Comprehensive information about the following Sexual Health Infections and Sexually Transmitted Diseases (STDs):

• Chlamydia
• Gonorrhea
• Genital herpes
• Pubic lice
• Scabies
• HIV & AIDS
• Syphilis
• Trichomonas vaginalis (TV)
• Thrush
• Genital warts
• Non-specific urethritis (NSU)

Chlamydia

What is Chlamydia and how is it passed on? Find out about signs and symptoms, testing and treatment and what happens if Chlamydia isn't treated. How to avoid STDs.

Information and advice
Anyone who has sex can catch a sexually transmitted infection (STI).

Chlamydia is one of the most common STIs - and usually goes untreated. Here's how to spot the symptoms of Chlamydia and where to go for help if you think you may be infected.

What is it and how is it passed on?

Chlamydia is one of the most common bacterial sexually transmitted infections (STIs) and is easily transmitted. It usually infects the genitals of both men and women, but can also infect the throat, rectum and eyes. It's particularly common in young people, but can affect anyone who's sexually active.

Chlamydia is mainly passed from one person to another through sexual activity such as:

• vaginal or anal sex with an infected partner
• oral sex, although this is less common
• sharing sex toys

It can also be passed from a mother to her baby at birth.

You can't catch Chlamydia from kissing, hugging, sharing baths, towels, cups, plates, cutlery, or from toilet seats or swimming pools.

Signs and symptoms of Chlamydia
Around 70% of women and 50% of men who have Chlamydia show no symptoms at all; others may have symptoms so mild they aren't noticed.

Symptoms in women:

• an unusual vaginal discharge
• pain when passing urine
• bleeding between periods
• pain during sex or bleeding after sex
• low abdominal pain

Symptoms in men:

• white/cloudy, watery discharge from the tip of the penis
• pain or a burning sensation when passing urine
• testicular pain and/or swelling

Testing and treatment
The tests for Chlamydia aren't usually painful but they may be uncomfortable. Either a urine test is done or a swab is taken from the urethra (the tube where urine comes out), the cervix (entrance to the womb), rectum, throat or eye.

Cervical smear tests and blood tests don't detect infections such as Chlamydia.

Chlamydia is simple to treat with antibiotics, either a single dose or a course lasting up to two weeks. To avoid re-infection, any sexual partners should be treated too. If complications occur, another treatment may be needed.

Once Chlamydia has been successfully treated, it won't come back unless a new infection is picked up.

What happens if Chlamydia isn't treated?
Without treatment, the infection can spread to other parts of the body causing damage and serious long-term health problems.

In women, Chlamydia can cause pelvic inflammatory disease. This can lead to:

• ectopic pregnancy (a pregnancy outside the womb)
• blocked fallopian tubes (the tubes which carry the egg from the ovaries to the womb), which can result in reduced fertility or infertility
• long-term pelvic pain
• early miscarriage or premature birth

Chlamydia can be safely treated during pregnancy and breastfeeding, but if untreated can cause an eye infection or pneumonia in the baby at birth.

In men, Chlamydia can lead to:

• painful inflammation of the testicles, which may result in fertility problems
• Reiter's syndrome (inflammation of the joints, urethra and eyes)

How to avoid STDs

• Before you have sex, talk to your partner about how to protect yourselves.
• A male or female condom can provide protection from most STDs if used correctly every time you have sex.
• Become familiar with how to use condoms and have a supply ready.
• Seek advice straight away if you think you've been at risk.

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Gonorrhea

What is Gonorrhea and how is it passed on? Find out about signs and symptoms of Gonorrhea, testing and treatment and what happens if Gonorrhea isn't treated. How to avoid STIs.

Gonorrhea - or 'the clap' - can have serious consequences for your health if not treated promptly. This article explains how Gonorrhea is passed on, which symptoms to look for and where to go for prompt and effective treatment.

What is it and how is it passed on?
Gonorrhoea is a bacterial infection sometimes called 'the clap'. It can infect the genitals, urethra, rectum and throat. More rarely, it can affect the blood, skin, joints and eyes.

Gonorrhea is infectious and easily passed on through:

• vaginal, oral or anal sex
• close physical contact
• sharing sex toys
• from a mother to her baby at birth

It can also be passed from the genitals to the eyes by the fingers.

You can't catch gonorrhea from kissing, hugging, sharing baths, towels, cups, plates or cutlery, or from toilet seats or swimming pools.

Signs and symptoms of Gonorrhea
About 50% of women and 10% of men with gonorrhoea show no symptoms at all. Any symptoms that do occur may be noticed one to 14 days after infection. Gonorrhea in the throat rarely shows symptoms.

Symptoms of Gonorrhea in women:

• strong smelling vaginal discharge that may be thin/watery or yellow/green
• pain when passing urine
• irritation or discharge from the anus
• possibly some low abdominal or pelvic tenderness

Symptoms of Gonorrhea in men:

• white, yellow or green discharge from the tip of the penis
• inflammation of the testicles and prostate gland
• pain when urinating
• irritation or discharge from the anus

Testing and treatment
Tests for gonorrhea shouldn't be painful, but they may be uncomfortable. They involve:

• giving a sample of urine
• a genital examination by a doctor or nurse
• taking swabs from the cervix (entrance to the womb), urethra (tube where the urine comes out), throat or rectum

Early treatment is simple and effective and involves a single dose of antibiotics. This is followed by a second test a month later to make sure the infection has gone. If complications occur another treatment may be needed.

It's important not to have unprotected vaginal, oral or anal sex until treatment is completed and the infection has cleared up.

Once gonorrhea is successfully treated it won't come back unless a new infection is picked up. To avoid re-infection, any sexual partners should be treated too.

The highest rates of gonorrhea are seen in women aged 16-19 and men aged 20-24.

What happens if it isn't treated?
Without treatment, gonorrhea can spread to other reproductive organs causing damage and serious long-term health problems.

In women, gonorrhea can cause pelvic inflammatory disease. This can lead to:

• blocked fallopian tubes (the tubes which carry the egg from the ovaries to the womb), which can result in reduced fertility or infertility
• long-term pelvic pain
• ectopic pregnancy (a pregnancy outside the womb)

A mother with gonorrhea can pass an eye infection to her baby at birth. If untreated, this can lead to blindness.

In men, gonorrhea can lead to:

• pain and inflammation of the testicles
• inflammation of the prostate gland and infertility

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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Genital Herpes

What is Genital Herpes and how is it passed on? Find out about signs and symptoms, testing and treatment and what happens if Genital Herpes isn't treated. How to avoid STIs.

Once the herpes virus is in your body, it's there for good. Here's how to reduce the chances of catching it in the first place, along with herpes symptoms and how to minimize its effects.

What is Genital Herpes and how is it passed on?

Genital herpes is caused by the herpes simplex virus. There are two types of the virus which affect the mouth and nose as cold sores or affect the genital and anal areas.

- - Warning - close-up image - - If you'd like to see what herpes looks like on skin, click on the links below. Be warned, though - the pictures are graphic and you may find them disturbing. Close-up picture of a penis affected by herpes simplex. Close-up picture of herpes zoster blisters around woman's vulva.

Some people have one outbreak of herpes, others have repeated outbreaks. Genital herpes is passed on by direct skin contact, mainly during vaginal, oral or anal sex, or sharing sex toys.

There are ways in which you can avoid passing on genital herpes:

• During an outbreak, the blisters and sores are highly infectious. Avoid contact with the infected area of skin at this time or during the warning signs of an outbreak.
• Condoms may help protect against genital herpes, although their effectiveness is unclear as the virus is present on the skin, and the condom only covers the penis so it can't offer complete protection.

It is possible to get herpes simplex by having sex with an infected person who has never had any signs or symptoms.

You can't catch genital herpes from hugging, sharing baths, towels, cups, plates or cutlery, or from toilet seats or swimming pools.

Signs and symptoms of Genital Herpes
Many people show no signs of the virus. Others don't recognize the symptoms if they're very mild. Symptoms can develop at any time after contact with the virus, but for most people it takes around three to four days.

Symptoms include:

• fluid-filled blisters that burst leaving painful sores
• flu-like symptoms - headache, backache, swollen glands in the groin or fever
• tingling or itching sensation in the genitals or anal area
• pain when passing urine

Left untreated, the symptoms last approximately two to three weeks. Recurrent infections are milder and symptoms clear up more quickly (within a week).

Testing and treatment
Tests for genital herpes shouldn't be painful but they may be uncomfortable. They may include:

• taking a swab from any visible sores
• genital examination by a doctor or nurse
• urine tests
• women may have an internal examination

The virus always remains in the body and no treatment gets rid of it completely. Antiviral tablets can be taken during the first outbreak to ease symptoms and help clear it up. However, these can be less effective if further outbreaks are experienced.

People often experience early warning signs of an outbreak, such as a tingling sensation in the affected area. Self-help measures can prove useful in reducing symptoms or preventing outbreaks, such as:

• avoiding stress
• eating a balanced diet
• cutting down on smoking and drinking
• avoiding direct sunlight on the affected area - including using sunbeds
• avoiding lycra or nylon underwear

In 2000, almost 16,800 men and women attended STD clinics in the UK with a first attack genital herpes.

What happens if Genital Herpes isn't treated?
Serious problems are uncommon. Genital herpes doesn't affect fertility. It's not linked to cancer of the cervix.

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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Pubic Lice

What are Pubic Lice and how do you catch them? Find out about signs and symptoms of Pubic Lice, testing and treatment. How to avoid STIs.

Pubic lice or crabs are unpleasant, but once diagnosed are thankfully easily treated. Here are the symptoms to look for, where to go for help and the various methods of treatment for pubic lice that are available.

How do you catch Lice?
Pubic lice are sometimes called crabs. They live in coarse body hair, such as pubic hair, but can also live in underarm hair, on hairy legs and chests and occasionally in beards, eyebrows and eyelashes.

They're yellow-grey in color, measure about 2mm long and have large, crab-like claws with which they fasten themselves to hair.

Pubic lice are easily passed on through sexual contact, or through close physical contact.

• they crawl from hair to hair; they don't fly or jump
• the eggs of the lice can survive away from the body for up to 24 hours, so it's possible for them to be passed on by sharing clothes, bedding or towels
• pubic lice are different to head lice

You can't catch pubic lice from sharing cups, plates or cutlery, or from toilet seats or swimming pools.

Signs and symptoms of pubic lice
Symptoms are noticed about five days to several weeks after infection. They include:

• itchy skin or inflammation of the affected area
• black powder (lice droppings) in underwear
• brown eggs on the hair
• occasionally, visible lice and eggs
• spots of blood are sometimes seen as lice feed from blood vessels close to the surface of the skin

Testing and treatment
Tests for pubic lice are simple and include:

• a physical examination by a doctor or nurse
• a medical history being taken
• lice being examined under a microscope

Pubic lice are easily treated. Special shampoos, creams or lotions are used to kill the lice and their eggs. You do not need to shave off pubic hair.

The itching or rash may continue after treatment and take a few weeks to clear up. A lotion to calm the skin may help with this.

Pubic lice don't cause any serious long-term health problems. However, to avoid re-infection, any sexual partners should be treated too. Clothes and bedding should also be washed.

Sex and all close contact should be avoided until treatment has been completed and the lice and their eggs have gone.

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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Scabies

What is Scabies and how it's passed on? Find out about signs and symptoms of scabies, testing and treatment and what happens if scabies isn't treated? How to avoid STIs.

The skin infection scabies isn't necessarily passed on through intercourse, but as it involves close physical contact, it's a possible method of transmission. Find out the symptoms of Scabies and how to get treatment.

What is it and how is it passed on?
Scabies is a common skin infection caused by a tiny mite invisible to the naked eye. The female mite burrows under the skin to lay her eggs. These become adult mites in about ten days.

The scabies mites are easily passed on through close physical contact with an infected person. The mites can live for 72 hours away from the body so it's possible for scabies to be spread through clothing, bedding and towels.

You can't catch scabies through sharing cups, plates or cutlery, or from toilet seats or swimming pools.

Signs and symptoms of scabies
Scabies can occur anywhere on the body, but sometimes the signs are hard to see. Symptoms can appear weeks after first contact and include itching (especially at night), a rash and tiny spots.

The mites concentrate in the body's skin creases and are commonly found:

• on the hands, especially between and along the side of the fingers
• under the arms
• on the wrists and elbows
• on the genitals
• underneath the buttocks

- - Warning - (close-up image) - - If you'd like to see what scabies looks like on the skin, click on the link below. Be warned, though - this picture is graphic and you may find it disturbing. Close-up picture of scabies on a man's arm.

Testing and treatment

Tests for scabies are simple and involve:

• a physical examination by a doctor or nurse
• taking a skin flake from one of the spots and examining it under a microscope
• taking a full medical history

Treatment for scabies is simple and involves applying a special cream or lotion all over the body.

The itching or rash may continue after treatment and take a few weeks to clear up, although a calming skin lotion may help with this.

To avoid re-infection, close contacts, family members and sexual partners should be treated too. Close personal contact should be avoided until treatment is completed and the infection has cleared up.

What happens if scabies isn't treated?
Scabies doesn't cause any long-term health problems.

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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HIV and AIDS

What is HIV and how is it passed on? Find out how to prevent HIV, what are the initial signs and symptoms of HIV, HIV testing and treatment.

Rates of infection for HIV are on the rise, especially among heterosexuals. Here's how HIV and AIDS are transmitted, when a person can be said to have AIDS and the treatment options open to those with this fatal disease.

How's HIV passed on?
HIV is a virus that damages a person's immune system, the body's defense against disease. A person infected with HIV is infected for life - there's no cure. Being infected with HIV is often referred to as being HIV-positive.

Over time, as the immune system weakens, a person with HIV may develop rare infections or cancers. When these are particularly serious, the person is said to have AIDS.

HIV can only be passed on through the transfer of blood, semen, vaginal fluids and breast milk. The two main ways in which a person can become infected are:

• vaginal or anal sexual intercourse (without a condom) with an infected person
• using a needle or syringe that's already been used by someone who's infected

An HIV infected pregnant woman can also pass the virus to her unborn baby, before or during the birth.

Other potential routes of transmission include:

• Giving and receiving first aid, although transmission will only occur if significant amounts of HIV-infected blood pass from one person to another.
• Contact with used needles and syringes.
• Giving and receiving oral sex, although there are very few proven instances of this. Generally, transmission will only occur if a person has cuts or sores in their mouth.
• Seeing a dentist, doctor or nurse. It's extremely rare for HIV to be passed from a healthcare professional to a patient, as all medical instruments are sterilized or used only once.
• Fighting and biting. There have been extremely few cases of infection in such cases.
• Kissing, although generally this won't pass on HIV as saliva doesn't contain a high enough concentration of HIV. The only risk would be if both people had noticeably bleeding cuts and sores in their mouths.
• Sport. The only risk in sport is if HIV-infected blood gets into a wound or a cut.

It's important to emphasize that even though the risk of transmission through any of the above is small, it still remains and care should always be taken.

Although blood transfusions and use of blood products are a potential route of transmission, all blood in the US and UK has been screened for HIV since 1985.

HIV isn't passed on by:

• sharing plates and utensils
• touching, hugging or shaking hands
• using the same toilet
• insect or animal bites

Improved treatment and care for HIV-positive women means far fewer children are now born HIV-positive.

Preventing HIV transmission
There are several ways in which you can prevent HIV being passed on:

• using a condom during sexual intercourse
• using a clean needle every time if you inject drugs

There are also a number of steps an HIV-positive woman can take to reduce the chance of passing on HIV to her child during pregnancy. These include:

• taking an anti-HIV drug towards the end of pregnancy and at the time of delivery
• considering having a cesarean section delivery
• giving the baby formula milk instead of breastfeeding

Who's at risk?
You're only at risk of HIV if you're involved in a high-risk activity. In some communities in the UK, particularly gay and African communities, there are a higher number of people who're HIV-positive.

Initial signs and symptoms of HIV
There are no immediate signs or symptoms after infection. Research has shown that after a few weeks some people experience flu-like symptoms, but these symptoms usually go undiagnosed. The only way to know if you are HIV-positive is to have a test.

In 2001, the number of new HIV diagnoses in heterosexuals in the UK exceeded the number of new homosexual diagnoses.

HIV Testing
The HIV test looks for HIV antibodies in the blood. It normally takes three months for antibodies to develop, so if you have a test soon after possible infection, the result may be inaccurate. You'll need to be tested again after three months to get a definite result.

Anyone in the US can have a free HIV test. The test is available from your family doctor or from any county health or Planned Parenthood clinic. Test results are completely confidential - and no one will be informed without your consent. You can also go anonymously. A trained counselor will explain the test procedure and discuss possible results. You normally have to wait one week for a result.

Treatment
There's no cure for HIV, but there are a number of drugs that can help prevent someone who's HIV-positive becoming ill. Drug treatment is free in the UK.

Treatment consists of taking several drugs every day, which is known as combination therapy. These drugs aren't a cure for HIV infection but they can increase enormously the life expectancy of someone with HIV. If the drugs aren't taken correctly, the treatment will stop being so effective and the person may become ill.

Research continues around the world to develop a HIV vaccine. Great progress is being made, although it's likely to be a number of years before such a treatment is widely

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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Syphilis

What is Syphilis and how is it passed on? Find out about signs and symptoms of syphilis, testing and treatment and what happens if syphilis isn't treated. How to avoid STIs.

It may sound like a disease that died out in the 19th century, but syphilis is still well and truly with us and can have devastating effects if left untreated. But how do you catch syphilis and what are the symptoms?

What is syphilis and how is syphilis passed on?
Syphilis is a bacterial infection, sometimes called 'the pox'. It has several stages: primary and secondary stages, which are very infectious, and the third or latent stage, which occur if the infection is left untreated.

Syphilis is easily passed on through:

• vaginal, oral or anal sex
• sharing sex toys
• intimate close body contact with syphilis sores or rashes
• from a mother to her unborn baby

You can't catch syphilis from hugging, sharing baths or towels, or from toilet seats or swimming pools.

Signs and symptoms of syphilis
The symptoms of syphilis can be difficult to recognize and can be missed. They can take up to three months to show after sex with an infected person.

Primary stage syphilis:

• Three to four weeks after infection, one or more painless sores appear. In women, these may be on the vulva (lips of the vagina), urethra (tube where the urine comes out) or cervix (entrance to the womb). In men, they may be on the penis or foreskin.
• Sores can also appear around the anus and mouth in both sexes and are very infectious. They may take up to six weeks to heal.

- - Warning - (close-up image) - - If you'd like to see what the effects of syphilis look like on the skin, click on any of the links below. Be warned, though - the pictures are graphic and you may find them disturbing. Close-up picture of syphilis chancre on penis. Close-up picture of secondary syphilis rash

Secondary stage syphilis:

• If the infection isn't treated, three to six weeks after the sores have gone the following symptoms appear: a non-itchy rash that covers the whole body; wart-like growths on the vulva or around the anus; a flu-like illness, including swollen glands, sore throat and headache; white patches in the mouth; patchy hair loss.
• These symptoms can last several weeks or months. Second stage syphilis is very infectious.

What happens if it isn't treated?
Once the sores and rash have cleared up, there may be no symptoms for many years. This is called third stage or latent syphilis.

Latent syphilis develops about ten years after first infection. It can cause very serious damage to the heart, brain, eyes, other internal organs and nervous system which can be fatal.

Testing and treatment
Tests for syphilis shouldn't be painful, but may be uncomfortable. They may include:

• blood and urine samples
• taking a swab from the sores
• examining the genitals and entire body
• an internal examination for women

Syphilis treatment is simple during the primary and secondary stages, and involves either a single antibiotic injection or two-week course of antibiotic tablets. It can also be treated during the third or latent stage, but any damage done to the body may be irreversible.

Any unprotected vaginal, oral and anal sex should be avoided until treatment is completed and the infection has cleared up. Direct contact between the sores and rashes and a partner should also be avoided until treatment is complete.

To avoid re-infection, all sexual partners should also be treated.

All pregnant women in the US and UK are tested for syphilis.

Treatment can be safely given to pregnant women with no risk to the unborn baby. Left untreated, syphilis during pregnancy can lead to miscarriage or stillbirth.

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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Trichomonas Vaginalis

What is Trichomonas Vaginalis and how is it passed on? Find out about signs and symptoms of Trichomonas Vaginalis, testing and treatment and what happens if Trichomonas Vaginalis isn't treated. How to avoid STIs.

The symptoms of Trichomonas vaginalis are often difficult to spot, especially among men. Here's what you should be looking for, where to go for testing and what treatments for Trichomonas Vaginalis are available.

What is Trichomonas vaginalis and how is it passed on?
Trichomonas vaginalis (TV) is caused by a tiny parasite found in the vagina and urethra (the tube where urine comes out).

It is passed on through:

• vaginal sex
• from a mother to her baby at birth
• sharing sex toys

You can't catch trichomonas vaginalis from kissing, hugging, sharing cups, plates or cutlery, or from toilet seats or swimming pools.

Signs and symptoms of Trichomonas vaginalis
Up to 50% of infected people show no symptoms, but symptoms can appear between three and 21 days after infection.

Trichomonas vaginalis symptoms in women:

• increased discharge from the vagina, which may be thinner or frothy, change in color and have a musty or fishy smell
• itching, soreness and inflammation in and around the vagina
• pain when passing urine or having sex
• tenderness in the lower abdomen

Trichomonas vaginalis symptoms in men:

• thin, whitish discharge from the tip of the penis, which can stain underwear
• pain or burning when passing urine

Men especially tend to act as carriers and not show symptoms.

Testing and treatment of Trichomonas vaginalis
Tests for Trichomonas vaginalis shouldn't be painful, but they may be uncomfortable. They may include:

• genital examination by a doctor or nurse
• taking a swab from the vagina or urethra and examining it under a microscope
• women may have an internal examination
• urine tests

TV is sometimes discovered during a routine cervical smear test.

Treatment is simple and involves a single dose or course of antibiotics. Once successfully treated, TV doesn't come back unless a new infection is acquired. To avoid re-infection, any sexual partners must also be treated.

Unprotected vaginal sex should be avoided until treatment is completed and the infection has cleared up. A check-up is advised after treatment to make sure the infection has gone.

What happens if Trichomonas vaginalis isn't treated?
Trichomonas vaginalis doesn't cause any serious long-term health problems.

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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Thrush

What is Thrush and how is it passed on? Find out about signs and symptoms of Thrush, testing and treatment and what happens if Thrush isn't treated. How to avoid STIs.

Most women will suffer from the yeast infection thrush at some point, but men can get it too. Recognizing the symptoms of Thrush will help you receive prompt treatment and prevent you passing the infection on to your partner.

What is Thrush and how is it passed on?
Thrush is a common infection caused by a yeast called Candida albicans. This yeast lives on the skin and in the mouth, gut and vagina. Usually it's harmless, but sometimes changes in the body cause the yeast to grow rapidly. This can lead to an outbreak of thrush.

Thrush can develop when you have sex with someone who has the infection. However, it isn't usually related to sex and is more likely to occur when you:

• wear tight trousers or nylon underwear
• take certain antibiotics
• are pregnant
• are diabetic
• are unwell or ill
• use products that may cause irritation such as vaginal deodorants

You can't catch thrush from kissing, hugging, sharing baths, towels, cups, plates or cutlery, or from toilet seats or swimming pools.

Signs and symptoms of Thrush
Both men and women can get thrush.

- - Warning - (close-up image) - - If you'd like to see what the effects of thrush look like, click on any of the links below. Be warned, though - the pictures are graphic and you may find them disturbing. Close-up picture of oral thrush. Close-up picture of penile thrush. Close-up picture of vaginal thrush.

Thrush symptoms in women:

• soreness, redness and itching around the vulva (lips of the vagina), the vagina and anus
• thick, white discharge from the vagina that looks like cottage cheese and smells of yeast
• pain during sex
• pain passing urine

Thrush symptoms in men:

• burning, itching, redness and red patches under the foreskin or on the tip of the penis
• thick, cheesy discharge under the foreskin
• problems pulling back the foreskin

Thrush Testing and treatment
Tests for Thrush shouldn't be painful, but they may be uncomfortable. They may include:

• a genital examination by a doctor or nurse
• taking swabs from the infected area and examining them under a microscope
• women may be given an internal examination

Thrush is easily treated using pessaries (almond-shaped tablets that are inserted into the vagina), cream or tablets. Men are usually treated with creams. It's best to avoid sex until the treatment is completed and the infection has cleared up.

At least three out of four women will experience thrush at some time in their lives.

Some self-help measures can be useful in preventing or clearing up outbreaks of thrush:

• avoid using perfumed soap, bubble bath and other irritants such as disinfectants
• avoid douching (washing out the vagina with liquids)
• avoid tight nylon underwear
• women should wash and wipe the genital area from front to back
• women should also use sanitary pads rather than tampons during their periods

What happens if Thrush isn't treated?
Thrush doesn't cause serious long-term health problems. It will clear up without treatment, but this will prolong the discomfort.

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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Genital Warts

What are Genital Warts and how do you catch them? Find out about signs and symptoms of Genital Warts, testing and treatment and what happens if it isn't treated. How to avoid STIs.

Genital warts are the most common STI seen at genitourinary medicine clinics in the U.S. and UK, although many people who carry the virus that causes them have no physical symptoms. Read about the possible symptoms and how genital warts are treated.

How do you catch Genital Warts?
Genital warts are caused by the human papilloma virus (HPV) and can appear anywhere on the genital or anal area.

Genital warts are passed on by direct skin-to-skin genital contact with an infected person. This includes:

• vaginal or anal sex
• close body contact
• sharing sex toys

Condoms can't offer full protection against genital warts, as the virus is passed on through direct skin-to-skin contact, and condoms only cover the penis.

You can't catch genital warts from kissing, hugging, sharing baths, towels, cups, plates or cutlery, from toilet seats or swimming pools.

Signs and symptoms of Genital Warts
Only about one per cent of people with HPV have any visible warts and it can take from two weeks to several months for them appear.

- -Warning - close-up image - - If you'd like to see what a genital wart looks like on the skin, click on the link below. Be warned, though - the pictures are graphic and you may find them disturbing. Close up picture of penile warts.

Warts don't affect everyone in the same way.

• Warts appear as small white lumps or larger, cauliflower-shaped growths.
• There may be just one wart or many.
• They can appear anywhere on the genitals - around the vulva, penis, scrotum or anus; they can appear around the anus without you having had anal sex.
• Warts are painless but can irritate the skin.
• Warts can develop inside the vagina or anus, or on the cervix.

Testing and treatment

Tests for genital warts shouldn't be painful but may be uncomfortable. Tests include:

• a doctor or nurse looking at the warts
• if warts are suspected but not obvious, a weak vinegar-like solution may be applied to turn them white
• an internal examination of the vagina or anus to check for hidden warts

No routine test is done when warts aren't visible.

Genital warts are easily treated, although it's unusual for one treatment to be enough. How they're treated depends on the type, number and distribution of the warts in the genital area.

The two most common treatments are:

• painting a liquid chemical or using special creams on the warts and washing it off later
• freezing the warts with a spray treatment

The number of treatments needed varies according to the individual. Sometimes the warts return and require further treatment. This is because the warts themselves can be treated but the virus remains within the body. Pregnant women can be safely treated for genital warts.

The highest rates of genital warts are recorded for men and women aged 20 to 24, although sexually active people of any age can be infected.

Genital warts should never be treated with remedies bought from pharmacies.

What happens if they aren't treated?
Genital warts generally don't cause any serious long-term health problems. Not everyone decides to be treated and sometimes they clear up by themselves.

There are over 100 different types of HPV and a few are linked to changes in the cervix which can lead to cervical cancer.

All sexually active women should have regular smear tests which can pick up the changes before they become cancer.

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

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Non-specific urethritis

What is non-specific urethritis and how is it passed on? Find out about signs and symptoms of non-specific urethritis, testing and treatment and what happens if non-specific urethritis isn't treated. How to avoid STIs.

There isn't one specific cause of the STI non-specific urethritis, and it affects only men. Find out what symptoms to look for, how the problem is diagnosed and the available treatment options for non-specific urethritis.

What is non-specific urethritis and how is it passed on?
Non-specific urethritis (NSU) is an inflammation of the urethra (the tube where urine comes out) that affects men only. It may also be called non-gonococcal urethritis.

It is usually caused by vaginal, oral or anal sex with a partner who already has a sexually transmitted infection (STI). It's called 'non-specific' as a variety of infections can cause it.

Other causes include:

• other genital or urinary tract infections
• damage to the delicate urethra through vigorous sex or masturbation
• a urine or bladder infection, although this is rare in young men

You can't catch NSU from kissing, hugging, sharing baths, towels, cups, plates or cutlery, or from toilet seats or swimming pools.

Signs and symptoms of non-specific urethritis
NSU has three main symptoms:

• white/cloudy discharge from the tip of the penis, which is often more obvious first thing in the morning
• pain, irritation or a burning sensation when passing urine
• wanting to pass urine often

Testing and treatment for non-specific urethritis
Tests for NSU shouldn't be painful, although they may be uncomfortable. They may include:

• genital examination by a doctor or nurse
• taking swabs from the penis or urethra
• taking a urine sample

It's important not to pass urine for at least four hours - and sometimes overnight - before a urine sample of swab is taken. Your doctor will advise you about this.

NSU is easily treated with antibiotics, although damage to the urethra can take time to heal. Vaginal, oral and anal sex should be avoided until the treatment is completed and the infection has cleared up. To avoid re-infection, any sexual partners should also be treated.

After treatments, a check-up is usually required to ensure the infection has cleared up. Sometimes, a second course of antibiotics is needed.

Cutting down on alcohol during treatment may be helpful as it can irritate the urethra.

What happens if non-specific urethritis isn't treated?
If left untreated, NSU can sometimes cause serious health problems, including:

• inflammation of the testicles, leading to reduced fertility
• occasionally, Reiter's syndrome - inflammation of the joints, urethra and eyes

How to avoid STIs

1. Before you have sex, talk to your partner about how to protect yourselves.
2. A male or female condom can provide protection from most STIs if used correctly every time you have sex.
3. Become familiar with how to use condoms and have a supply ready.
4. Seek advice straight away if you think you've been at risk.

What is HIV Antibody Testing?
Why Should I Be Tested for HIV? - The Benefits of Knowing
How Is HIV Spread?
Who Should Be Tested for HIV?
When Should I Be Tested for HIV?
What About My Privacy? Confidential or Anonymous.
Where Can I Get Tested for HIV?
I've Taken the Test. What Happens Now?
What Do My HIV Test Results Mean?
Should I Take the HIV Test Again?

What is HIV Antibody Testing?

HIV testing determines whether or not you are infected with the Human Immunodeficiency Virus (HIV). This virus destroys the body's ability to fight off illness, and is the cause of AIDS (Acquired Immune Deficiency Syndrome).

HIV testing tells you if you are infected with the Human Immunodeficiency Virus (HIV) which causes AIDS. These tests look for "antibodies" to HIV. Antibodies are proteins produced by the immune system to fight a specific germ.

Other "HIV" tests are used when people already know that they are infected with HIV. These help measure how quickly the virus is multiplying (a viral load test) or the health of your immune system (a T-cell test). For more information, see Fact Sheet 124 (T-cell Tests), and Fact Sheet 125 (Viral Load Tests).

Why Should I Be Tested? - The Benefits of Knowing

• Immune system monitoring and early treatment can greatly improve your long term health.
• Knowing you are positive may help you change behaviors that would put yourself and others at risk.
• You will know whether or not you can infect others.
• Women and their partners considering pregnancy can take advantage of treatments that potentially prevent transmission of HIV to the baby.
• If you test negative, you may feel less anxious after testing.

courtesy of San Francisco AIDS Foundation

How Is HIV Spread?

• Anal, vaginal, or oral sex without a condom. If you have another sexually transmitted disease, your chances of contracting HIV during sex are much higher.
• Direct blood or mucous membrane contact with an infected person's blood.
• From an infected mother to her child, during pregnancy, birth, or breastfeeding.
• Sharing needles or equipment for drug use.

Who Should Be Tested?

Testing is recommended if:

• You think you may have been exposed to the HIV. If you're not sure, take this anonymous survey.
• You are sexually active (3 or more sexual partners in the last 12 months)
• You received a blood transfusion between 1977 and 1985, or a sexual partner received a transfusion and later tested positive for HIV.
• You are uncertain about your sexual partner's risk behaviors.
• You are a male who has had sex with another male at any time since 1977.
• Any of your male sexual partners has had sex with another male since 1977.
• You have used street drugs by injection since 1977, especially when sharing needles and/or other equipment.
• You have a sexually transmitted disease (STD), including pelvic inflammatory disease (PID).
• You are a health care worker with direct exposure to blood on the job.
• You are pregnant. There are now treatments that can greatly reduce the risk that a pregnant woman who has HIV will give the virus to her baby.
• You are a woman who wants to make sure you are not infected with HIV before getting pregnant.

Even if you have no risk factors for HIV infection, you may still want to get tested to ease your own mind. This also encourages everyone to be more responsible about HIV transmission.

When Should I Be Tested?

After a possible HIV exposure:

An HIV test will not detect the presence of the HIV virus immediately after exposure. Statistics show that 96% (perhaps higher) of all infected individuals will test positive within 2 to 12 weeks. In some cases, this may take up to six months.

Think about this: if you got a negative HIV test at six weeks, would you believe it? Would it make you less anxious? If so, go for it. But to be certain, you will need to be tested again for HIV at six months.

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Periodic HIV Testing:

• Many people continue to engage in some degree of risky behavior, and choose to be tested for HIV periodically (every six months, every year, or every other year.)

  Since the window period for developing a positive test result can be as long as six months, it would rarely make sense to be tested more often than this.

  There are clear benefits to early medical attention for infection with the HIV virus. There is little agreement on how early this must be. But if you wait longer than two years, treatment of the disease may be less effective.

• If you are beyond the six month window period from a possible HIV transmission event and were reported HIV negative by an accurate HIV test (and you are not subsequently put at risk for HIV), you can consider yourself HIV negative. There is no need to retest. However if it eases your anxiety, you may wish to take the test again periodically.

What About My Privacy? Confidential or Anonymous.

Anonymous testing means that absolutely no one has access to your test results since your name is never recorded at the test site. Confidential testing sometimes means identifying yourself in some manner to the test site, with their assurance that this information will remain private.

Anonymous test sites are highly recommended because:

• The quality of the education and counseling that is provided is very good.
• The testing is usually free.
• The testing is reliable and automatically includes confirming tests.
• It protects you from risks of discrimination or adverse impact, especially in applications for insurance.
• Sometimes even taking an HIV test, regardless of the result, might cause an insurance application to be refused.

Anonymous HIV testing sites never give written results. Some sites who do anonymous testing also do confidential testing, which may also include written results. At least 11 states do not currently provide anonymous testing.

Where Can I Get Tested for HIV?

You can arrange for HIV testing at an established testing center, or at your doctor's office. Test results are usually available within one to two weeks. Home test kits allow you to mail in a sample, and receive your results sometime later via telephone.

HIV Testing Centers

Click here for NATIONAL HIV TESTING LOCATIONS

If you would like to talk to someone and have any questions, you can contact the

CDC National AIDS Hotline
at (800) 342-2437 (24 hrs/day, 365 days/year)

Home HIV Testing - Is It For Me?

Problems with Home Testing

• Getting test results over the phone can be very difficult, especially if the test is positive. A person can just hang up and never hear all the counseling and information they need to hear. Test counseling is best done face-to-face, and is most effective this way.
• If someone sees you purchase the test, finds the packaging in the garbage, or sees your test ID card, then your confidentiality may be compromised.
• Home testing is more expensive than going to the local health department. Testing through local health departments, and some private agencies, is free or low-cost. Home HIV test kits can cost up to $50.
• Another issue to be dealt with is confidentiality. If a person buys a home test kit in a store, everyone in the store will know that the person is taking an HIV test. Another option would be to purchase the kits by phone or through the Internet.
• When you order the tests (by phone or via the Internet), you must give your name and address. When you order by credit card, the charge for the test will appear on your credit card statement. Although your name is not linked to your test results, people who see your credit card statement may find out that you're being tested.
• When taking a test at home, after you're finished taking the test, all the packaging from the kit has to be well hidden in the garbage. If a garbage man empties your garbage and sees the test kit packaging, they'll know you took an HIV test. Also, if your garbage gets ripped open by animals, or if the garbage can gets blown open by the wind (and gets blown all over your neighborhood), your neighbors can also know you've been tested. So for people taking the home test, I say "hide your garbage!"
• In a home HIV test kit, a person has a test ID card that is used to identify the specimen by number. Anyone who has the number can get the test result over the phone. The person who is being tested has to make sure that nobody else sees the card. Otherwise, any person who sees the card or the number can get that other person's test results. So it's important that a person getting tested at home doesn't leave the ID number lying around the house, where other members of the household can see it. This differs dramatically from testing through the health department. To ensure confidentiality, health departments will usually not give test results over the phone or by mail. Test results through the health department are usually given in person.
• Getting test results over the phone can be hard to deal with, especially if the HIV test is positive. A person can just hang up and never hear all the counseling and information they need to hear. For this reason HIV test counseling is best done face-to-face and is most effective this way.
• Using HIV home testing, if a person is positive, there is no way to do partner notification (anonymously helping a person's sex/needle-sharing partners know they've been exposed). Partner notification is routinely done by local health departments around the country for HIV and other STDs. Home testing bypasses this important, and proven, preventive health measure.
• There are presently two home HIV testing companies that have received FDA approval for these types of tests, Home Access, and Confide, which is no longer on the market. Unfortunately I recently discovered at least three other companies that are selling home HIV tests that have not been approved by the FDA. The three companies I found were all advertising via the Internet. Beware of these unapproved kits and only use Home Access for now. (For more information, look at The Body.com section on HIV Testing.)

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What Home HIV Test Should I Buy?

Be sure you get an FDA approved home HIV test kit, such as "Home Access." Other tests are available, and some have been shown to be inaccurate. These are available over-the-counter at most drug stores. more from Federal Trade Commission

The FTC recently tested HIV kits advertised and sold on the Internet for self diagnosis at home. In every case, the kits showed a negative result when used on a known HIV-positive sample - that is, when they should have shown a positive result. Using one of these kits could give a person who might be infected with HIV the false impression that he or she is not infected.

I've Taken the Test. What Happens Now?

• Depending on the test you take, you may have to wait a week or more obtain your results.
• If you can, take a friend with you to pick up your results - especially if this is your first test or if it has been a long time since you last tested. They may be a source of comfort for you if your results are positive. If not, the two of you can celebrate together.
• Some more recently developed tests can provide you with your results within an hour. Occasionally these tests can be inconclusive, and you must still wait one or two weeks for the final result.

What Do My HIV Test Results Mean?

A negative HIV test result means:

• If you have not engaged in any risky behaviors for the last 6 months, you are not currently infected with HIV. If you have had unprotected sex or shared needles or have other risk factors in the last 6 months, you should be tested again. You could still be HIV positive, and pass the HIV on to other people, even though your test is negative.
• A negative test does not mean that you are immune to HIV.
• Some people who have a negative test may be tempted to continue risk behaviors, believing "It can't happen to me." If you continue unsafe behaviors, you are still at risk.

A positive HIV test result means:

• You are infected with the HIV virus. This does not necessarily mean that you have AIDS.
• A person with HIV is infected for life. He or she can pass the virus to others by having unprotected sex, or by sharing drug use needles or equipment. To protect yourself and others, you need to avoid doing these things. A woman who has HIV can pass it on to her unborn or breast feeding baby. Those carrying the HIV virus should not donate blood, plasma, semen, body organs, or other tissue.
• You should choose a doctor to monitor the progression of HIV in your body, and advise you on when it is appropriate to begin treatment. There are differing opinions about how early to begin treatment, but it's clearly much better to begin treatment long before symptoms of AIDS develop. The only way you can tell when to begin treatment is by having a doctor interpret additional tests. You may wish to change to a doctor that specializes in HIV care.
• If your HIV test is positive, your sexual partners and anyone with whom you have shared drug injection equipment may also be infected. They should be told they have been exposed to HIV and advised to seek HIV counseling and antibody testing. You can tell them yourself, work with your doctor, or ask for help from the local health department. Health departments do not reveal your name to sexual or drug-use partners, only the fact that they have been exposed to HIV.

Should I Take the HIV Test Again?

Periodic testing has the following benefits:

• It takes up to 6 months for the HIV virus to be detected. If you have tested before this time has passed, you should test again to allow for this.
• Always knowing your HIV status may empower you to continue doing the right things.
• May give you an increased peace of mind in knowing you are negative.
• If you should become positive, you will know at the earlier possible moment and will have more treatment options available to you than if you learn about this later.

An Ounce of Prevention is Worth a Pound Of Cure.

Pornified: How Pornography Is Transforming Our Lives, Our Relationships and Our Families

By Pamela Paul

Pornography "is where hip hop was ten to fifteen years ago," according to one Hollywood marketer -- visible, sassy and here to stay. Watching porn together is now on Glamour magazine's "ultimate milestones on any relationship resume." Pornography has somehow become interlinked with America's carnival of functionless celebrities, so that network reality TV star Paris Hilton becomes -- in the lurid, green gaze of a camcorder -- a porn star, while porn star Ron Jeremy is cast in the "The Surreal Life," a cable reality TV series. In fact, swaggering by Space Mountain or the twirling teacups on a trip to Disney World in March, Jeremy was frequently stopped to pose for pictures with families of four, his adoring fans.

But porn's pop image has nothing to do with the stuff many people are actually watching, films such as "Gag Factor 15," a gang-banging dumb show based on the slayings on video that came out of Iraq, which shows "Arab" men "standing over a woman dressed in military clothes and dog tags shouting 'I was only following orders!' " Nor does our flippancy about pornography in public reflect the anxiety it can create in private life.

Sen. Sam Brownback, R-Kan., told a congressional hearing on porn addiction last fall that, when traveling, some men he knows avoid their own hotel rooms, wary of the siren song of pay-per-view nudie flicks.

Brownback's remarks might sound like a typical Christian conniption fit -- as might the very idea of a congressional hearing on porn addiction. But with the political right bundling pornography with "family values" issues like gay marriage and abortion, and the left unconcerned or even embracing porn as a token of sexual liberation, a more serious conversation about how porn may be quietly warping our attitudes and relationships has yet to happen.

Pamela Paul, a frequent contributor to Time and author of "The Starter Marriage and the Future of Matrimony," has stripped porn of its culture-war claptrap by interviewing hundreds of people across almost every demographic. The results are sobering. Remember the guy who, halfway through "Fast Food Nation," pledged to stop eating meat but was back at McDonald's within days? "Pornified" is likely to inspire similar histrionics and -- let's face it -- similar fickleness.

Paul makes it clear that to discuss porn today is to discuss Internet porn. With its infinitely various acts, ethnicities and nipple sizes, the Web has quickly become the so-called "crack cocaine" of smut. It's a hassle-free delivery system heightening something that never "veers from the automated path to pleasure" to begin with. It's amazing anyone can still leave home and hold a job, except that people are looking at porn at their jobs too, often openly. At Kentucky's state transportation bureau, more than 200 computers were found to access porn on a given day. And Paul discovers one Houston oil company employee actually sidelining for an adult Web site from his desk.

But the ease of Internet porn means, ironically, that people get bored with it more quickly. The possibilities seem infinite, but all ultimately unsatisfying. Tastes get "refined." (One connoisseur interviewed in "Pornified" kvetches about "stringy inner-thigh tendons that seem to show up on a lot of these anorexic-type models." Another says, "I'm sure I could find 50 more interesting versions within a few keystrokes.") Then tastes skew, more dramatically and faster than most people realize. Many men Paul speaks with are surprised at how an innocent fetish for, say, freckles or teachers can slip into a drive to see more abusive, degrading sex acts. An interview with one 21-year-old begins, "At first I was just happy to see a naked woman," and concludes, "Recently ... I've found that I like to see a guy pissing on a girl."

Whether or not it's OK to enjoy a tasteless or politically incorrect fantasy is almost beside the point. Heavy porn users -- as much as 19 percent of respondents to one poll say they look at it every day -- are effectively having more sex with these images than with other human beings. Over time, studies and Paul's interviews show, the normalcy of what's on the screen is taken for granted. Porn begins to cleave a troubling distance between the porn watcher and everyone else around him. It's this estrangement Paul laments, rather than simply a rash of kinkiness.

One man, for example, can't get off unless his girlfriend shouts at him that she'd rather be having sex with a black man and, well, she's not so into that. A preteen daughter discovers photos her father has taken of himself in her underwear. "I spent a lot of time lusting after my niece," another man concedes.

It's not always so extreme. It turns out actual women don't always like to have sex or talk about it the way women in porn do, and Paul finds many a young man unwittingly alienating his girlfriend with his polished, porn-star moves. Women may not like to yelp and moan, or coif their pubic hair just so -- which in the bizarro world of porn is made to appear like things even the Amish must do.

Moreover, rifling through porn is time-consuming and easy to get lost in. Many men in "Pornified" describe -- with less guilt than regret -- hours spent looking at porn even after the thrill is gone; "just going through the motions," one says. They wish they'd been doing something useful. Like corporate workaholics, here are men who spend less time with their families than in holing up in their broadband-wired dens and getting jiggy with Filipino schoolgirls, taking, as one put it, an attitude with their wives of "I know you know and I don't really care."

Apparently, another of the perceptions skewed by looking at lots of porn is that your girlfriend should be totally cool with it. Often she's not, and that's another source of trouble. One-third of women see online porn as cheating; only 17 percent of men do. More than half the users of one Internet filtering software were women monitoring or blocking their partner's Web activity, not their children's. Several lawyers tell Paul that Internet porn is at the root of more and more divorces. One midsize Virginia law office claims it's always got at least one such case going. But this may not even matter, as studies show big-time porn enthusiasts are less likely to want families in the first place, and particularly less likely to want daughters.

With all these unsettling stories, it's almost a surprise to find that there are cases of perfectly healthy, casual users, or those who simply choose not to look. (One Gen-X film buff complains, "They're not concerned about whether the Swedish plumber actually fixes the washing machine. The outcome is always inevitable," bless his artsy heart.) Paul is not immune to exaggeration or questionable assumptions. (Is it fair to characterize all porn stars as victims, or to include browsing online personals as using pornography?) Yet while there are arguments to be made, "Pornified's" stream of anecdotes and surveys breaks important ground.

Surprise! Sen. Sam Brownback might be right -- though the situation's more nuanced than he could ever imagine.

"Pornified" may stand as a Kinsey Report for our time, when there's little intrigue left to be pried loose from the matrimonial bedrooms of suburbia. People are having sex in front of their computers now, alone, and it's time someone acknowledged that shift in a levelheaded way.

Jon Mooallem has written recently for Harper's and the Nation.

For some people, a negative HIV test result is a wake-up call and a chance to get things:

"I was totally relieved and happy. I got tested because my boyfriend and I had slipped up. Then I had to go back six months later for a second test to be sure. I'm not going through that stress again. I'll always use condoms now."
-- Nicole, Houston

For others, life goes on, but is changed forever:

"It was scary when the counselor at the clinic told me I was HIV positive, but she was really helpful and supportive. After I got over the shock, I started on treatment - 14 pills a day. I also figured out who to tell about my HIV and how. At first, I was afraid my family and friends would treat me differently because I had HIV and that my boyfriend wouldn't ever want me again. It wasn't easy, but the important thing for me is that I am LIVING with HIV."
-- Samiya, Boston

Whether your HIV test results are positive or negative, the important thing to remember is that you're not alone. You can get the help you need through support groups and individual counseling. Your testing and treatment site can refer you to a counselor if you need one.

Why it might be helpful to tell someone you're HIV-positive:

-- It may help you get support in dealing with your HIV diagnosis

• They're important to you and you tell them everything that happens in your life (a parent, brother, sister, partner, best friend or teacher)
• You think it may be a good idea for them to know your medical needs (a doctor or nurse at the emergency room, or someone who might help you in an accident)
• They're a former or current sexual partner, or someone you want to be with in the future
• Your HIV status is nothing to be ashamed of.

Why it might be hard to tell someone you're HIV-positive:

• You expect them to react in a negative or hostile way
• You don't trust them to keep the information confidential
• You feel you need time to think things through or tell other people first

Stop cutting yourself. End the desire to self-injure and feelings that motivate you to cut yourself. Stopping the cutting and self-injury takes work. Here's how.

However much it hurts
However much it takes
Believe and all your dreams will all come true
However hard it gets
However much it aches
Always believe in me
As I believe in you
Dredd Song - The Cure

How to Stop Cutting Yourself

Stopping the cutting is easier said than done. I have read a lot of different suggestions. Basically what it boils down to is that you have to want to stop cutting yourself. Of course, self-injury cutting releases pain and tension. Of course, it makes you feel better immediately, but in the long run, it makes you feels worse. When you cut, you generally end up feeling ashamed that you hurt yourself and embarrassed by the scratches and self-injury scars. There are other ways to cope with your pain that won't make you feel bad about yourself. Here are some of my suggestions on how to stop cutting yourself:

• Do something creative! Everyone enjoys doing something creative, whether you're good at it or not! I have a friend that paints, one that journals, and still another that writes poetry. I have several friends that write and compose music to release their frustrations. Personally, I like to create/modify websites to get my mind off the things that are bothering me. Sometimes I'll take photographs, work on graphics, or just surf the web for ideas.
• Entertain your mind! You can do a lot of things to occupy your mind besides expelling creative energy. You don't have to dwell on your problems. You can watch TV, rent a movie, or read a book. I would suggest something comical, not dramatic! I would also suggest going to a theater to see a movie because it helps to get out of the house. Also, if you go to a theatre you can't turn the movie off halfway through and you'll be less likely to leave since you've paid money to get in
• Talk! This is probably the most obvious suggestion in the book! You can and should talk to others about your self-injury problem! You'd be surprised at how understanding people can be. I would suggest turning to a close friend or significant other first, but parents can be a good thing to fall back on. If you are not sure how to broach the issue, here are some suggestions on how to tell someone you self-injure. (If you are a parent or friend and you've come across this page, how you react to self-injury disclosure is very important.)
• Practice Violence! Did I really say to do something violent? Yes, but not something that will hurt you or someone else. You can rip up or punch a pillow, scream your lungs off, jump up and down, or practice a combination of things. Exercise is also a good idea since it can be good for you.

Other Ways to Stop Cutting

If you're still wondering how to stop yourself from cutting, here are some ideas that a friend of mine suggests:

• Journal! Keep a self-injury journal of the bad times. Sometimes, writing can help sway your feelings and the desire to self-injure will subside. Afterward, you can analyze your feelings and possibly avoid what triggered the desire to self-injure in you in the first place.
• Music! Listen to music. Make mood tapes. Tori Amos seems to be a favorite. Little bits of her music and snippets of quotes twist themselves around the edge of my friend's journal. She has a lot of tapes she has made for herself that help her when she is in the mood to self injure. She has sent quite a few of these tapes to me. They give her something to identify with, so she knows she is not alone.
• Collages! Another interesting thing that she does when she feels down is to make collages. She has several that are very interesting, although most are painful to see. It hurts to know someone is in such pain, especially when you know what they are going through and still don't know how to help them. We talk about her collages, why she chooses the images she does, and I try to reinforce that she is just as intelligent, beautiful, and important as the people in her collages.

For more suggestions on ways to immediately avoid self-injuring, please take a look at this page on self-harm alternatives. This page offers ways to cope with self-injury based on the feelings that motivate you to self-injure.

Another thing to do, after you have calmed the urge to self-injure, is to go back through your day and try to determine what pushed you to want to SI. This self-injury test might come in handy for that. If you can recognize what is causing the problem, you can attempt to come to terms with it or handle it differently.

Stop Cutting For the Long-Term

Here, you will find methods and suggestions to stop self-injuring permanently, as well as more spur-of-the-moment suggestions. Be prepared to make a commitment to yourself and stop the self-harm. Cutting help and professional cutting treatment are key to your recovery.

Heal

I can't stress enough how important communication is in the healing process. If you want to get better, you have to come to terms with your problems, and the best way to do that is by getting self-injury help and support and another perspective by telling someone close to you about your problem.

Emergency!

If someone you care for needs to go to the hospital and wants you to go with them, there are a number of things you can do to ensure they get proper treatment. Sometimes the person that has injured themselves will feel meek or vulnerable. In this situation, you must stand up for them and be their "advocate."

About the author: Vanessa, is a self-injurer and started the self-injury website, "Blood Red."

Sexual aversion disorder is typically classified as a subcategory of hypoactive sexual desire disorder (HSSD) and is often confused with a lack of sexual desire.^(1,2) Many experts consider it a phobia or anxiety disorder, although its sexual context also classifies it as a sexual disorder. It also may be a dual disorder encompassing sexual anxiety and panic disorder.^(1,3)

Diagnostic Criteria

The second international multidisciplinary group gathered by the American Foundation for Urologic Disease defines the problem as "extreme anxiety and/or disgust at the anticipation of/or attempt to have any sexual activity.⁽³⁾ As with other sexual disorders, whether or not the disorder causes personal distress is critical to the diagnosis.⁽¹⁾ The DSM-IV-TR published in 2000 describes sexual aversion disorder as "the persistent or recurrent extreme aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner; the disturbance causes marked distress or interpersonal difficulty, and the sexual dysfunction is not accounted for by another Axis I disorder (except another sexual dysfunction)."⁽⁴⁾

Little is known about the etiology, prevalence, or treatment of the disorder, except that it is a lifelong or acquired conditioned response that is frequently associated with a history of sexual trauma or abuse, and it affects more women than men.^(1,2) Aversion to sexual activity is rarely an initial presenting complaint, because patients often seek to avoid any genital contact, even in the context of a gynecologic examination. They also may avoid talking about their aversion to sex in a therapeutic setting. It is important to rule out HSDD because there is some overlap of symptoms, and some women with aversion disorder have intact libidos and even report pleasure on the rare occasions when they engage in sexual activity.⁽¹⁾

Kingsberg and Janata have proposed revising the current DSM-IV-TR diagnoses and criteria in order to better distinguish between primary (lifelong) and secondary (acquired) sexual aversion disorder (see Table 11).⁽¹⁾

Treating Sexual Aversion Disorder

As with diagnosis, treatment of sexual aversion disorder is difficult, largely because patients are often resistant to discussing the disorder. At this time, treatment consists of referral to a psychologist or sexologist for desensitization therapy.⁽¹⁾

TABLE 11. Proposed Revision of Sexual Aversion Disorder Classification1
Diagnosis	Current DSM-IV-TR Criteria	Proposed Revised Criteria
Primary sexual aversion	Lifelong anxiety, fear, or disgust to sexual stimuli	Acquisition of anxiety or disgust before the development of healthy sexual interactions with a partner
Secondary sexual aversion	Acquired anxiety, fear or disgust to sexual stimuli	Acquisition of fear, anxiety or disgust after the development of healthy sexual interactions with a partner

References:

1. Kingsberg SA, Janata JW. Sexual aversion disorder. In: Levine S, ed. Handbook of Clinical Sexuality for Mental Health Professionals. New York, NY: Brunner-Routledge, 2003; pp 153-166.
2. Anastasiadis AG, Salomon L, Ghafar MA, et al. Female sexual dysfunction: state of the art. Curr Urol Rep 2002;3:484-491.
3. Basson R, Leiblum S, Brotto L, et al. Definitions of women's sexual dysfunction reconsidered: advocating expansion and revision. J Psychosom Obstet Gynecol 2003;24:221-229.
4. American Psychiatric Association. DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.

In the final phase of lovemaking - after desire and sufficient arousal - a woman often achieves orgasm. But a persistent delay in, or complete absence of, orgasm that causes the woman marked distress has been labeled "female orgasmic disorder" (FOD).

The condition can be primary, meaning that the woman has never reached an orgasm, or secondary - the woman can no longer achieve orgasm.

Primary FOD is the most challenging of all female sexual dissatisfactions to treat, says Jennifer Berman, M.D., a urologist and one of the nation's leading experts on sexual health.

Both primary and secondary FOD can be caused by:

• Emotional trauma or sexual or physical abuse: There is no doubt that women with a history of abuse are at greater risk for all sorts of emotional and physical problems - especially depression and anxiety - that can ruin their sex lives. "Feelings of guilt, shame, anger, fear anxiety, and isolation" are quite common for these women, write the Bermans in their book, For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life. For some, the feelings manifest in an inability to be present or connected while making love. Other women report being on the verge of orgasm and then hitting a wall.

• Medications and surgery can contribute to FOD: Excessive amounts of alcohol, drugs that reduce blood pressure, the class of antidepressants know as selective serotonin reuptake inhibitors Prozac(Fluoxetine), Paxil(Paroxetine)) and anti-anxiety drugs like Xanax and sedatives such as Halcion can delay or impede orgasm. Severed pelvic nerves as a result of surgery can inhibit the engorgement of the genitals - a precondition for building to a climax.

• Inadequate Sex: You simply can't talk about orgasm without mentioning sexual techniques. Making love is not something we are born knowing; we have to learn how to give and receive sexual stimulation and satisfaction. Due to a variety of reasons - cultural, religious and personal - some women are uncomfortable discussing and exploring the sexual techniques that might bring on or intensify an orgasm.

• Pelvic floor prolapse: This condition occurs with the loosening of the muscles that support internal pelvic organs. Prolapse can result from childbirth, aging, surgery and spinal cord injury. Women suffering from prolapse often experience an urge to urinate and complain of pressure in the vagina or rectum, report the Bermans.

Overcoming Female Orgasmic Disorder

We are conditioned to believe in sex = intercourse = orgasm. Such high-pressure expectation alone can prevent orgasm from occurring. Furthermore, as the Bermans frequently acknowledge, there is much more to sex than orgasm.

"For many couples, the intimacy, exploration, sensuality and connection of sex can be lost when it becomes goal-oriented, focusing on orgasm as the ultimate experience," they write. Nonetheless, there is no need to "grin and bear" sex without orgasm if you can do something about it. Possible solutions include:

• Counseling: The Bermans prescribe counseling for victims of sexual abuse. The treatment process is long and arduous, but it can help an abused woman reclaim her sexuality. "The first step is acknowledging what happened, the second is acknowledging that it wasn't your fault and the third is purging the shame," they write. All three steps are crucial to recovery.

• Changing meds: You may need to switch or even eliminate prescription drugs that have a negative impact on sexual function. Of course, you must work with your doctor before making any changes to your medication regimen. Depending on a woman's history, the Bermans generally advise taking antidepressants known to have less sexual side effects, including the medications marketed as Celexa, Wellbutrin, BuSpar, Serzone or Effexor. Sometimes, you can also change the way you take the drug to reduce side effects. For instance, there is now a version of Prozac that can be taken weekly instead of daily.

• Communication:: To have satisfying sex, you and your partner have to become experts in arousing each other, which requires honest communication. "Every woman is different," say the Bermans, and as such, it is every woman's "responsibility to tell a partner what she likes." If you feel uncomfortable talking about you want, the Bermans suggest introducing erotic books or videos to start the conversation. Stay on a positive track with statements like: "I would really love it if you would do more ________."

• Kegel exercises: Toning your pelvic muscles with Kegel exercises can help you achieve more intense orgasms. To strengthen these muscles, start and stop your stream of urine several times. The Bermans recommend working up to five sets of 10 contractions a day. The longer you hold the contractions, the stronger your muscles will become. Think of all the fun you can have at boring meetings and standing in line at the grocery store!

• Hormones: In their book, the Bermans describe a 38-year-old patient whose ability to reach orgasm improved after she began taking methyltestosterone, a synthetic form of testosterone sold by drug companies. The patient did not have any medical problems, but she did have very low levels of testosterone available for use by her body.

• How do the Bermans comfort a woman who has never been able to have an orgasm? Because "there is no orgasm pill at this time," says Jennifer Berman, you have to be "sensitive and supportive and explain the limitations of what is available now. We also explain our working knowledge of anatomy and attempt to provide alternatives toward sexual fulfillment."

Contents:

• How Big Should My Penis Be?
• The Skin on My Scrotum (Balls) is Getting Darker. Is That Normal?
• When Do Boys Start Growing Hair Around the Penis?
• Most of the Other Guys in the Locker Room Have Circumcised Penises. I am Uncircumcised. Is That Normal?
• Why Does the Doctor Have to Touch My Testicles During the Medical Exam?

How big should my penis be?

The size of your penis is simply determined by factors, called genetic traits, which you inherited from your parents. There is nothing you can do to increase or decrease the size of your penis-it will develop into its adult size as you change from a boy to a man through the process called puberty. Most boys start the changes of puberty between 10 and 14 years of age, though a few will start earlier or later than these ages. First, the testicles (balls) begin to enlarge and then hair starts to grow around the them. The penis then starts to enlarge, first in length and then later in thickness. Though there is much normal variation, the final penis size is reached four to six years after the testicles first started to enlarge.

This process of normal penis growth can be disturbing to many males. Since the testicles enlarge first (and later followed by growth of the penis), many young male teens do not notice the testicles growing and worry that they are not changing and that their penis is too small. If you are overweight, fat tissue can hide the penis somewhat and give an impression that the penis is smaller than it really is. Some males in your class may have started their changes of puberty well ahead of you and they may seem like they have an adult-size penis-that can be very upsetting! It is difficult to know how large a penis will be in its erect state, simply by looking at it when not erect (or when flaccid).

It is also true that adult penis size varies considerably from person to person. Just as with any body part, different people will have different penis sizes. We live in a society that pushes a myth that the male with a larger penis has a better sex life than one with a smaller penis. This is constantly noted in sexual jokes, in comments heard on TV, or in the movies and in many other places. Well, the truth is that normal penises vary tremendously in size, and sex is just as good for each of these males. You will need to wait a year or two after your overall height has stopped changing to see what final size your penis will be. If at any time during your growing, you are worried that your penis is abnormal, just go to your doctor and ask him or her directly about this. In almost every case, you will be told that it is fine.

The skin on my scrotum (balls) is getting darker. Is that normal?

Yes, it is normal for skin over the scrotum to get darker as you change from a boy to an adult. The result of puberty is an increase in chemicals called hormones. Darkening of the skin over the scrotum or balls is actually one of the first steps of puberty. It is noted to occur at the same time that skin over the balls changes from a smooth appearance to a more rough appearance (called stippling). Also at this time, the testicles or balls themselves will begin to enlarge. These changes are all the first visible signs that puberty has begun. The darkening of the scrotal skin is perfectly normal and will be followed over the next few years by even more dramatic changes: adult pubic hair, growth of the penis, hair in the armpits, larger and stronger muscles, facial hair, growth to adult size, among others. These changes are all determined by factors called genetic traits-these traits come from your parents and determine how fast these changes will occur and what the final results will look like. So if you see this normal darkening of your scrotal skin, you will know that many changes are about to happen over the next few years-changes that start out looking small, but result in taking you from being a boy to being a man!

When do boys start growing hair around the penis?

The growth of pubic hair over the penis and testicles is a normal part of puberty-the time when boys physically change into men. Most boys begin this time of puberty between 10 and 14 years of age and notice many changes in their bodies that occur over several years. Growth of the testicles is a first visible sign of puberty, followed by growth of the penis. Though much variation is noted, pubic hair usually begins to develop several months after the testicles, or balls, begin to grow. In some boys, the hair may even start growing before any changes in the balls are noted. At first, this hair is limited in amount, is straight (or slightly curled), and soft; it is found at the base or beginning of the penis. Over the next several months or few years, it becomes much darker and curly; it also spreads over the balls and inner parts of the thighs. The final amount of hair is usually reached as other parts of puberty are completed-such as final size of the penis and testicles, final height, and facial hair. However, there is much normal variation in the amount and distribution of this hair. The timing and amount of this hair growth is determined by genetic traits inherited from your mom and dad.

Most of the other guys in the locker room have circumcised penises. I am uncircumcised. Is that normal?

All males are born with a fold of skin over the tip of the penis. Doctors call this fold of skin a prepuce, or foreskin, and the surgical removal of this skin is called circumcision. It has been practiced in many cultures for many centuries, often because of religious reasons. There are some doctors who feel that males should be circumcised for medical reasons and note that circumcision will reduce the chances of male infants getting an infection in their bladders. Some doctors feel that circumcised males will have fewer infections when sexually active and will have less cancer of the penis as adults. But-not all doctors agree with these theories and the medical debate continues regarding the medical need for circumcision. However, doctors do agree that being either circumcised or uncircumcised is normal. When you were born, your parents or guardians chose not to have you circumcised. You are part of a large number of men in the world who are not circumcised-and you are all normal. So, do not worry about this difference! It is perfectly OK!

Why does the doctor have to touch my testicles during the medical exam?

The main reason to touch your testicles (balls) during a medical exam is to check for any abnormality with them. It is important to be sure both balls are of approximate size, and that there is no unusual lump or bump on them. Cancer of the testicle can occur in teen males and it is discovered by the doctor (or even you) touching your testicles. If this cancer is found early, most can have the testicle removed and do well. Finding the cancer early is the key to the best outcome. Your doctor should advise you to check your balls on a regular basis-once a month or so. It is often easy to do this while taking a shower. You will quickly learn how your testicles feel and will be able to discover a new lump or bump on them. If you do feel a lump, see your physician immediately to have it checked out. If you notice pain in or around the testicles, have it checked out also. For example, a lump in the scrotum may not be a tumor of the testicle, but a collection of veins called a varicocele. Sometimes surgery is recommended to remove it. At any rate, expect that a physical examination will include an examination of your testicles. The doctor needs to examine them by touching to be sure they and you are healthy! In fact, if your doctor does not do this during an examination, ask him or her why this very important part of your body is being ignored!

Diabetes need not hinder a happy, healthy sex life

Once, researchers basically ignored women's sexual problems. The only area deemed worthy of study involved difficulties bearing children.

Times are changing. As the Baby Boomers age, menopause and its problems are attracting more attention. And the increasing number of people with diabetes encourages more researchers to focus on diabetes-related problems, including sexual problems in women.

Sexual Problems Of Women With Diabetes

Experts divide women's sexual problems into four general categories:

• Lack of sex drive (libido), including a lack of sexual fantasies
• Problems becoming aroused (not enough vaginal lubrication, not feeling aroused, decreased sensation, tight vaginal muscles)
• Recurrent or persistent delay in or lack of orgasm
• Recurrent or persistent pain during sex or sexual stimulation

Experts label these situations "problems" only when they cause a woman distress. For example, a woman who has no partner may not consider lack of sex drive to be a problem.

Women with diabetes can experience all four problems. What scientists don't yet know is whether these problems are more common in women with diabetes than in other women. What little research has been done has produced conflicting results. For example, some studies have found women with diabetes have decreased libido compared with other women; others haven't. Estimates of the percentage of women with diabetes who have decreased sexual desire vary widely, ranging from 4 to 45 percent.

However, when it comes to arousal difficulties, research results have been fairly consistent: Women with diabetes appear to be twice as likely as other women to have decreased lubrication of problems becoming sexually stimulated.

Diabetic nerve disease is a major cause of impotence in men with diabetes. Men's and women's bodies are similar enough that researchers have expected nerve disease to underlie sexual problems in women with diabetes, too. But so far, research has found no link.

Two studies have looked at whether poor blood glucose (sugar) control or diabetes complications are associated with sexual problems in women with type 1 diabetes, as they are in men. Neither study found such an association. However, one of the studies found that the more complications a woman had, the more sexual problems she was likely to have.

One important way that diabetes affects women's sexuality is through its psychological effects. Diabetes doubles the risk of depression, a known cause of sexual problems in women. Diabetes changes a couple's relationship, sometimes for the worse. Having a chronic illness can damage self-esteem and alter a woman's perception of her desirability. Like a stone thrown into a pond, the psychological effects of diabetes ripple throughout many aspects of life, including sex.

High blood glucose levels also make it easier to get urinary infections and yeast infections, which can make sex uncomfortable.

In addition, women with diabetes can develop sexual problems for the same reasons as other women. One cause is menopause. The drop in hormones during menopause can reduce the sex drive. When estrogen levels drop, the lining of the vagina can become thin, which can make sex painful. Also, lubrication may decrease, possibly leading to pain during sex.

Other factors that increase the risk of sexual problems are:

• Having a disease involving the nerves, such as Parkinson's disease of a spinal cord injury
• Having a chronic illness
• Having had genital surgery
• Having liver or kidney failure
• Having disease of the blood vessels of the feet and legs
• Having been abused sexually
• Being under stress
• Having problems in a relationship
• Taking certain drugs (A wide variety of common drugs, including antihistamines, some kinds of high blood pressure pills, birth control pills, alcohol, and antidepressants, can cause sexual problems in women.)
• Worrying about getting pregnant

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Treatments

One easy and cheap self-help remedy for vaginal dryness is using a water-based lubricant during sex. Several kinds of lubricant are available without a prescription at your pharmacy or grocery store. For many women with arousal problems, a lubricant may be all they need to have sex comfortably.

Other things you can try yourself are to stop smoking, drink alcohol moderately or not at all, and get your blood glucose levels under good control. Even though the studies mentioned earlier failed to find a link between poor control and women's sexuality, doctors believe it probably does have an effect. High glucose levels can damage blood vessels and nerves, both of which play crucial roles in sexual response.

If self-help measures aren't enough, it's time to see your health care provider. The solution may be as easy as treating an infection or switching to a different blood pressure medicine.

If your problems stem from menopause, hormone replacement therapy may help. Treatment with the female hormone estrogen can help atrophy of the vagina, pain during sex, and genital insensitivity. Although estrogens can be taken as pills or patches, estrogen cream or a vaginal ring used directly in the vagina work better. Women who still have their uterus should take progestin when they take estrogen to protect the lining of their uterus from cancer.

However, taking estrogens after menopause has been linked to a higher risk of heart attack, stroke, breast cancer, and gall bladder problems. Because of this, doctors now prescribe estrogens after menopause with great caution.

Young women make both male and female hormones. Production of male hormones drops off greatly in the premenopausal years. Some doctors treat lack of desire in women after menopause with testosterone and other male hormones. But this kind of hormone therapy does not have Food and Drug Administration (FDA) approval and may be risky. There have been reports of women with diabetes whose blood glucose levels rose while they were taking testosterone. In addition, doctors believe it can cause acne, liver disease, and facial hair growth.

Some drug companies that make impotence drugs for men are testing these drugs in women. These drugs include , tadalafil (Cialis), and alprostadil in gel form. All target arousal problems. None has yet been approved by the FDA for this use; in fact, it's not yet clear whether any of them even work in women.

Because the most common causes of sexual problems in women with diabetes are psychological, your health care provider may refer you to a mental health professional who has training in treating sexual problems. Your therapist can help you work through depression, deal with stress, come to terms with your self-image as a woman with diabetes, or deal with whatever else is disrupting your sex life.

If you have genital pain or if your doctor thinks your sexual problems may be due to menopause, he or she may refer you to a gynecologist for diagnosis and treatment.

Last, but certainly not least, talk to your partner about the problems you are having. Together, you may be able to work out a solution--for example, by trying different positions that are more comfortable, or by taking more time with the arousal stage.

Shauna S. Roberts, PhD, is a science and medical writer and editor in New Orleans, La.

Diabetes need not hinder a happy, healthy sex life

by Shauna S. Roberts

Both those who engage in self-injury and those who do not may want to look at self-harm pictures. For those who engage in this sort of behavior, the pictures may intensify or trigger their compulsion to cut, burn, or otherwise inflict injury upon themselves. Other people may view self-mutilation pictures in an attempt to understand why teens and others self-injure or even for research purposes.

Self Harm Pictures Can Be Triggering

Things that trigger teens, young adults and adults to self-harm vary by individual, but viewing other peoples' photos of self-injury represents one of the most common triggers. These self-harm images may dredge up memories of past self-harming sessions, guilt, self-loathing, and other negative thought patterns that make people feel compelled to self injure again.

Imagine having such overwhelming feelings of guilt, sadness, emptiness, self-hate, and rage that you don't know how to cope with it. Some people engage in self-injuring activities like cutting to help themselves cope with these feelings. If you're like the majority of self-injurers, you keep your self-harm activities a secret and you feel you have no other choice. Maybe you tell yourself, "This is the last time," or "I can stop whenever I want," or "I'm in total control over this". But the truth is, each time you say those things, you do it again in an attempt to obtain the temporary relief it gives you.

In other words, it's a means of escape and possibly even provides a false feeling of deliverance from traumatic childhood experiences, such as sexual abuse or violence.

If you're interested in seeing actual self-injury pictures, there are several below. Self-mutilation photos may not be suitable for certain vulnerable individuals. Please consider this before viewing them.

As these self-harm pictures and photos indicate, there are many ways to self-harm. Where do self-injurers come up with some of these ideas? Sometimes from pro self-injury websites or they are "inspired" by movies about self-injury or celebrities who self-harm.

article references