Reproductive Health & Wellness

People who are sexually active can get chlamydia, a common, treatable, sexually transmitted disease (STD). This fact sheet answers general questions about chlamydia.

Chlamydia is a common STD that can cause infection among both men and women. It can cause permanent damage to a woman’s reproductive system. This can make it difficult or impossible to get pregnant later. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb).

You can get chlamydia by having vaginal, anal, or oral sex with someone who has chlamydia. Also, you can still get chlamydia even if your sex partner does not ejaculate (cum). A pregnant person with chlamydia can give the infection to their baby during childbirth.

The only way to completely avoid STDs 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; and
• Using condoms the right way every time you have sex.

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

Sexually active young people are at a higher risk of getting chlamydia. This is due to behaviors and biological factors common among young people. Gay and bisexual men are also at risk since chlamydia can spread through oral and anal sex.

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 STDs. Gay or bisexual men and pregnant people should also get tested for chlamydia. If you are a sexually active woman, you should get tested for chlamydia every year if you are:

• Younger than 25 years old.
• 25 years and older with risk factors, such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection.

If you are pregnant and have chlamydia, you can give the infection to your baby during delivery. This can cause an eye infection or pneumonia in your baby. Having chlamydia may also make it more likely to deliver your baby early.

If you are pregnant, you should receive testing for chlamydia at your first prenatal visit. Talk to your healthcare provider about getting the correct examination, testing, and treatment. Testing and treatment are the best ways to prevent health problems.

Chlamydia often has no symptoms, but it can cause serious health problems, even without symptoms. If symptoms occur, they may not appear until several weeks after having sex with a partner who has chlamydia.

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

• An abnormal vaginal discharge; and
• A burning sensation when peeing.

Symptoms in men can include

• A discharge from their penis;
• A burning sensation when peeing; and
• Pain and swelling in one or both testicles (although this is less common).

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; and
• Bleeding.

See a healthcare provider if you notice any of these symptoms. You should also see a provider if your partner has an STD or symptoms of one. Symptoms can include

• An unusual sore;
• A smelly discharge;
• Burning when peeing; or
• Bleeding between periods.

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.

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.

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.

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); and
• 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.

People who are sexually active can get genital herpes, a common sexually transmitted disease (STD). This fact sheet answers basic questions about genital herpes.

Genital herpes is an STD caused by two types of viruses – herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

HSV-1 often causes oral herpes, which can result in cold sores or fever blisters on or around the mouth. However, most people with oral herpes do not have any symptoms. Most people with oral herpes get it during childhood or young adulthood from non-sexual contact with saliva.

Yes. Oral herpes caused by HSV-1 can spread from the mouth to the genitals through oral sex. This is why some cases of genital herpes are due to HSV-1.

Genital herpes is common in the United States. In 2018, CDC estimates show there were 572,000 new genital herpes infections in the United States among people aged 14 to 49.1

You can get genital herpes by having vaginal, anal, or oral sex with someone who has the infection. You can get herpes if you have contact with:

• A herpes sore;
• Saliva from a partner with an oral herpes infection;
• Genital fluids from a partner with a genital herpes infection;
• Skin in the oral area of a partner with oral herpes; or
• Skin in the genital area of a partner with genital herpes.

You also can get genital herpes from a sex partner who does not have a visible sore or is unaware of their infection. It is also possible to get genital herpes if you receive oral sex from a partner with oral herpes.

You will not get herpes from toilet seats, bedding, or swimming pools. You also will not get it from touching objects, such as silverware, soap, or towels.

If you have more questions about herpes, consider discussing your concerns with a healthcare provider.

Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.

Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an “outbreak”. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms (e.g., fever, body aches, or swollen glands) also may occur during the first outbreak.

People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.

Ask a healthcare provider to examine you if:

• You notice any symptoms; or
• Your partner has an STD or symptoms of an STD.

STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods (if you have a menstrual cycle).

Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore(s) and test it. If sores are not present, a blood test may be used to look for HSV antibodies.

Have an honest and open talk with your healthcare provider about herpes testing and other STDs.

Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.

The only way to completely avoid STDs 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 genital herpes:

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

Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus (shed) from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.

If your sex partner(s) has/have genital herpes, you can lower your risk of getting it if:

• Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
• You avoid having vaginal, anal, or oral sex when your partner has herpes symptoms (i.e., during an “outbreak”).

There is no cure for genital herpes. However, there are medicines that can prevent or shorten outbreaks. A daily anti-herpes medicine can make it less likely to pass the infection on to your sex partner(s).

Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.

If you touch your sores or fluids from the sores, you may transfer herpes to another body part like your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, quickly wash your hands thoroughly to help avoid spreading the infection.

If you are pregnant, there can be problems for you and your unborn fetus, or newborn baby. See “I’m pregnant. How could genital herpes affect my baby?” for information about this.

If you are pregnant and have genital herpes, prenatal care visits are very important. Some research suggest that a genital herpes infection may lead to miscarriage or make it more likely to deliver your baby too early. You can pass herpes to your unborn child before birth, but it more commonly passes during delivery. This can lead to a deadly infection in your baby (called neonatal herpes). It is important that you avoid getting genital herpes during pregnancy. Tell your healthcare provider if you have ever had a genital herpes diagnosis or symptoms. Also tell them about any possible exposure to genital herpes.

If you have genital herpes, you may need to take anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes when you deliver. At the time of delivery, your healthcare provider should carefully examine you for herpes sores. If you have signs or symptoms of genital herpes at delivery, a ‘C-section’ is likely to occur.

If you have herpes, you should talk to your sex partner(s) about their risk. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.

You may have concerns about how genital herpes will impact your health, sex life, and relationships. While herpes is not curable, it is important to know that it is manageable with medicine. Daily suppressive therapy (i.e., daily use of antiviral medication) can lower your risk of spreading the virus to others. Talk to a healthcare provider about your concerns and treatment options.

A genital herpes diagnosis may affect how you will feel about current or future sexual relationships. Knowing how to talk to sexual partners about STDs is important.

Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body. Even without visible sores, herpes increases the number of immune cells in the lining of the genitals. HIV targets immune cells for entry into the body. Having both HIV and genital herpes increases the chance of spreading HIV to a HIV-negative partner during oral, vagina, or anal sex.

People who are sexually active can get gonorrhea, a common, treatable, sexually transmitted disease (STD). This fact sheet answers basic questions about gonorrhea.

Gonorrhea is an STD that can cause infection in the genitals, rectum, and throat. It is very common, especially among young people ages 15-24 years.

You can get gonorrhea by having vaginal, anal, or oral sex with someone who has gonorrhea. A pregnant person with gonorrhea can give the infection to their baby during childbirth.

The only way to completely avoid STDs 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.

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 STDs. 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.

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.

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

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; and
• Vaginal bleeding between periods.

Men who do have symptoms may have:

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

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

• Discharge;
• Anal itching;
• Soreness;
• Bleeding; and
• 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 STD or symptoms of one. Symptoms can include an unusual sore, a smelly discharge, burning when peeing, or bleeding between periods.

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).

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.

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.

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); and
• 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.

Hepatitis means inflammation of the liver. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can all cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.

Hepatitis A, hepatitis B, and hepatitis C are liver infections caused by three different viruses. Although each can cause similar symptoms, they are spread in different ways and can affect the liver differently. Hepatitis A is usually a short-term infection. Hepatitis B and hepatitis C can also begin as short-term infections but in some people, the virus remains in the body and causes chronic, or lifelong, infection. There are vaccines to prevent hepatitis A and hepatitis B; however, no vaccine is available for hepatitis C.

The page “What is viral hepatitis?” explains in detail the differences between hepatitis A, hepatitis B, and hepatitis C.

Hepatitis B is a liver infection caused by the hepatitis B virus. Some people with hepatitis B are sick for only a few weeks (known as “acute” infection), but for others, the disease progresses to a serious, lifelong illness known as chronic hepatitis B.

Acute hepatitis B is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis B virus. Some people with acute hepatitis B have no symptoms at all or only mild illness. For others, acute hepatitis B causes a more severe illness that requires hospitalization.

Some people, especially those who get infected in adulthood, are able to clear the virus from their bodies without treatment. For other people, acute hepatitis B leads to life-long infection known as chronic hepatitis B. Over time, chronic hepatitis B can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death.

Age plays a role in whether hepatitis B will become chronic. The younger a person is when infected with the hepatitis B virus, the greater the chance of developing chronic infection. About 9 in 10 infants who become infected go on to develop life-long, chronic infection. The risk goes down as a child gets older. About one in three children who get infected before age 6 will develop chronic hepatitis B. By contrast, almost all older children (those aged ≥6) and adults infected with the hepatitis B virus recover completely and do not develop chronic infection.

In 2018, a total of 3,322 cases of acute (short-term) hepatitis B were reported to CDC. Since many people may not have symptoms or don’t know they are infected, their illness is often not diagnosed so it can’t be reported or counted. CDC estimates the actual number of acute hepatitis B cases was closer to 21,600 in 2018. Many more people (about 862,000) are estimated to be living with chronic, long-term hepatitis B.

An estimated 257 million people are living with hepatitis B worldwide.

Hepatitis B is spread when blood, semen, or other body fluid infected with the hepatitis B virus enters the body of someone who is not infected or has not been vaccinated. People can become infected with the virus from:

• Birth (spread from a mother who has hepatitis B to her baby during birth)
• Sex with a partner who has hepatitis B
• Sharing needles, syringes, or drug preparation equipment
• Sharing items such as toothbrushes, razors, or medical equipment (like a glucose monitor) with a person who has hepatitis B
• Direct contact with the blood or open sores of a person who has hepatitis B
• Exposure to the blood from a person who has hepatitis B through needlesticks or other sharp instruments

Yes. Many people with hepatitis B don’t know they are infected with the virus because they don’t feel or look sick. However, they can still spread the virus to others.

Yes. The hepatitis B virus can be found in the blood, semen, and other body fluids of an infected person. A person who has sex with an infected partner can become infected with the virus.

Hepatitis B is not usually spread through food or water, unlike hepatitis A.

Although anyone can get hepatitis B, these people are at greater risk:

• Infants born to mothers with hepatitis B
• People who inject drugs or share needles, syringes, and other types of drug equipment
• Sex partners of people with hepatitis B
• Men who have sex with men
• People who live with someone who has hepatitis B
• Health care and public safety workers exposed to blood on the job
• People on dialysis

CDC recommends hepatitis B testing for:

• People born in certain countries where hepatitis B is common
• People born in the United States not vaccinated as infants whose parents were born in countries with high rates of hepatitis B
• Men who have sex with men
• People who inject drugs
• People with HIV
• Household and sexual contacts of people with hepatitis B
• People requiring immunosuppressive therapy
• People with end-stage renal disease (including people on dialysis)
• People with hepatitis C
• People with elevated ALT levels
• Pregnant women
• Infants born to mothers with hepatitis B

If you are concerned that you might have been exposed to the hepatitis B virus, call your health care provider or your local health department immediately. Infection with the hepatitis B virus can be prevented if you get the hepatitis B vaccine and/or a shot called “HBIG” (hepatitis B immune globulin) as soon as possible after exposure to the virus, ideally within 24 hours.

Hepatitis B immune globulin is a substance made from human blood samples that contains antibodies against the hepatitis B virus. It is given as a shot to people exposed to the hepatitis B virus to protect them from infection.

The hepatitis B virus can survive outside the body for at least 7 days. During that time, the virus is still capable of causing infection.

All blood spills (including those that have already dried) should be cleaned and disinfected with a mixture of bleach and water (1 part household bleach to 9 parts water). Gloves should always be worn when cleaning up any blood spills. Even dried blood can cause infection.

No. If you have been infected with hepatitis B virus in the past, you can’t get infected again. However, some people, especially those infected during early childhood, remain infected for life because they never cleared the virus from their bodies. These people are considered to have chronic infection and are at risk for developing severe liver disease.

The American Red Cross does not accept blood donations from anyone who has tested positive for hepatitis B or anyone experiencing symptoms of viral hepatitis.

According to the U.S. Department of Health & Human Service’s online information on organ donation and transplantation, few conditions would prevent someone from being an organ, eye, or tissue donor. Even with a history of hepatitis B, you may be able to donate your organs or tissues. The transplant team will determine what organs or tissue can be used based on a clinical evaluation, medical history, and other factors. CDC has recently published information about how to assess solid organ donors and monitor transplant recipients for hepatitis B infection.

Yes. The best way to prevent hepatitis B is by getting vaccinated. The hepatitis B vaccine is safe and effective. You need to get all shots in the series to be fully protected.

The ?Advisory Committee on Immunization Practices (ACIP) recommends that the following people should receive hepatitis B vaccination:

• All infants
• All children and adolescents younger than 19 years of age who have not been vaccinated
• Adults aged 19 through 59 years
• Adults aged 60 years and older with risk factors for hepatitis B

The following groups may receive hepatitis B vaccination:

• Adults aged 60 years and older without known risk factors for hepatitis B

Risk factors for hepatitis B

• People at risk for infection by sexual exposure

• • People whose sex partners have hepatitis B
  • Sexually active people who are not in a long-term, mutually monogamous relationship (for example, people with more than one sex partner in the past 6 months)
  • People seeking evaluation or treatment for a sexually transmitted infection
  • Men who have sex with men

• People at risk for infection by exposure to blood

• • People who inject drugs
  • People who live with someone who has hepatitis B
  • People who live or work in facilities for people with developmental disabilities
  • Health care and public safety workers at risk for exposure to blood or blood-contaminated body fluids on the job
  • People who receive dialysis
  • People with diabetes should ask their health care professional  

• Others:

• • International travelers to countries where hepatitis B is common
  • People with hepatitis C virus infection
  • People with chronic liver disease
  • People with HIV infection
  • People who are in jail or prison

Hepatitis B vaccination is recommended for all infants, children, and adults through age 59 years regardless of travel. For adults aged 60 years and older, hepatitis B vaccination is recommended for people visiting countries where hepatitis B is common.

Yes. The hepatitis B vaccine is safe, and soreness at the injection site is the most common side effect. As with any medicine, there are very small risks that a serious problem could occur after getting the vaccine. The safety of vaccines is always being monitored. For more information, visit CDC’s vaccine safety site.

No. The hepatitis B vaccine does not contain any live virus and can’t cause hepatitis B.

No, getting extra doses of hepatitis B vaccine is not harmful.

If the hepatitis B vaccine series is interrupted, the next dose should be given as soon as possible. The first dose(s) does not need to be repeated.

Anyone who has had a serious allergic reaction to a prior dose of hepatitis B vaccine, any part of the vaccine, or yeast should not get the hepatitis B vaccine.

A “booster” dose is an extra dose of vaccine that can increase or extend the effectiveness of the vaccine. Most healthy people do not need a booster dose, but a blood test can be performed to check your immunity and decide if a booster dose of vaccine is necessary.

Yes, there is a combination vaccine approved for adults that protects people from both hepatitis A and hepatitis B. The combined hepatitis A and hepatitis B vaccine is usually given as three separate doses over a 6-month period.

Yes. Getting two different vaccines at the same time is not harmful.

Talk to your health care provider or local health department about getting vaccinated. Some clinics offer free or low-cost hepatitis B vaccines.

Sometimes. Most children younger than 5 and people with serious health problems (like having compromised immune systems) have no symptoms. Up to half of all older children, adolescents, and adults experience symptoms of acute hepatitis B.

Symptoms of acute hepatitis B can include:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice (yellow color in the skin or the eyes)

If symptoms occur, they begin an average of 90 days (or 3 months) after exposure to the virus, but they can appear any time between 8 weeks and 5 months after exposure. They usually last several weeks, but some people can feel sick for as long as 6 months.

Yes. Many people with hepatitis B have no symptoms, but they can still spread the virus to others.

Most people with chronic hepatitis B do not have any symptoms, do not feel ill, and remain symptom free for decades. When and if symptoms do appear, they are similar to the symptoms of new infection, but can be a sign of advanced liver disease. About 1 in 4 people who become chronically infected during childhood and about 15% of those who become chronically infected after childhood will eventually die from serious liver conditions, like cirrhosis (scarring of the liver) or liver cancer. Some people still do not have symptoms even after their liver becomes diseased, although certain blood tests for liver function might show some abnormalities.

Chronic hepatitis B can develop into a serious disease resulting in long-term health problems, including liver damage, liver failure, liver cancer, and even death. There were 1,649 deaths related to hepatitis B virus reported to CDC in 2018, but this is an underestimate.

Talk to your health care provider if you have risk factors for or think you might have hepatitis B. Since many people with hepatitis B do not have symptoms, blood tests are used to diagnose the infection. Several different hepatitis B tests are available. Depending on the test, they can determine whether you

• have chronic or acute hepatitis B;
• are immune to hepatitis B after vaccination; or
• were infected in the past, have cleared the virus from your body, and are protected from future infection.

Certain tests can even determine how likely it is that someone who is infected with hepatitis B will transmit it to others. Ask your health care provider to explain what tests were ordered, when you can expect to get the results, and what those results mean.

If test results show that you are infected with the hepatitis B virus, you should consult a health care provider that is experienced in caring for people with hepatitis B. This can be an internist or family medicine practitioner, or it may be someone who specializes in treating people with infectious, digestive, or liver diseases.

There is no medication available to treat acute hepatitis B. For people with mild symptoms, health care providers usually recommend rest, adequate nutrition, and fluids. Those with more severe symptoms may need to be hospitalized.

Several medications have been approved to treat people who have chronic hepatitis B, and new drugs are in development. However, not every person with chronic hepatitis B needs medication, and the drugs may cause side effects in some patients. People who start hepatitis B treatment may need to take medication indefinitely because these medications do not lead to a cure.

Yes. The hepatitis B vaccine does not contain live virus, so neither pregnancy nor breastfeeding should be considered a reason not to get vaccinated. However, of the five available adult vaccines against hepatitis B, there are not enough data on Heplisav-B and PreHevbrio to know if the vaccines are safe to give in pregnancy or during breastfeeding. Thus, pregnant women who need hepatitis B vaccination should receive Engerix-B, Recombivax HB, or Twinrix.

There is a pregnancy exposure registry that monitors pregnancy outcomes in people who received HEPLISAV-B during pregnancy. A pregnancy exposure registry is a study that collects health information from people who take prescription medicines or vaccines when they are pregnant.

Toll-free number:  1-844-443-7734

Email: heplisavbpregnancyregistry@ppdi.com

There is a pregnancy exposure registry that monitors pregnancy outcomes in people who received PREHEVBRIO during pregnancy. People who receive PREHEVBRIO during pregnancy are encouraged to contact 1-888-421-8808 (toll-free). A pregnancy exposure registry is a study that collects health information from people who take prescription medicines or vaccines when they are pregnant.

Yes. When a pregnant woman comes in for prenatal care, she is given a series of routine blood tests, including one that checks for hepatitis B virus infection.

Yes. Almost all cases of hepatitis B can be prevented in babies born to mothers with hepatitis B, but these newborns must receive the necessary shots at the recommended times. The combination of hepatitis B immune globulin (known as HBIG) and hepatitis B vaccine can be given to infants born to mothers with hepatitis B within 12 hours of birth to protect them from infection. To best protect your baby, follow the advice from your baby’s doctor.

Nearly all newborns who become infected with the hepatitis B virus develop lifelong hepatitis B. This can eventually lead to serious health problems, including liver damage, liver cancer, and even death. Hepatitis B vaccination is recommended for all babies to protect them from this serious but preventable disease.

Content provided and maintained by the US Centers for Disease Control and Prevention (CDC). Please see our system usage guidelines and disclaimer.

Hepatitis means inflammation of the liver. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can all cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.

Hepatitis A, hepatitis B, and hepatitis C are liver infections caused by three different viruses. Although each can cause similar symptoms, they are spread in different ways and can affect the liver differently. Hepatitis A is usually a short-term infection. Hepatitis B and hepatitis C can also begin as short-term infections, but in some people, the virus remains in the body and causes chronic (long-term) infection. There are vaccines to prevent hepatitis A and hepatitis B; however, there is no vaccine for hepatitis C.

The page “What is viral hepatitis?” explains in detail the differences between hepatitis A, hepatitis B, and hepatitis C.

Hepatitis C is a liver infection caused by the hepatitis C virus. Hepatitis C can range from a mild illness lasting a few weeks to a serious, long-term illness. Hepatitis C is often described as “acute,” meaning a new infection, or “chronic,” meaning long-term infection.

• Acute hepatitis C occurs within the first 6 months after someone is exposed to the hepatitis C virus. Hepatitis C can be a short-term illness, but for most people, acute infection leads to chronic infection.
• Chronic hepatitis C can be a lifelong infection if left untreated. Chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis (scarring of the liver), liver cancer, and even death.

Chronic hepatitis C can be a serious disease resulting in long-term health problems, including liver damage, liver failure, cirrhosis, liver cancer, and even death. It is the most common reason for liver transplantation in the United States. There were 15,713 deaths related to hepatitis C virus reported to CDC in 2018, but this is believed to be an underestimate.

More than half of people who become infected with hepatitis C virus will develop a chronic infection.

Yes. However, less than half of people who are infected with the hepatitis C virus clear it from their bodies without treatment. Experts do not fully understand why this happens for some people.

In 2018, a total of 3,621 cases of acute hepatitis C were reported to CDC. Since many people do not have symptoms, they don’t seek care from a health provider and don’t get diagnosed with this infection. These cases aren’t reported to public health authorities and aren’t counted in yearly totals. CDC believes the actual number of acute hepatitis C cases in 2018 was probably closer to 50,300.

In 2016, an estimated 2.4 million people were living with hepatitis C in the United States.

The hepatitis C virus is usually spread when someone comes into contact with blood from an infected person. This can happen through:

Sharing drug-injection equipment.

Today, most people become infected with hepatitis C by sharing needles, syringes, or any other equipment used to prepare and inject drugs.

Birth.

Approximately 6% of infants born to infected mothers will get hepatitis C.

Health care exposures.

Although uncommon, people can become infected when health-care professionals do not follow the proper steps needed to prevent the spread of bloodborne infections.

Sex with an infected person.

While uncommon, hepatitis C can spread during sex, though it has been reported more often among men who have sex with men.

Unregulated tattoos or body piercings.

Hepatitis C can spread when getting tattoos or body piercings in unlicensed facilities, informal settings, or with
non-sterile instruments.

Sharing personal items.

People can get infected from sharing glucose monitors, razors, nail clippers, toothbrushes, and other items that may have come into contact with infected blood, even in amounts too small to see.

Blood transfusions and organ transplants.

Before widespread screening of the blood supply in 1992, hepatitis C was also spread through blood transfusions and organ transplants. Now, the risk of transmission to recipients of blood or blood products is extremely low.

Hepatitis C is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.

Yes. You can be infected again even if you have cleared the virus or were successfully treated and cured. This is why people who currently inject and share needles, syringes, or other drug preparation equipment, along with those who receive maintenance hemodialysis, should be tested for hepatitis C on a regular basis.

Yes, but the risk of transmission from sexual contact is believed to be low. The risk increases for men who have sex with men and for people who have multiple sex partners, have a sexually transmitted disease, engage in rough sex, or are infected with HIV.

Research has not shown that hepatitis C is spread within licensed, commercial tattooing facilities. However, transmission of hepatitis C (and other infectious diseases) is possible at facilities that don’t take the necessary measures to control infections during tattooing or piercing. Unregulated tattooing and piercing occurring in prisons and other informal settings may put a person at risk of infection.

Yes, but this does not occur very often. If hepatitis C virus is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member.

The following people are at increased risk for hepatitis C:

• People who use injection drugs or did so in the past, even those who injected only once many years ago
• People with HIV infection
• People with certain medical conditions, including those who ever received maintenance hemodialysis and those with persistently abnormal alanine aminotransferase (ALT) levels (an enzyme found within liver cells).
• People who have received transfusions or organ transplants, including those who

• • received clotting factor concentrates produced before 1987
  • received a transfusion of blood or blood components before July 1992
  • received an organ transplant before July 1992
  • were notified that they received blood from a donor who later tested positive for hepatitis C virus infection
• Health care, emergency medical, and public safety personnel who have been exposed to the blood of someone who has hepatitis C (through needle sticks, sharps, or mucosal exposures)
• Children born to mothers who have hepatitis C

Yes. A person can be “coinfected” with both HIV and the hepatitis C virus. People who are coinfected are more likely to get cirrhosis as a result of their chronic hepatitis C infection. To learn more about coinfection, read HIV and Viral Hepatitis.

Of every 100 infants born to mothers with hepatitis C, about six will become infected with the hepatitis C virus. However, the risk is greater if the mother has both HIV and hepatitis C.

Yes. There is no evidence that breastfeeding spreads hepatitis C, so infected women can safely breastfeed their babies. However, women with cracked or bleeding nipples should stop nursing temporarily until their nipples have healed. Hepatitis C is spread through contact with blood, and not enough is known about whether this practice is safe.

No. The hepatitis C virus has not been shown to be transmitted by mosquitoes or other insects.

The American Red Cross does not accept blood donations from anyone who has ever tested positive for hepatitis C or from anyone with current signs or symptoms of hepatitis.

According to the U.S. Department of Health & Human Service’s online information on organ donation and transplantation, very few conditions would prevent someone from being an organ, eye, or tissue donor. Even with acute or chronic hepatitis C, you may be able to donate your organs or tissues. The transplant team will determine what organs or tissue can be used based on a clinical evaluation, medical history, and other factors.

Many people newly infected with the hepatitis C virus don’t have symptoms, don’t look or feel sick, and therefore don’t know they are infected. For people who develop symptoms, they usually happen 2–12 weeks after exposure to the hepatitis C virus and can include yellow skin or eyes, not wanting to eat, upset stomach, throwing up, stomach pain, fever, dark urine, light-colored stool, joint pain, and feeling tired.

Most people with chronic hepatitis C don’t have any symptoms or have only general symptoms like chronic fatigue and depression. Many people eventually develop chronic liver disease, which can range from mild to severe and include cirrhosis (scarring of the liver) and liver cancer. Chronic liver disease in people with hepatitis C usually happens slowly, without any signs or symptoms, over several decades. Chronic hepatitis C virus infection is often not recognized until people are screened for blood donation or from an abnormal blood test found during a routine doctor’s visit.

Yes. If you are infected with the hepatitis C virus, you can spread it to others even if you have no symptoms.

You should get tested for hepatitis C if you:

• Are 18 years of age and older (get tested at least once in your lifetime)
• Are pregnant (get tested during each pregnancy)
• Currently inject drugs (get tested regularly)
• Have ever injected drugs, even if it was just once or many years ago
• Have HIV
• Have abnormal liver tests or liver disease
• Are on hemodialysis
• Received donated blood or organs before July 1992
• Received clotting factor concentrates before 1987
• Have been exposed to blood from a person who has hepatitis C
• Were born to a mother with hepatitis C

Yes. Regular testing is recommended for people who currently inject and share needles, syringes, or other drug preparation equipment and for those currently getting maintenance hemodialysis.

Yes, hepatitis C testing is recommended during every pregnancy.

A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. This test, sometimes called the anti-HCV test, looks for antibodies, which are proteins released into the bloodstream when someone gets infected with the virus that causes hepatitis C. People who have positive HCV antibody tests are given a follow-up HCV RNA test to learn whether they have active infection.

Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics, and the results of these tests are available in 20–30 minutes.

Your doctor will help interpret the results from your HCV antibody test and help guide you through next steps. The test can be “non-reactive,” or “negative,” meaning that you are not currently infected with the hepatitis C virus.  The test can also be “reactive,” or “positive,” which means you have been infected with the hepatitis C virus at some point in time. It is important to know that

• Once you have been infected, you will always have antibodies in your blood. This is true if you have cleared the virus, have been cured, or still have the virus in your blood.
• A reactive, or positive, antibody test does not necessarily mean that you currently have hepatitis C, so a follow-up test is needed.

• If the antibody test is reactive or positive, you need an additional test to see if you currently have hepatitis C. This test is called a nucleic acid test (NAT) for HCV RNA, but it can also be called a PCR test.
• If the nucleic acid test for HCV RNA (or PCR test) is:

• • Negative – this means you were infected with hepatitis C virus, but the virus is no longer in your body because you were cured or cleared the virus naturally.
  • Positive – this means you currently have the virus in your blood and are infectious, meaning you can spread the virus to others.

• If you have a reactive antibody test and a positive NAT for HCV RNA, you need to talk to a doctor about treatment. Treatments are available that can cure most people with hepatitis C in 8–12 weeks.

After exposure to the hepatitis C virus, it can take 8–11 weeks for an HCV antibody test to be positive. For most people who are infected, the anti-HCV blood test will become positive by 6 months after exposure. A special kind of blood test called a nucleic acid test (NAT) that detects HCV RNA (also called a PCR test) can tell if a person is infected within 1–2 weeks of exposure.

Yes. For people with hepatitis C, it is common for liver enzyme levels to go up and down, sometimes returning to normal or near normal. Some people with hepatitis C have liver enzyme levels that are normal for over a year even though they have chronic liver disease.

Treatment is recommended for all people, including non-pregnant women, with acute or chronic hepatitis C (including children aged ≥3 years and adolescents). Current treatments usually involve just 8–12 weeks of oral therapy (pills) and cure over 90% with few side effects. The FDA has a list of currently approved FDA treatments for hepatitis C.

People with chronic hepatitis C and those with cirrhosis (even if they have been cured of their hepatitis C infection) should be monitored regularly by a doctor, because these people have a continued risk of complications of advanced liver disease, including liver cancer. In addition, people living with hepatitis C should

• be vaccinated against hepatitis A and hepatitis B
• avoid alcohol because it can cause additional damage to the liver
• check with their doctor before taking any prescription pills, herbs, supplements, or over-the-counter medications, as these can potentially damage the liver
• be tested for HIV, because people who have both infections are more likely to get cirrhosis

People with chronic hepatitis B should be under the care of a health care provider that is knowledgeable about this illness (like an internist or provider that specializes in treating people with infectious, digestive, or liver diseases) and is able to regularly monitor their liver function. People recently diagnosed with hepatitis B should

• get vaccinated against hepatitis A and tested for hepatitis C;
• avoid drinking alcohol;
• follow a healthy diet and stay physically active, especially patients who are overweight (i.e., those with body mass index [BMI] ≥25kg/m2) or obese (BMI ≥30kg/m2); and
• check with a health professional before taking any prescription pills, nutritional or herbal supplements, or over-the-counter medications, as these can potentially damage the liver.

No. Currently, there is no vaccine to prevent hepatitis C.

CDC’s recommendations for prevention and control of the hepatitis C virus infection state that people should not be excluded from work, school, play, child care, or other settings because they have hepatitis C virus infection. There is no evidence that people can get hepatitis C from food handlers, teachers, or other service providers without blood-to-blood contact.

Content provided and maintained by the US Centers for Disease Control and Prevention (CDC). Please see our system usage guidelines and disclaimer.

If you have a sexually transmitted diseases (STD), you are more likely to get HIV or transmit it to others. This fact sheet answers basic questions about STDs and HIV.

Yes. In the United States, people who get syphilis, gonorrhea, and herpes often also have HIV, or are more likely to get HIV in the future.

If you get an STD, you are more likely to get HIV than someone who is STD-free. This is because the same behaviors and circumstances that may put you at risk for getting an STD also can put you at greater risk for getting HIV. In addition, having a sore or break in the skin from an STD may allow HIV to more easily enter your body. If you are sexually active, get tested for STDs and HIV regularly, even if you don’t have symptoms.

• Having anal, vaginal, or oral sex without a condom;
• Having multiple sex partners;
• Having anonymous sex partners;
• Having sex while under the influence of drugs or alcohol can lower inhibitions and result in greater sexual risk-taking.

It can. If you already have HIV, and then get another STD, it can put your HIV-negative partners at greater risk of getting HIV from you.

Your sex partners are less likely to get HIV from you if you

• Get on and stay on treatment called antiretroviral therapy (ART). Taking HIV medicine as prescribed can make your viral load very low by reducing the amount of virus in your blood and body fluids. HIV medicine can make your viral load so low that a test can’t detect it (an undetectable viral load). If your viral load stays undetectable, you have effectively no risk of sexually transmitting HIV to HIV-negative partners, even if you have other STDs.
• Choose less risky sex activities.
• Use a new condom, consistently and correctly, for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish).

The risk of getting HIV also may be reduced if your partner takes PrEP medications, as prescribed, after discussing this option with his or her healthcare provider and determining whether it is appropriate. When taken as prescribed, PrEP medications are highly effective for preventing HIV from sex. PrEP is much less effective if it is not taken consistently. Since PrEP does not protect against other STDs, use condoms the right way every time you have sex.

No. It’s not enough.

If you get treated for an STD, this will help to prevent its complications, and prevent spreading STDs to your sex partners. Treatment for an STD other than HIV does not prevent the spread of HIV.

If you are diagnosed with an STD, talk to your doctor about ways to protect yourself and your partner(s) from getting reinfected with the same STD, or getting HIV.

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. HPV vaccines can prevent some of the health effects HPV causes. This fact sheet answers basic questions about HPV.

HPV is the most common STI. There were about 43 million HPV infections in 2018, many among people in their late teens and early 20s. There are many different types of HPV. Some types can cause health problems, including genital warts and cancers. But there are vaccines that can stop these health problems from happening. HPV is a different virus than HIV and HSV (herpes).

You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex. A person with HPV can pass the infection to someone even when they have no signs or symptoms.

If you are sexually active, you can get HPV, even if you have had sex with only one person. You also can develop symptoms years after having sex with someone who has the infection. This makes it hard to know when you first got it.

In most cases (9 out of 10), HPV goes away on its own within two years without health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.

The only 100% effective way to avoid STDs 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 STDs and HIV:

• Choose less risky sex activities;
• Use a new condom, consistently and correctly, for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish);
• Reduce the number of people with whom you have sex;
• Limit or eliminate drug and alcohol use before and during sex;
• Have an honest and open talk with your healthcare provider and ask whether you should be tested for STDs and HIV;
• Talk to your healthcare provider and find out if either pre-exposure prophylaxis, or PrEP, or post-exposure prophylaxis, or PEP, is a good option for you to prevent HIV infection.

HPV can cause cervical and other cancers, including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat (called oropharyngeal cancer). This can include the base of the tongue and tonsils.

Cancer often takes years, even decades, to develop after a person gets HPV. Genital warts and cancers result from different types of HPV.

There is no way to know who will develop cancer or other health problems from HPV. People with weak immune systems (including those with HIV) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.

You can do several things to lower your chances of getting HPV.

Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. (See “Who should get vaccinated?” below.)

Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.

If you are sexually active:

• Use condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas the condom does not cover. So, condoms may not fully protect against getting HPV; and
• Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

CDC recommends HPV vaccination for:

• All preteens (including boys and girls) at age 11 or 12 years (or can start at age 9 years).
• Everyone through age 26 years, if not vaccinated already.

Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination.

At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.

There is no test to find out a person’s “HPV status.” Also, there is no approved HPV test to find HPV in the mouth or throat.

There are HPV tests that can screen for cervical cancer. Healthcare providers only use these tests for screening women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years.

Most people with HPV do not know they have the infection. They never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.

HPV (the virus): CDC estimates that there were 43 million HPV infections in 2018. In that same year, there were 13 million new infections. HPV is so common that almost every sexually active person will get HPV at some point if they don’t get vaccinated.

Health problems related to HPV include genital warts and cervical cancer.

Genital warts: Prior to HPV vaccines, genital warts caused by HPV affected roughly 340,000 to 360,000 people yearly.* About one in 100 sexually active adults in the U.S. has genital warts at any given time.

Cervical cancer: Every year, nearly 12,000 women living in the U.S. will have cervical cancer. More than 4,000 women die from cervical cancer—even with screening and treatment.

There are other conditions and cancers caused by HPV that occur in people living in the United States. Every year, about 19,400 women and 12,100 men experience cancers caused by HPV.

*These figures only look at the number of people who sought care for genital warts. This could be less than the actual number of people who get genital warts.

Pregnant people with HPV can get genital warts or develop abnormal cell changes on the cervix. Routine cervical cancer screening can help find abnormal cell changes. You should get routine cervical cancer screening even when you are pregnant.

There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:

1. Genital warts can go away with treatment from your healthcare provider or with prescription medicine. If left untreated, genital warts may go away, stay the same, or grow in size or number.
2. Cervical precancer treatment is available. Women who get routine Pap tests and follow up as needed can find problems before cancer develops. Prevention is always better than treatment. For more information visit cancer.org.
3. Other HPV-related cancers are also more treatable when found and treated early. For more information visit cancer.org.

People who are sexually active can get syphilis, a curable sexually transmitted disease (STD). This fact sheet answers general questions about syphilis.

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems without treatment. Infection develops in stages (primary, secondary, latent, and tertiary). Each stage can have different signs and symptoms.

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

Syphilis can spread from a mother with syphilis to her unborn baby.

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

• toilet seats
• doorknobs
• swimming pools
• hot tubs
• bathtubs
• sharing clothing, or eating utensils

The only way to completely avoid STDs 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.

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 STDs.

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; or
• have partner(s) who have tested positive for syphilis.

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

If you are pregnant and have syphilis, you can give the infection to your unborn 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.

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

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; and
• 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; or
• 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; and
• 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; and
• 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; and
• 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”); and
• dizziness or vertigo (feeling like you or your surroundings are moving or spinning).

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.

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

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.

Trichomoniasis a common, treatable, sexually transmitted disease (STD). Most people who have trichomoniasis do not have any symptoms. This fact sheet answers general questions about trichomoniasis.

Trichomoniasis (or “trich”) is a very common STD caused by infection with Trichomonas vaginalis (a protozoan parasite). Although symptoms vary, most people who have trich cannot tell they have it.

In the United States, CDC estimates that there were more than two million trichomoniasis infections in 2018. However, only about 30% develop any symptoms of trich. Infection is more common in women than in men. Older women are more likely than younger women to have the infection.

Sexually active people can get trich by having sex without a condom with a partner who has trich.

In women, the infection is most commonly found in the lower genital tract (vulva, vagina, cervix, or urethra). In men, the infection is most commonly found inside the penis (urethra). During sex, the parasite usually spreads from a penis to a vagina, or from a vagina to a penis. It can also spread from a vagina to another vagina.

It is not common for the parasite to infect other body parts, like the hands, mouth, or anus. It is unclear why some people with the infection get symptoms while others do not. It probably depends on factors like a person’s age and overall health. People with trich can pass the infection to others, even if they do not have symptoms.

About 70% of people with the infection do not have any signs or symptoms. When trich does cause symptoms, they can range from mild irritation to severe inflammation. Some people get symptoms within 5 to 28 days after getting the infection. Others do not develop symptoms until much later. Symptoms can come and go.

Men with trich may notice:

• Itching or irritation inside the penis;
• Burning after peeing or ejaculating; and
• Discharge from the penis.

Women with trich may notice:
Itching, burning, redness or soreness of the genitals;
Discomfort when peeing; and
A clear, white, yellowish, or greenish vaginal discharge (i.e., thin discharge or increased volume) with a fishy smell.
Having trich can make sex feel unpleasant. Without treatment, the infection can last for months or even years.

About 70% of people with the infection do not have any signs or symptoms. When trich does cause symptoms, they can range from mild irritation to severe inflammation. Some people get symptoms within 5 to 28 days after getting the infection. Others do not develop symptoms until much later. Symptoms can come and go.

Men with trich may notice:

• Itching or irritation inside the penis;
• Burning after peeing or ejaculating; and
• Discharge from the penis.

Women with trich may notice:

• Itching, burning, redness or soreness of the genitals;
• Discomfort when peeing; and
• A clear, white, yellowish, or greenish vaginal discharge (i.e., thin discharge or increased volume) with a fishy smell.

Having trich can make sex feel unpleasant. Without treatment, the infection can last for months or even years.

Trich can increase the risk of getting or spreading other sexually transmitted infections. For example, trich can cause genital inflammation, making it easier to get HIV, or pass it to a sex partner.

Pregnant people with trich are more likely to have their babies early. Also, their babies are more likely to have a low birth weight (less than 5.5 pounds).

It is not possible to diagnose trich based on symptoms alone. Your healthcare provider can examine you and a laboratory test will confirm the diagnosis.

Trich is the most common curable STD. A healthcare provider can treat the infection with medication (pills) taken by mouth. This treatment is also safe for pregnant people.

If you receive and complete treatment for trich, you can still get it again. Reinfection occurs in about 1 in 5 people within 3 months after receiving treatment. This can happen if you have sex without a condom with a person who has trich. To avoid reinfection, your sex partners should receive treatment at the same time.

You should not have sex again until you and your sex partner(s) complete treatment. You should receive testing again about three months after your treatment, even if your sex partner(s) received treatment.

The only way to avoid STDs 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 trich:

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

Also, talk about the potential risk of STDs before having sex with a new partner. This can help inform the choices you are comfortable taking with your sex life.

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

Workowski, KA, Bachmann, LH, Chang, PA, et. al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70(No. 4): 1-187.

Kreisel KM, Spicknall IH, Gargano JW, Lewis FM, Lewis RM, Markowitz LE, Roberts H, Satcher Johnson A, Song R, St. Cyr SB, Weston EJ, Torrone EA, Weinstock HS. Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2018. Sex Transm Dis 2021; in press.

Peterman TA, Tian LH, Metcalf CA, Satterwhite CL, Malotte CK, DeAugustine N, Paul SM, Cross H, Rietmeijer CA, Douglas JM Jr; RESPECT-2 Study Group. High incidence of new sexually transmitted infections in the year following a sexually transmitted infection: a case for rescreening. Ann Intern Med. 2006 Oct 17;145(8):564-72.

Hobbs M, Seña EC, Swygard H, Schwebke J. Trichomonas vaginalis and Trichomoniasis. In: KK Holmes, PF Sparling, WE Stamm, P Piot, JN Wasserheit, L Corey, MS Cohen, DH Watts (editors). Sexually Transmitted Diseases, 4th edition. New York: McGraw-Hill, 2008, 771-793.