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1 Chapter 1 : Sexually transmitted diseases (STDs) - Symptoms and causes - Mayo Clinic Sexually transmitted diseases (STDs) are passed from one person to another through intimate physical contact - such as heavy petting - and from sexual activity including vaginal, oral, and anal sex. Key facts More than 1 million sexually transmitted infections STIs are acquired every day worldwide. Each year, there are an estimated million new infections with 1 of 4 STIs: More than million people are estimated to have genital infection with herpes simplex virus HSV. More than million women have a human papillomavirus HPV infection 1. Over pregnant women were infected with syphilis resulting in approximately adverse birth outcomes including stillbirth in 2. In some cases, STIs can have serious reproductive health consequences beyond the immediate impact of the infection itself e. More than 30 different bacteria, viruses and parasites are known to be transmitted through sexual contact. Eight of these pathogens are linked to the greatest incidence of sexually transmitted disease. Of these 8 infections, 4 are currently curable: The other 4 are viral infections and are incurable: Symptoms or disease due to the incurable viral infections can be reduced or modified through treatment. STIs are spread predominantly by sexual contact, including vaginal, anal and oral sex. Some STIs can also be spread through non-sexual means such as via blood or blood products. Many STIsâ including chlamydia, gonorrhoea, primarily hepatitis B, HIV, and syphilisâ can also be transmitted from mother to child during pregnancy and childbirth. A person can have an STI without having obvious symptoms of disease. Common symptoms of STIs include vaginal discharge, urethral discharge or burning in men, genital ulcers, and abdominal pain. Scope of the problem STIs have a profound impact on sexual and reproductive health worldwide. More than 1 million STIs are acquired every day. Each year, there are estimated million new infections with 1 of 4 STIs: More than million people are living with genital HSV herpes infection. STIs can have serious consequences beyond the immediate impact of the infection itself. Mother-to-child transmission of STIs can result in stillbirth, neonatal death, low-birth-weight and prematurity, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities. HPV infection causes cases of cervical cancer and cervical cancer deaths each year. STIs such as gonorrhoea and chlamydia are major causes of pelvic inflammatory disease PID and infertility in women. Unfortunately, lack of public awareness, lack of training of health workers, and long-standing, widespread stigma around STIs remain barriers to greater and more effective use of these interventions. Barrier methods When used correctly and consistently, condoms offer one of the most effective methods of protection against STIs, including HIV. Female condoms are effective and safe, but are not used as widely by national programmes as male condoms. These are especially useful for the diagnosis of asymptomatic infections. However, in low- and middle-income countries, diagnostic tests are largely unavailable. Where testing is available, it is often expensive and geographically inaccessible; and patients often need to wait a long time or need to return to receive results. As a result, follow up can be impeded and care or treatment can be incomplete. The syphilis test is already in use in some resource-limited settings. The test is accurate, can provide results in 15 to 20 minutes, and is easy to use with minimal training. Rapid syphilis tests have been shown to increase the number of pregnant women tested for syphilis. However, increased efforts are still needed in most low- and middle-income countries to ensure that all pregnant women receive a syphilis test. Several rapid tests for other STIs are under development and have the potential to improve STI diagnosis and treatment, especially in resource-limited settings. Three bacterial STIs chlamydia, gonorrhoea and syphilis and one parasitic STI trichomoniasis are generally curable with existing, effective single-dose regimens of antibiotics. For herpes and HIV, the most effective medications available are antivirals that can modulate the course of the disease, though they cannot cure the disease. For hepatitis B, immune system modulators interferon and antiviral medications can help to fight the virus and slow damage to the liver. Resistance of STIsâ in particular gonorrhoeaâ to antibiotics has increased rapidly in recent years and has reduced treatment options. Antimicrobial resistance for other STIs, though less common, also exists, making prevention and prompt treatment critical. STI case management Low- and middle-income countries rely on identifying consistent, easily recognizable signs and symptoms to guide treatment, without the use of laboratory tests. This is called syndromic management. This approach, which Page 1

2 often relies on clinical algorithms, allows health workers to diagnose a specific infection on the basis of observed syndromes e. Syndromic management is simple, assures rapid, same-day treatment, and avoids expensive or unavailable diagnostic tests. However, this approach misses infections that do not demonstrate any syndromes - the majority of STIs globally. Vaccines and other biomedical interventions Safe and highly effective vaccines are available for 2 STIs: These vaccines have represented major advances in STI prevention. HPV vaccine is available as part of routine immunization programmes in 65 countries, most of them high- and middle-income. Research to develop vaccines against herpes and HIV is advanced, with several vaccine candidates in early clinical development. Research into vaccines for chlamydia, gonorrhoea, syphilis and trichomoniasis is in earlier stages of development. Other biomedical interventions to prevent some STIs include adult male circumcision and microbicides. Tenofovir gel, when used as a vaginal microbicide, has had mixed results in terms of the ability to prevent HIV acquisition, but has shown some effectiveness against HSV Current efforts to contain the spread of STIs are not sufficient Behaviour change is complex Despite considerable efforts to identify simple interventions that can reduce risky sexual behaviour, behaviour change remains a complex challenge. Research has demonstrated the need to focus on carefully defined populations, consult extensively with the identified target populations, and involve them in design, implementation and evaluation. Health services for screening and treatment of STIs remain weak People seeking screening and treatment for STIs face numerous problems. These include limited resources, stigmatization, poor quality of services, and little or no follow-up of sexual partners. In many countries, STI services are provided separately and not available in primary health care, family planning and other routine health services. In many settings, services are often unable to provide screening for asymptomatic infections, lacking trained personnel, laboratory capacity and adequate supplies of appropriate medicines. Marginalized populations with the highest rates of STIsâ such as sex workers, men who have sex with men, people who inject drugs, prison inmates, mobile populations and adolescentsâ often do not have access to adequate health services. WHO response WHO develops global norms and standards for STI treatment and prevention, strengthens systems for surveillance and monitoring, including those for drug-resistant gonorrhoea, and leads the setting of the global research agenda on STIs. Page 2

3 Chapter 2 : Sexually transmitted infection - Wikipedia Sexually transmitted diseases (STDs) are infections that are passed from one person to another through sexual contact. The causes of STDs are bacteria, parasites, yeast, and viruses. Persistent, unexplained fatigue Shaking chills or fever higher than Most people with HSV never know they have it, because they have no signs or symptoms or the signs and symptoms are so mild they go unnoticed. When signs and symptoms are noticeable, the first episode is generally the worst. Some people never have a second episode. Others, however, can have recurrent episodes for decades. When present, genital herpes signs and symptoms may include: Small red bumps, blisters vesicles or open sores ulcers in the genital, anal and nearby areas Pain or itching around the genital area, buttocks and inner thighs The initial symptom of genital herpes usually is pain or itching, beginning within a few weeks after exposure to an infected sexual partner. After several days, small red bumps may appear. They then rupture, becoming ulcers that ooze or bleed. Eventually, scabs form and the ulcers heal. In women, sores can erupt in the vaginal area, external genitals, buttocks, anus or cervix. In men, sores can appear on the penis, scrotum, buttocks, anus or thighs, or inside the tube from the bladder through the penis urethra. Ulcers can make urination painful. You may also have pain and tenderness in your genital area until the infection clears. During an initial episode, you may have flu-like signs and symptoms, such as a headache, muscle aches and fever, as well as swollen lymph nodes in your groin. Some forms put women at high risk of cervical cancer. Other forms cause genital warts. HPV usually has no signs or symptoms. The signs and symptoms of genital warts include: Small, flesh-colored or gray swellings in your genital area Several warts close together that take on a cauliflower shape Itching or discomfort in your genital area Bleeding with intercourse Often, however, genital warts cause no symptoms. Genital warts may be as small as 1 millimeter in diameter or may multiply into large clusters. In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sex with an infected person. Hepatitis symptoms Hepatitis A, hepatitis B and hepatitis C are all contagious viral infections that affect your liver. Hepatitis B and C are the most serious of the three, but each can cause your liver to become inflamed. Some people never develop signs or symptoms. But for those who do, signs and symptoms may occur several weeks after exposure and may include: Fatigue Nausea and vomiting Abdominal pain or discomfort, especially in the area of your liver on your right side beneath your lower ribs Loss of appetite. Page 3

4 Chapter 3 : Sexually Transmitted Diseases Healthy People Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are generally acquired by sexual contact. The organisms that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids. Trichomoniasis Trichomonas vaginalis, colloquially known as "trich" Main types Sexually transmitted infections include: Chlamydia is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. In women, symptoms may include abnormal vaginal discharge, burning during urination, and bleeding in between periods, although most women do not experience any symptoms. PID can cause serious problems during pregnancy and even has the potential to cause infertility. It can cause a woman to have a potentially deadly ectopic pregnancy, in which the egg implants outside of the uterus. However, Chlamydia can be cured with antibiotics. The two most common forms of herpes are caused by infection with herpes simplex virus HSV. HSV-1 is typically acquired orally and causes cold sores, HSV-2 is usually acquired during sexual contact and affects the genitals, however either strain may affect either site. Those that do experience symptoms usually notice them 2 to 20 days after exposure which last 2 to 4 weeks. Symptoms can include small fluid-filled blisters, headaches, backaches, itching or tingling sensations in the genital or anal area, pain during urination, Flu like symptoms, swollen glands, or fever. Herpes is spread through skin contact with a person infected with the virus. The virus affects the areas where it entered the body. This can occur through kissing, vaginal intercourse, oral sex or anal sex. The virus is most infectious during times when there are visible symptoms, however those who are asymptomatic can still spread the virus through skin contact. After the primary attack, one might have recurring attacks that are milder or might not even have future attacks. There is no cure for the disease but there are antiviral medications that treat its symptoms and lower the risk of transmission Valtrex. The virus, either type, will settle into a nerve bundle either at the top of the spine, producing the "oral" outbreak, or a second nerve bundle at the base of the spine, producing the genital outbreak. Symptoms might not show up until advanced stages. It is important for women to get pap smears in order to check for and treat cancers. There are also two vaccines available for women Cervarix and Gardasil that protect against the types of HPV that cause cervical cancer. HPV can be passed through genital-to-genital contact as well as during oral sex. It is important to remember that the infected partner might not have any symptoms. Gonorrhea is caused by bacterium that lives on moist mucous membranes in the urethra, vagina, rectum, mouth, throat, and eyes. The infection can spread through contact with the penis, vagina, mouth or anus. Symptoms of gonorrhea usually appear 2 to 5 days after contact with an infected partner however, some men might not notice symptoms for up to a month. Symptoms in men include burning and pain while urinating, increased urinary frequency, discharge from the penis white, green, or yellow in color, red or swollen urethra, swollen or tender testicles, or sore throat. Symptoms in women may include vaginal discharge, burning or itching while urinating, painful sexual intercourse, severe pain in lower abdomen if infection spreads to fallopian tubes, or fever if infection spreads to fallopian tubes ; however, many women do not show any symptoms. Secondary syphilis Syphilis is an STI caused by a bacterium. Untreated, it can lead to complications and death. In recent years, the prevalence of syphilis has declined in Western Europe, but it has increased in Eastern Europe former Soviet states. The virus kills CD4 cells, which are white blood cells that help fight off various infections. HIV is carried in body fluids, and is spread by sexual activity. It can also be spread by contact with infected blood, breast feeding, childbirth, and from mother to child during pregnancy. The stages include primary infection, asymptomatic infection, symptomatic infection, and AIDS. In the primary infection stage, an individual will have flu like symptoms headache, fatigue, fever, muscle aches for about 2 weeks. In the asymptomatic stage, symptoms usually disappear, and the patient can remain asymptomatic for years. People with AIDS fall prey to opportunistic infections and die as a result. By suppressing the amount of virus in the body, people can lead longer and healthier lives. Even though their virus levels may be low they can still spread the virus to others. Information on whether or not transmission occurs or whether the viruses cause disease is uncertain. Some of these microbes are known to be sexually Page 4

5 transmitted. Marburg virus â Virus in semen for seven weeks after clinical recovery. Mucous membranes differ from skin in that they allow certain pathogens into the body. The amount of contact with infective sources which causes infection varies with each pathogen but in all cases, a disease may result from even light contact from fluid carriers like venereal fluids onto a mucous membrane. The transfer of and exposure to bodily fluids, such as blood transfusions and other blood products, sharing injection needles, needle-stick injuries when medical staff are inadvertently jabbed or pricked with needles during medical procedures, sharing tattoo needles, and childbirth are other avenues of transmission. These different means put certain groups, such as medical workers, and haemophiliacs and drug users, particularly at risk. In particular, sexually transmitted diseases in women often cause the serious condition of pelvic inflammatory disease. Not all sexual activities involve contact: Proper use of condoms reduces contact and risk. Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom. Many infections are not detectable immediately after exposure, so enough time must be allowed between possible exposures and testing for the tests to be accurate. Certain STIs, particularly certain persistent viruses like HPV, may be impossible to detect with current medical procedures. Other facilities strongly encourage that those previously infected return to ensure that the infection has been eliminated. Novel strategies to foster re-testing have been the use of text messaging and as reminders. These types of reminders are now used in addition to phone calls and letters. Prevention counseling for STIs is usually offered to all sexually active adolescents and to all adults who have received a diagnosis, have had an STI in the past year, or have multiple sex partners. The development of vaccines to protect against gonorrhea is ongoing. Uncovered areas are still susceptible to many STIs. An infected fluid to broken skin borne direct transmission of HIV would not be considered "sexually transmitted", but can still theoretically occur during sexual contact. This can be avoided simply by not engaging in sexual contact when presenting open, bleeding wounds. Some microorganisms and viruses are small enough to pass through the pores in natural skin condoms, but are still too large to pass through latex or synthetic condoms. Putting the condom on snug can and often leads to failure. Wearing a condom too loose can defeat the barrier Avoiding inverting or spilling a condom once worn, whether it has ejaculate in it or not If a user attempts to unroll the condom, but realizes they have it on the wrong side, then this condom may not be effective Being careful with the condom if handling it with long nails Avoiding the use of oil-based lubricants or anything with oil in it with latex condoms, as oil can eat holes into them Using flavored condoms for oral sex only, as the sugar in the flavoring can lead to yeast infections if used to penetrate In order to best protect oneself and the partner from STIs, the old condom and its contents are be assumed to be infectious. Therefore, the old condom must be properly disposed of. A new condom is used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the effectiveness as a barrier. Trials, however, have found it ineffective [84] and it may put women at a higher risk of HIV infection. The CDC recommends that sexually active women under the age of 25 and those over 25 at risk should be screened for chlamydia and gonorrhea yearly. Appropriate times for screening are during regular pelvic examinations and preconception evaluations. No procedure tests for all infectious agents. STI tests may be used for a number of reasons: There is often a window period after initial infection during which an STI test will be negative. During this period, the infection may be transmissible. The duration of this period varies depending on the infection and the test. Diagnosis may also be delayed by reluctance of the infected person to seek a medical professional. One report indicated that people turn to the Internet rather than to a medical professional for information on STIs to a higher degree than for other sexual problems. Page 5

6 Chapter 4 : Sexually Transmitted Diseases - Chapter 3 - Yellow Book Travelers' Health CDC Sexually transmitted diseases (STDs) are infections that can be transferred from one person to another through any type of sexual contact. STDs are sometimes referred to as sexually transmitted infections (STIs) since they involve the transmission of a disease-causing organism from one person to another during sexual activity. STDs are very common. STDs can mostly be prevented by not having sex. If you do have sex, you can lower your risk by using condoms and being in a sexual relationship with a partner who does not have an STD. STDs do not always cause symptoms, so it is possible to have an infection and not know it. If you are diagnosed with an STD, know that all can be treated with medicine and some can be cured entirely. There are dozens of STDs. Some STDs, such as syphilis, gonorrhea, and chlamydia, are spread mainly by sexual contact. Other diseases, including Zika and Ebola, can be spread sexually but are more often spread through ways other than sex. The diseases, conditions, and infections below are listed in alphabetical order. Any woman can get bacterial vaginosis. Having bacterial vaginosis can increase your chance of getting an STD. Chlamydia is a common sexually transmitted disease STD that can be easily cured. If left untreated, chlamydia can make it difficult for a woman to get pregnant. Anyone who is sexually active can get gonorrhea. Gonorrhea can cause very serious complications when not treated, but can be cured with the right medication. Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation. Genital herpes is a common STD, and most people with genital herpes infection do not know they have it. Some health effects caused by HPV can be prevented with vaccines. Chlamydia and gonorrhea are preventable causes of pelvic inflammatory disease PID and infertility. For a healthier baby, ask your doctor about STD testing. Syphilis is a sexually transmitted disease STD that can have very serious complications when left untreated, but it is simple to cure with the right treatment. Most people who have trichomoniasis do not have any symptoms. Page 6

7 Chapter 5 : Sexually transmitted disease (STD) symptoms - Mayo Clinic Sexually transmitted diseases (STDs) are infections transmitted from an infected person to an uninfected person through sexual contact. STDs can be caused by bacteria, viruses, or parasites. Examples include gonorrhea, genital herpes, human papillomavirus infection, HIV/AIDS, chlamydia, and syphilis. Certain cancers, such as HPV-associated cervical and rectal cancers Prevention There are several ways to avoid or reduce your risk of sexually transmitted infections. The most effective way to avoid STIs is to abstain from sex. Stay with one uninfected partner. Avoid vaginal and anal intercourse with new partners until you have both been tested for STIs. Oral sex is less risky, but use a latex condom or dental dam â a thin, square piece of rubber made with latex or silicone â to prevent direct contact between the oral and genital mucous membranes. Getting vaccinated early, before sexual exposure, is also effective in preventing certain types of STIs. If not fully vaccinated at ages 11 and 12, the CDC recommends that girls and women through age 26 and boys and men through age 26 receive the vaccine. The hepatitis B vaccine is usually given to newborns, and the hepatitis A vaccine is recommended for 1-year-olds. Use condoms and dental dams consistently and correctly. Use a new latex condom or dental dam for each sex act, whether oral, vaginal or anal. Never use an oil-based lubricant, such as petroleum jelly, with a latex condom or dental dam. Keep in mind that while condoms reduce your risk of exposure to most STIs, they provide a lesser degree of protection for STIs involving exposed genital sores, such as human papillomavirus HPV or herpes. Before any serious sexual contact, communicate with your partner about practicing safer sex. Male circumcision may also help prevent transmission of genital HPV and genital herpes. Consider the drug Truvada. In July, the Food and Drug Administration approved the use of the combination drug emtricitabine-tenofovir Truvada to reduce the risk of sexually transmitted HIV infection in those who are at high risk. Truvada is also used as an HIV treatment along with other medications. Your doctor should also test for hepatitis B infection. If you have hepatitis B, your doctor should test your kidney function before prescribing Truvada. Truvada should only be used along with other prevention strategies such as condom use every time you have sex. Page 7

8 Chapter 6 : CDC - STD Diseases & Related Conditions Sexually transmitted diseases, commonly called STDs, are diseases that are spread by having sex with someone who has an STD. You can get a sexually transmitted disease from sexual activity that. For example, the following STDs are currently incurable: Treatment options are often available to help alleviate symptoms and lower your chances of transmitting the STD to someone else. Take a moment to learn more about curable and incurable STDs. In newborns, STDs can cause complications. In some cases, they can be life-threatening. If you test positive for one or more STDs while pregnant, your doctor might prescribe antibiotics, antiviral medications, or other treatments. In some cases, they might encourage you to give birth via a cesarean delivery to lower the risk of transmission during childbirth. But even symptom-free STDs can cause damage or be passed to other people. Healthcare providers can diagnose most STDs using a urine or blood test. They may also take a swab of your genitals. Home testing kits are also available for some STDs, but they may not always be reliable. Use them with caution. Check to see if the U. Food and Drug Administration has approved the testing kit before buying it. A Pap smear checks for the presence of precancerous cells on the cervix. Some people may benefit from more frequent testing than others. Find out if you should be tested for STDs and what the tests involve. Otherwise, you can pass an infection back and forth between you. Bacterial STDs Usually, antibiotics can easily treat bacterial infections. Continue taking them even if you feel better before you finish taking all of them. While most viral infections have no cure, some can clear on their own. And in many cases, treatment options are available to relieve symptoms and reduce the risk of transmission. For example, medications are available to reduce the frequency and severity of herpes outbreaks. Likewise, treatment can help stop the progression of HIV. Furthermore, antiviral drugs can lower your risk of transmitting HIV to someone else. Ask your doctor or other healthcare provider for more information about your condition and treatment options. But if you do have vaginal, anal, or oral sex, there are ways to make it safer. When used properly, condoms provide effective protection against many STDs. Dental dams can also provide protection during oral sex. Condoms are generally effective at preventing STDs that spread through fluids, such as semen or blood. Condoms can help protect against not only STDs, but also unwanted pregnancy. In contrast, many other types of birth control lower the risk of unwanted pregnancy but not STDs. Page 8

9 Chapter 7 : Sexually Transmitted Diseases Travelers' Health CDC Sexually transmitted diseases (STDs) are infections that are passed on from one person to another through sexual contact. There are many STDs, including chlamydia, genital warts, syphilis, and trich. Such factors may cause serious obstacles to STD prevention due to their influence on social and sexual networks, access to and provision of care, willingness to seek care, and social norms regarding sex and sexuality. Among certain vulnerable populations, historical experience with segregation and discrimination exacerbates the influence of these factors. Social, economic, and behavioral factors that affect the spread of STDs include: Racial and ethnic disparities. Race and ethnicity in the United States are correlated with other determinants of health status, such as poverty, limited access to health care, fewer attempts to get medical treatment, and living in communities with high rates of STDs. STDs disproportionately affect disadvantaged people and people in social networks where high-risk sexual behavior is common, and either access to care or health-seeking behavior is compromised. Access to health care. Access to high-quality health care is essential for early detection, treatment, and behavior-change counseling for STDs. Groups with the highest rates of STDs are often the same groups for whom access to or use of health services is most limited. Many studies document the association of substance abuse with STDs. Perhaps the most important social factors contributing to the spread of STDs in the United States are the stigma associated with STDs and the general discomfort of discussing intimate aspects of life, especially those related to sex. A person may have only 1 sex partner, but if that partner is a member of a risky sexual network, then the person is at higher risk for STDs than a similar individual from a lower-risk network. Each state must address system-level barriers to timely treatment of partners of persons infected with STDs, including the implementation of expedited partner therapy for the treatment of chlamydial and gonorrheal infections. Innovative communication strategies are critical for addressing issues of disparities, facilitating HPV vaccine uptake, and normalizing perceptions of sexual health and STD prevention, particularly as they help reduce health disparities. It is necessary to coordinate STD prevention efforts with the health care delivery system to leverage new developments provided by health reform legislation. References 1 King K, et al. Janus considers the HIV pandemic: Harnessing recent advances to enhance AIDS prevention. Am J Public Health. Sexually transmitted infections among U. Prevalence and incidence estimates, Sex Transm Dis ; 40 3: The estimated direct medical cost of selected sexually transmitted infections in the United States, Confronting sexually transmitted diseases. National Academies Press; Impaired fecundity in the United States: Sexually Transmitted Disease Surveillance Department of Health and Human Services; Monitoring socioeconomic inequalities in sexually transmitted infections, tuberculosis and violence: Geocoding and choice of area-based socioeconomic measures. Health insurance coverage, health-care-seeking behaviors, and genital chlamydia infection prevalence in sexually active young adults. Confronting racial and ethnic disparities in health care. Substance abuse and the spread of sexually transmitted diseases. Institute of Medicine; Crack, sex, and STDs. A social history of venereal disease in the United States since Oxford University Press; Page 9

10 Chapter 8 : Sexually transmitted infections (STIs) The term sexually transmitted disease (STD) is used to refer to a condition passed from one person to another through sexual contact. You can contract an STD by having unprotected vaginal, anal. ShareCompartir An estimated one in five travelers say they had sex with a new partner while in a foreign country. Travelers who have unprotected sex whether vaginal, anal, or oral sex are at risk for sexually transmitted diseases STDs, including HIV, chlamydia, syphilis, and gonorrhea. Many STDs can occur without any signs or symptoms, so you may not realize that you or your partner is infected. While most STDs are treatableâ some can cause serious health problems if left untreated. Preventing an STD is always best. What can I do to prevent an STD? This includes vaginal, oral, or anal sex. The only sure way to prevent an STD is to not have sex, including oral sex. However, if you are sexually active, here are other steps you can take to protect yourself: Consider getting vaccinated for hepatitis A and hepatitis B before you travel. Ask your doctor about an HPV human papillomavirus vaccine. Bring condoms from the United States, because those in other countries may not be up to US quality standards. Be cautious when having sex after drug or alcohol use. What are the symptoms of an STD? The symptoms of STDs are different depending on the infection. When symptoms do occur, you may experience: Pain when you urinate or have sex Discharge from the vagina, penis, or anus Unexplained rash, sore, or ulcer on your skin, genitals, or throat Jaundice yellow color of the skin and eyes What do I do if I think I have an STD? If you are sexually active, talk to your doctor about getting tested for STDs. Make sure to have an open and honest conversation with your doctor about your sexual history so he or she can determine the right STD tests for you. Treating STDs early is important to prevent more serious and long-term complications, and prevent spreading infection to your partners. If you think you have an STD: Do not have sex. If you feel sick during your trip and think you may have an STD, see a doctor or nurse as soon as possible. See Getting Health Care Abroad. Tell the doctor your recent sexual history and international travel because some STDs may be more common in other countries. If your doctor diagnoses you with an STD, notify your recent sex partner s. Your partner s may also be infected and not know it and may need to get tested and treated. Foreign travel, casual sex, and sexually transmitted infections: International Journal of Infectious Diseases. Page 10

11 Chapter 9 : Sexually Transmitted Diseases - Information from CDC Check out our interactive infographic to see progress toward the Sexually Transmitted Diseases objectives and other Healthy People topic areas. STDs refer to more than 35 infectious organisms that are transmitted primarily through sexual activity. STD prevention is an essential primary care strategy. Human immunodeficiency virus HIV attacks the immune system, leaving its host much more vulnerable to infections and diseases. If the virus is left untreated, the susceptibility to infection worsens. HIV can be found in semen, blood, breast milk, and vaginal and rectal fluids. HIV can be transmitted through blood-to-blood contact, sexual contact, breast-feeding, childbirth, the sharing of equipment to inject drugs, such as needles and syringes, and, in rare instances, blood transfusions. With treatment, the amount of the virus present within the body can be reduced to an undetectable level. This means the amount of HIV virus within the blood is at such low levels that it cannot be detected in blood tests. It also means that HIV cannot be transmitted to other people. A person with undetectable HIV must continue to take their treatment as normal, as the virus is being managed, not cured. However, modern medicine means that HIV need not reduce life expectancy. Human papillomavirus HPV Human papillomavirus is a name for a group of viruses that affect the skin and mucous membranes, such as the throat, cervix, anus, and mouth. There are over types of HPV, of which, about 40 can affect the genital areas. These types may also transmit to the mouth and throat. HPV infection can lead to: HPV is so common in the U. HPV is most commonly transmitted through vaginal or anal sex, oral sex, and genital-to-genital contact. People with an HPV virus but no signs and symptoms can still infect others. A woman who is pregnant and has HPV might transmit the virus to her baby during childbirth, although this is very rare. Vaccination is the best way to prevent HPV. Molluscum contagiosum Molluscum contagiosum is a contagious, viral skin infection. There are four types: Symptoms include small, round bumps and indents on the skin. If left untreated, the bumps usually go away, but this can take up to 2 years. A doctor can remove the bumps with chemicals, an electrical current, or by freezing them. There are some prescription medicines that will eventually get rid of the growths. Scabies Scabies is a contagious skin condition caused by Sarcoptes scabiei, a tiny mite. They burrow into the skin and lay their eggs. A person with scabies develops a skin rash and experiences intense itchiness. People with scabies are often unaware of their condition for several weeks after initial infection, which means scabies infestations spread rapidly. The cause of scabies is unknown, although some believe poor living conditions and a lack of personal hygiene are linked to the condition. However, there is no scientific proof of this. Scabies is most commonly transmitted through close body contact, such as holding hands for a long time or sexual intercourse. Hugging or simply shaking hands with a person who has scabies is unlikely to lead to transmission. The scabies mite cannot jump or fly. However, it can survive for 1 to 2 days after leaving the human body. This means that sharing clothes or bedding with a person who has scabies increases the risk of infection. However, prolonged physical contact, as is likely to occur during sexual intercourse, is the most common route of transmission. Symptoms of scabies may not occur for several weeks after initial transmission and may include: The scabies mite leaves small red spots, known as burrow marks. They look like tiny insect bites, and some people may think it is eczema. Burrow marks typically appear as a small line of at least four tiny spots and appear around the area of the elbows, wrists, and in between the toes and fingers. Women experience this rash around the nipples and men near the genitals. This gets worse at night or after taking a hot shower. After scratching the rash, the area can become inflamed, and crusty sores may develop. Less commonly, the rash may appear on the buttocks, ankles, armpits, genitalia, groin, scalp, neck, face, head, shoulders, waist, soles of the feet, lower leg, and knees. Syphilis Syphilis is the result of Treponema pallidum, a bacterium. It is transmitted by sexual contact, and the person passing on the infection will have a syphilitic lesion. A woman who is pregnant and also has syphilis can pass on this STD to her baby, which can result in stillbirth or serious congenital deformities. There is an incubation period of between 9 and 90 days after initial infection before the symptoms of the disease occur, with an average incubation period of 21 days. Each stage of syphilis has characteristic signs and symptoms. Some people with syphilis show no symptoms, while others may experience more mild presentations. For Page 11

12 some people with the condition, even if symptoms resolve, the bacterium is still in the body and can cause serious health problems later on. Gonorrhea This sexually transmitted bacterial infection usually attacks the mucous membranes. It is also known as the clap or the drip. The bacterium, which is highly contagious, stays in the warmer and moister cavities of the body. The majority of women with gonorrhea show no signs or symptoms. If left untreated, females may develop pelvic inflammatory disease PID. Males may develop inflammation of the prostate gland, urethra, or epididymis. The disease is caused by Neisseria gonorrhoeae. The bacteria can survive in the vagina, penis, mouth, rectum, or eye. They can be transmitted during sexual contact. As soon as a person contracts gonorrhea, they risk spreading the bacteria to other parts of the body. An individual may accidentally rub their eye and spread the infection. This prolongs the treatment period. A woman who is pregnant can pass the infection on to the infant during childbirth. Symptoms of gonorrhea may occur between 2 to 10 days after initial infection, in some cases, it may take 30 days. Some people experience very mild symptoms that lead to mistaking gonorrhea for a different condition, such as a yeast infection. Males may experience the following symptoms: When transmission occurs as a result of oral sex, there may be a burning sensation in the throat and swollen glands. Prevention Condoms can help prevent the spread of STDs. Sex using a condom is the safest way to prevent the spread of STDs. Condoms are known as barrier contraceptives, due to their presentation of a physical barrier to microbes. For each oral, vaginal, or anal sex act, use a new latex condom. Condoms are available to purchase online. Avoid using an oil-based lubricant, such as petroleum jelly, when using a latex condom. Non-barrier forms of contraception, such as oral contraceptives or intrauterine devices, do nothing to protect people from sexually transmitted infections. Here are other steps you can take to reduce the risk of an STD: Abstaining from any sexual act is the most effective way to avoid an STD. Monogamy to one uninfected partner: A long-term, monogamous relationship with one person who is not infected can reduce the risk of contracting an STD. There are vaccinations that can protect an individual from eventually developing some types of cancer that are caused by HPV and hepatitis B. Before sexual intercourse with a new partner, check that the partner and yourself have no STDs. Drink alcohol in moderation: People who have consumed too much alcohol are more likely to engage in risky behavior. Avoid using recreational drugs, which may also affect judgment. Explain you want safe sex: Before engaging in any sexual act with a new partner, communicate that you would only consider safe sex. Parents, schools, and society need to teach children about the importance of safe sex, and explain how to prevent becoming infected with an STD, including information relevant to the LGBTQ community. Take a responsible approach to getting intimate with another person, and it could protect you from a range of health problems further down the line. You can choose from a wide range of condoms and barrier contraceptives, rated by thousands of customers, by clicking here. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link s above. Page 12