STIs

Listed below are some of the most common sexually transmitted infections.

1. Chlamydia

Also known as chamydial infection, Chlamydia is an STI caused by Chlamydia trachomatis (C. trachomatis), a bacterium that infects humans exclusively. Chlamydia is the most common infectious cause of genital and eye diseases globally – it is also the leading bacterial STI.

Women with Chlamydia do not usually have signs or symptoms. If there are any, they are usually non-specific and may include:

• Cystitis
• A change in vaginal discharge
• Mild lower abdominal pain

If the Chlamydia is left untreated, it may lead to the following signs and symptoms

• Pelvic pain
• Painful sexual intercourse, either intermittently or all the time
• Bleeding between menstrual periods

2. Chancroid

Also known as soft chancre and ulcus molle. A bacterial infection caused by fastidious Gram-negative streptobacillus Haemophilus ducreyi, and is characterized by painful sores on the genitalia. It is spread solely through sexual contact.

Infection rates are very low in rich countries; it is more common in developing nations, especially among commercial sex workers and some low socioeconomic groups.

Within one day to two weeks after becoming infected, the patient develops a bump that turns into an ulcer within a day. The ulcer can be from 1/8 of an in to 2 inches across, it is very painful, may have well defined, undermined borders, has a yellowish-gray material at its base. If the base is grazed it will typically bleed. In about 30% to 60% of cases, the lymph nodes swell and become painful (lymphadenopathy).

Women often have at least four ulcers, while men usually have just one. Males tend to have fewer and less severe symptoms. The ulcers typically appear at the groove at the back of the glans penis (coronal sulcus) in uncircumcised males, or the labia minora or fourchette in females.

3. Crabs (Pubic Lice)

Pthiriasis (pubic lice manifestations) are primarily spread through sexual contact. Pets do not play any part in the transmission of human lice. The lice attach to the pubic hair, and may also be sometimes found in the armpits, moustache, beard, eyelashes, and eyebrows. They feed on human blood.

The vernacular “crabs” comes from the appearance of the lice, with their crab-like claws and body shape.

4. Genital herpes

This STI is caused by the herpes simples virus (HSV). The virus affects the skin, cervix, genitals, and some other parts of the body. There are two types:

• HSVp1, also known as Herpes Type 1
• HSV-2, also known as Herpes Type 2

Herpes is a long-term (chronic) condition. A significant number of infected individuals never show any symptoms and do not know about their herpes status.

HSV is easily transmissible from human-to-human – by direct contact. Most commonly, transmission occurs through vaginal, oral or anal sex. In most cases, the virus remains dormant after entering a human being.

The signs and symptoms associated with genital herpes, if they do appear, may include:

• Blisters and ulceration on the cervix
• Vaginal discharge
• Pain on urinating
• Fever
• Generally feeling unwell (malaise)
• Cold sores around the mouth
• Red blisters – these can be painful, especially after they burst and leave ulcers on the external genital area, rectum, thighs and buttocks.

5. Hepatitis B

This STI is caused by the Hepatitis B Virus (HBV). It is transmitted via contact with infected semen, blood and some other body fluids. A person can become infected by having unprotected sex, using an unsterilized syringe, being accidentally pricked by a sharp object, drinking infected breast milk, or being bitten by an infected person.

The patient’s liver swells and he/she can suffer serious liver damage as a result of the infection, which can eventually lead to cancer. In some cases, the disease can become chronic. Blood donation centers always check to make sure the donor’s blood is free of the hepatitis B virus.

6. HIV/AIDS

HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immune Deficiency Syndrome or Acquired Immunodeficiency Syndrome). Put simply, HIV is the virus while AIDS is the illness/disease. When a person has AIDS, their immune system is altered, and they become much more vulnerable to infections and diseases. As the disease progresses, this susceptibility worsens.

HIV exists in the body fluids of infected people, such as semen, blood, breast milk and vaginal fluids. HIV can be transmitted through blood-to-blood contact, which may occur during sexual contact (vaginal oral or anal sex), blood transfusions, breastfeeding, childbirth, and the sharing of infected needles.

7. Human Papillomavirus (HPV)

Human Papillomavirus is a name for a group of viruses that affect the skin, as well as the moist membranes that line the body, such as the throat, cervix, anus and mouth. There are over 100 types of HPV, of which about 40 can affect the genital areas of males and females; these types may also infect the mouth and throat. The ones that affect the genital area are known as genital human papillomavirus.

HPV infection can lead to:

• The abnormal growth and alteration of cells within the cervix, which can significantly increase the risk of developing cancer of the cervix
• Genital warts, the most common STI in the majority of developed nations

The majority of infected individuals have no symptoms and are unaware.

HPV is most commonly transmitted through vaginal or anal sex. However, oral sex and genital-to-genital contact (without penetration) are also avenues for transmission. Infected people with no signs and symptoms can infect others.

An infected pregnant mother can transmit the virus to her baby during childbirth, although this is very rare.

The best way to be protect from HPV infection is to be vaccinated.

8. Trichomoniasis

Trichomoniasis is a common sexually transmitted disease that can affect both males and females. However, women are more likely to experience symptoms. The infection is caused by a single-celled protozoan parasite, Trichomonas vaginalis.

For women, the most common site of infection is the vagina, while for men it is the urethra (urine canal). Transmission may occur either by penis-to-vagina sexual intercourse or vulva-to-vulva contact.

While women may be infected from either male or female sexual partners, men nearly always become from having sex with women (not men).

Signs and symptoms of trichomoniasis include:

• Vaginal odor
• Vaginal discharge
• Pain or discomfort during sexual intercourse
• Pain when urinating

A woman with trichomoniasis is more likely to become HIV infected if she is exposed to the virus. A woman with trichomoniasis and HIV is also more likely to pass the HIV onto other sexual partners.

9. Molluscum Contagiosum

Molluscum Contagiosum is a contagious skin infection caused by a virus called molluscum contagiosum. There are four types: MCV-1 (most common), MCV-2 (most commonly sexually transmitted one), MCV-3, and MCV-4. When it infects young children it is not considered an STI.

Signs and symptoms include small, round bumps and indents on the skin. If left untreated, the bumps usually go away, but this can take up to two years. A health care provider 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.

10. Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease is a broad term for inflammation of the uterus, ovaries, or fallopian tubes. The disease can eventually lead to scar formation and fibrous brands that form between tissues and organs. In most cases, PID is caused by a vaginal or cervical infection, which then spreads. PID can be caused by bacteria, fungi, or parasites – in the majority of cases the cause is a bacterium.

STIs are the most common causes of PIDs. However, PIDs may also be a consequence of abortion, miscarriage, childbirth, or using an intrauterine device. Chlamydia and gonorrhea are common causes of PID.

Untreated PID can lead to chronic persistent pelvic pain, ectopic pregnancy, and infertility.

Many females with PID have no signs or symptoms. Some women find out after seeing a doctor for an infertility problem. PID caused by Chlamydia usually has no symptoms.

If signs and symptoms do appear, they may include:

• Lower abdominal pain, this may sometimes be severe
• Fever
• Fatigue
• Oligomenorrhea (irregular periods)
• Lower back pain
• Pain during sexual intercourse
• Rectal pain
• Change in vaginal discharge
• Nausea and vomiting

11. Scabies

Scabies is a contagious skin condition caused by Sarcoptes scabiei, a tiny mite. They burrow into the skin and lay their eggs. The patient develops a skin rash and experiences intense itchiness. Sufferers are often unaware of their condition for several weeks after initial infection, which means scabies infestations spread rapidly.

Some experts believe scabies is caused by poor living conditions and a lack of personal hygiene – 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 infected people or simply shaking hands with them is unlikely to lead to transmission.

The scabies mite cannot jump or fly. However, it can survive for one or two days after leaving the human body – this means that sharing clothing or bedding with an infected person raises the risk of infection. However, prolonged physical contact, as may occur during sexual intercourse, is the most common route of transmission.

Signs and symptoms of scabies may not become apparent for several weeks after initial infection, and may include:

• A skin rash – small red spots, known as burrow marks; they look like tiny insect bites. Some people may think it is eczema.
• Intense itching, which gets worse at night or after taking a hot shower
• The burrow marks, which typically appear as a small line of at least four tiny spots, appear on the elbows, wrists, around the nipples (in women), near the genitals (in men), and in between the toes and fingers.
• Upon scratching areas of skin where the rash is, the area can become inflamed and crusty sores may develop.

Less commonly the rash may appear on the buttocks, ankles, axillae (armpits), genitalia (in women), groin, the inside of the elbow, scalp, neck, face, head, shoulders, waist, soles of the feet, lower leg, and knees.

12. Syphilis

Syphilis is the result of infection by Treponema pallidum, a bacterium. It is transmitted by sexual contact – the infected person has a syphilis lesion. An infected mother can pass on this STI to her baby during pregnancy, which can result in stillbirth or serious birth defects. An infected person, when exposed to HIV, has a higher risk of becoming HIV-positive.

There is a 9 to 90 day incubation period after initial infection – average time 21 days, before the initial signs and symptoms of the disease emerge. Each syphilis stage has characteristic signs and symptoms. Some infected people have no signs, while for others they may be mild. In some cases, even if signs and symptoms go away, the bacterium is still there and can cause serious health problems later on.

13. Gonorrhea

Also known as the clap or the drip, this sexually transmitted bacterial infection usually attacks the mucous membranes. Gonorrhea is the second most common STI in the USA, after Chlamydia. The bacterium, which is highly contagious, resides in the warm and moist cavities of the body.

The majority of infected women show no signs or symptoms. If left untreated, females may develop pelvic inflammatory disease, while males may develop inflammation of the prostate gland, urethra, or epididymis.

The disease is caused by the proliferation of Neisseria gonorrhoeae. The disease can survive in the vagina, penis, mouth, rectum, or eye; it can be transmitted in a variety of sexual contacts.

As soon as a person is infected, he/she risks spreading the bacteria to other parts of their body – somebody may inadvertently rub their eye and spread the infection; this prolongs the treatment period. A mother can pass the infection on to her baby during childbirth.

Signs and symptoms of gonorrhea may appear from two to ten days after initial infection, in some cases it may take 30 days. Some patients have such mild symptoms that their infection is mistaken for something else, such as a yeast infection.

Males may have the following signs and symptoms:

• Burning during urination
• Testicular pain and/or swelling
• A green, white or yellow discharge from the penis

Women are more likely to show no symptoms, if they do, they may include:

• Spotting after sexual intercourse
• Swelling of the vulva (vulvitis)
• Irregular bleeding (between periods)
• Pink eye (conjunctivitis)
• Pain in the pelvic area
• Burning or pain during urination

If the rectum becomes infected, there may be anal itching, painful bowel movements, and sometimes discharge. When transmission occurred from oral sex, there may be burning sensation in the throat and swollen glands.

DIAGNOSIS

If your sexual history and current signs and symptoms suggest that you have an STI, laboratory tests can identify the cause and detect coinfections you might have contracted.

• Blood tests. Blood tests can confirm the diagnosis of HIV or later stages of syphilis.
• Urine samples. Some STIs can be confirmed with a urine sample.
• Fluid samples. If you have active genital sores, testing fluid and samples from the sores may be done to diagnose the type of infection. Laboratory tests of material from a genital sore or discharge are used to diagnose some STIs.

 

TREATMENT/RECOMMENDED MEDICATIONS

1. Chlamydia

If you have chlamydia, your doctor will prescribe oral antibiotics, usually azithromycin (Zithromax) or doxycycline. Your doctor will also recommend your partner(s) be treated to prevent reinfection and further spread of the disease.

With treatment, the infection should clear up in about a week or two. It is important to finish all of your antibiotics even if you feel better.

Women with severe chlamydia infection may require hospitalization, intravenous antibiotics (medicine given through a vein), and pain medicine.

After taking antibiotics, people should be re-tested after three months to be sure the infection is cured. This is particularly important if you are unsure that your partner(s) obtained treatment. But testing should still take place even if your partner has been treated. Do not have sex until you are sure both you and your partner no longer have the disease.

2. Chancroid

Chancroid is treated with a seven-day course of Erythromycin, a single oral 1 gram dose of Azithromycin, or a single intramuscular injection of Ceftriaxone.

3. Pubic Lice

A lice-killing lotion containing 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide can be used to treat pubic lice. These products are available over-the-counter without a prescription at a local drug store or pharmacy.

4. Genital herpes

Treatment with antiviral drugs can help people who are bothered by genital herpes outbreaks stay symptom-free longer. These drugs can also reduce the severity and duration of symptoms when they do flare up. Drug therapy is not a cure, but it can make living with the condition easier.

There are three major drugs commonly used to treat genital herpes symptoms: acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). These are all taken in pill form. Severe cases may be treated with the intravenous (IV) drug acyclovir.

5. Hepatitis B

Treatments for hepatitis B include:

• Antiviral medications. Several antiviral medications — including lamivudine (Epivir), adefovir (Hepsera), telbivudine (Tyzeka) and entecavir (Baraclude) — can help fight the virus and slow its ability to damage your liver. Talk to your doctor about which medication might be right for you.
• Interferon alfa-2b (Intron A). This synthetic version of a substance produced by the body to fight infection is used mainly for young people with hepatitis B who don’t want to undergo long-term treatment or who might want to get pregnant within a few years. It’s given by injection. Side effects may include depression, difficulty breathing and chest tightness.

6. HIV/AIDS

There’s no cure for HIV/AIDS, but a variety of drugs can be used in combination to control the virus. Each class of anti-HIV drugs blocks the virus in different ways. It’s best to combine at least three drugs from two classes to avoid creating strains of HIV that are immune to single drugs.

The classes of anti-HIV drugs include:

• Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
• Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine-tenofovir (Truvada), and lamivudine-zidovudine (Combivir).
• Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and indinavir (Crixivan).
• Entry or fusion inhibitors. These drugs block HIV’s entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
• Integrase inhibitors. These drugs work by disabling integrase, a protein that HIV uses to insert its genetic material into CD4 cells. Examples include raltegravir (Isentress), elvitegravir (Vitekta) and dolutegravir (Tivicay).

7. HPV

While there is no cure for HPV, the good news is the infection often clears on its own. If it does not, and treatment is needed, there are many HPV treatment options. Plus, as more males and females are vaccinated against HPV, the rates of infection may be greatly reduced. There are currently three vaccines currently available: Cervarix, Gardasil, and Gardasil-9.

8. Trichomoniasis

Trichomoniasis can be cured with a single dose of prescription antibiotic medication (either metronidazole or tinidazole), pills which can be taken by mouth. It is okay for pregnant women to take this medication. Some people who drink alcohol within 24 hours after taking this kind of antibiotic can have uncomfortable side effects.

People who have been treated for trichomoniasis can get it again. About 1 in 5 people get infected again within 3 months after treatment. To avoid getting reinfected, make sure that all of your sex partners get treated too, and wait to have sex again until all of your symptoms go away (about a week). Get checked again if your symptoms come back.

9. Molluscum Contagiosum

In most cases, molluscum contagiosum doesn’t need to be treated. The bumps usually go away on their own in 6 to 9 months. But in some cases, they may last much longer-sometimes even for years.

Doctors usually recommend treatment for these bumps in the genital area to prevent them from spreading.

If you need treatment, your choices may include:

• Freezing the bumps, called cryotherapy or cryosurgery.
• Scraping off the bumps, called curettage.
• Putting a chemical on the bumps, like cantharidin or potassium hydrochloride.
• Using medicines (liquids or creams), such as those used to treat warts.

Children may not need treatment, because molluscum contagiosum usually goes away on its own. But if your child needs treatment, talk to your child’s doctor about how to prevent pain and scarring.

10. PID

• Antibiotics. The initial treatment for mild cases of PID usually consists of one or more antibiotic medications taken by mouth. More significant cases can be treated with a combination of intravenous and oral antibiotics. If treatment is not effective, if you cannot take antibiotics by mouth, or if the infection is severe, you may need to be hospitalized to receive medication intravenously (directly into a vein).
• If you are diagnosed with PID, your sexual partner(s) also must be treated even if they do not have any symptoms. Otherwise, the infection will likely recur when you have sex again.
• Surgery. When PID causes an abscess (when the inflamed tissue forms a collection of pus), antibiotics are no longer as effective. Surgery is often needed to remove the abscesses (or the organ with the abscess) to prevent them from rupturing and causing widespread infection throughout the pelvis and abdomen. Depending on the conditions, this may be done with a laparoscope (a thin, lighted instrument) or with a procedure in which the doctor opens the abdomen to view the internal organs (laparotomy). Both techniques are major surgical procedures and are performed under general anesthesia (you are put to sleep).

If abscesses have formed on the uterus or ovaries, your doctor may recommend hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries).

11. Scabies

The usual scabies treatment is with permethrin cream. Permethrin is an insecticide that kills the mites. This is known to be the treatment that works the best. If permethrin cannot be used, an alternative is to use a lotion called malathion liquid. (For example, some people may be allergic to permethrin.)

You can buy both of these products from pharmacies. You can also obtain them on prescription. They are easy to apply and normally work well if used properly.

Re-apply the same treatment seven days after the first application. This helps to make sure that all the mites are killed.

Daily hot baths, and scrubbing with soap and water will NOT cure a scabies infestation. Insecticide MUST be used.

12. Syphilis

There are no home remedies or over-the-counter drugs that will cure syphilis, but syphilis is easy to cure in its early stages. A single intramuscular injection of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) will cure a person who has primary, secondary or early latent syphilis. Three doses of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) at weekly intervals is recommended for individuals with late latent syphilis or latent syphilis of unknown duration. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.

Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis. Combinations of some penicillin preparations (e.g., Bicillin C-R, a combination of benzathine penicillin and procaine penicillin) are not appropriate treatments for syphilis, as these combinations provide inadequate doses of penicillin.

Although data to support the use of alternatives to penicillin is limited, options for non-pregnant patients who are allergic to penicillin may include doxycycline, tetracycline, and for neurosyphilis, ceftriaxone. These therapies should be used only in conjunction with close clinical and laboratory follow-up to ensure appropriate serological response and cure.

Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

13. Gonorrhea

Gonorrhea can be cured with the right treatment. CDC recommends dual therapy, or using two drugs, to treat gonorrhea – a single dose of 250mg of intramuscular ceftriaxone AND 1g of oral azithromycin. It is important to take all of the medication prescribed to cure gonorrhea. Medication for gonorrhea should not be shared with anyone. Although medication will stop the infection, it will not repair any permanent damage done by the disease. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult. If a person’s symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated.