Men’s Health:

A Guide to Preventing Infections

Men’s Health:

A Guide to Preventing Infections

Infection: Don’t Pass It On (IDPIO)

Infection: Don’t Pass It On Campaign

VHA National Center for Health Promotion and Disease Prevention

Veterans Health Administration

Campaign Contributing Team

National Center for Health Promotion and 

Disease Prevention (lead office)

Occupational Health Services

Patient Care Services

Women Veterans Health Services

Employee Education System

National Infectious Diseases Service

Office of Nursing Services

VA National Center for Patient Safety

Facility Health Care Professionals

Veterans Health Administration i

Men’s Health: A Guide to Preventing Infections

Introduction

We all want to stay healthy. And, we all want our friends and loved ones to be healthy too. Preventing infection is a 

good start. The first step is knowing how infections are spread. The second is learning how to prevent infection.

The VHA National Center for Health Promotion and Disease Prevention along with the Infection: Don’t Pass It 

On Campaign are pleased to provide Men’s Health: A Guide to Preventing Infections. This guide provides an 

overview of infections ranging from the common cold to sexually transmitted infections. This information has been 

customized to address the health concerns and issues specific to men. I hope you will use this guide to learn how 

to reduce your risk of getting sick, which will also help stop the spread of illness to those around you.
ii www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Each section has information on:

◗ How the infection is spread.

◗ What the signs of infection are.

◗ How the infection is treated.

◗ How to avoid infection.

◗ What you should do if you are infected.

◗ Links to more online information. 

If you have specific concerns or think you have an 

infection, talk with your health care provider. He or 

she will be able to advise you on tests and treatments 

and develop a plan to keep you healthy and free from 

infection.

Remember that we all play a role in stopping the 

spread of infection. I hope this guide is a useful 

resource on infections and how you can take steps

to prevent them. 

Jane Kim, MD, MPH

Chief Consultant for Preventive Medicine

VA National Center for Health Promotion

and Disease Prevention
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Men’s Health: A Guide to Preventing Infections

Acknowledgements

This book would not be possible without the commitment and determination of the Infection: Don’t Pass It On

(IDPIO) campaign members. Special acknowledgement goes to Jim Schneider, Mick Gillis, and Jonna Brenton. 

From concept, they have worked months to collect and assemble the content and organize it into this guide – 

while maintaining care and services to Veterans.
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Men’s Health: A Guide to Preventing Infections

My sincere thanks goes to other members of IDPIO whose edits have diversified and strengthened the 

educational value of the guide. Special recognition goes to these and other colleagues within the Veterans Health 

Administration who made contributions, small and large alike, and supported development of this guide and made 

it a reality.

◗ Lorraine Bem, EdD, MSHA, MSN, FACHE; National Project Manager/ANCC Nurse Planner, Birmingham Employee 

Education Resource Center

◗ Jonna Brenton, RN, MN, CNL; Women Veteran Program Manager, VA Montana Health Care System

◗ Maggie Chartier, PysD, MPH; Deputy Director; HIV, Hepatitis and Related Conditions; Office of Specialty Care 

Services, VA Central Office

◗ Marla Clifton, RN, MSN, CIC; Clinical Programs Coordinator, National Infectious Diseases Service, VA

Central Office

◗ Kathleen De Roos, APRN, MSN, CIC; Clinical Programs Coordinator, Healthcare Associated Infections (HAI), 

National Infectious Diseases Service, VA Central Office

◗ Cynthia L Gibert, MD, MSc, Professor of Medicine, George Washington University Medical Center, Director of 

Special Projects Medical Service, Washington DC VA Medical Center

◗ Mary “Micki” Gillis, RN, MSN, CIC; Infection Control Coordinator, Boise VA Medical Center

◗ John Goldizen, MSN, RN, CCRN; VHA-CM, Deputy Associate Director, Nursing and Patient Care Services, 

Charleston VA Medical Center

◗ Pamela Hirsch, NP-C, BS, MEd, MS; Director of Employee Occupational Health, Occupational Health Services; 

VA Central Office

◗ Jane Kim, MD; Chief Consultant for Preventive Medicine; VHA National Center for Health Promotion and Disease

Prevention; VA Central Office

◗ Stephen M. Kralovic, MD, MPH, Hospital Epidemiologist, Cincinnati VA Medical Center and Medical 

Epidemiologist, National Infectious Diseases Service, VA Central Office

◗ Darren R. Linkin, MD, MSCE; Hospital Epidemiologist, Philadelphia VA Medical Center, Assistant Professor, 

University of Pennsylvania (lead clinical advisor)

◗ Vicki Macks, RN, BSN, CIC; MDRO Prevention Coordinator, Memphis VA Medical Center

◗ Scott E. Mambourg, PharmD, BCPS, AAHIVP; Associate Chief, Clinical Pharmacy and Education Programs, Sierra 

Nevada Health Care System

◗ Lorenzo McFarland, DHA, MPH, MSW, PMP; Senior Program Manager; HIV, Hepatitis and Related Conditions; 

Office of Specialty Care Services

◗ Dore Mobley, Communications Specialist, Patient Care Services; VA Central Office

◗ Kristin L. Nichol, MD, MPH, MBA, Chief of Medicine and Director; Primary and Subspecialty Medicine Service 

Line, Minneapolis VA Healthcare System
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Men’s Health: A Guide to Preventing Infections

◗ Jacqueline Parker, RN, MS, MPH; Patient Safety Officer, VISN3–NY/NJ HCS

◗ Eli Perencevich, MD, MS, Director, Center for Comprehensive Access and Delivery Research & Evaluation 

(CADRE), VA Iowa City Health Care System

◗ Kathleen Pittman, RN, MPH; National Program Manager for HPDP Programs; VHA National Center for Health 

Promotion and Disease Prevention; VA Central Office

◗ Sherri Pruett, RN, BSN; Occupational Health Services, Salisbury VA Medical Center

◗ Heather Reisinger, Ph.D., Associate Director for Research, Center for Comprehensive Access and Delivery 

Research & Evaluation (CADRE), VA Iowa City Health Care System

◗ Amy Sanchez, MD; Preventive Medicine Resident; VHA National Center for Health Promotion and Disease 

Prevention; VA Central Office

◗ Alex (Jim) Schneider, PharmD; Pharmacoeconomist, VA Nebraska Western Iowa HCS

◗ Jay Shiffler, Communication Specialist; VHA National Center for Health Promotion and Disease Prevention; VA 

Central Office

◗ Cynthia Wilson, RN; Cardiac Cath/Electrophysiology Lab Manager, Palo Alto VA Medical Center

Troy Knighton, LPC, EdS, MEd

National Seasonal Flu & IDPIO Program Manager

VHA National Center for Health Promotion & Disease Prevention (NCP)

VA Central Office

810 Vermont Ave, NW | Washington, DC 20240

Infection: Don’t Pass It On

Infection: Don’t Pass It On (IDPIO) is an ongoing public health campaign to involve VA staff, Veterans, 

their families and visitors in preventing the transmission of infection. The campaign develops and 

distributes education and communication materials for the VA community that promote:

◗ Hand hygiene and respiratory etiquette.

◗ Annual seasonal influenza vaccination.

◗ Correct and appropriate use of personal protective equipment.

◗ Pandemic influenza preparedness and response.

◗ Basic public health measures to prevent transmission of infection.

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Men’s Health: A Guide to Preventing Infections

Contents

Sexually Transmitted Diseases (STDs). . . . . . . . .3

l Chlamydia . . . . . . . . . . . . . . . . . . . . . 7

l Genital Herpes. . . . . . . . . . . . . . . . . . . 11

l Genital Warts. . . . . . . . . . . . . . . . . . . . 15

l Gonorrhea . . . . . . . . . . . . . . . . . . . . 19

l Human Immunodeficiency Virus (HIV) . . . . . 23

l Human Papillomavirus (HPV) . . . . . . . . . . 29

l Syphilis. . . . . . . . . . . . . . . . . . . . . . .33

l Trichomoniasis. . . . . . . . . . . . . . . . . . . 37

Hepatitis . . . . . . . . . . . . . . . . . . . . . . . 39

l Hepatitis A. . . . . . . . . . . . . . . . . . . . . 41

l Hepatitis B. . . . . . . . . . . . . . . . . . . . .45

l Hepatitis C. . . . . . . . . . . . . . . . . . . . . 51

Genital Yeast Infections. . . . . . . . . . . . . . . .57

Urinary Tract Infections (UTIs) . . . . . . . . . . . 59

Epididymitis . . . . . . . . . . . . . . . . . . . . . 63

Shingles . . . . . . . . . . . . . . . . . . . . . . . 67

Safer Sex. . . . . . . . . . . . . . . . . . . . . . . . 71

Colds. . . . . . . . . . . . . . . . . . . . . . . . . .75

Influenza (Flu) . . . . . . . . . . . . . . . . . . . . 79

Pneumonia. . . . . . . . . . . . . . . . . . . . . . .83

Vaccines . . . . . . . . . . . . . . . . . . . . . . . 87

Food and Water Safety. . . . . . . . . . . . . . . . 91

Clean Hands. . . . . . . . . . . . . . . . . . . . . .99

Contact Lens Safety. . . . . . . . . . . . . . . . . 103

Definition of Terms . . . . . . . . . . . . . . . . . 107

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Men’s Health: A Guide to Preventing Infections

Sexually Transmitted 

Diseases (STDs)

Sexually transmitted diseases (STDs) are infections 

spread by sexual contact with someone who is 

infected. STDs, or sexually transmitted infections 

(STIs), are caused by bacteria, parasites, or viruses.

There are about 20 million new STD infections each 

year in the United States. There are 20 types of 

infections spread by sexual contact. These often show 

different signs of infection or no signs at all. You can 

have an STD and not know it.

Bacterial STDs can be treated and cured with 

antibiotics. These include:

◗ Chlamydia.

◗ Gonorrhea.

◗ Syphilis. 

Viral STDs that can be managed with treatment. 

These include:

◗ Hepatitis.

◗ Herpes.

◗ HIV.

◗ HPV.

The only way to know if you have an STD 

is by a medical exam and testing from 

your health care provider.
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Men’s Health: A Guide to Preventing Infections

How do you know if you have an STD?

Your health care provider (HCP) can examine and test 

you for STDs. Some men are at a higher risk for getting 

STDs. They should have regular exams and testing. 

Higher risk men include those who:

◗ Have had a previous STD.

◗ Have new or multiple sexual partners.

◗ Men who have sex with men (MSM). 

◗ Use condoms only some of the time. 

◗ Have sex for drugs or money.

◗ Use needles for illegal drugs.

If you have an STD, tell current and 

recent sex partners of the infection

How can men avoid STDs?

◗ Avoid sexual contact.

l This includes vaginal, anal, oral sex, or genital touching.

l This is the only way to be absolutely sure of 

avoiding STDs.

◗ Have safer sex:

l Reduce the number of sexual partners.

l Always use condoms and use correctly.

l Have sex with only one partner who does not have 

sex with others and does not have an STD.

l Limit or stop drug and alcohol use before and 

during sex.

For more 

information, 

see Safer Sex

on page 71

The Role of Circumcision

What Is circumcision?

Male circumcision is the surgical removal of some or the 

entire foreskin covering the tip of the penis. Germs can 

grow under the foreskin and create hygiene problems.

Why do men get circumcised?

◗ Parents made the decision when they were an infant.

◗ Religious, social, or cultural reasons.

◗ Medical reasons (to prevent infections or fix tight foreskin).
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Men’s Health: A Guide to Preventing Infections

Benefits of circumcision

Research studies have shown that male circumcision 

lowers the risk of:

◗ Acquiring HIV, genital herpes, human papilloma virus 

and syphilis.

◗ Penile cancer over a lifetime.

◗ Cervical cancer in sex partners.

◗ Urinary tract infections in the first year of life.

Uncircumcised men can speak with their health care 

provider about:

◗ How circumcision may impact disease and infections.

◗ How circumcision may impact sexual sensitivity.

◗ Benefits and risks of the procedure.

◗ Who will perform the procedure.

Learn more:

Centers for Disease Control and Prevention (CDC):

STD Prevention Today

www.cdcnpin.org/scripts/std/prevent.asp

Condom Fact Sheet In Brief

www.cdc.gov/condomeffectiveness/brief.html

STD Fact Sheet for MSM

https://npin.cdc.gov/resource/cdc-fact-sheet-what-gay-bisexual-and-other-men-who-have-sex-menneed-know-about-sexually

HIV/AIDS & STDS

http://www.cdc.gov/std/hiv/default.htm

Circumcision

https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/mc-factsheet-508.pdf

HIV Risk Reduction: Male Circumcision

https://wwwn.cdc.gov/hivrisk/decreased_risk/male_circumcision.html

U.S. Department of Health and Human Services (HHS), Office on Women’s Health:

Sexually transmitted infections (STI) fact sheet

http://www.womenshealth.gov/mens-health/sexual-health-for-men/sexually-transmitted-infections.html

National Center for Health Promotion and Disease Prevention

http://www.prevention.va.gov/Healthy_Living/Be_Safe_Sexually_Transmitted_Infections.asp

American Academy of Pediatrics

https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/New-Benefits-Point-to-Greater-Benefitsof-Infant-Circumcision-But-Final-Say-is-Still-Up-to-parents-Says-AAP.aspx#sthash.eb9qeZJA.dpuf

http://pediatrics.aappublications.org/content/130/3/585

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Men’s Health: A Guide to Preventing Infections

Chlamydia

Chlamydia is an infection caused by bacteria. 

Chlamydia is the most common sexually transmitted 

disease (STD) in the U.S.

How is it spread?

Men get chlamydia through vaginal, oral, or anal sex (or 

sexual contact) with an infected partner.

What are signs of chlamydia in men?

There may be no signs or symptoms of infection. 

Symptoms may not appear until several weeks after 

exposure and can include: 

◗ Pain/burning with urination.

◗ Watery/mucus discharge from penis.

◗ Redness, swelling or itching at the tip of the penis.

◗ Hard to start urination.

◗ Blood in semen or urine.

◗ Discomfort during sex. 

◗ Rectal pain, bleeding, or discharge.

◗ Testicular pain, tenderness and swelling (less common).

See your health care provider to be 

tested if you have signs of chlamydia.
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Men’s Health: A Guide to Preventing Infections

How do you know if you have chlamydia?

The only way to know if you have chlamydia is by 

a medical exam. Many men with chlamydia do not 

have any signs of infection and routine testing is not 

recommended. Get tested if you:

◗ Have an oral, anal or vaginal sex partner who has 

been recently diagnosed with an STD.

◗ Are sexually active and have signs as listed above.

◗ Are having sex with someone who might be having 

sex with others.

How is it treated?

Chlamydia can be treated and cured with antibiotics. 

Always finish antibiotic treatment, even if signs of 

chlamydia go away. Do not have sex until after 

treatment and signs of it are gone. See your health 

care provider if your signs do not go away after 

treatment. 

People who have had chlamydia and have been 

treated may get infected again if they have sexual 

contact with a person infected with chlamydia.

What can happen if you have chlamydia 

for a long time?

◗ Swelling in the anus.

◗ Eye and joint redness and pain.

◗ Inflammation of the liver capsule resulting in right 

sided abdominal pain.

◗ More likely to get HIV from a partner who is infected 

with HIV.

If you have chlamydia:

◗ Always finish all antibiotic treatment.

◗ Do not have sex with someone who has chlamydia or 

has not finished treatment (to prevent re-infection).

◗ Tell current and recent sex partners of the infection so 

they can get checked. 

◗ Know that it can increase the risk of getting and 

spreading HIV.

Chlamydia trachomatis microscopy
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Men’s Health: A Guide to Preventing Infections

How can you avoid chlamydia?

◗ Avoid sexual contact.

◗ Have safer sex:

l Reduce the number of sexual partners.

l Condoms, when used correctly, can reduce the risk 

of getting chlamydia. Each time you have sex use a 

condom:

n During vaginal sex.

n During anal sex.

n During oral sex.

l Have sex with only one partner who does not have 

sex with others and does not have chlamydia.

For more 

information, 

see Safer Sex

on page 71

Learn more:

Veterans Health Library:

Chlamydia

http://www.veteranshealthlibrary.org/DiseasesConditions/InfectiousDiseases/142,85081_VA

Centers for Disease Control and Prevention (CDC): 

Chlamydia - CDC Fact Sheet

www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm

U.S. National Library of Medicine:

Chlamydia infections in men

http://www.nlm.nih.gov/medlineplus/ency/article/000659.htm

U.S. Preventive Services Task Force: 

Gonorrhea and Chlamydia: Screening, September 2014

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/

chlamydia-and-gonorrhea-screening#Pod2

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Men’s Health: A Guide to Preventing Infections

Genital Herpes

Genital herpes is a chronic, life-long, sexually 

transmitted disease caused by two herpes simplex 

viruses (HSV-1 and HSV-2).

◗ HSV-2 causes most genital herpes.

◗ HSV-1 can also cause genital herpes. More often it 

causes blisters of the mouth and lips (e.g., cold sores 

or fever blisters).

The U.S. Centers for Disease Control and Prevention 

(CDC) estimates that over 50 million persons, or about 

1 out of 6 people ages 14 to 49 in the U.S. have genital 

herpes. It occurs in about 1 in 8 men. Many people with 

herpes have no signs of infection and do not know 

they have it. They can still pass it to others.

Herpes is more easily 

spread from men to 

women than from women 

to men.

How is it spread?

The herpes virus is spread by skin-to-skin contact with 

a person who has it:

◗ Most often, from herpes sores or blisters. 

◗ Less often, from normal looking skin where the virus 

first entered the body.

◗ During vaginal, anal, or oral sexual contact, or skin-to-skin 

contact. This may happen even without visible sores. 

◗ The herpes virus gets into the body from:

l The lining of the mouth. 

l Regular skin that has small cracks or cuts.

Those who don’t know they have herpes 

can still spread the virus to others.
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Men’s Health: A Guide to Preventing Infections

Those with a weak immune system can get herpes 

infection more easily. A weak immune system is caused 

by some diseases (e.g., cancer, HIV/AIDS) and by some 

medicines used to treat serious diseases.

See your health care provider (HCP) to 

be tested if you have signs of herpes.

What are signs of genital herpes 

in men?

Men who have the herpes virus may have no outbreaks 

or signs of infection. Many do not know they have the 

virus. Once you are infected, the virus stays in your 

nerve cells for life. When the virus is not active, there is 

no sign of infection. When the virus becomes active, a 

herpes outbreak occurs. Some men may: 

◗ Not have any outbreaks.

◗ Have only one outbreak.

◗ Have multiple outbreaks.

First Outbreak

The first herpes outbreak often occurs within two weeks 

after sexual contact with an infected person. Sometimes 

the first outbreak will not occur until months or years 

after the first infection. The first signs may include:

◗ Itching, tingling, or burning feeling in the genital area.

◗ Flu-like symptoms, including fever.

◗ Swollen glands.

◗ Pain or tingling in the legs, buttocks, or anal area.

◗ Headache.

◗ A feeling of pressure in the area below the stomach.

After a few days, painful sores, blisters, or ulcers may 

appear where the virus entered the body. These areas 

include: 

◗ Genital or anal area.

◗ The mouth.

◗ In the urinary tract.

◗ On the buttocks or thighs.

◗ On other parts of your body where the virus has entered.

Other Outbreaks

After the first outbreak, you may have more outbreaks. 

For most, these occur less often over time. The signs of 

herpes infection are mostly milder than during the first 

outbreak, and they go away faster.

For those with a weak immune system, outbreaks can be 

severe and long-lasting.
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Men’s Health: A Guide to Preventing Infections

How do you know if you have genital 

herpes?

The only way to know if you have genital herpes is by a 

medical exam. Your HCP can examine you and test for 

it. Lab samples are taken from a sore, blister, or blood. 

Your HCP may ask to test you for other infections at the 

same time.

Tell past and current sex partners of your 

herpes infection.

How is it treated?

Genital herpes can be treated, but it cannot be cured. 

Antiviral drugs may be used during an outbreak to help 

to make it:

◗ Shorter.

◗ Less severe.

◗ Less frequent.

Antivirals can also be taken daily to reduce outbreaks.

Living with genital herpes causes some to: 

◗ Feel embarrassed or ashamed. 

◗ Worry about infecting a sexual partner.

◗ Worry that having herpes will affect relationships with 

sexual partners. 

◗ Avoid dating or sexual relationships. 

Most people with herpes are able to live with the virus 

and manage outbreaks. Talking to trusted HCPs and 

friends can help. Discuss treatment options with your 

HCP. Also talk about ways to reduce passing the virus

to others.

Drugs can help lower the 

chance that you will pass 

the virus to others.

During outbreaks of genital herpes,

you should:

◗ Keep the infected area clean and dry.

◗ Avoid touching the sores or blisters.

◗ Clean hands after contact with the infected area.

◗ Avoid skin-to-skin contact from the time you first 

notice signs of herpes until the sores have healed.

◗ Avoid sexual activity.

How can you avoid genital herpes?

Most men get genital herpes from sexual contact with 

a person who has herpes. You can get the virus without 

having sex. To avoid it:

◗ Do not have vaginal, oral, or anal sex.

◗ Avoid skin-to-skin and sexual contact.

◗ If you do have sex, practice safe sex:

l Reduce the number of sexual partners.

l Use condoms correctly. Condoms can reduce the 

risk of getting genital herpes. But, condoms may 

not cover all infected areas. Each time you have sex 

use a condom (male or female type):

n During vaginal sex.

n During anal sex.

n During oral sex.

l Have sex with 

only one partner 

who does not 

have sex with 

others and does 

not have herpes.

For more 

information, 

see Safer Sex

on page 71
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Men’s Health: A Guide to Preventing Infections

Learn more:

Veterans Health Library:

Herpes

http://www.veteranshealthlibrary.org/Encyclopedia/142,85089_VA

Department of Veterans Affairs (VA):

Herpes simplex virus

www.hiv.va.gov/patient/diagnosis/OI-herpes-simplex.asp

Centers for Disease Control and Prevention (CDC):

Genital Herpes - CDC Fact Sheet

www.cdc.gov/std/Herpes/STDFact-Herpes.htm

Sexually Transmitted Diseases Treatment Guidelines, 2015

http://www.cdc.gov/mmwr/pdf/rr/rr6403.pdf

National Institute of Allergy and Infectious Diseases (NIAID/NIH): 

Genital Herpes

www.niaid.nih.gov/topics/genitalherpes/pages/default.aspx

U.S. Department of Health and Human Services (HHS), Office on Women’s Health:

Genital herpes fact sheet

https://www.womenshealth.gov/publications/our-publications/fact-sheet/genital-herpes.html
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Men’s Health: A Guide to Preventing Infections

Genital Warts

Genital warts appear as a small bump or groups of 

bumps in the genital area. They can be small or large, 

raised or flat, or shaped like a cauliflower. They are 

caused by some types of human papilloma virus (HPV). 

These viruses may not cause warts in everyone.

How are they spread?

Men can get genital warts from sexual contact with 

someone who has HPV. Genital warts are spread by 

skin-to-skin contact, usually from contact with the 

warts. It can be spread by vaginal, anal, oral, or handgenital sexual contact. Genital warts will spread HPV 

while visible and after recent treatment. Long-term 

sexual partners usually have the same type of wartcausing HPV. 

What are signs of genital warts 

in men?

Genital warts can grow anywhere in the genital area:

◗ On the groin.

◗ Under the foreskin of the uncircumcised penis.

◗ On the shaft of the circumcised penis.

◗ In or around the anus.

◗ In the mouth or throat (rare).
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Men’s Health: A Guide to Preventing Infections

Genital warts:

◗ Can be any size – from so small they can’t be seen, to 

big clusters and lumps.

◗ Can be smooth with a “mosaic” pattern or bumpy like 

a cauliflower.

◗ Are soft, moist and flesh-colored.

◗ Can cause itching, burning or pain.

Not all HPV infections cause genital warts. HPV 

infections often do not have any signs that you can 

see or feel. Some HPV infections can be more serious, 

see HPV and Men, page 30. 

Even if you see no visible genital warts, 

you could still have HPV infection.

How is it treated?

See your health care provider (HCP) to discuss 

treatment. Even when genital warts are treated, the 

HPV infection may remain. Warts may also return after 

treatment. Over-the-counter treatments for other types 

of warts should not be used. Treatments include:

◗ Medicines (creams, ointments, solutions or gels) 

applied directly to the warts.

◗ Burning off the warts.

◗ Freezing off the warts.

◗ Cutting the warts out.

◗ Using special lights or lasers to destroy the warts.

Condoms may not fully protect 

against HPV since HPV can infect 

areas not covered by a condom.

What can happen if you have genital 

warts for a long time?

The immune system fights HPV infection. The types 

of HPV that cause genital warts do not cause cancer. 

Without any treatment, genital warts may:

◗ Go away.

◗ Remain unchanged.

◗ Increase in size or number.

If you have genital warts:

◗ Talk with your HCP about treatment.

◗ Know that you may never know when you got HPV

or who you got it from.

◗ Know that partners who have been together for a 

while can have the same HPV types, even if both 

have no signs.
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Men’s Health: A Guide to Preventing Infections

How can you avoid genital warts?

◗ Get the HPV vaccine.

l Certain types of HPV vaccines protect against the 

low-risk HPV that causes 90% of genital warts.

l HPV vaccine can be given to males aged 9 to 21 

years old.

l The Centers for Disease Control and Prevention 

(CDC) recommends all 11-12 year old males get the 

HPV vaccine (in 3 doses).

l Young men can get vaccinated through age 21.

l Men who have sex with men and men with 

compromised immune systems (including HIV) can 

be vaccinated through age 26.

◗ Avoid sexual contact.

◗ Have safer sex:

l Reduce the number of sexual partners.

l Condoms, when used correctly, can reduce the risk of 

getting HPV. But, condoms may not cover all infected 

areas. Each time you have sex use a condom:

n During vaginal sex.

n During anal sex.

n During oral sex.

l Have sex with 

only one partner 

who does not 

have sex with 

others and does 

not have HPV.

For more 

information, 

see Safer Sex

on page 71

Learn more:

Veterans Health Library:

http://www.veteranshealthlibrary.org/Encyclopedia/142,85095_VA

Centers for Disease Control and Prevention (CDC):

Human Papillomavirus (HPV)

www.cdc.gov/hpv/index.html

Genital HPV Infection - Fact Sheet

www.cdc.gov/std/HPV/STDFact-HPV.htm

HPV Vaccination

www.cdc.gov/vaccines/vpd-vac/hpv/default.htm

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6411a3.htm

Morbidity and Mortality Weekly Report (MMWR) — Human Papillomavirus Vaccination: 

Recommendations of the Advisory Committee on Immunization Practices

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6305a1.htm

Use of a 2-Dose Schedule for Human Papillomavirus Vaccination – Updated Recommendations of the 

Advisory Committee on Immunization Practices 

https://www.cdc.gov/mmwr/volumes/65/wr/mm6549a5.htm

National Institute of Allergy and Infectious Diseases (NIAID/NIH):

Human Papillomavirus (HPV) and Genital Warts

https://www.niaid.nih.gov/diseases-conditions/std-research

U.S. Department of Health and Human Services (HHS), Office on Women’s Health:

Human papillomavirus (HPV) and genital warts fact sheet

https://www.womenshealth.gov/files/assets/docs/fact-sheets/genital-warts-factsheet.pdf
18 www.publichealth.va.gov/InfectionDontPassItOn
Veterans Health Administration 19

Men’s Health: A Guide to Preventing Infections

Gonorrhea

Gonorrhea is an infection spread by bacteria. Also 

known as “the clap” or “the drip”, it affects both 

women and men. Men can get it in moist, warm areas 

such as the urethra, anus, mouth, throat, and eyes.

How is it spread?

Men get gonorrhea from sexual contact with someone 

who is infected. Anyone who has gonorrhea can 

spread it to others. Gonorrhea can be spread through 

oral, vaginal, and anal contact between:

◗ Men and women.

◗ Men and men.

Men can get or spread HIV more easily if 

they have gonorrhea.

What are signs of gonorrhea in men?

Some women and men can have gonorrhea without 

any signs. For men, signs include:

◗ Painful or burning urination.

◗ White, yellow or green discharge from penis.

◗ Testicular/scrotal pain.

◗ Anal discharge, pain/itching, bleeding or painful 

bowel movements.

◗ Fever, abdominal pain, rashes, and swelling or pain in 

joints over time.

◗ Sore throat.

◗ Red or itchy eyes.

◗ Eye discharge.

See your HCP to be 

tested if you have 

signs of gonorrhea.
20 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Get tested for gonorrhea if your sex 

partner has it.

How do you know if you have gonorrhea?

The only way to know if you have gonorrhea is by a 

medical exam. Your health care provider (HCP) can 

examine you and test for it. Lab samples may be taken 

from the bladder, bowels, throat, urine, or eyes. Your 

HCP may ask to test you for other infections at the same 

time. See your HCP to be tested for gonorrhea if you: 

◗ Have any sign of gonorrhea.

◗ Have new or multiple sex partners.

◗ Do not practice safe sex.

◗ Are having sex with someone who might be having 

sex with others.

◗ Are having sex with a partner who has a sexually 

transmitted disease (STD).

◗ Are exchanging sex for money or drugs.

How is it treated?

Gonorrhea can be treated and cured with antibiotics. 

Always finish antibiotic treatment, even if signs of 

gonorrhea go away. Do not have sex until after 

treatment and signs of it are gone. See your HCP if your 

signs do not go away after treatment.

What can happen if you have it for a long 

time?

Gonorrhea can lead to swelling in the testes but rarely 

results in infertility.

If you have gonorrhea:

◗ Always finish all antibiotic treatment.

◗ Wait seven days after finishing treatment before 

having sex.

◗ Do not have sex with someone who has gonorrhea or 

has not finished treatment (to prevent re-infection).

◗ Tell current and recent sex partners of the infection so 

they can get checked.

◗ Know that it can raise the risk of getting and spreading 

HIV.

◗ People with gonorrhea should be tested for other STDs.

Tell current and 

recent sex partners 

of the infection.
Veterans Health Administration 21

Men’s Health: A Guide to Preventing Infections

How can you avoid gonorrhea?

◗ Avoid sexual contact.

◗ Have safer sex:

l Reduce the number of sexual partners.

l Condoms, when used correctly, can reduce the risk

of getting gonorrhea. Each time you have sex use a 

condom (male or female type):

n During vaginal sex.

n During anal sex.

n During oral sex.

l Have sex with only one partner who does not have 

sex with others and does not have gonorrhea.

For more 

information, 

see Safer Sex

on page 71

Learn more:

Veterans Health Library:

http://www.veteranshealthlibrary.org/Encyclopedia/142,85087_VA

Centers for Disease Control and Prevention (CDC):

Gonorrhea - CDC Fact Sheet

www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm 

National Institute of Allergy and Infectious Diseases (NIAID/NIH):

Gonorrhea

www.niaid.nih.gov/topics/gonorrhea/Pages/default.aspx

U.S. National Library of Medicine:

Gonorrhea

www.nlm.nih.gov/medlineplus/gonorrhea.html

Veterans Health Administration 23

Men’s Health: A Guide to Preventing Infections

Human Immunodeficiency 

Virus (HIV)

HIV stands for human immunodeficiency virus. HIV is 

a virus that attacks and weakens the immune system. 

The immune system is the body’s defense against 

infections.

If you are infected with HIV, you are said to be “HIVpositive.” Over time as HIV weakens your immune 

system, you are more likely to get other infections. 

The late stage of HIV infection is known as Acquired 

Immune Deficiency Syndrome (AIDS). With medicines, 

the virus can be controlled so AIDS may not occur.

HIV is NOT

spread by:

◗ Tears

◗ Sweat

◗ Feces

◗ Urine

◗ Saliva

How is it spread?

Each year in the U.S. about 50,000 people get 

infected with HIV. More than 1.2 million people in the 

U.S. are living with HIV infection and approximately 

13% are not aware they are infected. Men account for 

76% of all adults and adolescents living with HIV. The 

HIV virus is found only in certain body fluids: 

◗ Blood.

◗ Vaginal fluid. 

◗ Semen. 

◗ Breast milk.
24 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

You can’t tell if a person is HIV infected 

by looking at them.

Contact with infected body fluids can spread HIV by:

◗ Sexual contact.

l Vaginal and anal sex.

l Sharing unclean sex toys.

l Oral sex, very rarely.

l Body fluids with HIV can enter tiny breaks or rips in 

the linings of the rectum or mouth. Rips and tears 

may not be seen or felt.

◗ Needle sharing:

l Used or unclean needles.

l During illegal drug use.

◗ Breast feeding:

l HIV can be spread to babies and others who drink 

breast milk from a woman who is HIV positive.

◗ Pregnancy and birth:

l HIV-positive women can spread the virus to their 

babies during pregnancy and birth. 

HIV is rarely spread from a blood transfusion because:

◗ All donated blood is tested for HIV.

◗ There is no risk of getting HIV when donating blood.

What are signs of HIV?

Most people with HIV will not show signs of HIV until 

years after getting the virus. Those who have been 

infected with HIV may have: 

◗ Fever. 

◗ Chills. 

◗ Night sweats. 

◗ Headache. 

◗ Sore throat. 

◗ Swollen lymph nodes, mainly on the neck. 

◗ Tiredness. 

◗ Rash. 

◗ Sores or infections in the mouth. 

◗ Body aches.

How do you know if you have HIV?

The only way to know you have HIV is by getting an 

HIV test. Routine HIV testing is recommended for all 

adults. HIV tests are offered by health care providers 

(HCP) in doctor’s offices, hospitals, local public health 

departments, and in local clinics. Most HIV tests use 

either blood or saliva. HIV tests are very accurate but 

may not show HIV from a recent infection. Always 

discuss your test result and retesting with your test 

provider.

VA offers HIV testing and treatment to 

all enrolled Veterans.
Veterans Health Administration 25

Men’s Health: A Guide to Preventing Infections

How is it treated?

There is no cure for HIV. But there are medicines 

to help your body fight HIV. Your HCP can help you 

choose which to take and when to start. Treatment is 

lifelong. It can: 

◗ Reduce the amount of virus in your body. 

◗ Reduce the spread of HIV to others.

◗ Help most people with HIV live longer and 

healthier lives. 

The sooner you know if you have HIV, 

the sooner your HCP can know when 

you will need treatment.

What can happen if you have HIV for a 

long time?

If HIV is not diagnosed and treated, it can progress 

into AIDS. AIDS stands for acquired immunodeficiency 

syndrome. AIDS is the late stage of HIV infection. When 

you have AIDS, the virus has greatly weakened your 

immune system. If HIV is not treated, other infections 

can occur that can be life threatening. The only way to 

know if you have AIDS is through a medical exam and 

testing by your HCP. Signs of AIDS are:

◗ Rapid weight loss. 

◗ Fevers. 

◗ Night sweats. 

◗ Extreme tiredness. 

◗ Swelling of the lymph nodes in the armpits, groin, or 

neck which doesn’t go away. 

◗ Diarrhea that lasts for more than a week. 

◗ Sores of the mouth, anus, or genitals. 

◗ Infections such as pneumonia, tuberculosis, and 

certain cancers. 

◗ Red, brown, pink, or purplish blotches on or under the 

skin or inside the mouth, nose, or eyelids. 

◗ Depression. 

◗ Memory loss and other brain or nerve problems.

If you have HIV:

◗ See a HCP regularly.

◗ Take medicines as prescribed.

◗ Tell current and recent sex partners that you have HIV.

◗ Avoid spreading HIV to others by:

l Using condoms during all sexual contact.

l Not sharing used or unclean needles and sex toys.
26 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

How can you avoid HIV?

The best ways to avoid HIV are:

◗ Not having sexual contact.

◗ Using condoms during all sexual contact.

◗ Not using or injecting illegal drugs. If you do, use a 

new sterile needle and drug equipment each time to 

prep and inject drugs.

Other ways to avoid HIV are:

◗ Having less sex partners.

◗ Have sex with only one partner:

l Who does not have HIV.

l Who does not have sex with others.

For more 

information, 

see Safer Sex

on page 71

◗ Not reusing or sharing needles or drug equipment 

(works).

◗ If unused (new) needles and sterile works are not used:

l Boil in water, or 

l Clean with bleach water and rinse with water before 

each use.

Ask your sex partners to test for HIV and 

other STDs

Pre-Exposure Prophylaxis (PrEP) 

◗ PrEP is medicine taken daily. When used with safer sex practices it prevents HIV infection.

◗ Truvada® is the pill that is used for PrEP. It is more than 90% effective if taken as prescribed.

◗ Discuss PrEP with your health care provider if you:

l Are sexually active.

l Are an injection drug user.

l Have one or more of these risk factors for HIV:

n Inconsistent condom use.

n High number of sex partners.

n HIV-positive sex partner.

n A recent STD, such as gonorrhea, chlamydia, or syphilis.

n An HIV-positive injecting partner.

n Sharing of injection equipment.

n Commercial sex work.
Veterans Health Administration 27

Men’s Health: A Guide to Preventing Infections

Learn more:

Veterans Health Library:

http://www.veteranshealthlibrary.org/Encyclopedia/142,82145_VA

Department of Veterans Affairs (VA):

VA National HIV/AIDS Website; for Veterans and the Public

www.hiv.va.gov/patient/

U.S. Department of Health and Human Services (HHS):

HIV/AIDS Basics

www.aids.gov/hiv-aids-basics/

Centers for Disease Control and Prevention (CDC):

HIV Among Men in the United States

https://www.cdc.gov/hiv/group/gender/men/index.html

HIV/AIDS Basics

https://www.cdc.gov/hiv/basics/index.html

Oral Sex and HIV Risk

https://www.cdc.gov/hiv/risk/oralsex.html

HIV Transmission

https://www.cdc.gov/hiv/basics/transmission.html

National Institute of Allergy and Infectious Diseases (NIAID/NIH):

What are HIV and AIDS?

www.niaid.nih.gov/topics/HIVAIDS/Understanding/Pages/whatAreHIVAIDS.aspx

Office on Women’s Health, U.S. Department of Health and Human Services:

https://www.womenshealth.gov/mens-health/top-health-concerns-for-men/hiv-aids.html

Veterans Health Administration 29

Men’s Health: A Guide to Preventing Infections

Human Papillomavirus 

(HPV)

Human papilloma virus or HPV is the most common 

sexually transmitted disease (STD) in the United 

States. About 79 million Americans have HPV. The 

Centers for Disease Control and Prevention (CDC) 

says one in two sexually active people will have HPV 

at some point in their life.

There are over 100 known types of HPV.

About 40 types can infect female and male genital areas.

Genital HPV is grouped into two types:

◗ Low-risk types can cause genital warts or may

be harmless. 

◗ High-risk types can raise the chances for cancer of 

the penis and anus.

Most sexually active men and women get 

genital HPV at some time in their lives.

How is it spread?

HPV is spread by skin-to-skin contact. Men get HPV 

from sexual contact with someone who has it. HPV 

can be spread by vaginal, anal, oral or hand-genital 

sexual contact. Some may have no signs of HPV but 

can still spread it to others. People can have more 

than one type of HPV. Long-term sex partners with 

HPV often have the same HPV types.

Risk of having HPV rise if you:

◗ Have been sexually active at an earlier age.

◗ Have multiple sex partners.

◗ Smoke.

◗ Have a weak immune system due to:

l A medical condition (cancer or HIV).

l Medicines.
30 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

What are signs of HPV in men?

If you have HPV, you may not be able to see or feel it. You 

can have HPV even if years since your last sexual contact 

with an infected person. You may never know which sex 

partner gave you HPV. HPV infection may cause:

◗ Genital warts (low-risk HPV).

l See Genital Warts (page 17) for more information.

◗ Cancer (high-risk HPV).

l Cancer of the penis (more common).

l Cancers of the anus, throat, tongue or tonsils

(less common).

How do you know if you have HPV?

Most men with HPV have no signs or signs go away 

on their own. Right now, there is no approved test 

for HPV in men. Testing before having signs is not 

recommended. Some providers may offer anal 

Papanicolaou or “PAP” tests to men who are at high 

risk for anal cancer (men with HIV or those who receive 

anal sex).

How is it treated?

Genital HPV infections are very common but:

◗ Most show no signs.

◗ Most go away with no treatment within a few years.

If HPV does not go away, treatments are not the same 

for low risk HPV and high-risk HPV:

◗ Low-Risk HPV (Genital warts) – Even when treated, 

virus may remain. Warts can also come back after 

treatment. Over-the-counter medicines for other types 

of warts should not be used. Treatments include: 

l Watch and wait to see if the warts stay the same, 

get bigger, or go away.

l Medicines put on the warts.

l Burning off the warts.

l Freezing off the warts.

l Cutting the warts out.

l Using special lights or lasers to destroy the warts.

◗ High-Risk HPV – cancers from HPV are more 

treatable if found and treated promptly.

What can happen if you have HPV for a 

long time?

Some types of low-risk HPV can cause genital warts. If 

not treated, genital warts may:

◗ Go away.

◗ Remain unchanged.

◗ Increase in size or number.

See Genital Warts (page 17) for more information.

High-risk HPV can cause cancer. See your provider 

if you have strange growths, lumps or sores on your 

penis, scrotum, anus, mouth, or throat.

If you have HPV:

◗ Talk to your health care provider (HCP).

◗ Know that long time sex partners often share the 

same HPV types, even if both have no signs.
Veterans Health Administration 31

Men’s Health: A Guide to Preventing Infections

How can you avoid HPV?

◗ Get the vaccine for HPV.

l One type of HPV vaccine can protect against the 

low-risk HPV that causes 90% of genital warts.

l It is for all males 11 or 12 years old – up to 26 years 

of age for men with weak immune systems and 

men who have sex with men.

l The Centers for Disease Control and Prevention 

(CDC) recommends all 11-12 year old girls and boys 

get the HPV vaccine.

◗ Avoid sexual contact.

◗ Have safer sex:

l Reduce the number of sexual partners.

l Condoms, when used correctly, can reduce the 

risk of getting HPV. But, condoms may not cover 

all infected areas. Each time you have sex use a 

condom (male or female type):

n During vaginal sex.

n During anal sex.

n During oral sex.

◗ Have sex with only one partner who does not have 

sex with others and does not have HPV.

Condoms may not fully protect against 

HPV since HPV can infect areas not 

covered by a condom.

For more 

information, 

see Safer Sex

on page 71

Learn more:

Veterans Health Library:

HPV and Genital Warts: Understanding Your Diagnosis

http://www.veteranshealthlibrary.org/Encyclopedia/142,87539_VA

Centers for Disease Control and Prevention (CDC):

HPV and Genital Warts: Understanding Your Diagnosis

HPV and Men – Fact Sheet

Genital HPV Infection - Fact Sheet

www.cdc.gov/std/HPV/STDFact-HPV.htm

HPV Vaccination

www.cdc.gov/vaccines/vpd-vac/hpv/default.htm

National Cancer Institute (NCI/NIH):

Vaccine Reduces HPV Infections in Young Men

http://www.cancer.gov/types/anal/research/quad-hpv-vaccine-men

Veterans Health Administration 33

Men’s Health: A Guide to Preventing Infections

Syphilis

Syphilis is a sexually transmitted disease (STD) caused 

by bacteria.

How is it spread?

Men get syphilis from sexual contact with someone 

who has it. Anyone with syphilis can spread it to others. 

Those who have it may not show signs or know they 

have it. Syphilis can be spread by contact with a 

syphilis sore which occurs on external genitals, vagina, 

anus, or in the rectum. Syphilis can be spread between: 

◗ Men and women.

◗ Men and men.

What are signs of syphilis in men?

There are four stages of syphilis. Each is defined by how 

long the person has had it. Signs vary in each stage.

1. Primary Stage: The first sign of syphilis is often a 

small, round, firm sore. These appear at the place 

where it entered the body such as the penis, tongue, 

or lips. Most do not cause pain. There can also be 

more than one sore. Signs often go away in about 3 

to 6 weeks even without treatment. If not treated in 

this stage, it will progress into the other stages.
34 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

2. Secondary Stage: This stage can start with a rash 

over one or more areas of the body. These appear 

mostly on the palms of the hands and the bottoms of 

the feet. Other signs may be:

l Sores in the mouth or anus.

l Sore throat.

l Swollen glands.

l Large, raised gray/white lesions in mouth, 

underarm, or groin area.

l Fever.

l Hair loss in patches.

l Head and muscle aches.

l Weight loss. 

l Tiredness.

If not treated in this stage, signs will still go away. 

However, the syphilis bacteria are still in the body. 

The infection will progress into the latent stage.

3. Latent Stage: This stage is also called the hidden 

stage. It can last many years. Syphilis remains in the 

body with no signs of infection. Without treatment, 

syphilis can pass to the Late Stage. This can take 10 

to 20 years.

4. Late Stage: Syphilis in this stage can cause: 

l Numbness.

l Problems with blood vessels.

l Damage to bones and joints.

l Difficulty walking. 

l Blindness.

l Paralysis.

l Brain damage.

l Dementia.

l Heart disease.

l Death.

Syphilis Bacterium

How do you know if you have syphilis?

Your health care provider (HCP) can examine and test 

you for syphilis. Blood or fluid from a sore can be tested.

How is it treated? 

Syphilis can be cured with antibiotics in all stages of 

the disease. Always finish treatment. Do not have sex 

until after treatment and signs of it are gone. See your 

HCP if your signs do not go away after treatment. Some 

damage to your body caused by the disease may 

remain. 

If you have syphilis:

◗ Always finish all antibiotic treatment.

◗ Do not have sex with someone who has syphilis or 

has not finished treatment (to prevent re-infection).

◗ Tell current and recent sex partners of the infection so 

they can get checked. 

◗ Know that it can raise the risk of getting and 

spreading HIV.

◗ Get tested again after 6 and 12 months. Only a 

HCP can tell you when you no longer have it.
Veterans Health Administration 35

Men’s Health: A Guide to Preventing Infections

How can you avoid syphilis?

◗ Avoid sexual contact.

◗ Have safer sex:

l Reduce the number of sexual partners.

l Condoms, when used correctly, can reduce the 

risk of getting syphilis. Each time you have sex 

use a condom (male or female type):

n During vaginal sex.

n During anal sex.

n During oral sex.

l Have sex with only one partner who does not 

have sex with others and does not have syphilis.

◗ Know that other forms of birth control do not protect 

against syphilis.

For more 

information, 

see Safer Sex

on page 71

Learn more:

Veterans Health Library:

Syphilis

http://www.veteranshealthlibrary.org/Encyclopedia/142,85083_VA

Centers for Disease Control and Prevention (CDC):

Syphilis - CDC Fact Sheet

www.cdc.gov/std/Syphilis/STDFact-syphilis.htm

National Institute of Allergy and Infectious Diseases (NIAID/NIH):

Syphilis

www.niaid.nih.gov/topics/syphilis/Pages/default.aspx

U.S. Department of Health and Human Services (HHS), Office on Women’s Health:

Men’s Health: Sexually Transmitted Infections (STIs)

http://www.womenshealth.gov/mens-health/sexual-health-for-men/sexually-transmitted-infections.html

Veterans Health Administration 37

Men’s Health: A Guide to Preventing Infections

Trichomoniasis

Trichomoniasis is an infection caused by a tiny 

parasite. It affects both men and women. It is also 

known as “trich”.

How is it spread? 

Men get trichomoniasis from sexual contact. Anyone 

who has it can spread it to others. It can be spread 

between:

◗ Men and women.

◗ Men and men.

What are signs in men?

Most men show no signs of “trich”. Others have signs 

that include:

◗ Itching and irritation inside the penis.

◗ Burning after urination or ejaculation.

◗ Discharge from penis.

◗ Painful intercourse.

Most infected men have no signs of 

trichomoniasis. Even so, “trich” can still 

be spread.
38 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

How do you know if you have “trich”?

The only way to know if you have “trich” is by a medical 

exam. Your health care provider (HCP) can take a 

sample for testing. Your HCP may also ask to test for 

other infections at the same time. 

How is it treated? 

“Trich” can be treated and cured with prescribed 

medicines that kill the parasite. Always finish treatment. 

See your HCP if your signs do not go away after 

treatment.

If you have trichomoniasis:

◗ Always finish treatment.

◗ Do not have sex with someone who has “trich” or has 

not finished treatment (to prevent re-infection).

◗ Tell current and recent sex partners of the infection so 

they can get checked.

How can you avoid “trich”?

◗ Avoid sexual contact.

◗ Have safer sex:

l Reduce the number of sexual partners.

l Condoms, when used correctly, can reduce the 

risk of getting trichomoniasis. Each time you have 

sex use a condom (male or female type):

n During vaginal sex.

n During anal sex.

n During oral sex.

l Have sex with only one partner who does 

not have sex with others and does not have 

trichomoniasis.

For more 

information, 

see Safer Sex

on page 71

Learn more:

Centers for Disease Control and Prevention (CDC): 

Trichomoniasis - CDC Fact Sheet

www.cdc.gov/std/trichomonas/STDFact-Trichomoniasis.htm
Veterans Health Administration 39

Men’s Health: A Guide to Preventing Infections

Hepatitis

Hepatitis means that the liver is inflamed. This can 

be caused by germs, viruses, some medicines, some 

diseases, or heavy alcohol use.

Three common types are caused

by viruses: 

◗ Hepatitis A virus causes hepatitis A.

◗ Hepatitis B virus causes hepatitis B. 

◗ Hepatitis C virus causes hepatitis C.

These three can be acute. Hepatitis B and C can 

become chronic.

Acute viral hepatitis:

◗ Is caused by hepatitis A, B, and C viruses. 

◗ Usually occurs within a few weeks after you have

the virus. 

◗ Can be mild, severe or even life-threatening.

◗ Hepatitis B or C may lead to long-term (chronic) infection.

Chronic hepatitis B and C are serious 

health problems.
40 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Chronic viral hepatitis: 

◗ May be lifelong.

◗ Can cause liver damage, cirrhosis (scarring of the 

liver), and liver cancer.

◗ Often is caused only by hepatitis B and C viruses.

There are safe and effective vaccines for 

hepatitis A and B.

What are the signs of hepatitis?

You may not have any sign of hepatitis. Or, you may 

have:

◗ Yellow skin or eyes (jaundice).

◗ Tiredness.

◗ Fever.

◗ Nausea. 

◗ Vomiting.

◗ Loss of appetite.

◗ Stomach pain.

◗ Light stools.

◗ Dark urine.
Veterans Health Administration 41

Men’s Health: A Guide to Preventing Infections

Hepatitis A

Hepatitis A is a disease of the liver caused by hepatitis 

A virus. It may make you sick for a few weeks to a few 

months. Most recover with no lasting liver damage. 

How is it spread?

Hepatitis A is spread by contact with the hepatitis A 

virus. This includes:

◗ Contact with any person infected with the hepatitis A 

virus.

◗ Oral-anal sexual contact with an infected person.

◗ Touching contaminated surfaces and then placing your 

hands near or in your mouth.

◗ Sharing forks, spoons, knives, and other utensils that 

have virus on them.

Those with hepatitis A can spread it to 

others a few weeks before they begin to 

feel bad.

◗ Eating food or drinking water that has been 

contaminated by feces that contain the virus. These 

can include: 

l Fruits.

l Vegetables.

l Shellfish.

l Ice.

l Water.

In the United States, chlorine in water kills hepatitis 

A virus. But infected food workers can still spread 

it directly to food. This occurs when hands are not 

washed or cleaned and food is handled.
42 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Who is at risk of hepatitis A?

In the U.S., you are at a higher risk if you:

◗ Have not been vaccinated for hepatitis A.

◗ Use illegal drugs, whether injected or not.

◗ Live with someone who has hepatitis A.

◗ Have bleeding problems and take certain medicines 

for blood clotting.

◗ Have oral-anal sexual contact with someone who has 

hepatitis A.

◗ Travel to areas that have high rates of hepatitis A.

Travel to Africa, Asia, Eastern Europe, 

or Central and South America, including 

Mexico, increases the risk of getting 

hepatitis A.

What are signs of hepatitis A?

Hepatitis A does not always cause you to feel bad. It 

may make you sick for a few weeks to a few months. 

Older people can get sicker when they have it. Young 

children usually do not show any signs. Signs include:

◗ Yellow skin or eyes (jaundice).

◗ Tiredness.

◗ Fever.

◗ Nausea.

◗ Vomiting.

◗ Loss of appetite.

◗ Stomach pain.

◗ Light stools.

◗ Dark urine.

◗ Diarrhea.

Symptoms can show 2 to 6 weeks after 

contact with the virus.

How do you know if you have 

hepatitis A?

The only way to know if you have it is by seeing a 

health care provider (HCP). S/he may take a sample of 

your blood to test. 

How is it treated?

There are no medicines for treating hepatitis A. If you 

have been recently exposed to the virus, tell your HCP. 

Most people recover by resting and drinking plenty of 

fluids. A few people will need to be hospitalized.

What can happen if you have hepatitis A 

for a long time?

Most people improve without treatment and have no 

lasting liver damage. Signs usually last less than 2 

months. Some can be ill for as long as 6 months. The 

virus can cause liver failure and death mostly in:

◗ People 50 years of age or older.

◗ People with other liver diseases, such as hepatitis B 

or C.
Veterans Health Administration 43

Men’s Health: A Guide to Preventing Infections

If you have hepatitis A: 

◗ Get plenty of rest.

◗ Eat healthy foods. 

◗ Drink plenty of fluids. 

◗ Avoid drinking any alcohol. 

◗ Check with your HCP before taking:

l Medicines.

l Supplements.

l Over-the-counter drugs.

◗ Clean hands often, especially after using the bathroom.

◗ Avoid preparing food, while you are sick.

◗ Talk to those below so they can learn more to protect 

themselves:

l Household contacts.

l Sexual contacts.

l Playmates/attendees at childcare centers.

l Persons sharing illegal drugs.

l Persons sharing food or drink.

l Coworkers and/or restaurant patrons where there 

is an infected food worker.

If you have hepatitis A, 

avoid drinking alcohol. 
44 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

How can you avoid hepatitis A? 

The best way to prevent hepatitis A is to be 

vaccinated. People with certain risk factors and health 

problems need this vaccine. Ask your doctor if the 

vaccine is right for you. You cannot get hepatitis A 

from the vaccine. The vaccine is for:

◗ All children at age 1 year.

◗ Those who use injection and non-injection 

illegal drugs.

◗ Those with chronic (lifelong) liver diseases, such 

as hepatitis B or hepatitis C.

◗ Those who take medicines for blood clotting.

◗ People whose work has a risk such as:

l Sanitation workers.

l Plumbers.

◗ Those who live in areas with high rates of hepatitis

A infection.

◗ Travelers to countries that have high rates of hepatitis 

A. These include:

l Africa. 

l Asia. 

l Latin America.

l South America. 

l Eastern Europe.

Learn more at the CDC’s Travelers’ Health site

wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-

infectious-diseases-related-to-travel/hepatitis-a.htm.

Other ways to avoid hepatitis A, especially if you 

have not been vaccinated:

◗ Consider boiling water or drinking bottled water if you 

live in a place with untreated water.

◗ Eat cooked foods and fruits that you can peel. 

◗ Avoid eating uncooked vegetables or fruits that could 

have been washed with dirty water, such as lettuce.

◗ Avoid eating raw or steamed shellfish such as oysters. 

Shellfish may live in dirty water.

◗ Use condoms correctly and every time you have sex.

◗ Clean hands often.

Getting vaccinated is 

the best way to prevent 

hepatitis A.

Learn more:

Department of Veterans Affairs (VA): 

Hepatitis A Basics

https://www.hepatitis.va.gov/patient/hav/index.asp

Centers for Disease Control and Prevention (CDC):

Hepatitis A Information for the Public

www.cdc.gov/hepatitis/A/

National Institute for Allergy and Infectious Diseases (NIAID/NIH):

Hepatitis A

www.niaid.nih.gov/topics/hepatitis/hepatitisa/Pages/Default.aspx
Veterans Health Administration 45

Men’s Health: A Guide to Preventing Infections

Hepatitis B

Hepatitis B is inflammation of the liver caused by the 

hepatitis B virus (HBV). Most adults who have hepatitis 

B will recover on their own. Hepatitis B can be either 

“acute” or “chronic.” 

Acute Hepatitis B virus infection is a short-term illness 

that occurs within the first 6 months after exposure to 

the Hepatitis B virus. Acute infection can — but does 

not always — lead to chronic infection.

Chronic Hepatitis B virus infection is a long-term illness that occurs when the Hepatitis B virus remains in 

a person’s body.

How is it spread?

Hepatitis B virus is spread by contact with body fluids 

that carry the virus, such as: 

◗ Blood. 

◗ Semen. 

◗ Vaginal fluids. 

◗ Other body fluids. 

Contact with infected body fluids can spread hepatitis 

B. It is mostly spread by:

◗ Sexual contact: (This is the most common way it is 

spread in the U.S.).

l Vaginal and anal sex.

l Sharing unclean sex toys.

l Body fluids with hepatitis B can enter tiny breaks 

or rips in the linings of the vagina, vulva, rectum, 

or mouth. Rips and tears in these areas can be 

common and often unnoticed.

◗ Needle sharing: 

l Used or unclean needles. 

l During illegal drug or drug equipment use. 
46 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

◗ Contact with blood:

l Open sores of an infected person. 

l Sharing items such as razors or toothbrushes with 

an infected person.

l Being tattooed or pierced with tools that were not 

properly cleaned.

l During occupational exposures to needles, 

splashes of blood, and body fluids.

l During blood transfusions given before 1975 

(since then all blood is screened).

◗ You may have hepatitis B from before you were born: 

l Hepatitis B can spread to babies during 

pregnancy, birth, and during breastfeeding.

◗ There is no risk of getting hepatitis B when donating

or giving blood.

Men are 6 times more likely to become 

chronic carriers

Who is at risk of hepatitis B?

Anyone can get hepatitis B. However, in the U.S., you 

may be at a higher risk if you:

◗ Have not been vaccinated for hepatitis B. 

◗ Have sex partners that have hepatitis B.

◗ Have HIV or hepatitis C.

◗ Share needles, syringes, or other drug-injection 

equipment.

◗ Live with someone who has hepatitis B. 

◗ Have a weak immune system.

◗ Have diabetes.

◗ Work in health care or public safety and are exposed 

to blood or body fluids on the job.

◗ Are an infant born to an infected mother.

◗ Travel to areas that have moderate to high rates 

of hepatitis B (see: wwwnc.cdc.gov/travel/

yellowbook/2010/chapter-2/hepatitis-b.aspx#363).

◗ Are a man who has sex with men.

What are signs of hepatitis B?

When you first get hepatitis B, it is called acute

hepatitis B. Most adults who have it will recover on their 

own. However, children and some adults can develop 

chronic (lifelong) hepatitis B.
Veterans Health Administration 47

Men’s Health: A Guide to Preventing Infections

Acute hepatitis B: Signs of acute hepatitis B can 

appear within 3 months after you get the virus. These 

signs may last from several weeks to 6 months. Most 

adults have signs of acute hepatitis B virus infection. 

Many young children do not show any signs. Signs 

include:

◗ Yellow skin or eyes (jaundice).

◗ Tiredness.

◗ Fever.

◗ Nausea. 

◗ Vomiting.

◗ Loss of appetite.

◗ Stomach pain.

◗ Light stools.

◗ Dark urine.

◗ Joint pain.

Chronic hepatitis B: Hepatitis B is chronic when the 

body can’t get rid of the virus. Children, mostly infants, 

are more likely to get chronic hepatitis B than adults. 

People with chronic hepatitis B may have no signs 

for as long as 20 or 30 years. Signs may be the same 

as acute hepatitis B. There may also be signs of liver 

damage and cirrhosis such as:

◗ Weakness.

◗ Weight loss. 

◗ Small, red, spider-like blood vessels on the skin. 

◗ Confusion or problems thinking. 

◗ Loss of interest in sex. 

◗ Swollen stomach or ankles.

◗ A longer than normal amount of time for bleeding 

to stop.

How do you know if you have 

hepatitis B?

The only way to know if you have hepatitis B is by 

seeing a health care provider (HCP). S/he may take a 

sample of your blood. There are several blood tests to 

see: 

◗ If it is an acute or a chronic infection.

◗ If you have recovered from infection.

◗ If you are immune to hepatitis B.

◗ If you could benefit from vaccination.

How is it treated?

Acute hepatitis B: Your HCP may suggest rest, good 

nutrition, and fluids. S/he may give you a type of protein 

that may help fight the virus. Some people may need to 

go to the hospital.

Chronic hepatitis B: People with chronic hepatitis B 

should seek care from a HCP experienced in treating 

hepatitis B. These can be: 

◗ Some primary care providers. 

◗ Infection specialists. 

◗ Gastroenterologists (digestive system specialists).

◗ Hepatologists (liver specialists).

If you have chronic hepatitis B, get checked regularly 

for signs of liver damage. Talk with your HCP about 

treatment. Not every person with chronic hepatitis B 

needs treatment. If you show no signs of liver damage, 

your provider will continue to check for liver problems. 
48 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

What can happen if chronic hepatitis B is 

not treated?

Chronic hepatitis B is a serious disease that can result 

in long-term health problems. Up to 1 in 4 people with it 

have serious liver problems. These include: 

◗ Liver damage and scarring (cirrhosis). 

◗ Liver failure. 

◗ Liver cancer.

◗ Death.

Human Liver

If you have hepatitis B: 

◗ See your health care provider regularly.

◗ Tell current and recent sex partners that you have 

hepatitis B. 

◗ Get plenty of rest.

◗ Eat healthy foods. 

◗ Drink plenty of fluids.

◗ Avoid drinking any alcohol. There are ways to 

help you stop drinking alcohol at: www.hepatitis.

va.gov/patient/alcohol/what-you-can-do.

asp or https://www.mentalhealth.va.gov/resvatreatmentprograms.asp.

◗ Check with your HCP before taking:

l Prescription medicines.

l Vitamins or supplements.

l Over-the-counter drugs.

◗ Avoid spreading hepatitis B to others by:

l Having safer sex and using condoms during all 

sexual contact. 

l Not sharing used or unclean needles and sex 

toys.

l Not donating blood, blood products, or organs. 

l Cleaning all blood spills – even those that have 

already dried. Use a mixture of bleach and water 

(one part household bleach to 10 parts water). 

Even dried blood is a risk to others.

l Not sharing personal care items like razors, 

toothbrushes, nail clippers or earrings.

l Not sharing glucose-monitoring equipment.

l Asking sexual partner(s) and people living in close 

contact with you to be tested and vaccinated.

For more 

information, 

see Safer Sex

on page 71

How can you avoid hepatitis B?

Getting the vaccine for hepatitis B is the best way 

to prevent it. The vaccine is safe and effective. It can 

take 3-4 shots over a 6-month period. You will not

get hepatitis B from the vaccine. Ask your HCP if you 

should get this vaccine. It is recommended for adults

if you:

◗ Have sex with or live in the same house as a person 

with hepatitis B virus infection.

◗ Have sex with more than one partner.

◗ Seek care in a clinic for sexually transmitted diseases, 

HIV testing or treatment, or drug treatment.

◗ Are a man who has sex with other men.

◗ Inject drugs.
Veterans Health Administration 49

Men’s Health: A Guide to Preventing Infections

◗ Have a job that involves contact with human blood.

◗ Are on the staff of, or a client in, a facility for the 

developmentally disabled.

◗ Are a hemodialysis patient or have end-stage renal

disease.

◗ Have HIV infection.

◗ Are a dialysis patient.

◗ Have chronic liver disease.

◗ Have diabetes and are under age 60.

◗ Seek care in a clinic for sexually transmitted diseases,

HIV testing, or drug treatment.

◗ Live or travel for more than 6 months a year in

countries where hepatitis B is common (see wwwnc.

cdc.gov/travel/yellowbook/2010/chapter-2/

hepatitis-b.aspx#363). 

Travelers at increased risk for infection include:

◗ Adventure travelers.

◗ Peace Corps volunteers. 

◗ Missionaries.

◗ Military personnel. 

Theses may raise the risk for hepatitis B for 

travelers:

◗ An injury or illness that breaks the skin such as shots, 

fluids in the vein, transfusion, stitches, and surgery.

◗ Dental treatment.

◗ Unprotected sexual contact.

◗ Sharing syringes or drug injection equipment.

◗ Tattooing, ear piercing, or acupuncture that break

the skin.

◗ Manicures and pedicures which may break the skin.

◗ Sharing certain items such as earrings, razors,

toothbrushes and nail clippers.

Other ways to avoid hepatitis B:

◗ Avoid sexual contact.

◗ Have safer sex:

l Reduce the number of sexual partners.

l Condoms, when used correctly, can reduce the 

risk of getting hepatitis B. Each time you have sex 

use a condom (male or female type):

n During vaginal sex.

n During anal sex.

n During oral sex.

l Have sex with only one partner who does not have

sex with others and does not have hepatitis B.

◗ Know that other forms of birth control do not protect

against hepatitis B.

◗ Not using or injecting drugs.

◗ Not reusing or sharing syringes or drug equipment.

◗ Wear gloves if you have to touch another person’s 

blood.

◗ Do not use another person’s toothbrush, razor, nail 

clippers or any other item that might have even a tiny 

bit of blood on it.

◗ Make sure any tattoos or body piercings are done 

under good conditions, using:

l Sterile tools.

l Clean hands and single use gloves.

l Disinfected work surfaces.

The hepatitis B vaccine 

is the best way to 

prevent hepatitis B.
50 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Learn more:

Department of Veterans Affairs (VA):

Hepatitis B Basics

www.hepatitis.va.gov/patient/basics/hepatitisB-index.asp

Centers for Disease Control and Prevention (CDC):

Hepatitis B Information for the Public

www.cdc.gov/hepatitis/B/

Infectious Diseases Related to Travel; Hepatitis B

wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/hepatitis-b.aspx#363/

Protect Your Baby for Life; When a Pregnant Woman Has Hepatitis B

www.cdc.gov/hepatitis/HBV/PDFs/HepBPerinatal-ProtectWhenPregnant-BW.pdf

National Institute of Allergy and Infectious Diseases (NIAID/NIH):

Hepatitis B 

www.niaid.nih.gov/topics/hepatitis/hepatitisb/Pages/Default.aspx

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK/NIH):

What I need to know about Hepatitis B

digestive.niddk.nih.gov/ddiseases/pubs/hepb_ez/

U.S. National Library of Medicine:

Cirrhosis

www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001301/
Veterans Health Administration 51

Men’s Health: A Guide to Preventing Infections

Hepatitis C

Hepatitis C is a disease of the liver caused by hepatitis 

C virus. Hepatitis C virus can lead to chronic viral 

hepatitis, including liver damage, cirrhosis (scarring of 

the liver), and liver cancer.

How is it spread?

Hepatitis C is mostly spread by blood from an infected 

person from:

◗ Sharing needles or other equipment to inject drugs.

◗ Needle sticks with unclean needles.

◗ Sharing items that may have come in contact with 

blood, such as razors, nail clippers, pierced earrings 

and toothbrushes. 

◗ Being tattooed or pierced with uncleaned tools that 

were used on an infected person.

◗ Having sexual contact with a person who has the 

hepatitis C virus. The risk of getting it from sexual 

contact is thought to be low. 

Hepatitis C is rarely spread from a blood 

transfusion because:

◗ Hepatitis C tests are done on all donated blood

since 1992.

◗ There is no risk of getting hepatitis C when

donating blood. 

Hepatitis C is not spread by kissing, 

hugging, coughing, or sharing food and 

eating utensils.
52 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Who is at risk of hepatitis C?

Anyone can get hepatitis C. Those at high risk should 

be tested and treated. In the U.S., you are at a higher 

risk if you:

◗ Were born between 1945 and 1965.

◗ Have ever used a needle to inject drugs, even if once 

and long ago.

◗ Had a blood transfusion or organ transplant

before 1992.

◗ Have ever been on kidney dialysis.

◗ Were born of a mother who had hepatitis C at 

the time. 

◗ Are a Vietnam-era Veteran. 

◗ Had contact with hepatitis-C-positive blood to nonintact skin or to mucous membranes.

◗ Received tattoos or body piercings in non-regulated 

settings. 

◗ Have ever snorted drugs or shared equipment.

◗ Have liver disease.

◗ Have abnormal liver tests. 

◗ Have a history of alcohol abuse.

◗ Have hemophilia and received medicine for blood 

clotting before 1987.

◗ Have had a sexual partner with hepatitis C, now or 

in the past.

◗ Have had 10 or more lifetime sexual partners.

◗ Have HIV.

The only way to know if you have 

Hepatitis C is to be tested. See your 

health care provider.

What are signs of hepatitis C?

When you first get hepatitis C, it is called acute

hepatitis C. About 15% of people who have acute

hepatitis C infection clear the virus from their bodies. 

The other 85% of people develop a chronic (lifelong) 

hepatitis C infection. New medications to treat hepatitis 

C have a very high cure rate.

Hepatitis Virus
Veterans Health Administration 53

Men’s Health: A Guide to Preventing Infections

Acute hepatitis C: Most people with acute hepatitis 

C do not show signs. If signs occur, the average time 

is 6–7 weeks after exposure, but can be less or more. 

Some people can have mild to severe signs like: 

◗ Yellow skin or eyes (jaundice).

◗ Tiredness.

◗ Fever.

◗ Nausea. 

◗ Vomiting.

◗ Loss of appetite.

◗ Stomach pain.

◗ Light stools.

◗ Dark urine.

Chronic hepatitis C: Millions of people in the United 

States have chronic hepatitis C infection. Most do not 

know they are infected. They don’t look or feel sick 

until the virus causes liver damage. This can take 10 

years or more to happen. Signs may be the same as 

acute hepatitis C. There may also be signs of liver 

damage and cirrhosis such as:

◗ Weakness. 

◗ Weight loss. 

◗ Small, red, spider-like blood vessels on the skin. 

◗ Confusion or problems thinking. 

◗ Loss of interest in sex. 

◗ Swollen stomach or ankles.

◗ A longer than normal amount of time for bleeding 

to stop.

How do you know if you have 

hepatitis C?

The only way to know if you have hepatitis C is by a 

medical exam. Blood tests can tell you:

◗ If it is acute or chronic infection.

◗ If you have recovered from infection.

◗ If you could benefit from vaccination for 

hepatitis A and B.

In some cases, your health care provider (HCP) may take 

a liver biopsy. A needle is used to remove a tiny piece of 

liver. This will help to know the degree of liver damage.

How is it treated?

Chronic Hepatitis C is curable. If you have chronic 

hepatitis C infection, your HCP will examine you for liver 

problems. Talk to your HCP about treatment that can:

◗ Clear the virus from the body.

◗ Slow down or prevent liver damage.

◗ Lower the chance of getting cirrhosis and 

liver cancer.

Talk with your HCP about all options before treatment. 

Treatment may not be for everyone. Some patients 

might not need it. Others might not be able to be 

treated due to other medical problems. 
54 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

What can happen if hepatitis C is 

not treated?

Of every 100 persons infected with HCV, approximately:

◗ 75–85 will go on to develop chronic infection.

◗ 60–70 will go on to develop chronic liver disease.

◗ 5–20 will go on to develop cirrhosis over a period of 

20–30 years.

1–5 will die from the consequences of chronic infection 

(liver cancer or cirrhosis) Chronic hepatitis C infection 

is the leading cause of liver cancer and cirrhosis in 

the U.S. Cirrhosis is scarring of the liver which causes 

it to not work well. Both liver cancer and cirrhosis can 

be fatal. A liver transplant may be needed if chronic 

hepatitis C causes the liver to fail.

If you have hepatitis C: 

◗ See your HCP regularly.

◗ Tell current and recent sex partners. 

◗ Get vaccinated against hepatitis A and B.

◗ Get plenty of rest.

◗ Eat healthy foods. 

◗ Drink plenty of fluids. 

◗ Avoid drinking any alcohol. There are ways to 

help you stop drinking alcohol at: www.hepatitis.

va.gov/patient/alcohol/what-you-can-do.

asp or https://www.mentalhealth.va.gov/resvatreatmentprograms.asp.

◗ Check with your HCP before taking:

l Prescription drugs.

l Vitamins and supplements. 

l Over-the-counter drugs.

◗ Avoid spreading hepatitis C to others by:

l Having safer sex and using condoms during all 

sexual contact. 

l Not sharing used or unclean needles and 

sex toys.

l Not donating blood, blood products, or organs. 

l Cleaning all blood spills – even those that have 

already dried. Use a mixture of bleach and water 

(one part household bleach to 10 parts water). 

Even dried blood is a risk to others.

l Not sharing personal care items like razors, 

toothbrushes, nail clippers or earrings.

l Not sharing glucose-monitoring equipment.

l Asking your sexual partner(s) to be tested for 

hepatitis C (and perhaps other infections). 

If you have hepatitis C, you can prevent 

liver damage by not drinking alcohol. Get 

vaccinated for hepatitis A and B.
Veterans Health Administration 55

Men’s Health: A Guide to Preventing Infections

How can you avoid hepatitis C? 

Right now there is no vaccine to protect you against 

hepatitis C. You can take steps to protect yourself:

◗ Never share needles, syringes, water, or “works” for 

intravenous drug use, to inject steroids, or cosmetic 

substances. 

◗ Get vaccinated against hepatitis A and B if you use 

drugs.

◗ Consider VA substance use and recovery services if you 

use drugs.

◗ Handle needles and other sharp objects safely.

◗ Do not use personal items that may have come into 

contact with an infected person’s blood.

◗ Do not get tattoos or body piercings from an unlicensed 

facility or in an informal setting.

◗ Wear gloves if you have to touch another person’s 

blood. Always clean hands after removing gloves.

◗ Have safer sex. Each time you have sex use 

a condom.

For more 

information, 

see Safer Sex

on page 71

Learn more:

Department of Veterans Affairs (VA): 

Hepatitis C Basics

www.hepatitis.va.gov/patient/basics/hepatitisC-index.asp

Hepatitis C medications: A review and update for patients

www.hepatitis.va.gov/products/patient/treatment-update.asp

National Institute of Allergy and Infectious Diseases (NIAID/NIH):

Hepatitis C

www.niaid.nih.gov/topics/hepatitis/hepatitisC/Pages/Default.aspx

Centers for Disease Control and Prevention (CDC):

Hepatitis C Information for the Public

www.cdc.gov/hepatitis/C/

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK/NIH):

What I need to know about Hepatitis C

digestive.niddk.nih.gov/ddiseases/pubs/hepc_ez/

Veterans Health Administration 57

Men’s Health: A Guide to Preventing Infections

Genital Yeast Infection

A genital yeast infection is caused by a fungus called 

candida. Although more common in women, men can 

get yeast infections.

How is it spread? 

A yeast infection is not a sexually transmitted disease. 

Men can get a genital yeast infection from unprotected 

sex with a partner who has a yeast infection. It is easier 

to get a yeast infection if:

◗ You use antibiotics.

◗ You have diabetes.

◗ Your immune system is weak.

What are signs of yeast infection?

◗ Redness, itching or burning at the tip of the penis.

How do you know if you have it?

Your health care provider (HCP) can examine you. S/he 

will look for signs of infection and may collect samples 

for lab tests.
58 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

How is it treated?

Yeast infections in men are treated with over-thecounter antifungals. See your HCP if signs don’t go 

away or they reoccur.

What can happen if you don’t get 

treated?

Signs of infection may get worse. It can lead to balanitis 

— inflammation of the head of the penis.

How can you avoid a yeast infection?

Refrain from sexual contact until all signs of the 

infection are gone. Ask your sex partner(s) to see an 

HCP for an exam.

Learn more:

The Mayo Clinic:

Male Yeast Infections: Can I get it from my girlfriend?

http://www.mayoclinic.org/male-yeast-infection/expert-answers/faq-20058464?FLUSHCACHE=0

National Institutes of Health:

Yeasts and Circumcision in the Male

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1045367/
Veterans Health Administration 59

Men’s Health: A Guide to Preventing Infections

Urinary Tract Infection 

(UTI)

A UTI occurs when bacteria grow in the urinary tract. It 

makes and stores urine and carries it out of the body. 

The organs that can be infected include:

◗ Bladder (common) – Stores urine.

◗ Urethra (common) – The tube that carries urine from the 

bladder out of the body.

◗ Kidneys – Collect waste from blood to make urine.

◗ Ureters – Move urine from the kidneys to the bladder.

UTIs cannot be spread between people. 

How is it spread?

The foreskin of the uncircumcised penis makes it easier 

for germs to get trapped and enter your urinary tract. 

Besides age, your risk for UTIs can be increased by: 

◗ Sexual intercourse, especially anal sex.

◗ When urine stays in the bladder too long.

◗ Problems emptying the bladder fully.

◗ Diabetes.

◗ Kidney Stones.

◗ Having a tube that drains urine from the bladder.

◗ Obesity.

◗ An enlarged prostate gland or an infected

prostate (prostatitis).
60 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

What are signs of UTIs in men?

UTIs in the bladder and urethra may cause:

◗ Urge to urinate often, but not much urine comes out.

◗ Burning, stinging or pain with urination.

◗ Discharge/fluid seeping from the penis.

◗ Heavy feeling in the lower belly.

◗ Waking in the night to urinate.

Other signs of UTI may include:

◗ Pain or pressure in the lower back or sides.

◗ Rectal Pain.

◗ Urine that smells bad or looks dark, cloudy, or red.

◗ Tiredness, fever and chills.

How do you know if you have a UTI?

A health care provider (HCP) can examine you for UTIs. 

A urine sample will be tested. Other tests may be done 

if your HCP thinks it has spread, or if you have had 

many UTIs. You may be asked about:

◗ Signs of your UTI.

◗ Past UTIs

◗ Sexual Contact.

◗ Other health conditions, such as diabetes.

Men who are uncircumcised are at 

higher risk for UTIs. Bacteria can build 

up easily in the folds of the extra skin 

on the penis. Also, men who engage in 

anal sex are more at risk.
Veterans Health Administration 61

Men’s Health: A Guide to Preventing Infections

How is it treated?

UTIs are treated and cured with antibiotics. Always 

finish treatment. If treated quickly, most UTIs do 

not cause serious problems. You may need longer 

treatment or a different antibiotic if you:

◗ Have UTIs often.

◗ Have diabetes.

◗ Have a UTI that has spread to your kidneys.

If you have a UTI:

◗ Always finish antibiotic treatment.

◗ Return to your health care provider if:

l Signs don’t go away.

l Signs come back.

l Signs get worse.

l You have more or different signs of UTI.

UTIs in the bladder and urethra that are 

not treated can spread to the kidneys and 

cause serious illness.

How can you avoid UTIs?

◗ Urinate when you have the urge.

◗ Don’t hold in urine for a long time.

◗ Urinate before and after having sex.

◗ Drink plenty of fluids.

◗ Clean your genital area every day, especially after

having sex.

◗ Use barriers such as condoms during sex.

To reduce UTIs, some HCPs suggest 

showers instead of baths

Learn more:

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK/NIH):

Urinary Tract Infections in Adults

www.kidney.niddk.nih.gov/kudiseases/pubs/utiadult/

U.S. National Library of Medicine:

Urinary tract infection - adults

www.nlm.nih.gov/medlineplus/ency/article/000521.htm

Veterans Health Administration 63

Men’s Health: A Guide to Preventing Infections

Epididymitis

Epididymitis is swelling of the coiled tube connected 

to the testicle. The tube is called the epididymis. Males 

of any age can get epididymitis but mostly men ages 

19 to 35. It causes pain, swelling, and inflammation of 

the epididymis and can last longer than 6 weeks. 

What causes it?

◗ A bacterial infection from the urethra, the prostate, or

the bladder.

◗ Gonorrhea and chlamydia infections.

◗ E. coli and similar bacteria (mostly in elderly men

and children).

◗ Some medicines such as amiodarone.

◗ Trauma to the groin.

In older men, acute epididymitis may 

be due to a recent prostate biopsy or 

urinary tract procedure or surgery. It 

can also be due to sexual contact and 

from a weak immune system. 

What increases your risk?

◗ History of prostate or urinary tract infections.

◗ Enlarged prostate.

◗ Being uncircumcised.

◗ Recent surgery.

◗ Past structural problems with your urinary tract.

◗ Regular use of a urethral catheter.

◗ Sexual intercourse with more than one partner while not 

using condoms.
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Men’s Health: A Guide to Preventing Infections

What are signs?

◗ Epididymitis may start with a low fever, chills and a heavy

feeling in the testicle area:

l The area will get more sensitive to pressure and 

become painful as it progresses.

l This infection can easily spread to the testicles.

Other Signs:

◗ Blood in the semen.

◗ Discharge from the penis.

◗ Pain or discomfort in the lower abdomen or pelvis.

◗ Enlarged lymph nodes in the groin.

◗ Fever (less common).

◗ Lump on testicle.

◗ Pain during sex.

◗ Pain or burning during ejaculation and urination.

◗ Swelling of the scrotum.

◗ Tender, swollen, and painful groin area.

◗ Testicle pain.

How do you know if you have it?

The only way to know if you have epididymitis is by getting 

a medical exam. Your health care provider (HCP) may:

◗ examine you for signs of infection.

◗ do an ultrasound or nuclear scan of the testicles.

◗ run lab tests for bacteria.

If caused by sexually transmitted 

bacteria, partners of men with 

epididymitis will need treatment. 

How is it treated?

◗ Antibiotics.

◗ Pain or anti-inflammatory medications.

◗ Lying down with your scrotum elevated.

◗ Applying ice packs to the painful area.

◗ Wearing an athletic supporter.

◗ Avoiding lifting heavy objects.

◗ Avoiding sex until your infection has cleared.

Follow-up with your health care provider to make sure it is 

gone, especially if the signs fail to improve within 72 hours 

of starting treatment.

If it gets worse

Most often, Epididymitis improves with antibiotic treatment 

and does not cause other health problems. However, it 

may return and cause:

◗ An abscess in the scrotum.

◗ Infected testicles.

◗ Chronic epididymitis.

◗ Opening on the skin of the scrotum.

◗ Death of the testicular tissue due to lack of blood flow.

◗ Infertility (rare).
Veterans Health Administration 65

Men’s Health: A Guide to Preventing Infections

If you have it:

◗ Always finish antibiotic treatment, even if the signs of it 

go away. Know that it may take several weeks for the 

tenderness to disappear.

◗ Talk to sex partners about getting treatment if you got it 

from sexual contact.

◗ Sudden and severe pain in the scrotum is a medical 

emergency. You need to be seen by your provider 

right away.

How can you avoid it?

◗ Avoid sexual contact.

◗ Have safer sex.

l Reduce the number of sexual partners.

l Condoms, when used correctly, can reduce the 

risk of getting and spreading STDs, bacteria, 

and viruses. However, condoms may not cover 

all infected areas. Each time you have sex use a 

condom (male or female type):

n During vaginal sex.

n During anal sex.

n During oral sex.

l Have sex with only one partner who does not have 

sex with others.

For more 

information, 

see Safer Sex

on page 71

Learn more:

Epididymitis – CDC 2015 Sexually Transmitted Diseases Treatment Guidelines Sheet

http://www.cdc.gov/std/tg2015/epididymitis.htm

Epididymitis – Medline Plus – U.S. Library of Medicine

http://www.nlm.nih.gov/medlineplus/ency/article/001279.htm

Veterans Health Administration 67

Men’s Health: A Guide to Preventing Infections

Shingles (Herpes Zoster)

Shingles is caused by the varicella zoster virus (VZV). 

This is the same virus that causes chickenpox. 1 out 

of every 3 people in the U.S. will get shingles (herpes 

zoster) in their lifetime.

If you have had chickenpox, you can get shingles. Even 

children can get shingles. For some people over age 

60, shingles will cause severe pain which can last for 

months, even years.

Who is at risk?

You have a high risk of getting shingles if:

◗ Your immune system doesn’t work well.

◗ You have human immunodeficiency virus (HIV).

◗ You take drugs that suppress your immune system.

Most people have just one outbreak of shingles in their 

lifetime, but some can have more.

There are about 1 million cases of 

shingles every year in the U.S.
68 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

What are signs of shingles?

◗ Most get a painful rash or blisters on one side of the 

body. These scab over in 7-10 days and clear in 2-4 

weeks.

◗ There can be pain, itching or tingling in the rash/blister 

area. This can happen 1-5 days before it can be seen.

◗ The rash/blister can occur:

l in a single patch or a stripe around the left side of 

the body.

l in a single patch or a stripe around the right side 

of the body.

l on one side of the face.

◗ In rare cases, the rash can look like chickenpox.

Other signs that are not always present may include:

◗ Fever.

◗ Headache.

◗ General ill feeling.

◗ Joint pain.

◗ Muscle weakness.

Can I give it to someone else?

The virus that causes shingles can be spread from 

a person with active shingles to a person who has 

never had chickenpox. The person exposed may get 

chickenpox but not shingles.

The virus is spread by direct contact with fluid from the 

blisters caused by shingles. 

◗ Shingles does not spread before the blisters appear.

◗ When the blisters dry up (crust over) the person can 

no longer spread the virus.

What can happen if you have it for

a long time?

◗ Shingles that occurs on the face or scalp can affect 

the eye and cause a loss of vision.

◗ Rarely, it can lead to pneumonia, hearing problems, 

brain inflammation, and even death.

Shingles is less contagious than 

chickenpox. The chance of spread is

very low if the rash/blister is covered.
Veterans Health Administration 69

Men’s Health: A Guide to Preventing Infections

If you have shingles:

◗ Keep the rash/blisters covered.

◗ Avoid touching or scratching the rash/blisters.

◗ Wash your hands often to prevent the spread of the 

zoster virus.

◗ Avoid contact with these people until the rash/blisters 

is crusted: 

l Pregnant women who have never had chickenpox 

or the chickenpox vaccine.

l Children under the age of one.

l Old children who have not been vaccinated for 

chickenpox.

l Premature or low birth weight infants.

l Those with weak immune systems.

l Those undergoing chemotherapy.

l Those who have had an organ transplant.

l Those with human immunodeficiency virus

(HIV) infection.

Can shingles be prevented?

Talk with your healthcare provider (HCP) about the 

shingles zoster vaccine.

What is the treatment?

Antiviral medicines such as acyclovir, valacyclovir, 

and famciclovir can reduce the length and severity of 

shingles. For best effect, these must be started as soon 

as possible after the rash/blister appears. Contact your 

HCP as soon as possible.

Other treatments:

◗ Medicines for pain.

◗ Antihistamines for itching.

◗ Wet compresses, Calamine Lotion, and Colloidal 

oatmeal baths for itching.

Shingles usually clears in 2-3 weeks.

Learn more:

Department of Veterans Affairs (VA):

My HealtheVet Veterans Health Library – Health Encyclopedia

http://www.veteranshealthlibrary.org/Encyclopedia/142,89203_VA

Centers for Disease Control and Prevention (CDC):

Shingles (Herpes Zoster)

http://www.cdc.gov/shingles/index.html

Fact Sheet on Shingles

http://www.cdc.gov/vaccines/hcp/patient-ed/adults/downloads/fs-shingles.pdf

National Institute of Health-Senior Health:

About Shingles

http://nihseniorhealth.gov/shingles/aboutshingles/01.html

U.S. National Library of Medicine – Medline Plus:

Shingles

http://www.nlm.nih.gov/medlineplus/ency/article/000858.htm

Veterans Health Administration 71

Men’s Health: A Guide to Preventing Infections

Safer Sex

Safer sex uses barriers to reduce the risk of blood 

or body fluids entering the body. The most common 

barrier used is the male condom. Barriers should be 

used during all sexual contact. These barriers include: 

male condoms, female condoms, dental dams and 

other barriers

Why have safer sex?

Safer sex can reduce your exposure to sexually 

transmitted diseases (STDs). STDs are spread by 

sexual contact with an infected person. This occurs 

through vaginal, anal or oral sex, and genital touching. 

Having safer sex is one of the best ways to protect 

yourself from STDs. The only way sure way of avoiding 

STDs is to not have any sexual contact.

How are barriers used?

◗ Use each time you have sex. They can be made of 

plastic or latex and protect against viral and bacterial 

STDs. Use for: 

l Vaginal sex.

l Anal sex.

l Oral sex.

◗ Talk to your partner about using barriers before sex.

◗ Know that alcohol and drugs can alter how you think 

about if, when, or how to use barriers.

◗ Agree what type to use: male or female condoms, dental 

dams or other barriers.

l Make sure to have these on hand if there is any 

chance you may have sex.
72 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Male Condoms

◗ Use for oral, anal or vaginal sex.

◗ Choose lubricated latex condoms:

l “Lambskin” condoms do not block HIV or other 

STDs.

l If you have allergies to latex, choose polyurethane 

(plastic) condoms.

◗ Use before date expires.

◗ Store in a cool, dry place.

◗ Use a new condom for each sex act, from start to finish.

◗ Make sure there are no holes in the package.

◗ Check the condom for rips or signs of damage like 

brittleness or stickiness.

◗ Place the condom only on the erect penis.

◗ Hold onto the tip as you unroll it down the penis shaft. 

◗ Use a water-soluble lubricant (e.g., ID Glide, K-Y Jelly, 

Slippery Stuff, Foreplay, Wet, and Astroglide) after it is on. 

This prevents the condom from breaking.

l Do not use petroleum jelly, massage oils, mineral 

oil, cooking oil, body lotions, butter, Crisco, 

Vaseline, or hand creams as lubricant. These can 

weaken condoms.

◗ Remove the condom after ejaculation, but before the 

penis gets soft. Avoid spilling ejaculate.

◗ If it breaks, remove it. Put on a new one.

◗ Use on sex toys such as dildos or vibrators that are 

shared: 

l Use new ones for each partner.

l Clean sex toys after each use.

Condoms kept in a wallet, stored 

somewhere warm, or that have been 

washed in the washer should not be used.

Female Condoms

◗ Use during vaginal sex.

◗ Note its shape is not like the male condom.

◗ Made of a plastic called polyurethane.

◗ Use before the expiration date.

◗ Store in a cool, dry place.

◗ Use a new one for each sex act, from start to finish.

◗ Make sure there are no holes in the package.

◗ Check the condom for rips or signs of damage like 

brittleness or stickiness.

◗ Put on lubricant before inserting the condom.

l Female condoms are already lubricated.

l Water or oil-based lubes can be used.

l Put lube on the inside and outside of the condom.

◗ Put it in the vagina no more than eight hours before 

having sex and before the start of any sexual contact.

◗ Squeeze the ring of the closed end and insert into the 

back of the vagina. Keep the open end outside of the 

vagina, covering the lip area.

◗ If the outer ring slips into the vagina, or if the penis goes 

outside of the condom pouch, remove and replace it.

◗ After sex, remove it by twisting the outside ring to trap 

any fluid before standing up. Throw it in the trash.
Veterans Health Administration 73

Men’s Health: A Guide to Preventing Infections

Both male and female condoms can be 

found without co-pay at the VA pharmacy.

Dental Dams

Dental dams are a square piece of latex (rubber) found 

at surgical supply stores. Use dental dams for vaginal 

or anal contact during oral sex.

Other Barriers

Other barriers listed below can also be used to 

make oral sex safer. These work by reducing contact 

between blood or fluids and the mouth. Place over the 

opening to the vagina or anus During oral sex.

◗ A natural latex sheet.

◗ A “cut open” male condom.

◗ Plastic cling wrap (may be safe but has not been proven).

Learn more:

Veterans Health Library:

Safer Sex

http://www.veteranshealthlibrary.org/Search/142,41502_VA

Centers for Disease Control and Prevention (CDC):

Condom Fact Sheet In Brief

www.cdc.gov/condomeffectiveness/brief.html

U.S. Department of Health and Human Services (HHS), Office on Women’s Health:

Sexually transmitted infections (STI) fact sheet

https://www.womenshealth.gov/mens-health/sexual-health-for-men/sexually-transmitted-infections.html

U.S. National Library of Medicine:

Safer Sex

https://medlineplus.gov/ency/article/001949.htm

Veterans Health Administration 75

Men’s Health: A Guide to Preventing Infections

Colds

A cold is an infection of the nose, sinuses, and/or 

throat. There are more than 200 types of viruses that 

can cause a cold. A virus is a type of germ that causes 

infections. In the U.S., most colds occur in the Fall and 

Winter.

How is it spread?

Most people get a cold from a person who has a cold. 

A cold virus spreads easily. For example: when a 

person with a cold sneezes, coughs, talks, or laughs, 

the virus can spread into the air as droplets. These 

droplets can spread to people as they breathe and to 

surfaces up to 6 feet away. Cold viruses can spread to 

your hands if you touch anything that has the virus on 

it. If you then touch your eyes, nose, or mouth, you can 

get the cold virus. 

What are signs of a cold?

◗ Stuffy or runny nose.

◗ Sneezing.

◗ Sore throat.

◗ Coughing.

◗ Headache (mild).

◗ Muscle aches and pains (mild).

◗ Chest discomfort (sometimes).

◗ Tiredness (sometimes).

◗ Fever (rare).
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Men’s Health: A Guide to Preventing Infections

Flu vs. Cold: Know the Difference

Symptoms Flu Cold

Fever Usual – 100°F or higher Rare

Chills Common Uncommon

Body or muscle aches Common – can be severe Uncommon or mild

Headache Common – can be severe Uncommon

Feeling tired and weak Common – can be severe Sometimes – usually mild:

you don’t feel tired

Cough Common – can last 2-3 weeks Common – mild to

moderate hacking

Sneezing Sometimes Common

Runny or stuffy nose Sometimes Common

Sore throat Sometimes Common

Chest discomfort Common – can be severe Sometimes – can be mild to 

moderate

How can you feel better

if you have a cold?

◗ Get plenty of rest.

◗ Consider the use of over-the-counter drugs. Note: not 

all over-the-counter drugs are safe for children. Find 

more on drugs safe to give children at: www.cdc.gov/

getsmart/antibiotic-use/symptom-relief.html#d.

◗ Use a clean humidifier to help relieve congestion.

◗ Soothe a sore throat with ice chips, throat spray, or

lozenges (do not give lozenges to young children).

◗ Gargle with warm salt water.

◗ Do not smoke.

◗ Avoid second-hand smoke.

If you have a cold?

◗ Clean hands often with soap and water or alcohol hand 

cleaner.

◗ Cough or sneeze into a tissue or into your sleeve.

◗ Don’t share eating or drinking utensils, hand towels or 

toothpaste.

◗ Stay at home if possible.

◗ Drink plenty of non-caffeinated fluids, such as water,

teas, broths, and sports drinks. 

◗ See your health care provider if your:

l Temperature goes over 100.4°F.

l Symptoms last over 10 days.
Veterans Health Administration 77

Men’s Health: A Guide to Preventing Infections

For more information 

on cleaning hands 

see Clean Hands on 

page 99.

How can you avoid a cold?

◗ Limit or avoid people who are at risk.

◗ Clean hands often.

◗ Eat the right foods and get enough sleep to stay healthy.

Learn more:

Centers for Disease Control and Prevention (CDC): 

Common Cold and Runny Nose

www.cdc.gov/getsmart/antibiotic-use/URI/colds.html

Get Smart: Know When Antibiotics Work – Symptom Relief

www.cdc.gov/getsmart/antibiotic-use/symptom-relief.html

Veterans Health Administration 79

Men’s Health: A Guide to Preventing Infections

Influenza (Flu)

Influenza or “flu” is a respiratory illness caused by a flu 

virus. Flu viruses spread each fall, winter, and spring.

Young (infants) and the very old are most at risk for 

severe illness from seasonal flu. In the U.S., about 

3,000 to 49,000 people die yearly from seasonal flu. 

The Centers for Disease Control and Prevention (CDC) 

recommends that everyone age 6 months and older 

get a flu shot each year.

How is it spread?

The flu virus spreads easily. For example, when a 

person with the flu sneezes, coughs, talks, or laughs, 

the flu virus can spread into the air as droplets. These 

droplets can spread to people and surfaces up to 6 

feet away.

The flu virus can spread to your hands if you touch 

anything that has the virus on it. If you then touch your 

eyes, nose, or mouth, you can get the flu. 

The flu virus can live on some surfaces, such as 

countertops and door knobs, for up to 48 hours.

Seasonal flu is contagious from 1 day before any signs 

appear to up to 5 days after you get sick.

Flu spreads easily between people and can 

live for up to 2 days on some surfaces such 

as doorknobs, tabletops, and counters.
80 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Flu vs. Cold: Know the Difference

Symptoms Flu Cold

Fever Usual – 100°F or higher Rare

Chills Common Uncommon

Body or muscle aches Common – can be severe Uncommon or mild

Headache Common – can be severe Uncommon

Feeling tired and weak Common – can be severe Sometimes – usually mild:

you don’t feel tired

Cough Common – can last 2-3 weeks Common – mild to

moderate hacking

Sneezing Sometimes Common

Runny or stuffy nose Sometimes Common

Sore throat Sometimes Common

Chest discomfort Common – can be severe Sometimes – can be mild to 

moderate

What are signs of flu?

◗ Fever (100°F or higher).

◗ Body or muscle aches.

◗ Headache.

◗ Feeling tired or weak.

◗ Cough.

◗ Sore throat.

◗ Runny or stuffy nose.

◗ Stomach symptoms (mostly in children).

How do you know if you have the flu?

Your health care provider (HCP) can examine and test 

you for the flu virus.

How is it treated?

Your HCP may treat you with antiviral drugs. Antiviral 

drugs are most effective if taken within the first two 

days of being sick.

If you have the flu, how can

you feel better?

◗ Stay home.

◗ Rest.

◗ Drink fluids.

◗ Take medicines for fever such as acetaminophen (e.g. 

Tylenol®) or ibuprofen (e.g. Advil® or Motrin®).

◗ Call your healthcare team within 48 hours for advice 

about what to do next

l Antiviral medicines may reduce flu symptoms if 

started within 48 hours of your first symptoms.
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What can happen if the flu gets worse?

Most people with the flu will not need medical care or 

antiviral drugs. Most will recover in less than two weeks. 

Even healthy people can have severe illness from the flu. 

Adults should get medical help right away if they have:

◗ Shortness or breath or wheezing.

◗ Coughing up blood.

◗ Pain or pressure in your chest when breathing.

◗ Chest pain, especially if you have heart disease like 

angina or congestive heart failure.

◗ Trouble with balance, walking or sitting up, or 

becoming confused.

Over time, flu can lead to:

◗ Pneumonia.

◗ Bronchitis.

◗ Sinus and ear infections.

Flu can also make other health problems worse. Those 

with asthma may have more asthma attacks. Those 

with heart problems may also get worse. Flu can cause 

severe illness and even death in:

◗ Children under 5, more so those under age 2.

◗ Adults 65 years of age or older.

◗ Pregnant women.

◗ Those who have medical conditions such as:

l Asthma.

l Diseases of the brain or muscles such as brain 

injury, muscular dystrophy, cerebral palsy and 

stroke.

l Chronic lung disease, such as emphysema 

(COPD) and cystic fibrosis.

l Heart disease.

l Blood diseases such as sickle cell disease.

l Gland diseases such as diabetes.

l Kidney diseases.

l Liver diseases.

l Weak immune system due to disease or 

medicines, such as people with HIV/AIDS, cancer, 

or those on chronic steroids.

l People younger than 19 years of age who are 

taking aspirin pills long-term.

◗ Those who are obese.

◗ American Indians and Alaskan Natives.

These people should alert their HCP if they get signs of 

the flu. They may need early treatment.

Use this flow-chart to help decide how to best handle 

the flu: www.publichealth.va.gov/docs/flu/flu_

selfassess_flowchart.pdf.

People who are more likely to have 

severe illness from the flu should talk to 

their HCP about taking antiviral drugs if 

they get the flu. 
82 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

For more information 

on cleaning hands 

see Clean Hands on 

page 99.

If you have the flu:

◗ Clean your hands often with soap and water or alcohol 

hand cleaner.

◗ Cough or sneeze into a tissue or into your sleeve.

◗ Do not share eating or drinking utensils, hand towels 

or toothpaste.

◗ Stay home until 24 hours after their fever is gone except 

to get medical care.

◗ Avoid contact with others.

◗ Drink plenty of fluids, such as water, herbal teas, broths, 

and sports drinks.

◗ Do not smoke.

◗ Avoid second-hand smoke.

How can you avoid the flu?

◗ GET A FLU SHOT each year. Everyone 6 months of 

age and older should get a flu shot each year because 

flu virus can change from one year to the next.

◗ Clean hands and surfaces often.

◗ Limit or avoid contact with people who are sick.

The best way to avoid the flu is to get a flu 

shot each year.

Learn more:

Department of Veterans Affairs (VA):

Seasonal Flu

www.publichealth.va.gov/flu

Centers for Disease Control and Prevention (CDC):

Seasonal Influenza (Flu)

www.cdc.gov/flu

U.S. Department of Health and Human Services (HHS):

What You Should Know about Flu Antiviral Drugs 

www.flu.gov/news/blogs/blog20110211.html

National Institute of Allergy and Infectious Diseases (NIAID/NIH):

Flu (Influenza)

https://www.niaid.nih.gov/diseases-conditions/influenza
Veterans Health Administration 83

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Pneumonia

Pneumonia is an infection of one or both lungs. 

Pneumonia may be caused by:

◗ Bacteria. Pneumococcus, a type of bacteria, causes 

pneumococcal pneumonia, the most common type of 

bacterial pneumonia.

◗ Viruses. Influenza (flu) virus is one of the most 

common causes of viral pneumonia.

◗ Fungi (rare).

◗ Parasites (rare).

How is it spread?

◗ When a person with pneumonia sneezes, coughs, 

talks, or laughs, germs can spread into the air.

◗ The germs can spread to people and surfaces up to 6 

feet away.

◗ Germs can spread to your hands if you touch anything 

that has the germs on it.

◗ If you then touch your eyes, nose or mouth before 

cleaning your hands, the germs can get into your 

body and you might get pneumonia.

◗ Can occur after contact with germs in your community 

or during a stay in a healthcare facility.
84 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Who is at risk?

◗ Adults age 65 years or older.

◗ Persons with certain chronic illnesses or conditions 

including asthma, diabetes or heart disease.

◗ Persons with a weakened immune system.

◗ Smokers.

◗ Children younger than 5 years of age. 

What are signs of pneumonia?

◗ Cough (sometimes with thick, creamy, or bloody mucus).

◗ Fever.

◗ Chills.

◗ Tiredness.

◗ Confusion.

◗ Rapid breathing or shortness of breath.

◗ Chest pain.

◗ Loss of appetite.

◗ Headache.

◗ Nausea and vomiting.

How do you know if you have pneumonia?

A health care provider can look for pneumonia by:

◗ Asking questions about your symptoms.

◗ Listening to your lungs.

◗ Taking a chest X-ray.

◗ Taking a blood or mucus sample.

More tests may be done if it gets worse or if you have 

other health problems.

How is it treated?

◗ Bacterial pneumonia is treated with antibiotics.

◗ Viral pneumonia can be treated with antiviral drugs. 

Mild cases of pneumonia can be treated at home with 

medicine and rest. Most severe cases are treated in 

a hospital. In addition to medicine, oxygen and other 

methods may be used to support breathing and body 

functions.

What can happen if pneumonia gets worse?

◗ The lungs cannot send enough oxygen to the body.

◗ Pus pockets and fluid can form around the lung.

◗ Infection can spread to other areas of the body.

◗ In severe cases, pneumonia can cause death.

Pneumonia causes about 1 million 

hospitalizations and about 50,000 deaths 

a year.
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If you have pneumonia:

◗ Always finish treatment.

◗ Clean your hands often with soap and water or 

alcohol hand rub.

◗ Cough or sneeze into a tissue or into your sleeve.

◗ Do not share eating or drinking utensils, hand towels 

or toothpaste.

◗ Do not smoke.

◗ Clean surfaces often such as:

l Countertops.

l Refigerator and freezer handels.

l Doorknobs.

l Light switches.

For more information 

on cleaning hands 

see Clean Hands on 

page 99.

How can you avoid pneumonia?

◗ Get vaccinated. Discuss pneumococcal vaccine 

options with your health care provider.

◗ Keep your hands clean with soap and water or 

alcohol hand rub.

◗ Limit or avoid contact with people who are sick.

◗ Keep healthy. Eat the right foods and get enough sleep.

Learn more:

Centers for Disease Control and Prevention (CDC): 

Pneumonia Can Be Prevented - Vaccines Can Help 

www.cdc.gov/Features/Pneumonia/

Pneumococcal Vaccination

www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm

Podcasts at CDC: Preventing Pneumonia

www2c.cdc.gov/podcasts/player.asp?f=268703

U.S. National Library of Medicine:

Pneumonia

www.nlm.nih.gov/medlineplus/ency/article/000145.htm
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Men’s Health: A Guide to Preventing Infections

Vaccines

Vaccines are medical preparations given to help the 

body boost its immune system or to fight disease. 

Vaccines can prevent disease and save lives. Some 

diseases are rare in the U.S. as a result of safe 

vaccines that work. 

What types of vaccines are available?

◗ Chicken Pox (Varicella).

◗ Influenza (Seasonal Flu).

◗ Hepatitis A.

◗ Hepatitis B.

◗ Haemophilus influenza Type B (Hib).

◗ Human Papillomavirus (HPV).

◗ Measles/Mumps/Rubella.

◗ Meningococcal.

◗ Pertussis (whooping cough).

◗ Polio.

◗ Shingles.

◗ Pneumococcal.

◗ Tetanus/Diphtheria.

Your health care provider (HCP) can help you decide 

which vaccines to receive. Read more about vaccines 

in the Immunization Schedules for Adults.

In the 19th and early 20th century illnesses 

such as whooping cough (pertussis), 

measles, mumps and German measles 

struck hundreds of thousands of people in 

the United States, mostly children. Tens of 

thousands of people died.
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Are vaccines safe?

Vaccines are some of the safest medical products. 

Before approved by the U.S. Food and Drug 

Administration (FDA), vaccines are tested many times 

by scientists. Their goal is to ensure that vaccines are 

effective and safe. Vaccines are the best defense we 

have against diseases; however, no vaccine is 100% 

safe or effective for everyone. People don’t react 

to vaccines the same way. Talk to your health care 

provider (HCP) about vaccines. Talk about any possible 

side effects. Vaccines are held to the highest standard 

of safety. The benefits of getting a vaccine far outweigh 

the risks.

In the U.S.:

◗ Vaccine supplies are the safest, most effective in 

history.

◗ Vaccines are tracked for safety and effectiveness.

◗ Vaccines are tested over and over.

◗ Vaccine makers use strict production standards.

◗ The Department of Health and Human Services (HHS) 

and three federal agencies work on vaccine safety:

l Centers for Disease Control and Prevention (CDC).

l National Institutes of Health (NIH).

l Food and Drug Administration (FDA).

◗ Scientists from FDA and CDC work closely to track 

reports of vaccine side effects (adverse events). The 

Veterans Health Administration tracks side effects in 

its facilities as well.

◗ A Vaccine Information Statement (VIS) is given to 

those who get a vaccine. It:

l Explains vaccine benefits and risks.

l Is handed out before each dose of certain 

vaccines.

l Is available in Spanish and other languages at 

http://www.cdc.gov/vaccines/hcp/vis/index.html.

Vaccines are the most effective tool we 

have to prevent some diseases.

Are vaccines effective?

Most childhood vaccines build immunity about 90 - 

100% of the time. None are perfect. Each vaccine has 

its own degree of effectiveness. History shows that 

disease drops when a new vaccine released. Vaccines 

work best when most members of a community get 

it– the more people vaccinated, the lower the risk of 

exposure to disease.

Immunity is when your body can avoid 

infection or disease.

How do vaccines work with your

immune system?

◗ When germs, such as bacteria or viruses, invade 

the body, they attack and multiply. This is called an 

infection. Infection can cause illness and disease.

◗ Vaccines help your body’s immune system (natural 

defenses) prepare to fight germs and infection. 

◗ When vaccinated, your immune system attacks the 

harmless vaccine and prepares for future infections. 

◗ When the infection comes along, your body will 

quickly know how to stop it. You may never feel sick. 

Or you may have a milder illness than you would have 

if you hadn’t been vaccinated.
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How do vaccines protect you and

your community?

Vaccines can prevent disease and save lives. If enough 

people get vaccinated, large outbreaks of disease can 

be avoided. This is known as “community” or “herd” immunity. Herd immunity helps protect people who cannot be vaccinated. These include infants and people 

with certain types of weakened immune systems. Herd 

immunity is found for many conditions, such as:

◗ Influenza.

◗ Measles.

◗ Mumps.

◗ Rotavirus (stomach and intestinal).

◗ Pneumococcal disease.

◗ Pertussis (whooping cough).

◗ Polio.

◗ Rubella (German measles).

Your HCP should have a record of all the 

vaccines have been given. You should also 

keep a record.

A community in which no one is immunized and 

an outbreak occurs.

Some are immunized but not enough for 

herd immunity.

Herd immunity – enough people are immunized, 

protecting most in the community.

Image Source: The National Institute of Allergy and Infectious Diseases (NIAID) at: www.vaccines.gov
90 www.publichealth.va.gov/InfectionDontPassItOn

Men’s Health: A Guide to Preventing Infections

Learn more:

Centers for Disease Control and Prevention (CDC):

Key Facts about Seasonal Flu Vaccine

www.cdc.gov/flu/protect/keyfacts.htm

Vaccines & Preventable Diseases

http://www.cdc.gov/vaccines/vpd-vac/vaccines-list.htm

Vaccines and Immunizations Safety

http://www.cdc.gov/vaccines/vac-gen/safety/default.htm

Immunization Schedules

http://www.cdc.gov/vaccines/schedules/index.html

Immunizations for Infants and Toddlers

www.cdc.gov/vaccines/parents/infants-toddlers.html

Pregnant Women and Vaccines

http://www.cdc.gov/vaccines/adults/rec-vac/pregnant.html

U.S. Department of Health and Human Services (HHS):

Preventing Seasonal Flu with Vaccination

https://www.cdc.gov/flu/protect/vaccine/index.htm 

Vaccines, Who & When: Adults 

www.vaccines.gov/who_and_when/adults/index.html

U.S. National Library of Medicine:

Medline Plus – Vaccines (immunizations) – overview

http://www.nlm.nih.gov/medlineplus/ency/article/002024.htm

Department of Veterans Affairs (VA): Public Health:

Vaccines and Immunization

http://www.publichealth.va.gov/vaccines.asp
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Food & Water Safety

The Centers for Disease Control and Prevention 

(CDC) estimates that 1 out of every 6 (about 48 million) 

Americans will suffer a foodborne illness during any 

given year. Thousands of those made sick by germs in 

food will need hospitalization and die.

What are the signs of illness from food?

◗ Diarrhea.

◗ Fever.

◗ Vomiting.

◗ Abdominal cramps.

◗ Dehydration.

How is food handled safely? 

◗ Be smart when buying groceries (see section on

next page).

◗ Keep hands, surfaces, and foods clean.

◗ Store foods in the right containers.

◗ Store foods at the right temperature.

◗ Thaw and prepare frozen foods as recommended.

◗ Follow specific preparation techniques.

◗ Recognize serving principles.

◗ Use good judgement when eating out.

Tips for the outdoorsman:

◗ Field dress, butcher, and store wild game using clean 

processes.

◗ Learn to how to safely select, clean, and store fish 

and shell fish.

◗ Select and clean wild produce with care. Discard any 

damaged or insect infested fruits, vegetables or game.
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You can’t see, smell, or taste harmful 

bacteria that may cause illness.

When buying groceries: 

◗ Visit the refrigerated or frozen section last.

◗ Keep raw meat, poultry, fish and shellfish separate 

from fruits and vegetables while shopping.

◗ Keep raw foods separate from ready-to-eat foods.

◗ Do not buy food if the package is torn, damaged or 

leaking.

◗ Do not buy foods after the “Sell-By” or “Use-By” dates.

◗ Use insulated coolers if traveling or delaying your trip 

home.

When hunting and gathering:

◗ Do not gather, handle or eat wild game that seems 

ill or abnormal. Do not take any part of their body, 

including antlers.

◗ Wash hands and wear gloves while cleaning wild game.

◗ Do not eat or drink while gathering or cleaning game.

◗ Discard the entire carcass if the chest or abdomen is 

abnormal.

◗ Quickly take out intestines to prevent leakage. Game 

meat with leakage should be cut away. Meat touched 

by leakage should not be eaten by people or pets.

The American Veterinary Association provides 

information for hunters at: https://www.avma.org/

public/Health/Pages/Disease-Precautions-forHunters.aspx#protecting.

Check the temperature of your 

refrigerator and freezer with 

an appliance thermometer. The 

refrigerator should be at 40 °F or below 

and the freezer at 0 °F or below.

Clean hands, surfaces, and foods

◗ Keep hands clean.

◗ Wash hands using hot soapy water after contact with raw 

meat, poultry, seafood, or unwashed fruits or vegetables.

◗ Wash hands before and after handling food.

◗ Clean hands after using the bathroom, changing 

diapers, or handling pets.

◗ Use separate cutting boards and knives for meats and 

vegetables. This avoids the spread of germs.

◗ Keep cutting boards, dishes, counters, utensils, and 

hands clean.

◗ Clean cutting boards and work surfaces with warm 

soapy water (with one tablespoon of bleach added).

◗ Wash fruits and vegetables before eating.

For more information 

on cleaning hands 

see Clean Hands on 

page 99.
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When storing foods you should:

◗ Refrigerate perishable food within two hours (one 

hour when above 90°F).

◗ Store meats on the bottom shelves to avoid dripping 

on other foods.

◗ Keep meat in the original package and wrap with foil 

or plastic wrap before freezing.

◗ Remember: freezing meat does not always protect 

against disease. 

◗ Cook beef, veal, lamb, or pork within three to five days.

◗ Cook or freeze fresh poultry, fish, ground meats, and 

other meats within two days.

◗ Store cans in a cool, clean, dry place. 

◗ Discard dented, leaking, bulging, or rusted cans.

◗ Do not store food beyond expiration dates.

For hunters and gatherers:

◗ Promptly freeze, preserve, refrigerate or properly 

dispose of uncooked game.

◗ Keep uncooked wild game separate from cooked or 

ready-to-eat foods to avoid the spread of germs.

The Food and Safety Inspection Service, U.S. 

Department of Agriculture has recommendations and 

information on refrigerator and freezer food storage. 

Visit: www.fsis.usda.gov/factsheets/basics_for_

handling_food_safely/.

When thawing food:

◗ Thaw in the refrigerator.

l Make sure thawing meat and poultry are covered. 

l Keep juices from dripping into or touching other food.

l Refrigerator-thawed meat and poultry may be 

refrozen before or after cooking. 

◗ Use cold water for quick thawing if needed. 

l Place food in a leak-proof plastic bag.

l Submerge in cold tap water.

l Change the water every 30 minutes.

l Cook right away.

◗ Use a microwave to thaw as needed.

l Cook food right away.

Always cook any wild game until 

juices are clear – follow cooking 

directions on all packaged meat

and poultry. 

The Danger Zone is the temperature 

that germs can grow in food. Keep 

food below 40° or above 140°F (4°

and 60°C).

140

160

180

200
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Table 1: Safe Minimum Cooking Temperatures

Category Food Temperature (°F) Rest Time

Ground Meat & Meat Mixtures

Beef, Pork, Veal & Lamb 160 None

Turkey & Chicken 165 None

Fresh Beef, Veal & Lamb Steaks, Roasts & Chops 145 3 Minutes

Poultry

Chicken & Turkey (whole) 165 None

Poultry Breasts & Roasts 165 None

Poultry thighs, Legs & Wings 165 None

Duck & Goose 165 None

Stuffing (cooked alone or in bird) 165 None

Pork & Ham

Fresh Pork 145 3 Minutes

Fresh Ham (raw) 145 3 Minutes

Precooked Ham (to reheat) 140 None

Egg & Egg Dishes

Eggs Cook until yolk & white 

are firm. None

Egg Dishes 160 None

Leftovers & Casseroles

Leftovers 165 None

Casseroles 165 None

Seafood

Fin Fish

145 or cook until flesh 

is opaque & separates 

easily with a fork.

None

Shrimp, Lobster & Crabs Cook until flesh is pearly 

& opaque. None

Clams, Oysters & Mussels Cook until shells open 

during cooking. None

Scallops Cook until flesh is milky 

white or opaque & firm. None

* Table from: Safe Minimum Cooking Temperatures, www.foodsafety.gov/keep/charts/mintemp.html
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When preparing food:

◗ Clean your hands before and after.

l Keep cutting boards, utensils, and countertops 

clean. Use hot, soapy water and mix with liquid 

chlorine bleach (1 tablespoon per 1 gallon of water).

l Separate raw meat, poultry, and seafood from 

ready-to-eat foods.

l Use at least two cutting boards.

l One for raw meat, poultry, and seafood.

l One for fresh fruits and vegetables.

l Don’t let “juice” from foods and packaging touch 

other foods, utensils, or surfaces.

◗ Use a clean plate or bowl for cooked food.

◗ Never use the same plate or bowl that held the 

uncooked or raw food. Germs from the raw food 

could get into the cooked food. Marinate meat and 

poultry in a covered dish in the refrigerator.

When using a thermometer:

◗ Use a food thermometer to check that meat, poultry, 

and egg dishes reach a safe temperature. Refer to 

the chart in Table 1 or visit: www.fsis.usda.gov/Is_It_

Done_Yet/Brochure_Text/index.asp#SMIT.

◗ Follow the instructions for your food thermometer.

◗ Place thermometer in the thickest part of the food, not 

touching bone, fat, or gristle.

◗ Check at the end of the cooking time, but before the 

food is expected to be “done”.

◗ Check the temperature in several places to make 

sure the food is evenly heated.

◗ Clean your food thermometer with hot, soapy water 

before and after each use.

◗ Large-dial oven-safe or oven-probe thermometers 

may be used during cooking.

Leftover food should be used within 4 

days. Reheat leftovers to 165 °F.

◗ After cooking, allow food to “rest” before cutting or 

eating. “Rest” times are in Table 1.

◗ During the rest time, the temperature of the food will stay 

the same or rise. This will help destroy harmful germs.

When serving foods:

◗ Keep hot food at 140°F or warmer.

◗ Keep cold food at 40°F or colder.

◗ Keep food hot with chafing dishes, slow cookers, and 

warming trays during parties.

◗ Keep food cold by nesting dishes in bowls of ice or 

use small serving trays. Replace them often.

◗ Don’t leave perishable foods out for more than 

2 hours at room temperature (1 hour when the 

temperature is above 90°F).

2 Hour Rule: Keep hot food hot and cold 

food cold. If food that has been left out is 

not eaten within 2 hours, discard it.

When eating out:

◗ Choose a clean restaurant. Look for health 

department reports online or posted in the restaurant. 

◗ Look around you before you sit down. If it’s not clean 

think about eating somewhere else.

◗ Clean your hands with soap and warm water before 

eating. If soap and water aren’t available, use alcohol 

hand rub to clean your hands.

◗ Pay close attention to the type of food and how it’s 

prepared - harmful germs can be hidden in some foods.

◗ Request that your food be cooked completely 

through - especially meat, poultry, fish, and eggs.

◗ Make sure your hot food is piping hot and completely 

cooked. If lukewarm, send it back.
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◗ Know that raw or undercooked finfish or shellfish 

(including oysters, clams, and mussels) are more likely 

to contain parasites or bacteria than foods made from 

cooked fish.

◗ Refrigerate take-out and “leftover” food within 2 hours 

after being served. If you will not be home within 2 

hours, don’t take the leftovers home with you.

◗ Bring take-out and “leftover” food directly home after 

eating out and put your leftovers in the refrigerator as 

soon as you arrive.

◗ Eat delivery food within two hours after it arrives. This 

prevents the growth of harmful germs.

If the food is not going to be eaten within two hours, 

you can keep it hot in the oven—but the temperature 

must be set at or above 200°F (93°C). Side dishes, like 

stuffing, must also be kept hot in the oven. Covering 

food will help keep it moist while you keep it warm. 

Check with a food thermometer to make sure that the 

inside of the food is held at a temperature 140°F (60°C).

Water Safety

The U.S. has one of the safest water systems in the 

world. The quality and safety of tap water can vary 

based on the water source. Water at your home or work 

may come from a private well or spring, or community 

system. The Centers for Disease Control and Prevention (CDC) receive reports of illnesses related to drinking water such as:

◗ Chemicals and minerals (arsenic).

◗ Viruses.

◗ Bacteria.

◗ Parasites.

◗ Pesticide use.

◗ Industrial waster.

Water sources can also be made unusable by a failed 

septic system or from natural or man-made disasters. 

All U.S. public water systems follow the standards set 

by the U.S. Environmental Protection Agency (EPA). All 

water requires regular testing and disinfection. The 

EPA does not oversee private wells or springs. Owners 

using these should test their own water from time to 

time. Check with your local public/water works office 

or local health department to learn more about water 

testing such as:

◗ What to test for.

◗ Where to send tests.

◗ How often to test.

◗ What to do if your water is contaminated.

Reasons to test your water:

◗ ongoing “stomach” problems, nausea, diarrhea.

◗ old pipes that might be lead or are corroded.

◗ water that smells or tastes odd, “smells like gasoline”.

◗ water that is cloudy, frothy, or colored.
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Learn more:

Department of Veterans Affairs (VA):

What Should I Know About Food Safety?

https://www.hiv.va.gov/patient/daily/diet/food-safety.asp

U.S. Department of Agriculture (USDA), Food and Safety Inspection Service:

Food Safety While Hiking, Camping & Boating

https://www.fsis.usda.gov/wps/wcm/connect/82318e67-8c96-47ac-8615-747f4c403816/Food_Safety_

While_Hiking_Camping_Boating.pdf?MOD=AJPERES

Kitchen Companion; Your Safe Food Handbook

https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-factsheets/safe-food-handling/kitchen-companion-your-safe-food-handbook/ct_index

Safe Food Handling

https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets

Cooking Meat? Check the New Recommended Temperatures

www.foodsafety.gov/blog/meat_temperatures.html

At Risk Populations

https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-factsheets/at-risk-populations

Centers for Disease Control and Prevention (CDC)

http://www.cdc.gov/healthywater/drinking/public/index.html

http://www.cdc.gov/healthywater/drinking/private/index.html

http://www.cdc.gov/healthywater/pdf/drinking/Backcountry_Water_Treatment.pdf

Environmental Protection Agency (EPA)

https://www.epa.gov/privatewells/protect-your-homes-water

Camping

http://www.dhhr.wv.gov/campsafety/campers/Pages/water-safety.aspx

Veterans Health Administration 99

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Clean Hands

Keeping your hands clean is one of the best ways to 

prevent the spread of germs and infection.

Germs can be spread from hands to high-touch items 

such as doorknobs, grocery carts, handrails, phones 

and computer keyboards. When you handle these 

items, then touch their eyes, nose, or mouth, germs

can spread. This is just one way that germs spread. 

Keeping your hands clean helps you: 

◗ Avoid getting sick.

◗ Avoid spreading germs to others.

◗ Keep your family.

◗ Be a healthy role model for others.

When should you clean your hands?

Before:

◗ Preparing or eating food.

◗ Caring for someone who is sick.

◗ Treating a cut or would.

◗ Putting in contact lenses.
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After:

◗ Going to the bathroom.

◗ Contact with body fluids such as blood, vomit, or feces.

◗ Changing diapers or helping someone with toileting.

◗ Caring for someone who is sick.

◗ Blowing your nose.

◗ Coughing or sneezing.

◗ Touching an animal or handling their toys or waste.

◗ Handling garbage, trash cans, or drains.

◗ Treating a cut or wound.

◗ Handling raw meat.

Simply put: Clean your hands often, 

whether they look dirty or not.

How should you clean your hands?

You can clean your hands using soap and water. Or, 

you can use an alcohol hand cleaner.

With soap and water:

1. Wet your hands with clean running water. 

2. Add soap to make suds and scrub all over your 

hands and wrists.

3. Rub:

l Palms.

l Back of hands.

l Between the fingers.

l Fingers.

l Wrists.

4. Continue rubbing hands for at least 20 seconds.

5. Rinse hands well under running water.

6. Dry your hands using a clean paper towelor air dryer.

If possible, use your paper towel to turn off the water 

and to open the door when leaving the restroom.

Need a hand washing timer? Sing “Happy 

Birthday” through twice in your head!

With alcohol hand cleaner:

1. Apply product to the plam of one hand (see product 

label for directions/enough to use on BOTH hands.)

2. Rub:

l Palms.

l Back of hands.

l Between the fingers.

l Fingers.

l Wrists.

3. Keep rubbing until hands are dry, at least 30 seconds

Use soap and water instead of alcohol hand cleaner:

◗ When your hands are visibly dirty.

◗ Before eating or preparing food.

◗ After handling raw meat.

◗ After handling animal waste.

◗ After going to the bathroom.

◗ After changing a diaper.

◗ After assisting someone with toileting. 

Most alcohol hand cleaners from 

grocery or drug stores contain alcohol 

to reduce or kill most germs and viruses. 

They come in all sizes – even ones that 

fit in a child’s pocket.
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How can you help others to clean

their hands?

◗ Lead by example and clean your own hands often.

◗ Teach your friends and family when and how to keep 

their hands clean. 

◗ Keep alcohol hand cleaner handy. Place it near you at 

work, each room at home, and in your car. Teach your 

family and friends to do the same.

◗ Teach your children good hand cleaning habits, like 

cleaning their hands before touching their eyes, nose 

or mouth.

One way to remind everyone of when to 

clean hands is to put a bottle of alcohol 

hand cleaner next to each box of tissues in 

your home.

Don’t be afraid to ask anyone, including 

health care providers, to clean their hands 

before touching a patient.

If you are a patient or a visitor in a 

hospital or medical facility:

◗ Clean your hands and ask your family to do the same:

l Before entering a patient room or touching

a patient.

l After leaving a patient room or touching a patient.

◗ See that staff put on gloves before touching broken 

skin or open wounds.

◗ Use alcohol hand cleaners in halls or in patient rooms.

◗ Ask staff about the steps the hospital is taking to help 

staff keep their hands clean.

◗ Ask or remind hospital staff to clean their hands 

before and after touching a patient. 

Learn more:

Department of Veterans Affairs (VA):

Infection: Don’t Pass It On

https://www.publichealth.va.gov/infectiondontpassiton/index.asp

Hand Hygiene Video

http://www.publichealth.va.gov/flu/materials/videos.asp

Centers for Disease Control and Prevention (CDC): 

CDC TV: Put Your Hands Together

www.cdc.gov/CDCTV/HandsTogether/

Hand Hygiene Saves Lives

www.cdc.gov/Features/HandHygiene/

Wash Your Hands

www.cdc.gov/Features/HandWashing/

An Ounce of Prevention Keeps the Germs Away; Seven Keys to a Safer Healthier Home

www.cdc.gov/ounceofprevention/docs/oop_brochure_eng.pdf

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Contact Lens Safety

Lenses can collect bacteria, fungi, and other germs 

if not cleaned correctly. Wearers are at risk of eye 

infections and corneal ulcers since contacts are worn 

directly on the eye.

Eye infections can cause:

◗ Pain.

◗ Blurred vision.

◗ Blindness.

How should you clean and store your 

contact lenses?

Safely cleaning and storing your contact lenses is the 

best way to prevent eye infections. Follow your eye 

care provider’s and the maker’s instructions.

1. Always clean hands before touching your eyes and 

contact lenses.

2. Remove the lens and place in the palm of your hand.

3. Rub the contact lens with solution for 5 to 10 

seconds on each side.

4. Rinse the lens with a stream of solution. This helps to 

remove bacteria and deposits.

5. Store lenses in the proper storage case with fresh 

solution.

6. Rinse the empty case with fresh solution and allow 

to air dry. Never use tap water.

7. Replace your contact lens storage case at least once 

every 3 months.

Replace contact storage cases at least 

once every 3 months.
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When should you wear contact lenses?

Most types of lenses are only worn while awake. 

Contact lenses should not be worn when:

◗ Sleeping (some can be worn overnight*).

◗ Showering.

◗ Swimming.

◗ Using a hot tub.

*Some types of extended wear lenses can be worn 

when sleeping. Talk to your eye care provider about 

when to remove your contact lenses.

Never expose contact 

lenses to water.

If you wear contact lenses:

Always:

◗ See your eye care provider:

l For regular exams.

l To ask what products and solutions to use.

l To ask when to replace your lenses.

l If you have any problems with your eyes, vision,

or lenses.

◗ Clean hands before touching your eyes and lenses.

◗ Use fresh, sterile solutions to clean and store lenses.

Never:

◗ Re-use lens solutions to clean or store lenses. Discard 

all solutions after use. Used solutions may have 

germs that can cause eye infections.

◗ Expose your lenses to water, including distilled, 

bottled, tap, lake, or ocean water. Water can contain 

germs that cause eye infections.

◗ Use saliva to wet your lenses.

◗ Transfer sterile contact lens solution to another 

container for later use.
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What are signs of an eye infection?

◗ Discomfort.

◗ Excessive tearing or mucus.

◗ Unusual sensitivity to light.

◗ Itching.

◗ Burning.

◗ “Gritty” feeling.

◗ Unusual redness.

◗ Blurred vision.

◗ Swelling.

◗ Pain.

See your eye care provider right away if you have

signs of an eye infection. Allergies can cause some of 

the same signs as an eye infection. Allergies usually 

affect both eyes equally. Some infections may affect 

only one eye. 

See your eye care provider right away if 

you have signs of an eye infection.

Learn more:

Centers for Disease Control and Prevention (CDC):

Parasites - Acanthamoeba; Contact Wearers

http://www.cdc.gov/parasites/acanthamoeba/microbial-keratitis.html

Food and Drug Administration (FDA):

Focusing on Contact Lens Safety

www.fda.gov/forconsumers/consumerupdates/ucm048893.htm

Video on Contact Lens Safety

www.accessdata.fda.gov/videos/cdrh/contactlens.wmv

Ensuring Safe Use of Contact Lens Solution

www.fda.gov/forconsumers/consumerupdates/ucm164197.htm
106 www.publichealth.va.gov/InfectionDontPassItOn
Veterans Health Administration 107

Men’s Health: A Guide to Preventing Infections

Definition of Terms

The terms below are defined in the context of their 

use within this health guide. For complete definitions, 

consult a reputable medical dictionary.

Acute infection. . . . . . . . . . . . . . . . . . . . A short-term illness caused by a germ.

AIDS (acquired

immunodeficiency syndrome). . . . . . . The late stage of HIV infection. When you have AIDS, your immune system 

is very weak. 

Alcohol hand cleaner. . . . . . . . . . . . . . A liquid, foam, or gel used to clean hands. It contains alcohol to kill germs. 

Antibiotics. . . . . . . . . . . . . . . . . . . . . . . . A type of medicine used to treat bacterial infections. Antibiotics do not 

work on viral infections.

Antiviral drugs. . . . . . . . . . . . . . . . . . . . . A type of medicine used for viral infections such as influenza (flu) and HIV. 

Bacteria. . . . . . . . . . . . . . . . . . . . . . . . . . . A type of germ that may cause infection. Not all bacteria are harmful or 

cause infection. Most bacterial infections are treated with antibiotics. 

Biopsy. . . . . . . . . . . . . . . . . . . . . . . . . . . . The removal of a small piece of an organ or tissue to look for signs of 

disease or damage. 

Bladder. . . . . . . . . . . . . . . . . . . . . . . . . . . The organ in the urinary tract that stores urine.

Chronic infection. . . . . . . . . . . . . . . . . . A long-term illness caused by a germ.
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Men’s Health: A Guide to Preventing Infections

Chlamydia. . . . . . . . . . . . . . . . . . . . . . . . An infectioncaused by bacteria. It Is the most common STD in the U.S.

Circumcision. . . . . . . . . . . . . . . . . . . . . . The surgical removal of some or the entire foreskin covering the tip of the 

penis.

Cirrhosis. . . . . . . . . . . . . . . . . . . . . . . . . . Scarring of the liver.

Cold. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . An infection of the nose, sinuses, or throat caused by a virus.

“Community” or

“Herd” Immunity. . . . . . . . . . . . . . . . . . . Immunity that occurs when most people have been vaccinated against or 

have had an infection. This stops the spread of a contagious disease to 

protect even those not vaccinated to avoid large outbreaks of disease.

Condom, female. . . . . . . . . . . . . . . . . . . A plastic barrier inserted into the vagina before intercourse to reduce the 

risk of sexually transmitted diseases (STDs) and pregnancy.

Condom, male. . . . . . . . . . . . . . . . . . . . . A latex, “lambskin”, or plastic barrier used to cover the penis during vaginal, 

anal or oral sex to reduce the risk of sexually transmitted diseases (STDs) 

and pregnancy.

Contagious. . . . . . . . . . . . . . . . . . . . . . . . The spread of germs from one person (or other living organism) to another.

Dental dam. . . . . . . . . . . . . . . . . . . . . . . . A square piece of latex (rubber) or silicone used as a barrier during oral sex 

to reduce the risk of sexually transmitted diseases (STDs).

Fungus (fungi). . . . . . . . . . . . . . . . . . . . . A type of organism that may cause infection. Fungi can cause vaginal yeast 

infections and severe diseases like pneumonia in people with poor immune 

systems. 

Genital warts. . . . . . . . . . . . . . . . . . . . . . Small bumps or groups of bumps in the genital area caused by human 

papillomavirus (HPV).

Genital yeast infection. . . . . . . . . . . . . More common in women, an infection caused by a fungus called candida.

Gonorrhea. . . . . . . . . . . . . . . . . . . . . . . . A sexually transmitted disease (STD) caused by bacteria. Also known as 

“the clap” or “the drips”. It affects both men and women. 

Hepatitis. . . . . . . . . . . . . . . . . . . . . . . . . . A swollen (inflamed) liver that can be caused by viral infections, drugs, 

diseases, alcohol, and/or toxins. 

Herpes. . . . . . . . . . . . . . . . . . . . . . . . . . . . A sexually transmitted disease (STD) caused by two types of herpes simplex 

viruses. 

HIV (human

immunodeficiency virus). . . . . . . . . . . A virus that attacks and weakens the immune system.

Human papillomavirus (HPV). . . . . . . The most common sexually transmitted disease (STD) in the United States. 

There are over 40 types of HPV viruses that can infect genital, mouth or 

throat areas. Some can lead to genital warts and others increase the risk 

for cancer.

Immune system. . . . . . . . . . . . . . . . . . . . Parts of the body that protect against germs and diseases. 

Immunity. . . . . . . . . . . . . . . . . . . . . . . . . . The ability of your body to avoid an infection or disease.

Influenza (flu). . . . . . . . . . . . . . . . . . . . . . A respiratory illness caused by a flu virus.
Veterans Health Administration 109

Men’s Health: A Guide to Preventing Infections

Kidneys. . . . . . . . . . . . . . . . . . . . . . . . . . . Organs in the urinary tract that collect waste from blood to make urine. 

Lymph nodes. . . . . . . . . . . . . . . . . . . . . . Small organs within the immune system spread throughout the body that 

help fight infection. 

Parasite. . . . . . . . . . . . . . . . . . . . . . . . . . . An organism that can cause infection. Parasites may cause infections such 

as trichomoniasis.

Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . An infection of the lungs that can be caused by bacteria, virus, fungi, or 

parasites.

Safer sex. . . . . . . . . . . . . . . . . . . . . . . . . . The use of barriers such as condoms during vaginal, anal or oral sex to 

prevent and control the spread of sexually transmitted diseases (STD) and 

other infections.

Sexually transmitted

disease (STD). . . . . . . . . . . . . . . . . . . . . . Infection spread by vaginal, anal or oral sex, and genital touching. STDs 

can be caused by bacteria, parasites, or viruses. Common STDs include 

chlamydia, HPV, and herpes. 

Sexually transmitted

infection (STI). . . . . . . . . . . . . . . . . . . . . See sexually transmitted disease (STD).

Syphilis. . . . . . . . . . . . . . . . . . . . . . . . . . . A sexually transmitted disease (STD) caused by bacteria that can produce 

sores on the genitals, vagina, anus, rectum, and even on the lips and in the 

mouth. 

Trichomoniasis. . . . . . . . . . . . . . . . . . . . A sexually transmitted disease (STD) caused by a small parasite. It Affects 

both men and women. It is known as “trich”.

Ureters. . . . . . . . . . . . . . . . . . . . . . . . . . . Tubes of the urinary tract that move urine from the kidneys to the bladder. 

Urethra. . . . . . . . . . . . . . . . . . . . . . . . . . . The tube within the urinary tract that carries urine from the bladder out of 

the body. 

Urinary tract. . . . . . . . . . . . . . . . . . . . . . . The body system that makes, stores, and carries urine out of the body. 

Includes the kidneys, ureters, bladder, and urethra. 

Urinary tract infection (UTI). . . . . . . . . An infection that occurs when bacteria grow in the urinary tract.

Vaccine. . . . . . . . . . . . . . . . . . . . . . . . . . . A medical preparation given to help the body produce immunity or to fight 

disease. 

Virus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A type of germ that causes infections and disease. Influenza (flu), HIV, 

and herpes are caused by viruses. Antiviral drugs are used to treat viral 

infections.

Yeast. . . . . . . . . . . . . . . . . . . . . . . . . . . . . A type of fungus that can lead to infection. 
Infection: Don’t Pass It On 

A Campaign For Public Health

Veterans Health Administration

U.S. Department of Veterans Affairs

VHA National Center for Health Promotion

and Disease Prevention (10P4N)

810 Vermont Ave, NW

Washington, DC 20420

July 2017 This material is NOT copyrighted and may be reproduced.