Vindhyachal

Academy Dewas (M.P.)

BIOLOGY 2019-20
ASSIGNMENT
Sexually
Transmitting
Infection(S.T.I)
Submitted by-Aaysuh Raikwar
Submitted to-
Sir.R.K.Shivastava
 Acknowledgement

I would like to express my special thanks of gratitude to my

teacher Mr. R.K.Shrivastava as well as our principal
(Name of the principal)who gave me the golden opportunity
to do this wonderful project on the topic Sexually
Transmitting Disease, which also helped me in doing a lot
of Research and i came to know about so many new things I
am really thankful to them.

Secondly i would also like to thank my parents and friends

who helped me a lot in finalizing this project within the
limited time frame.

Aayush Raikwar Sir.R.K.Shrivastava

12 ‘Bio’
 Certificate
This is to certify that Aayush Raikwar student of
class XII th - B; Vindhyachal Academy has
completed the project titled “Sexually Transmitted
Infection” during the academic year 2019-2020
towards partial fulfillment of credit for the Biology
practical evaluation of AISSCE 2019-2020, under
the supervision of Mr.R.K.shrivastava. Teacher
In-charge Examiner Principal
 Index
 Introduction
 Cause
 Main Types
 Diagnosis
 Study of HIV AIDS
 Transmission of HIV
 Types and Myths of HIV
 Treatment of HIV
 Prevention
 Conclusion
 Bibliography
 Introduction
 Sexually transmitted
infections (STIs), also referred
to as sexually transmitted
diseases (STDs),
are infections that are
commonly spread by sexual
activity, especially vaginal
intercourse, anal sex and oral
sex. Many times STIs initially do
not cause symptoms. This results
in a greater risk of passing the
disease on to others. Symptoms and
signs of disease may
include vaginal discharge, penile
discharge, ulcers on or around the
genitals, and pelvic pain. STIs
can be transmitted to an
infant before or during childbirth
and may result in poor outcomes
for the baby. Some STIs may
cause problems with the ability to
get pregnant.
 More than 30
different bacteria, viruses,
and parasites can be transmitted
through sexual activity. Bacterial
STIs include chlamydia, gonorrhea,
and syphilis. Viral STIs
include genital herpes, HIV/AIDS,
and genital warts. Parasitic STIs
include trichomoniasis. While
usually spread by sex, some STIs
can be spread by non-sexual
contact with donor tissue,
blood, breastfeeding, or
during childbirth. STI diagnostic
tests are usually easily available
in the developed world, but this
is often not the case in the
developing world.
 The most effective way of
preventing STIs is by not having
sex. Some vaccinations may also
decrease the risk of certain
infections including hepatitis
B and some types of HPV. Safer
 sex practices such as use
of condoms, having a smaller
number of sexual partners, and
being in a relationship where each
person only has sex with the other
also decreases the
risk. Circumcision in adult males
may be effective to prevent some
infections. During
school, comprehensive sex
education may also be useful. Most
STIs are treatable or curable. Of
the most common infections,
syphilis, gonorrhea, chlamydia,
and trichomoniasis are curable,
while herpes, hepatitis B,
HIV/AIDS, and HPV are treatable
but not curable.[1] Resistance to
certain antibiotics is developing
among some organisms such as
gonorrhea.
 In 2015, about 1.1 billion people
had STIs other than
HIV/AIDS. About 500 million were
infected with either syphilis,
gonorrhea, chlamydia or
trichomoniasis. At least an
additional 530 million people have
genital herpes and 290 million
women have human
papillomavirus. STIs other than
HIV resulted in 108,000 deaths in
2015. In the United States there
were 19 million new cases of
sexually transmitted infections in
2010. Historical documentation of
STIs date back to at least
the Ebers papyrus around 1550 BC
and the Old Testament. There is
often shame and stigma associated
with these infections. The
term sexually transmitted
infection is generally preferred
over sexually transmitted
disease or venereal disease, as it
includes those who do not have
symptomatic disease
 Cause
Transmission
A sexually transmitted infection present in a pregnant
woman may be passed on to the infant before or after
birth.[16]

Risk of transmission per unprotected sexual

act with an infected person

Known risks Possible

 Throat chlamydia
 Hepatitis
Performing  Throat gonorrhea (25–
B (low risk)
30%)
oral sex on a  HIV (0.01%)
 Herpes (rare)
man  Hepatitis
 HPV
C (unknown)
 Syphilis (1%)
Performing  Throat
 Herpes
gonorrhea
oral sex on a  HPV[18]
 Throat
 woman chlamydia

 Chlamydia
Receiving oral  Gonorrhea
sex—man  HPV
 Herpes
 Syphilis (1%)
 HPV
Receiving oral  Bacterial
sex—woman  Herpes
vaginosis
 Gonorrhea
 Chlamydia (30–50%)
 Crabs
 Scabies
 Gonorrhea (22%)
 Hepatitis B
 Herpes (0.07%
for HSV-2)
Vaginal sex—  HIV (0.05%)
man  Hepatitis C
 HPV (high: around 40–
50%)
 Mycoplasma hominis
infection
 Mycoplasma genitalium
 Syphilis
 Trichomoniasis
 Ureaplasma infection
Vaginal sex—  Chlamydia (30–50%)
woman  Hepatitis C
 Crabs
  Scabies
 Gonorrhea (47%)
 Hepatitis B (50–70%)
 Herpes
 HIV (0.1%)
 HPV (higharound 40–
50%)[24]
 Mycoplasma hominis
infection
 Syphilis
 Trichomoniasis
 Ureaplasma infection
 Chlamydia
 Crabs
 Scabies (40%)
Anal sex—  Gonorrhea
insertive  Hepatitis B  Hepatitis C
 Herpes
 HIV (0.62%)
 HPV
 Syphilis (14%)
 Chlamydia
 Crabs
Anal sex—  Scabies
receptive  Gonorrhea  Hepatitis C
 Hepatitis B
 Herpes
 HIV (1.7%)
  HPV
 Syphilis (1.4%)
 Amebiasis
 Cryptosporidiosis (1%)
Anilingus  Giardiasis  HPV (1%)
 Hepatitis A(1%)
 Shigellosis(1%)

 Bacterial
 Chancroid (Haemophilus ducreyi)
 Chlamydia (Chlamydia trachomatis)
 Gonorrhea (Neisseria gonorrhoeae),
colloquially known as "the clap"
 Granuloma inguinale or (Klebsiella
granulomatis)
 Mycoplasma genitalium
 Mycoplasma hominis
 Syphilis (Treponema pallidum)
 Ureaplasma infection
 Fungal
 Candidiasis (yeast infection)
 Viral
 Micrograph showing the
viral cytopathic effect of herpes
(ground glass nuclear inclusions,
multi-nucleation). Pap test. Pap stain.
 Viral hepatitis (Hepatitis B virus)—
saliva, venereal fluids.
(Note: Hepatitis A and Hepatitis E are
transmitted via the fecal-oral
route; Hepatitis C is rarely sexually
transmittable,[47] and the route of
transmission of Hepatitis D (only if
infected with B) is uncertain, but may
include sexual transmission.)
 Herpes simplex (Herpes simplex
virus 1, 2) skin and mucosal,
transmissible with or without visible
blisters
 HIV (Human Immunodeficiency Virus)—
venereal fluids, semen, breast milk,
blood
 HPV (Human Papillomavirus)—skin and
mucosal contact. 'High risk' types of
HPV cause almost all cervical cancers,
as well as some anal, penile,
and vulvar cancer. Some other types of
HPV cause genital warts.
 Molluscum contagiosum (molluscum
contagiosum virus MCV)—close contact
  Parasites
 Crab louse, colloquially known as
"crabs" or "pubic lice" (Pthirus
pubis)[52][53][54] The infestation and
accompanying inflammation
is Pediculosis pubis
 Scabies (Sarcoptes scabiei)
 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. Symptoms
in men include pain when
urinating, and abnormal discharge
from their penis. If left
untreated in both men and women,
Chlamydia can infect the urinary
tract and potentially lead
to pelvic inflammatory
disease (PID). 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. Some
people are asymptomatic or have
very mild symptoms. 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. The initial infection
and symptoms are usually the most
severe because the body does not
have any antibodies built up.
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).
Although HSV-1 is typically the
"oral" version of the virus, and
HSV-2 is typically the "genital"
version of the virus, a person
with HSV-1 orally CAN transmit
that virus to their partner
genitally. 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.
 The human papillomavirus (HPV)
is the most common STI in the
United States.There are more than
40 different strands of HPV and
many do not cause any health
problems. In 90% of cases the
body's immune system clears the
infection naturally within 2
years. Some cases may not be
cleared and can lead to genital
warts (bumps around the genitals
that can be small or large,
raised or flat, or shaped like
cauliflower) or cervical cancer
and other HPV related cancers.
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. There are some
 antibiotic resistant strains for
Gonorrhea but most cases can be
cured with antibiotics.

Secondary syphilis
 Syphilis
is an STI caused by a
bacterium. Untreated, it can lead
to complications and
death. Clinical manifestations of
syphilis include the ulceration
of the uro-genital tract, mouth
or rectum; if left untreated the
symptoms worsen. In recent years,
the prevalence of syphilis
 has declined in Western Europe,
but it has increased in Eastern
Europe (former Soviet states). A
high incidence of syphilis can be
found in places such
as Cameroon, Cambodia, Papua New
Guinea.[63] Syphilis infections
are increasing in the United
States.[64]
 Trichomoniasis
 is a common STI that is
caused by infection with a
protozoan parasite
called Trichomonas
vaginalis.[65] Trichomoniasis
affects both women and men,
but symptoms are more common
in women. Most patients are
treated with an antibiotic
called metronidazole, which is
very effective.

Diagnosis
 Chlamydia :-

 Because of the chance of

other health problems if you
contract chlamydia
trachomatis, ask your doctor
how often you should have
chlamydia screening tests if
you're at risk. The Centers
for Disease Control and
Prevention recommends
chlamydia screening for:

 Sexually active women age 25 or

younger. The rate of chlamydia infection is
highest in this group, so a yearly screening
test is recommended. Even if you've been
tested in the past year, get tested when you
have a new sex partner.
 Pregnant women. You should be tested
for chlamydia during your first prenatal exam.
If you have a high risk of infection — from
changing sex partners or from your regular
 partner's possible infection — get tested
again later in your pregnancy.
 Women and men at high
risk. Consider frequent chlamydia screening
if you have multiple sex partners, if you don't
always use a condom during sex or if you're a
man who has sex with men. Other markers of
high risk are current infection with another
sexually transmitted infection and possible
exposure to an STI through an infected
partner.
Screening and diagnosis of chlamydia is relatively
simple. Tests include:

 A urine test. A sample of your urine

analyzed in the laboratory may indicate the
presence of this infection.
 A swab. For women, your doctor takes a
swab of the discharge from your cervix for
culture or antigen testing for chlamydia. This
can be done during a routine Pap test. Some
women prefer to swab their vaginas
themselves, which has been shown to be as
diagnostic as doctor-obtained swabs.
 For men, your doctor inserts a slim swab into the
end of your penis to get a sample from the
urethra. In some cases, your doctor may swab
the anus

 Gonorrhea
To determine whether the gonorrhea bacterium
is present in your body, your doctor will analyze
a sample of cells. Samples can be collected by:
 Urine test. This may help identify bacteria in your
urethra.
 Swab of affected area. A swab of your throat,
urethra, vagina or rectum may collect bacteria that
can be identified in a laboratory.
For women, home test kits are available for gonorrhea.
Home test kits include vaginal swabs for self-testing that
are sent to a specified lab for testing. If you prefer, you
can choose to be notified by email or text message when
your results are ready. You may then view your results
online or receive them by calling a toll-free hotline

 Syphilis:-
can be diagnosed by testing samples of:
 Blood. Blood tests can confirm the presence
of antibodies that the body produces to fight
infection. The antibodies to the syphilis-
causing bacteria remain in your body for
years, so the test can be used to determine a
current or past infection.
 Cerebrospinal fluid. If it's suspected that you
have nervous system complications of
syphilis, your doctor may also suggest
collecting a sample of cerebrospinal fluid
through a procedure called a lumbar puncture
(spinal tap)
 Through the Centers for Disease Control and
Prevention, your local health department
offers partner services, which will help you
notify your sexual partners that they may be
infected. That way, your partners can be
tested and treated and the spread of syphilis
can be limited

 Trichomoniasis
  symptoms are similar to those of other
STIs. It can’t be diagnosed by symptoms
alone. See your doctor for a physical exam
and laboratory tests if you think that you
might have an infection.

A number of tests can diagnose trich, including:

 cell cultures
 antigen tests (antibodies bind if
the Trichomonas parasite is present, which
causes a color change that indicates
infection)
 tests that look for Trichomonas DNA
 examining samples of vaginal fluid (for
women) or urethral discharge (for men)
under a microscope
 Study of AIDs
 The first cases of acquired immunodeficiency
syndrome (AIDS) were reported in the United States
in the spring of 1981. By 1983 the human
immunodeficiency virus (HIV), the virus that causes
AIDS, had been isolated. Early in the U.S.
HIV/AIDS pandemic, the role of substance abuse in
the spread of AIDS was clearly established.
Injection drug use (IDU) was identified as a direct
route of HIV infection and transmission among
injection drug users. The largest group of early
AIDS cases comprised gay and bisexual men
(referred to as men who have sex with men(or
MSMs). Early cases of HIV infection that were
sexually transmitted often were related to the use of
alcohol and other substances, and the majority of
these cases occurred in urban, educated, white
MSMs.
 Currently, injection drug users represent the largest
HIV-infected substance-abusing population in the
United States. HIV/AIDS prevalence rates among
injection drug users vary by geographic region, with
the highest rates in surveyed substance abuse
treatment centers in the Northeast, the South, and
Puerto Rico. From July 1998 through June 1999, 23
percent of all AIDS cases reported were among men
 and women who reported IDU (Centers for Disease
Control and Prevention [CDC], 1999b).
 IDU practices are quick and efficient vehicles for
HIV transmission. The virus is transmitted primarily
through the exchange of blood using needles,
syringes, or other IDU equipment (e.g., cookers,
rinse water, cotton) that were previously used by an
HIV-infected person. Lack of knowledge about safer
needle use techniques and the lack of alternatives to
needle sharing (e.g., available supplies of clean, new
needles) contribute to the rise of HIV/AIDS.
 Another route of HIV transmission among injection
drug users is through sexual contacts within
relatively closed sexual networks, which are
characterized by multiple sex partners, unprotected
sexual intercourse, and exchange of sex for money
(Friedman et al., 1995). The inclusion of alcohol and
other noninjection substances to this lethal mixture
only increases the HIV/AIDS caseload (Edlin et al.,
1994; Grella et al., 1995). A major risk factor for
HIV/AIDS among injection drug users is crack use;
one study found that crack abusers reported more
sexual partners in the last 12 months, more sexually
transmitted diseases (STDs) in their lifetimes, and
greater frequency of paying for sex, exchanging sex
for drugs, and having sex with injection drug users
(Word and Bowser, 1997)
 Transmition of AIDs
 You can only get HIV by coming into
direct contact with certain body fluids
from a person with HIV who has a
detectable viral load. These fluids are:

 Blood
 Semen (cum) and pre-seminal fluid
 Rectal fluids
 Vaginal fluids
 Breast milk

 For transmission to occur, the HIV in

these fluids must get into the
bloodstream of an HIV-negative person
through a mucous membrane (found in
the rectum, vagina, mouth, or tip of the
penis); open cuts or sores; or by direct
injection.
  People with HIV who take HIV
medicine daily as prescribed and get
and keep an undetectable viral load
have effectively no risk of sexually
transmitting HIV to their HIV-negative
partners

 Spreading of HIV from Person to Person?

 HIV can only be spread through

specific activities. In the United States,
the most common ways are:

 Having vaginal or anal sex with

someone who has HIV without using
a condom or taking medicines to
prevent or treat HIV. Anal sex is
riskier than vaginal sex.
 Sharing injection drug equipment
(“works”), such as needles, with
 someone who has HIV.

 Less common ways are:

 From mother to child during

pregnancy, birth, or
breastfeeding. However, the use of
HIV medicines and other strategies
have helped lower the risk of mother-
to-child transmission of HIV to 1% or
less in the United States.
 Getting stuck with an HIV-
contaminated needle or other sharp
object. This is a risk mainly for health
care workers. The risk is very low.

 HIV is spread only in extremely rare cases by:

 Having oral sex. But in general, the

chance that an HIV-negative person will
get HIV from oral sex with an HIV-
positive partner is extremely low.

 Receiving blood transfusions, blood

products, or organ/tissue transplants
that are contaminated with HIV. The
risk is extremely small these days
because of rigorous testing of the
U.S. blood supply and donated
organs and tissues.
 Being bitten by a person with
HIV. Each of the very small number of
documented cases has involved
severe trauma with extensive tissue
damage and the presence of blood.
There is no risk of transmission if the
skin is not broken.
 Contact between broken skin,
wounds, or mucous membranes and
 HIV-infected blood or blood-
contaminated body fluids.
 Deep, open-mouth kissing if both
 partners have sores or bleeding
gums and blood from the HIV-
positive partner gets into the
bloodstream of the HIV-negative
partner. HIV is not spread through
saliva.
 Eating food that has been pre-
chewed by a person with HIV. The
contamination occurs when infected
blood from a caregiver’s mouth
mixes with food while chewing. The
only known cases are among infants
  You cannot get HIV from…
 Someone who has an undetectable viral
load
If a healthcare professional has confirmed that someone living
with HIV has an undetectable viral load (meaning effective
treatment has reduced the amount of virus in their blood so that
it cannot be detected through a blood test) there is no risk of
transmission. Undetectable = Untransmissable (U+U).

 Someone who doesn’t have HIV

You can only get HIV from someone who is already
living with HIV.
 Touching someone who has HIV
HIV can only be transmitted through specific bodily fluids so
you can’t get HIV from touching someone, hugging them or
shaking their hand.
 Kissing
There is such a small amount of HIV in the saliva of a person
living with HIV that the infection can’t be passed on from
kissing.
 Sweat, tears, urine or faeces of someone
who has HIV
HIV can’t be transmitted through sweat, tears, urine or faeces.1
 Mutual masturbation
Mutual masturbation, fingering and hand-jobs can’t give you
HIV. However, if you use sex toys make sure you use a
new condom on them when switching between partners.
 Used condoms
Outside of the body, HIV in semen can only survive for a very
short amount of time. So, even if a condom had sperm from an
HIV-positive person in it, it would not pose any risk.
 Air
HIV can’t survive in air so you can’t get it from sharing a
space with someone who is HIV-positive.
 Coughs, sneezes or spit
There is only a trace of HIV in these bodily fluids so they can’t
transmit HIV.
 Food, drink and cooking utensils
HIV can’t be passed on through sharing food, drinks or
cooking utensils, even if the person preparing your food is
living with HIV.
 Toilet seats, tables, door handles, cutlery,
sharing towels
You can’t get HIV from any of these as it can only be
transmitted through specific bodily fluids.
 Water
HIV can’t survive in water, so you can’t get HIV from
swimming pools, baths, shower areas, washing clothes or from
drinking water.
 Insects
You can’t get HIV from insects. When an insect (such as a
mosquito) bites you it sucks your blood only – it does not inject
the blood of the last person it bit.
 Animals
HIV stands for Human Immunodeficiency Virus, which means
that the infection can only be passed between humans.
 New or sterilised needles
New needles can’t infect someone because they haven’t been
in contact with infected blood. If used needles are cleaned and
sterilised they can’t transmit HIV either.
 Musical instruments
HIV can’t survive on musical instruments. Even if it is an
instrument that you play using your mouth, it can’t give you
HIV.
 Tattoos and piercings
There is only a risk if the needle used by the professional has
been used in the body of someone living with HIV and not
sterilised afterwards. However, most practitioners are required
by law to use new needles for each new client.
  Treatement of HIV/AIDs

There's no cure for HIV/AIDS, but many different drugs

are available to control the virus. Such treatment is called
antiretroviral therapy, or ART. Each class of drug blocks
the virus in different ways. ART is now recommended for
everyone, regardless of CD4 T cell counts. It's
recommended to combine three drugs from two classes
to avoid creating drug-resistant strains of HIV.

The classes of anti-HIV drugs include:

 Non-nucleoside reverse transcriptase inhibitors

(NNRTIs) turn off 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) are faulty versions of the
building blocks that HIV needs to make copies of
itself. Examples include Abacavir (Ziagen), and the
combination drugs emtricitabine/tenofovir (Truvada),
Descovy (tenofovir alafenamide/emtricitabine), and
lamivudine-zidovudine (Combivir).
 Protease inhibitors (PIs) inactivate HIV 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 Tblock HIV's entry into
CD4 T cells. Examples include enfuvirtide (Fuzeon)
and maraviroc (Selzentry).
 Integrase inhibitors work by disabling a protein
called integrase, which HIV uses to insert its genetic
material into CD4 T cells. Examples include
raltegravir (Isentress) and dolutegravir (Tivicay).

 When to start the treatment

Everyone with HIV infection, regardless of CD4 T cell

count, should be offered antiviral medication.

HIV therapy is particularly important for the following

situations:

 You have severe symptoms.

 You have an opportunistic infection.
 Your CD4 T cell count is under 350.
 You're pregnant.
 You have HIV-related kidney disease.
  You're being treated for hepatitis B or C.
 Treatment can be difficult

HIV treatment plans may involve taking several pills at

specific times every day for the rest of your life. Each
medication comes with its own unique set of side effects.
It's critical to have regular follow-up appointments with
your doctor to monitor your health and treatment.

 Some of the treatment side effects are:

 Nausea, vomiting or diarrhea

 Heart disease
 Weakened bones or bone loss
 Breakdown of muscle tissue (rhabdomyolysis)
 Abnormal cholesterol levels
 Higher blood sugar
  Prevention of STI
To prevent getting a sexually
transmitted disease, or STD, always
avoid sex with anyone who has genital
sores, a rash, discharge, or other
symptoms. The only time
unprotected sex is safe is if you and
your partner have sex only with each
other, and if it's been at least six
months since you each tested negative
for STDs. Otherwise you should:
 Use latex condoms every time you
have sex. If you use a lubricant,
make sure it's water-based.
Use condoms for the entire sex
act. Condoms are not 100%
effective at preventing disease
or pregnancy. However, they are
extremely effective if used
properly. Learn how to use condoms
correctly.
 Avoid sharing towels or
underclothing.
 Wash before and after intercourse.
  Get a vaccination for hepatitis B.
This is a series of three shots.
 Get tested for HIV.
 If you have a problem with drug
or alcohol abuse, get help. People
who are drunk or on drugs often
fail to have safe sex.
 Consider that not having sex is
the only sure way to prevent STDs.
It was once thought that using condoms
with nonoxynol-9 helped to prevent STDs
by killing the organisms that can cause
disease. New research shows that doing
so also irritates a
woman's vagina and cervix and may
increase the risk of an STD infection.
Current recommendations are to avoid
using condoms with nonoxynol-9.

 How Can I Prevent Spreading an STD?

To prevent giving an STD to someone
else:
 Stop having sex until you see a
doctor and are treated.
 Follow your doctor's instructions for
treatment.
 Use condoms whenever you have sex,
especially with new partners.
 Don't resume having sex unless your
doctor says it's OK.
 Return to your doctor to get
rechecked.
 Be sure your sex partner or partners
also are treated.