Sexually Transmitted

Infections
Group B: Taylor Olson, Rachel Flynn, Bethany Keenan, Seungyoon Han, Chris Kouris,
Kristen Youtsey, Paige Dinehart, Rachel Lepore, Samantha Heidersdorf
STI- Sexually transmitted infection

● Infections passed through any sexual contact such as oral, anal or vaginal
● There are nearly 20 million new STDs every year in the United States
● STDs can be prevent with abstinence, or with condoms
● 1 in 2 people that are sexually active will get an STD by age 25
● They can cause infertility in women if untreated
● It is easy to get tested
Gonorrhea
What is it?
● Gonorrhea is a sexually transmitted disease that affects both men and women
What organism is responsible?
● Neisseria gonorrhoeae
● Causes infections in the throat, rectum, and genitals
What is the prevalence?
● 15-24 years old
● In 2016, there was an 18.5% increase in the number of cases of Gonorrhea since 2015
How is it diagnosed?
● Urine sample
● Oral or anal sex → need throat and/or rectum samples
So, is there a vaccine?
● There is no current vaccination for gonorrhea
Gonorrhea continued...
Signs and Symptoms:
● Men: burning painful sensation when urinating, white, yellow or green discharge from the penis, painful
or swollen testicles (less common than other symptoms)
● Women: often mistaken for a UTI, burning when urinating, more vaginal discharge than normal, vaginal
bleeding when not menstruating.
● Rectal infections are the same for both men and women: itching, soreness, bleeding, discharge, and
painful bowel movements.

Current Treatments:
● Dual Therapy treatment: single dose of intramuscular Ceftriaxone AND oral Azithromycin
Gonorrhea continued...
Re-screening:
● Not necessary for uncomplicated cases unless symptoms persist
● Complicated cases may need 14 day follow-up after treatment
Potential complications:
● If left untreated, can spread to the uterus and fallopian tubes causing PID
(pelvic inflammatory disease) which causes scarring in the fallopian
tubes, and can lead to infertility in women
● Men can also be at risk for infertility
● Infection can cause joint swelling and stiffness
● Increased risk of HIV/AIDS
● Complications with babies such as blindness, infections, and sores
Chlamydia Infection
What is it?
Chlamydia is a sexually transmitted infection spread through bodily secretions causing an inflammatory
reaction with scarring of the epithelial tissue in male and female genitalia and reproductive organs

What organism is responsible?

Chlamydia trachomatis

What is the prevalence?

The most frequently reported bacterial sexually transmitted infection in the United States!!! 1 in 20
sexually active individuals ages 14-24
Chlamydia cont’d...
How is it diagnosed?
★ Vaginal Swabs
★ Urine test
➢ Nucleic Amplification tests (NAATs)---> MOST SENSITIVE
➢ Cell Culture
★ Pelvic Exam (Symptomatic)

So, is there a vaccine?

No! They have not yet come up with a vaccine for chlamydia!
Chlamydia cont’d...
Signs & Symptoms: “The silent infection”

Female (5-30%) Male (50%)

➢ Symptoms of cervicitis ➢ Urethritis
■ Discharge ■ Mucoid or watery
■ Bleeding discharge
➢ Pelvic Pain ■ Dysuria
➢ Rectal pain, discharge, bleeding
➢ Cervical motion tenderness
➢ Burning, pain, frequent urination
➢ Uterine tenderness ➢ Swollen & painful testicles
➢ Swelling ➢ Unusual sores
Chlamydia cont’d...

Current Treatments: (Infected & any partners of last 60 days )

1st Line: 1g oral azithromycin
2nd Line: 7-day course doxycycline 100mg q 12 hr
Others: Oral erythromycin, erythromycin E, ofloxacin and other antibiotics

Re-screening after treatment?

Yes, 3 wk. After treatment, get retested to ensure the bacterial infection was killed and there
are no risks of further complications
 Chlamydia Complications
● Initial damage goes unnoticed
● Reactive arthritis following infection
● Increased risk of acquiring HIV
● Perihepatitis (Inflammation liver capsule) & surrounding peritoneum (RUQ pain)
● Untreated-->Fallopian Tubes = Pelvic Inflammatory Disease (Pelvic pain, ectopic pregnancy, infertility)
● Pregnant mother is infected with chlamydia → vaginal route with the delivery of a child (Infect eyes,
nasopharynx, rectum, vagina and if secretions are aspirated chlamydial pneumonitis can occur leading to
morbidity. or even morbidity

So….
Annual screening is recommended for all women under 26 who are sexually active, pregnant women and those
who are not monogamous at any age + PREVENTION (Latex condoms + 1 partner:)
Herpes Genitalis
What is Herpes Genitalis?
● A sexually transmitted disease spread by bodily
secretions and contact

What Organism is Responsible?

● Herpes Simplex Virus 2 & Herpes Simplex
Virus 1

Prevalence of Herpes Genitalis

● Over 50 million people in the US
● 1 in 6 adults
● More common in women
Herpes Genitalis

Diagnosed via Signs and Symptoms

● Laboratory tests ● Asymptomatic
● Blood tests ● Painful sores and blisters around genitals or anus
● Flu-like symptoms (e.g. fever, chills, muscle ache,
fatigue, nausea)
● Dysuria
● Lymphadenopathy
● Cervicitis
● Proctitis
Herpes Genitalis Complications
● Pain
There are no vaccines present for herpes ● Recurrent sores
● Pregnancy complications
genitalis! ○ C-section
○ Breastfeeding
Treatment ● Psychosocial effects
● Antiviral therapy ○ Emotional stress
○ 1st line: Acyclovir
○ Famciclovir and valacyclovir
Rescreening
● Within 10 days of antiviral treatment

For the partner

● Sexual intercourse is discouraged
● Condoms
● Tests
● Antiviral treatment
Syphilis
What is it?
● Bacterial infection spread through sexual contact (skin and mucous membranes), which result in
sores on genitalia and rectum

Organism Responsible?
● Treponema pallidum

Prevalence?
● 2016 total cases: 27,814
● From 2015-2016 the cases have increased 17.6%. Mostly among men having sex with other men
Syphilis

Diagnosis:

● Blood test- antibodies against the bacteria (can remain in body for years)
● Dark field microscopy- sample from a lesion examined under a microscope
● Lumbar puncture- if patient is experiencing nervous system symptoms
Syphilis
Signs and Symptoms: Occurs in stages

● Primary: chancre lesion, small, painless

● spot where bacteria entered body, shows up in three weeks

● Secondary: rash begins at trunk, spreads throughout

○ not itchy, warts on mouth and genitalia
Syphilis

Signs and symptoms cont’d...

● Latent- if no treatment is done, no symptoms

● Tertiary- damage brain, bones, joints, blood vessels, heart, eyes, nerves, and liver
● Congenital- can be passed through the placenta to the newborn
Syphilis
Treatment:

Antibiotics- #1 choice is Penicillin, earlier the better. No vaccine

● All pregnant women should be tested for syphilis at first prenatal visit and in the third trimester
● Pregnant women have to take penicillin and their infants need to be treated with antibiotics as well
● Once the infection is removed from the body and no lesions, need blood tests done to determine if
infection is eliminated

Notify partners to be tested as well, and do not have any sexaul intercourse until infection is eliminated
Condyloma Acuminata (HPV)
What is it?

● Sexually transmitted infection

● Spread via sexual contact with another person who has the virus
● Often asymptomatic

What organism is responsible?

● Human papillomavirus

What is the prevalence?

● The most common sexually transmitted infection in the United States

● Has affected more than 79 million Americans

● Predicted that almost every person who is sexually active and has not received the vaccine will contract
HPV at some point in their life
Condyloma Acuminata (HPV) Continued
How is it diagnosed?

● No official test to determine if someone is HPV positive

● May be diagnosed after an abnormal pap smear during a cervical screen
● Certain cancers may indicate someone has HPV (cervical, anal, vulvar, etc.)

Signs and symptoms?

● No signs or symptoms most of the time

● Abnormal pap smear during a cervical screen
● Genital warts

Is there a vaccine?

● Yes, a 2-3 part vaccine

● Recommended for boys and girls at 11-12 years old (Catch-up vaccines available)
● Two shots 6-12 months apart or 3 shots if first two are within 5 months of each other
Condyloma Acuminata (HPV) Continued

Treatment Recommendations?

● No treatment for the virus itself

● Can treat genital warts with prescribed medication
● Cancer prevention- screening

Is re-screening required?

● No, since it is mostly asymptomatic

● No screen to detect presence of the virus

Potential Complications?

● Can be spread to other people

● Various forms of cancer (cervical, vulvar, penile, anal, etc.)
● Genital warts that require extensive treatment if left untreated
AIDS
What is AIDS?
● Acquired Immunodeficiency syndrome
● Third stage of HIV
What is the organism causing it?
● Human Immunodeficiency virus
● People with HIV do not automatically have AIDS
What is the prevalence?
● Takes about 10 years to develop
○ Without treatment
● 36.7 million worldwide in 2016
○ 18,160 in the United States
■ Most common in African Americans
■ Hispanic/Latinos and Whites second

https://aidsinfo.nih.gov/understanding-hiv-
aids/infographics/3/hiv-and-aids--
what%E2%80%99s-the-difference-
AIDS
How is it diagnosed?
● CD4 count <200 cells/mm^3
● Presence of opportunistic infections

What are the signs and symptoms?

● Weakened immune system
○ Severe and frequent infections
○ Especially rare infections, types of cancer
● Thrush, sore throat
● Diarrhea, fevers, night sweats
● Swollen/firm glands in throat, armpit, groin
AIDS
Is there a vaccine?
● No
● PrEP
Is there a treatment?
● Antiretroviral Therapy (ART)
● Pregnant: mother takes HIV medication during pregnancy, labor, and delivery
○ Baby takes medication for 4-6 weeks after birth
Is there rescreening?
● No
● Monitor CD4 T cell count and HIV RNA count
○ Done every 3-6 months
What are the complications?
● Body cannot fight off infections or disease
● Treatment side effects: N/V, diarrhea, dry mouth, difficulty sleeping, dizziness, headache, fatigue, pain, rash
Which age group has the highest incidence of Gonorrhea?
A. 15-24 years old
B. 30-45 years old
C. 9-14 years old
D. 60+ years old

http://libguides.brooklyn.cuny.edu/asd/lifespan
Which age group has the highest incidence of Gonorrhea?
A. 15-24 years old
B. 30-45 years old
C. 9-14 years old
D. 60+ years old

http://libguides.brooklyn.cuny.edu/asd/lifespan
Which of the following is a sign of a primary Syphilis infection?

A. Rash on the abdomen

B. Painless lesion in genital area
C. Warts in the mouth
D. Painful sore in rectum

https://www.dreamstime.com/stock-illustration-nerd-geek-
thinking-clipart-picture-cartoon-character-image78583260
Which of the following is a sign of a primary Syphilis infection?

A. Rash on the abdomen

B. Painless lesion in genital area
C. Warts in the mouth
D. Painful sore in rectum

https://www.dreamstime.com/stock-illustration-nerd-geek-
thinking-clipart-picture-cartoon-character-image78583260
 References
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https://www.acog.org/Patients/FAQs/Genital-Herpes.

American Sexual Health Association. (2018). STD Statistics. Retrieved from

http://www.ashasexualhealth.org/stdsstis/statistics/.

AIDS info (2017). HIV/AIDS: The basics. Retrieved from

https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/19/45/hiv-aids--the-basics

Centers for Disease Control and Prevention. (2018). Chlamydia- CDC Fact Sheet. Retrieved from

https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm.

Centers for Disease Control and Prevention. (2018). Gonorrhea- CDC Fact Sheet. Retrieved from
 References
Centers for Disease Control and Prevention. (2016). HIV treatment. Retrieved from

https://www.cdc.gov/actagainstaids/campaigns/hivtreatmentworks/stayincare/treatment.html

Centers for Disease Control and Prevention. (2017). HIV treatment and prevention. Retrieved from

https://www.cdc.gov/hiv/risk/art/index.html

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https://www.cdc.gov/std/hpv/stdfact-hpv.htm

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https://www.cdc.gov/hiv/risk/prep/index.html

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https://www.cdc.gov/hiv/statistics/overview/index.html
 References
HIV.gov. (2017). HIV treatment overview. Retrieved from

https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/hiv-treatment-overview

HIV.gov. (2017). HIV vaccines. Retrieved from

https://www.hiv.gov/hiv-basics/hiv-prevention/potential-future-options/hiv-vaccines

McCance, K. L. & Huether, S. E. (2014). Pathophysiology the biologic basis for disease in adults and children (7th ed.).

St. Louis, MO: Elsevier.

Planned Parenthood. (2018). What are the symptoms & signs of HPV? Retrieved from

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hpv/what-are-symptoms-hpv

Planned Parenthood. (2018). HIV & AIDS. Retrieved from

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hiv-aids
 References

Planned Parenthood. (2018).What are the symptoms of gonorrhea? Retrieved from

https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/gonorrhea/what-are-symptoms-gonorrhea.

Sauerbrei, A. (2016). Herpes genitalis: Diagnosis, treatment and prevention. Geburtshilfe Und Frauenheilkunde, 76(12),

1310–1317. http://doi.org/10.1055/s-0042-116494
Sexually Transmitted Diseases (STDs). (2017). Retrieved from

https://www.cdc.gov/std/syphilis/stdfact-congenital-syphilis.htm

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20351756

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UNAIDS. (2016). AIDS by the numbers [PDF document]. Retrieved from