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Sexual Transmitted Infections
Definition

Sexually transmitted diseases (STD), or venereal
diseases (VD), are infections that are commonly spread
by sexual activity.
Trichomoniasis

Trichomoniasis is a commonly occurring STI caused by Trichomonas
vaginalis, a microscopic motile protozoan that thrives in an alkaline
environment.

Trichomonas is the most common curable STD with estimates
ranging from 3.1% to 13%.

Acquired through sexual intimacy.

The transmission by shared bath facilities, wet towels, or wet
swimsuits may also be possible. Coinfection with other sexually
transmitted infections is common and HIV has been shown to be
transmitted more easily with trichomoniasis present.
Cont’

Often women with trichomoniasis are asymptomatic or have only mild
symptoms.

More pronounced symptoms of trichomoniasis can include a yellowgreen, frothy, odorous discharge and vulvar itching.

Dysuria, dyspareunia, and subepithelial hemorrhages on the cervix
(strawberry-like red spots) can be seen with the naked eye;

smaller areas of hemorrhage are generally visible with a colposcope.

Microscopic visualization of mobile trichomonads and increased
leukocytes, a vaginal pH of 0.5 or higher,

Pregnant women : increased risk for premature rupture of
membranes, preterm birth, and low birth weight.

Pregnant women who are symptomatic should be treated with
metronidazole orally to relieve their symptoms
Cont’

Recommended treatment for trichomoniasis is metronidazole
(Flagyl) administered in a single 2-g dose or tinidazole in a
single 2-g dose or, metronidazole 500 mg twice daily for 7
days for both male and female sexual partners

Partners should avoid intercourse until both are cured
Chlamydia

Chlamydial infection, caused by Chlamydia trachomatis
(an intracellular bacterium)

Transmission commonly occurs through vaginal sex.

Chlamydia is a major cause of nongonococcal urethritis
in men. In women it can cause infections similar to
those that occur with gonorrhea. However,
asymptomatic infection is common in both men and
women.

In women, chlamydia can infect the fallopian tubes,
cervix, urethra, and Bartholin’s glands.

untreated chlamydial infection may result in pelvic
inflammatory disease, infertility, and ectopic
pregnancy. In men, chlamydial infection can result in
epididymitis and infertility.

In addition, chlamydia infection is associated with an
increased risk of acquiring and transmitting HIV
infection
Cont’

Symptoms of chlamydia include a thin or mucopurulent
discharge, friable cervix (bleeds easily), burning and
frequency of urination, and lower abdominal pain.
However, up to 50% of women are asymptomatic

The recommended treatment is a single dose of
azithromycin 1 g orally or doxycycline 100 mg by mouth
twice a day for 7 days. During this period couple should
abstain from intercourse.
Gonorrhea

Gonorrhea, an infection caused by the bacterium Neisseria
gonorrhoeae

Transmission can occur through vaginal, anal, or oral sex.

If a pregnant woman becomes infected after the third month
of gestation, the newborn exposed to a gonococcal-infected
birth canal is at risk of developing ophthalmia neonatorum

About 80% of women with gonorrhea are asymptomatic

screening for this infection by doing a cervical culture during
the initial prenatal examination.
Cont’

The most common symptoms of gonorrheal infection,
include a purulent, greenish-yellow vaginal discharge,
dysuria, and urinary frequency.

Some women also develop inflammation and swelling of
the vulva. The cervix may appear swollen and eroded
and may secrete a foul-smelling discharge in which
gonococci are present.

Bilateral lower abdominal or pelvic pain may also occur.

Treatment consists of antibiotic therapy with
ceftriaxone 125 mg I.M or cefixime 400 mg orally in a
single

Both sexual partners should be treated if either has a
positive test for gonorrhea

Women should be informed of the need for reculture to
verify cure and the need for abstinence or condom use
until cure is confirmed.
Syphilis

Syphilis is a chronic infection caused by the spirochete
Treponema pallidum

Syphilis is commonly acquired through vaginal, oral, or
anal sex. Less commonly, it can result from nonsexual
exposure to exudates from an infected individual.

The incubation period varies from 10 to 90 days, and
even though no symptoms or lesions are noted during
this time, the blood contains spirochetes and is
infectious
Cont’

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


Syphilis is divided into early and late stages.
During the early stage (primary), a chancre (painless ulcer)
appears at the site where the T pallidum organism entered
the body. Symptoms include slight fever, loss of weight,
and malaise. The chancre persists for about 4 weeks and
then disappear
In 6 weeks to 6 months, secondary symptoms appear like :
Skin eruptions (condylomata lata), which resemble wartlike
plaques and are highly infectious, may appear on the vulva.
Acute arthritis, enlargement of the liver and spleen,
nontender enlarged lymph nodes, iritis, and a chronic sore
throat with hoarseness.
Cont’

Transplacentally transmitted syphilis is as high as 95% in
the primary and secondary stages but decreases to 10%
in the late latent phase.

Congenital syphilis can cause intrauterine growth
restriction, preterm birth, and stillbirth.

For pregnant and nonpregnant women with syphilis of
less than a year’s duration (early latent syphilis), it is
recommended 2.4 million units of benzathine penicillin
G intramuscularly in a single dose. If syphilis is of long
duration (more than 1 year) or of unknown duration,
2.4 million units of benzathine penicillin G are given
intramuscularly once a week for 3 weeks. If a woman is
allergic to penicillin and nonpregnant, doxycycline or
tetracycline can be given
Herpes Genitalis

The herpes simplex virus (HSV) causes herpes
infections, which are recurrent, lifelong infections.

Two serotypes of HSV cause human infections: HSV-1
and HSV-2. HSV-2 causes most cases of recurrent genital
herpes and is spread through vaginal, anal, or oral sex.
It can also be spread through skin-to skin contact with
an infected site

HSV-1 infections are often orally acquired as children,
while HSV-2 infections are primarily acquired sexually
Cont’

The primary episode (first outbreak) of herpes genitalis
is characterized by the development of single or
multiple blisterlike vesicles, which usually occur in the
genital area and sometimes affect the vaginal walls,
cervix, urethra, and anus

Primary episodes usually last the longest and are the
most severe. Lesions heal spontaneously in 2 to 4
weeks

Diagnosis is made on the basis of the clinical
appearance of the lesions, culture of the lesions,
polymerase chain reaction (PCR) identification, and
glycoprotein G-based type-specific assays
Cont’

No known cure for herpes exists; however, medications
are available to partially control the symptoms of
herpes and prevent complications from secondary
infection. The recommended treatment of the first
clinical episode of genital herpes is oral acyclovir

Other diseases include:

HPV (Condylomata Acuminata)

PEDICULOSIS PUBIS

Scabies
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HBV

HIV
Effective prevention and control of STIs
1. Education and counseling for people at risk on ways to
practice safer sexual behavior.
2. Identification of infected, asymptomatic individuals and of
people with symptoms of STI who are not likely to seek
diagnostic and treatment services.
3. Effective diagnosis and treatment of people with an STI.
4. Evaluation, treatment, counseling, and education for
individuals who are the sex partners of people with an STI.

5. Expedited partner therapy (EPT), whereby partners are
treated, is recommended by the CDC (2006a). Infected
individuals deliver medications or prescriptions to their
partners to manage and decrease the reinfection rates of STIs.