Administration are 98 percent effective, said Henkelman, health educator.

Laboratory tests have shown that neither sperm nor STD-causing organisms can penetrate a latex condom. And studies have shown that Nonoxynol-9, the chief spermicide ingredient that many condoms are pre-coated with, may kill sexually transmitted bacteria that cause gonorrhea and chlamydia.

Henkelman said condom use is up.

``I think a lot of people use them, but they don't use them consistently,'' Henkelman said.

Dr. Michael Pacyga, a Decatur obstetrician, said physicians can help by stressing condom use and responsible behavior to their patients.

``More people are using condoms, but most of the ones who are in their 20s and 30s.

They're not the teen-agers -- the population that really needs to use them.''

Many condom manufacturers have tried to encourage condom use by offering a wider variety -- including extra-thin, ribbed, colored (even glow-in-the-dark), flavored, lubricated, scented and even extra-large.

Contraceptive foams and gels are a step closer to approval as a way for women to protect against two sexually transmitted diseases. Spermicides appear to protect women against gonorrhea and chlamydia, although not as well as condoms do.

But the FDA is charging that some spermicides fail to do the basic task of preventing pregnancy, and conflicting studies suggest gels or foams may actually increase women's chances of catching the AIDS virus.

For local information about STD prevention, call Planned Parenthood at 877-6474 or the Macon County Health Department at 423-6988 or talk to your physician.

The Health Department at 1221 E. Condit St. in Decatur offers a free STD clinic from 1:30 to 3:30 p.m. every Tuesday and Thursday.

-- STEPHANIE ERICKSON