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Week 11 - Sexually Transmitted Infections

Sexually transmitted infections (STIs) are infections transmitted through sexual contact, with over 30 pathogens identified, and more than 1 million STIs acquired daily worldwide. Key risk factors include unprotected sex, multiple partners, and a history of STIs, with common symptoms being sores, painful urination, and unusual discharge. Prevention strategies include education, screening, and the use of condoms, while treatment varies between bacterial infections, which can be cured, and viral infections, which are typically managed but not curable.

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17 views23 pages

Week 11 - Sexually Transmitted Infections

Sexually transmitted infections (STIs) are infections transmitted through sexual contact, with over 30 pathogens identified, and more than 1 million STIs acquired daily worldwide. Key risk factors include unprotected sex, multiple partners, and a history of STIs, with common symptoms being sores, painful urination, and unusual discharge. Prevention strategies include education, screening, and the use of condoms, while treatment varies between bacterial infections, which can be cured, and viral infections, which are typically managed but not curable.

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armajd676
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We take content rights seriously. If you suspect this is your content, claim it here.
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Sexually Transmitted Infections

Rabih Nasrallah, MD
Overview
• Sexually transmitted infection (STI) refers to infection with a pathogen that is
transmitted during oral, anal or genital sex with an infected partner through:
• Blood
• Semen
• Vaginal fluids
• Other body fluids
• Some STIs can also be transmitted from mother-to-child during pregnancy,
childbirth and breastfeeding
Statistics
• More than 30 different bacteria, viruses and parasites are known to be
transmitted through sexual contact.
• More than 1 million STIs are acquired every DAY worldwide, the majority of which
are asymptomatic.
Pathogens

Bacteria Viruses Parasites

• Syphilis • Genital warts (HPV) • Trichomoniasis


• Chlamydia • Genital Herpes • Scabies
• Gonorrhea • HIV • Lice (pubic lice)
• Chancroid • Molluscum
• LGV Contagiosum
• Granuloma • Hepatitis B and C
inguinale
• Mycoplasma
Pathogens
• Eight pathogens are linked to the greatest incidence of STIs.
• Of these, 4 are currently curable:
• Syphilis
• Gonorrhea
• Chlamydia
• Trichomoniasis
• The other 4 are incurable viral infections:
• Hepatitis B (HBV)
• Herpes simplex virus (HSV)
• HIV
• Human papillomavirus (HPV)
Risk Factors
• Unprotected sexual intercourse
• Multiple partners
• History of another STI
• Rape
• Misuse of alcohol or recreational drugs
• Young age
Signs and Symptoms
Depends on the infection but mainly symptoms include:
• Sores or bumps on the genitals or in the oral or rectal area.
• Painful or burning urination.
• Discharge from the penis or vagina.
• Unusual vaginal bleeding.
• Sore, swollen lymph nodes, particularly in the groin
• Lower abdominal pain.
• Fever.
• Rash over the trunk, hands or feet.
Chlamydia and Gonorrhea
• Most common bacterial STI (chlamydia > gonorrhea)
• Mainly occur in young population (15 – 24 years)
• 50% have no symptoms
• Symptoms include burning while urination and discharge
Chlamydia and Gonorrhea
Chlamydia and Gonorrhea: Complications
• Pelvic inflammatory disease (PID) in females:
condition where the bacteria causes
inflammation of the upper genital tract
(uterus, fallopian tubes, ovaries) and
symptoms include fever, severe abdominal
pain and discharge.

• Epididimitis in males: when the infection


reaches the epidydimis and can cause fever,
testicular pain and swelling.

• Infertility for both males and females.


Syphilis
• A bacterial infection that progresses in
three stages:

• Primary syphilis (first 3 months):


small painless sore on genitals

• Secondary syphilis (up to 2 years):


rash all over the body with fever
and feeling sick (malaise)
Syphilis
• If left untreated: may lead to tertiary syphilis where it can damage the heart, the
brain and other organs
• Complications can lead to death.
HPV (Human Papilloma Virus)
• Very common STI, >100 types of HPV are present.
• Low risk types: cause warts including genital warts.
• High risk types: cause cancers (mainly cervical cancer)
• Preventable by vaccination.
• Most people are asymptomatic but warts can appear on genitals, slightly itchy
and can bleed.
HSV (Herpes Simplex Virus)
• HSV 1 mainly causes cold sores (oral – on mouth) and HSV 2 mainly causes genital
herpes.
• Very painful lesions. Prior to lesion appearance, the person can feel tingling and
burning sensation.
Scabies
• Mites that burrow below the skin to lay their eggs
• Transmitted through direct contact
• Can live on surfaces (towels, beds..) for 1-3 days
• Symptoms include severe itching and a rash
Lice
• Are crab like insects that nest in hairs.
• They bite their hosts and feed on blood.
• Pubic lice (located in pubic area) are the ones mainly transmitted through sexual
contact.
• Symptoms include rash, and itching
Diagnosis of STI
• History and physical exam
• Blood tests
• Cultures and special tests from urethral or vaginal discharge
Prevention
• Education of health care practitioners and the public
• Avoidance of high-risk behaviors by patients
• Adequate access to facilities for diagnosis and treatment
• Public health programs for locating and treating recent sex partners of patients
• Vaccines (HPV, Hepatitis)

• Condoms if used correctly, greatly decrease risk of some STIs but do not prevent
it completely.
Screening
• Screening is important for all people at least once in a lifetime.
• Pregnant women to assure a safe pregnancy and prevent transmission to baby.
• Frequent testing (every 6 – 12 months) if:
• Sexually active with multiple partners
• Men who have sex with men (MSM)
Treatment
• Antimicrobial therapy + treatment of complications if present.
• Complete cure with antibiotics for bacterial infections (syphilis, chlamydia and
gonorrhea) and for trichomonas.
• Patients who are being treated for a bacterial STI should abstain from sexual
intercourse until the infection has been eliminated from them and their sex
partners.
• Sex partners should be evaluated and treated simultaneously.
Treatment
• Viral STIs (like HPV, Hepatitis and HIV) usually persist for life.
• Antiviral medications can control but not yet cure most of these infections.
• Warts can be treated with certain creams and/or cryotherapy (freezing the wart)
but these techniques do not cure, the virus remains inside the body and the risk
of recurrence is present.
Questions?

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