SEXUALLY TRANSMITTED

DESEASES
Health Education HFT 201
Sophia Kol, MD
Introduction

• By having unprotected sex with multiple partners,

you put yourself at risk of contracting STD’s

• Prevalence from age 15-24

• The infection is roughly equal among young

men(49%) and young women (51%)

Male Vs. Female

Females esp. young girls are higher risk due to:

- more mucosal tissue exposed/trauma

- cervical immaturity and low level of IgA in their cervical

mucosa

- cervix area: columnar epithelium (later on will transfer to

squamous epith.)
Facts

• Women infected with STD’s suffer long term damage to health than men.

• With minimal or no symptoms: undiagnosed

• Untreated infections can lead to:

- chronic pelvic pain

- infertility/ectopic pregnancy

- perinatal infection, preterm baby

- increase risk for CA and acquisition of HIV

The Five P’s
• Partners
• Do you have sex with men, women, or both?
• Practices
• Have you had vaginal sex, meaning ‘penis in vaginal sex. If yes, “Do
you use condoms: never, sometimes, or always?”
• Prevention of Pregnancy
• What are you doing to prevent pregnancy?
• Protection from STDs
• What do you do to protect yourself from STDs and HIV?
• Past History of STDs
• Have you ever had an STD or have any of your partners had an STD?
HPV

• Human Papilloma Virus is most common inf.

- mouth, throat, and genitalia

• Nearly all sexual active people will be infected with the virus
at some point of their lives

• Infection with HPV causes 90% of cervical CA

HPV

• About 100 strains (serotypes) of HPV, more than 40 types can infect
human genital area

• Spread by direct contact skin-to-skin

• HPV-16/HPV-18: 70% of cervical CA

• HPV-16: oropharyngeal CA

• HPV-11: 90% of genital warts

• The infections are transient and asymptomatic

How do I know if I have HPV?

• No test available to find out the “HPV status”

• Screening test for cervical CA for women> 30

• Pap smear: every 3-5 years for women ages 21-65
• 90% of the infections will resolve spontaneously within 2-3 years or
will cause visible changes in a form of genital warts or cancer.
Preventions

• Vaccines (Cervarix, Gardasil) recommended at age 11-12 before

initiation of sexual activity

• Gardasil 9 for males and females can help preventing the

infections esp. from 9 of the most common HPV serotypes that
cause 90% of cervical, vulva, anal CA, and genital warts

• Having a safe and protected sex

• www.cdc.gov/std/healthcomm/fact_sheets.htm
Chlamydia

• Bacteria Chlamydia trachomatis

• Highest rate among sexually active females ages 25 and

younger

• S/Sx: vaginal/urethral discharge, dysuria

• Males w/out symptoms are the reservoir

• Infected females have greater risk of contracting HIV

Can chlamydia be cured?

• Abx:
• Doxycycline 100 mg po bid x7 days
• Azithromycin 1g po x1 only

• Treat both

• Routine screening for chlamydia and STD’s

•  Long-term mutually monogamous relationship with a partner

• Use latex condom in a right way

Chlamydia and Pregnancy

• Can pass down to baby during delivery causing eyes infection,

pneumonia

• Infected mother can lead to early child birth

• Long term infection lead to ectopic pregnancy, pelvic

inflammatory diseases (PID), and infertility
Gonorrhea
• Bacteria G- intracellular diplococcus Neisseria gonorrhea
• Highly infectious
• Transmitted through sexual contact, mother to child during
delivery
• Most infected from ages 15-24
• Females are at greater risk than males (20%)
S/SX

 Females:
 Dysuria, increased vaginal discharge
 Vaginal bleeding between period
 No symptoms, PID

 Males:
 Dysuria, unilateral epididymitis
 Copious mucopurulent or purulent urethral discharge
Can gonorrhea be cured?

• Drugs of choice: Rocephin 250 mg IM and Azithromycin 1g po

as single dose due to the emergence of
drug-resistant strains of gonorrhea.

• When can I have sex again?

• You should wait at least 1 week after treatment or complete a full
dose of prescribed drugs
Trichomonasis

• Protozoan Trichomonas vaginalis

• 70% of infected people don’t have any S/Sx

• 30% develop symptoms 5- 28 days

• Frothy foul smelling yellow/green vaginal discharge
• Vulva itching, vaginal erythema, abd pain
• Men: clear/mucopurulent urethral discharge, dysuria
Prevention & Treatment

• Protected sex

• Routine health screening

• Diagnosed by a microscopic of the protozoan in vaginal

secretion

• Metronidazole (Flaggyl) 2g po x1

• Tinidazole 2g po x1
Syphilis
• Spirochete Treponema pallidum
• Infected individual with syphilis have very mild symptoms or
none at all.
• Intimate contact with infectious lesions/body fluid during
sexual intercourse
• Stages: primary, secondary, latent, and late syphilis
• If left untreated, it can cause serous complications
Stage by Stage

• Primary begins 10-90 days after exposure

• Chancre: single painless indurated non purulent ulcer at the site of
inoculation
• Location: vulva, cervix, penis, around anus, mouth, nipple, hand, and
tongue
• Heals w/out treatment in 3-6 weeks
Stage by Stage

• Secondary: 4-10 weeks after the chancre

• Papular/pustular rash to the trunk, and extremities, then later on they

spread to palm and sole

• sores in your mouth, vagina, or anus (also called mucous membrane lesions)

• Swollen lymph nodes

• Fever and chill, malaise, patchy hair loss

• All symptoms will resolve w/out treatment

Stage by Stage

• Tertiary lasts from 1-20 years, 15% of untreated syphilis may

spread to any organs or systems
• brain/nerves (Neurosyphilis)
• Eye (Ocular syphilis)
• Blood vessels (aortitis)
• Bones and joints (Gummatous syphilis)
Prevention & Treatment

• Avoids sexual risk-taking behavior

• One dose of long acting PCN G 2.4 million units IM

• Infected pregnant women can transmitted to their fetus,

leading to fetal death or congenital infections which account
for 40% of untreated infected women
The Right Way To Use A Male Condom
• DO use a condom every time you have
sex.
• DO put on a condom before having
sex.
• DO read the package and check the
expiration date.
• DO make sure there are no tears or
defects.
• DO store condoms in a cool, dry place.
• DO use latex or polyurethane
condoms.
• DO use water-based or silicone-based
lubricant to prevent breakage.
• DON’T store condoms in your wallet as
heat and friction can damage them.
• DON’T use nonoxynol-9 (a spermicide),
as this can cause irritation.
• DON’T use oil-based products like baby
oil, lotion, petroleum jelly, or cooking
oil because they will cause the condom
to break.
• DON’T use more than one condom at a
time.
• DON’T reuse a condom.
Q&A

Which of the statement related to Gonorrhea is TRUE?

A- For men, the risk of infection from one vaginal exposure is 90%
B- Treatment of gonorrhea requires a two-drug regimen
C- Only 10% of men have symptoms
D- For women, the infection risk from one sexual encounter is 100%

Why are adolescent females at higher risk of STD infection? 

A- More mucosal tissue is exposed during sex
B- More trauma occurs to mucosal tissue during sex
C- They have a lower level of protective antibodies in their cervical mucosa
D- All the above
Sources

• "Genital HPV Infection - Fact Sheet." Centers for Disease Control and
Prevention. Centers for Disease Control and Prevention, 2016. Web.
15 May 2016. <http://www.cdc.gov/std/hpv/stdfact-hpv.htm>.

• "CE Search Results at Nurse.com | Gannett Education Continuing

Education." CE Search Results at Nurse.com | Gannett Education
Continuing Education. Connie C. Chettle, MS, MPH, RN. Web. 15
May 2016. <http://ce.nurse.com/RCourseSearch.aspx?
SearchT=CE594>.