AWARENESS

PARTNERS NEED TO BE
TREATED
• All partners should be examined and treated.
 SEXUALLY TRANSMITTED
DISEASES

• Most STDs have no symptoms

• A person can have a STD and not know it

Why would you be at greater risk of getting

an STI that doesn't cause any symptoms?
 WHAT IS STD?
This is an infection that can be transmitted through sexual contact with
an infected individual. They are sometimes called sexually transmitted
infections (STIs) or venereal disease

STDs can be transmitted many different ways, but most can be passed by:

Vaginal sex
Anal sex
Oral sex
Skin-to-skin contact
Transmission from mother to baby during childbirth
Skin to Skin contact
Sharing equipment
Exchange of bodily fluids
 MYTH OR FACT
1.You CANNOT get an STD from oral sex.
2.Birth control protects against pregnancy and STDs.
3.Once you’ve had an STD, you CANNOT get it again.
4.Anal sex has a higher risk of spreading STDs than many other
types of sexual activity.
5.Only gay and bisexual men get STDs.
6.You CANNOT get an STD if your partner is a virgin.
7.Only promiscuous or “trashy” people get STDs.
8.You CANNOT have two STDs at once
9.You can get an STD from a toilet seat.
10.Women are more likely to get tested for STDs.
11.Lesbians CANNOT get STDs.
12.If my partner has an STD, I’ll know/see it.
3 TYPES OF STD
STDS PATHOGENS:
 ARE STDS CURABLE?
Antibiotics can Cure Treatment can improve
Bacterial STDs, but cannot the lives of many
reverse the long-term people living with Viral
damage: STDs,
• Chlamydia (but there is NO CURE)
• Gonorrhea* • HIV
• Syphilis • Herpes
• Trichomoniasis • HPV
(parasitic protozoan) • Hepatitis B
AREAS OF INFECTIONS
ANTIBIOTICS CAN CURE
BACTERIAL STDS…
but not always the long-term damage.
 BACTERIAL INFECTIONS
Infections caused by bacteria, this
agent represents about half of the STIs
identified.

Bacterial infections are curable.

Medication does not protect against
future exposure.
“The SILENT Disease”
 CHLAMYDIA
• Chlamydia is a common sexually transmitted disease
(STD) caused by bacterium.
CHLAMYDIA TRACHOMATIS
-which can damaged a woman’s reproductive organs.

• Even though symptoms of chlamydia are usually mild or

absent, serious complications that cause irreversible
damage, Including infertility, can occur “silently”.

• It is called “silent” disease because three quarters of

women do not know they are infected.
 CHLAMYDIA
TRANSMISSION
1. Vaginal, anal, or oral sex with someone who
has chlamydia.

2. Infected pregnant women can pass it to their

baby during pregnancy or childbirth.
CHLAMYDIA
Possible symptoms include:
• Abnormal vaginal/penile discharge
• Burning sensation when urinating
• Rectal pain, discharge, or bleeding
• Pain/swelling in one or both testicles (less common)

Can lead to:

• Sterility or infertility
• Infection spreading to tube that carries sperm to/from the testicles
(causing pain and/or fever)
• Pelvic Inflammatory Disease (PID)
-Long-term abdominal/pelvic pain
-Scar tissue formation in fallopian tubes
-Ectopic pregnancy
 CHLAMYDIA: CLINICAL PRESENTATION
• Mucopurulent cervicitis/vaginal discharge
-inflammation of the cervix
• Dysuria • Proctitis
-painful or difficult urination. -inflammation of the rectum and anus.
• Lower abdominal pain • Post coital bleeding – friable cervix
• Urethritis .

-inflammation of the urethra. -refers to spotting or bleeding unrelated

• Salpingitis to menstruation that occurs during or after
sexual intercourse. Occurs when a person's
-inflammation of the fallopian tubes. cervix, which is the opening between the
vagina and uterus, becomes more sensitive
than usual.

Key Considerations:
 50% of females are asymptomatic
 Sterile pyuria with urinary tract symptoms should
trigger you to think chlamydia
 CHLAMYDIA: DIAGNOSIS
 Chlamydia culture
-culture is the gold standard for diagnosis, but this test is
expensive and can take from 2-6 days to obtain results.
 New tests include:

• Direct immunofluorescence assays (DFA) • Enzyme immunoassay (EIA)

- Also known as direct fluorescent antibody (DFA -A rapid enzyme
or dFA) immunochemical method for
-Its name derives from the fact that it directly tests determining the presence of
the presence of an antigen with the tagged antibody, an antigen, antibody, or hapten
unlike western blotting, which uses an indirect method in the blood.
of detection, where the primary antibody binds the
target antigen, with a secondary antibody directed
against the primary, and a tag attached to the
secondary antibody.
CHLAMYDIA: TREATMENT
CONSIDERATIONS
 Antibiotics
-Azithromycin
-is an antibiotic that fights bacteria.

 Evaluate and treat sexual partners

 Avoid sex for seven days after completion of
treatment
 CHLAMYDIA

ANAL CHLAYMDIA EYE CHLAMYDIA

The “THE CLAP”
 GONORRHEA
• Gonorrhea is a highly contagious sexually
transmitted infection (STI) is caused by gram- N. gonorrhoeae-gram negative diplococci
negative diplococcus: Neisseria gonorrhoeae.

• Bacteria can grow in warm moist areas in the

reproductive tract, including:
-Cervix, opening to the womb, in woman
-Fallopian tubes, egg canals, in woman
-Urethra, urine canal, in men and woman

• Gonorrhea, also known as “The Clap” or

“The Drip”,
diplococci
 THERE ARE A FEW THEORIES BEHIND WHY
GONORRHEA IS REFERRED TO AS THE CLAP:

• Theory #1:
From the old French word for brothel: “Clapier.”
• Theory #2: - is also used to refer to a rabbit’s nest or
From a terrible treatment form hutch.
that involved clapping hard on both
-the disease became known as clapier
sides of the penis simultaneously to try bubo (or clapior bubo) in French.
to rid the urethra of pus/discharge.

• Theory #3:
From the old English word “clappan”

-meaning to beat or to throb

 GONORRHEA
TRANSMISSION
1.Vaginal, anal, or
oral sex with someone
who has gonorrhea

2. A pregnant woman infected with

gonorrhea can give the infection to her baby
during childbirth
GONORRHEA
Possible symptoms include:
 Painful or burning sensation when urinating
 Abnormal vaginal/penile discharge (white, yellow, or green)
 Rectal discharge, itching, soreness, bleeding
 Vaginal bleeding between periods
 Painful or swollen testicles (less common)

Can lead to:

 Sterility or infertility
 Disseminated infection (rash, arthritis, fever, meningitis, etc.)
 Painful infection of tubes attached to the testicles
 Pelvic Inflammatory Disease (PID)
-Scar tissue formation in fallopian tubes
-Ectopic pregnancy
-Inability to get pregnant
-Long-term pelvic/abdominal pain
 GONORRHEA: CLINICAL
PRESENTATION
Areas of Infection Signs and Symptoms

 Urethra  Frequently asymptomatic

 Endocervix  Vaginal discharge
 Upper genital tract  Abnormal uterine
 Pharynx bleeding
 Rectum  Dysuria
 Mucopurulent cervicitis
 Lower abdominal pain
 GONORHEA : DIAGNOSIS
 Clinical exam

 Cervical culture

 Polymerase chain reaction (PCR) or ligase chain

reaction (LCR)

 Gram stain–polymorphonucleocytes with gram

negative intracellular diplococci
GONORRHEA: TREATMENT AND
CONSIDERATION
 Intramuscular Ceftriaxone

 For pregnant women only:

 Ceftriaxone single dose but substitute
Quinolones with Erythromycin
 Do not treat with Quinolones or Tetracyclines

 Evaluate and treat all sexual partners

 WHAT IS PID STAND FOR?
PELVIC INFLAMMATORY DISEASE
A serious infection that affects a woman’s reproductive organs

 Often caused by untreated STDs, like chlamydia and gonorrhea

 May experience mild or no symptoms:
 Pain in your lower abdomen
 Fever
 An unusual discharge with a bad odor from your vagina
 Pain and/or bleeding when you have sex
 Burning sensation when you urinate
 Bleeding between periods

 Treatment can help if caught early but won’t undo any damage or
complications to the reproductive system:
 Formation of scar tissue outside & inside the fallopian tubes (blockage)
 Ectopic pregnancy
 Infertility
 Long-term pelvic/abdominal pain
(Vaginal bacteriosis)
 BACTERIAL VAGINOSIS
Bacterial vaginosis is also known as Vaginal bacteriosis, it is the most common cause of vaginal
infection for women of childbearing age.

The other causes of bacterial vaginosis include:

 Having multiple sex partners, our doctor doesn't fully understand the link between sexual
activity and bacterial vaginosis, but the condition happens more often in women who have
multiple sex partners or a new sex partner, and it also frequently in women who have sex with
women.

 Douching, the practice of rinsing out your vagina with water or a cleansing agent
(douching) upsets the natural balance of your vagina. This can lead to an overgrowth of
anaerobic bacteria, and cause bacterial vaginosis since the vagina is self-cleaning, douching
isn't necessary.

 Natural lack of lactobacilli bacteria, if your natural vaginal environment doesn't produce
enough of the good lactobacilli bacteria, you're more likely to develop bacterial vaginosis.
 RISK FACTOR OF BACTERIAL
VAGINOSIS
The risk factor that has been linked to bacterial vaginosis includes a higher risk of:

 HIV infection, as BV increases susceptibility to the virus

 Post-surgical infection, for example, after a termination or a hysterectomy
 STIs, such as the herpes simplex virus, chlamydia, gonorrhea, and human papillomavirus
(HPV)
 Possible complications of bacterial vaginosis during pregnancy include:
 Early, or preterm, delivery
 Miscarriage
 The amniotic sac breaking open too early
 Postpartum endometritis, it is an irritation or inflammation of the lining of the uterus after
delivery
 Tubal factor infertility, caused by damage to the fallopian tubes in which connect the ovaries
to the uterus
 Chorioamnionitis, an inflammation of the membranes surrounding the fetus, known as the
chorion and the amnion
BACTERIAL VAGINOSIS: DIAGNOSIS
To diagnose bacterial vaginosis, your doctor may:

 Ask questions about your medical history. Your doctor may ask about
any previous vaginal infections or sexually transmitted infections.
 Perform a pelvic exam. During a pelvic exam, your doctor visually
examines your vagina for signs of infection, and inserts two fingers
into your vagina while pressing on your abdomen with the other hand
to check your pelvic organs for signs that may indicate disease.
 Take a sample of vaginal secretions. This may be done to check for an
overgrowth of anaerobic bacteria in your vaginal flora. Your doctor
may examine the vaginal secretions under a microscope, looking for
"clue cells," vaginal cells covered with bacteria that are a sign of
bacterial vaginosis.
 Test your vaginal pH.Your doctor may check the acidity of your
vagina by placing a pH test strip in your vagina. A vaginal pH of 4.5 or
higher is a sign of bacterial vaginosis.
PELVIC EXAM
 BACTERIAL VAGINOSIS
TREATMENT
To treat bacterial vaginosis, your doctor may prescribe one of the following medications:

 Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine may be taken as a pill by

mouth (orally). Metronidazole is also available as a topical gel that you insert into your
vagina. To reduce the risk of stomach upset, abdominal pain or nausea while using this
medication, avoid alcohol during treatment and for at least one day after completing
treatment — check the instructions on the product.

 Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream that you
insert into your vagina. Clindamycin cream may weaken latex condoms during treatment
and for at least three days after you stop using the cream.

 Tinidazole (Tindamax). This medication is taken orally. Tinidazole has the same potential
for stomach upset and nausea as oral metronidazole does, so avoid alcohol during
treatment and for at least three days after completing treatment.
The “Great Imitator”
SYHPILIS
A chronic bacterial disease that is contracted chiefly by
infection during sexual intercourse, but also congenitally by
infection of a developing fetus.

 Syphilis has been called the great imitator because its signs
and symptoms are so similar to other infections and diseases.

 Over 36,000 new cases of syphilis occur in the U.S. each year.

PRIMARY SECONDARY LATE AND

SYPHILIS SYPHILIS LATENT SYPHILIS
PRIMARY SYPHILIS
Chancre (shangker)- syphilis sore

 Firm, round, and painless

 Appears within 2-6 weeks after exposure (could

take up to 3 months)

 Found on the part of the body exposed to the

infection (penis, vagina, anus, lips, in rectum, or in
mouth)

 Typically disappear after a few weeks without

treatment (still progresses to next stage)
PRIMARY SYPHILIS
 Can be solitary or multiple (eg. kissing lesions)
SECONDARY SYPHILIS
Appears about 4 weeks after chancre heals

Will go away without treatment, but infection

will progress

non-itchy RASH with ALOPECIA MUCOUS PATCHES

rough red or reddish Or patchy hair usually in the mouth,
brown spots loss vagina, or anus

Condylomata lata or “fleshy warts” in anogenital region

LATENT SYPHALIS
 The period when there are no signs/symptoms but
syphilis is still present in the body

 If left untreated, you can continue to have syphilis in

your body for years without any signs or symptoms.
 The latent (HIDDEN) stage of syphilis

 Can develop in about 15% of people who have not

been treated for syphilis, and can appear 10-20 years
after infection was acquired
LATE (TERTIARY) SYPHILIS
Typically Occurs 10-30 years after infection begins!

Can damage almost any part of the body including

the heart, brain, spinal cord, eyes and bones
Can result in mental illness, blindness, deafness,
heart disease and death
Gumma: soft, gummy tumor

Types
Cardiovascular Syphilis
Late Benign Syphilis
Neurosyphilis Syphilis
 TYPES OF LATE SYPHILIS
 Cardiovascular syphilis
- The lesions of cardiovascular syphilis include aortitis and
aorticaneurysms, aortic valvular insufficiency, and narrowing of the
coronary ostia.
-refers to the infection of the heart and related blood vessels by
the syphilis bacteria. This complication usually begins as an AORTITIS (Proximal Aorta)
inflammation of the arteries. Destruction caused by cardiovascular
syphilis can be life-threatening.

Complications of cardiovascular syphilis include:

 Narrowing of the blood vessels that supply blood to the heart,
which may lead to heart attack and possibly death.
 Damage to heart valves that may lead to heart failure .
 Aortic aneurysm . If a vessel becomes weak enough, it can
rupture and cause death.
 Antibiotic treatment cures the syphilis infection and stops the
progress of cardiovascular syphilis. But the damage that has
already occurred may not be reversed.
1. LATE BENIGN SYPHILIS
 Benign tertiary syphilis (BTS)
-includes all forms of symptomatic acquired syphilis occurring
beyond the secondary and relapsing stages, with the exception of
cardiovascular and neurosyphilis. This group of manifestations is
sometimes also called “late benign syphilis.”

 The characteristic lesion is the gumma, and generally speaking,

the longer the interval between initial infection and lesion onset,
the more destructive the manifestations will be.

 The great majority of lesions are concentrated in the skin, mucous

membranes, and bone, however; and the material presented in
this section will deal principally with disease in those structures.

 BTS lesions can appear as early as two years and as late as 35

years after the initial infection. The great majority of cases fall in
the 2-to 7-year time period.
2. NEUROSYPHILIS SYPHILIS
 Neurosyphilis is caused by Treponema pallidum.
 Is a bacterial infection of the brain or spinal cord. It usually occurs in people who have had
untreated syphilis for many years.
 Usually occurs during late syphilis but can occur at anytime during the infection
 Neurosyphilis usually occurs about 10 to 20 years after a person is first infected with syphilis. Not
everyone who has syphilis develops this complication.
Symptoms:
 Difficulty coordinating muscle movements
 Paralysis (not able to move certain parts of your body)
 Numbness There are four different forms of
 Blindness neurosyphilis:
 Dementia (mental disorder)  Asymptomatic (most common form)
 Damage to internal organs  General paresis (General paralysis)
 Can result in death  Meningovascular
 Tabes dorsalis

More likely to occur early in the disease process if HIV infection is also present!
3. CONGENITAL SYPHILIS
Is a chronic infectious disease caused by a spirochete (treponema pallidum)
acquired by the fetus in the uterus before birth. Symptoms of this disease may
not become apparent until several weeks or months after birth and, in some
cases, may take years to appear.40% will be stillborn or die in the hospital

Transmission can occur during any stage of syphilis and during any trimester of
pregnancy.

Can cause:
Prematurity
Birth defects
Hutchinson’s teeth
Osteochondritis
Developmental delays
SYPHILIS: CLINICAL PRESENTATION
Primary / Infectious / Early Syphilis Stage:

Primary chancre Secondary Phase Secondary / Latent Stage:

 Begins as papule and  Occurs 6 weeks – 6 months  Positive serology

erodes into painless ulcer
with a hard edge and clean
base
 Usually in the genital area
 Appears 9-90 days after
exposure
 Can be solitary or multiple
(eg. kissing lesions)
 Heals with scarring in 3-6
weeks and 75% of patients
show no further symptoms
after chancre
 Lasts several weeks
 Accompanied with fever,
malaise, generalized
lymphadenopathy, and
patchy alopecia
 Maculo-papular rash usually
on palms and soles
 Condyloma lata on perianal
or vulval areas
 Possible mild
hepatosplenomegaly
 Rapid Plasma Reagin (RPR)
 Venereal Disease Research Lab
(VDRL)
 Patients are asymptomatic and not
infectious after first year, but may
relapse
 One-third will convert to sero-
negative status
 One-third will stay sero-positive
but asymptomatic
 One-third will develop tertiary
syphilis
SYPHILIS: CLINICAL PRESENTATION (CONTINUED)
TERTIARY STAGE:
Cardiovascular: Aortic valve disease, aneurysms

Neurological: Meningitis, encephalitis, tabes dorsalis,

dementia

Gumma formation: Deep cutaneous granulomatous

pockets

Orthopedic: Charcot’s joints, osteomyelitis

Renal: Membranous Glomerulonephritis

SYPHILIS DIAGNOSIS
Requires demonstration of:

Organisms on microscopy using dark field

Positive serology on blood or cerebrospinal fluid (CSF)
Non-Specific Treponemal Tests:
1. Venereal Disease Research Laboratory (VDRL)
2. Rapid Plasma Reagin (RPR)
Positive serology on blood or CSF
Specific Treponemal Test:
1. Fluorescent Treponemal Antibody Absorption
(FTA-ABS)
2. Microhemagglutination-Treponema pallidum (MHA-TP)

Organism may not be cultured but diagnosis cannot be determined by clinical findings only.
 SYPHILIS: TREATMENT
CONSIDERATIONS
 Primary/ secondary/ latent stage:
Benzathine penicillin

 Neurosyphilis:
Penicillin G

 Ask about penicillin allergy before

treatment
 VIRAL INFECTIONS

VIRAL INFECTIONS
are not curable.

They can be treated and

managed with medication to
reduce symptoms and
outbreaks caused by the virus.
Human alphaherpesvirus
HERPES
Also known by their taxonomical names Human alphaherpesvirus

HSV-1: ORAL HERPES

Herpes Simplex in Women with AIDS
HSV2: GENITAL HERPES

Caused by the Herpes Simplex Virus (HSV)

Herpes
- is a super-common infection that stays in your body
for life. More than half of Americans have oral herpes, and
about 1 out of 6 Americans has genital herpes. So chances are a
few people you know are living with herpes. Anyone can be
infected with HSV, regardless of age. Your risk is based almost
entirely on exposure to the infection. In cases of sexually
transmitted HSV, people are more at risk when they have sex not
protected by condoms or other barrier methods.
TWO TYPES OF HERPES
 HERPES
How is it Spread?
Vaginal, oral, or anal sex OR skin-to-skin contact with
someone who has the virus

Usually characterized by NO or very mild symptoms… NO CURE.

1 in 8 people aged 14-49 have genital herpes.

Most people do not know it!

 HSV: CLINICAL PRESENTATION
Primary Infection
 Prodrome phase: Tingling/itching of skin
 Appearance of painful vesicles in clusters
on an erythematous base
 Vesicles ulcerate then crust over and heal
within 7-14 days
 Viral shedding continues for up to 2-3
weeks
Recurrent Disease
 After primary infection, virus migrates to sacral
ganglion and lies dormant
 Reactivation occurs due to various triggers
 Reoccurrence is usually milder and shorter in
duration
 HSV: DIAGNOSIS AND TREATMENT
CONSIDERATIONS
Diagnosis Treatment Considerations

Antivirals
Clinical presentation
 Lesions may be bathed in mild soap
Viral culture
and water
Tzanck smear/Giemsa smear
 Sitz baths may provide some relief
Skin biopsy
 Sex partners may benefit from
evaluation and counseling
Transmission is possible when lesions
not present due to viral shedding
HPV(HUMAN PAPILLOMAVIRUS)

Scientific name: Papillomaviridae

 HUMAN PAPILLOMAVIRUS
(HPV)
Is usually harmless and goes away by itself, but some types
can lead to cancer or genital warts. HPV specializes in infecting
epithelial cells, which make up much of the skin and the body's
mucous membranes.
How is HPV transmitted?
• Skin-to-Skin contact
• Vaginal, Anal, and Oral sex
(Vaginal & anal most common)
 HPV-RELATED HEALTH PROBLEMS

1. Genital warts
2. Cervical pre-cancer
3. Other HPV-related cancers

- #1 cause of cervical, anal, and penile cancers

- Most people with HPV do not know they have it
-Can remove the warts but does not remove the virus from the blood
-Most warts will clear over time
- There is no treatment for the virus itself, but there are treatments for health problems it
can cause
- In most cases, the immune system will overcome HPV on its own
“inflammation of the liver”
 HEPATITIS
“INFLAMMATION
Hepatitis is a virus that OF THE LIVER”
affects your liver

It can cause permanent

liver disease and
cancer of the liver
Hepatitis A & B can be
prevented by vaccines
There is no vaccine for
Hepatitis C

Remember hepatitis is
not CURABLE!
 TYPES OF HEPATITIS B
ACUTE:
Virus “clears out” of person’s system after initial exposure. This must be confirmed by
a negative blood test after 6 months.

CRONIC:
Virus stays in the person’s systems, and person tests positive after 6 months.
CHRONIC HEPATITIS may stay with a person for a lifetime. About 10% of adults who
contact Hepatitis B will develop the chronic type.

How can someone lower their chances of getting

Hepatitis B and C?
 Get vaccinated against Hepatitis B Practice safer sex
 Do not share instruments used in body-piercing,
tattooing or hair removal
 Do not share personal items such as toothbrushes,
razors and needles
 HEPATITIS: SYMPTOMS AND TREATMENT

SYMTOMS: TREATMENT :
 Jaundice (yellowing of skin  Medication will slow down the virus
an the whites on the eyes) and reduce liver damage.

 Fatigue  In some cases they may even rid of

the virus completely.
 Abdominal and joint pain
 Hepatitis B vaccine is the best
protection. Tree injections given
 Nausea over 5-6 months

 LOSS of apetitte  Remember to be tested before

getting vaccinated.
About 30%of person’s have no signs or
symptoms
 HUMAN IMMUNODEFICIENCY VIRUS (HIV) AND
ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)

HIV
(Human Immunodeficiency Virus)
• Virus that affects the immune
system.
• HIV attacks CD4 (T-Cells) that
helps to fight disease.
• It is the virus that causes
AIDS.
How is HIV Spread?
From person to person through the
exchange of bodily fluids
3 Main Ways:
• Unprotected sex with people living with HIV (vaginal,
oral, or anal)
• Blood to blood contact
• Exposure to HIV before or during birth or through
breastfeeding

AIDS
(Acquired Immune deficiency
Syndrome)
• When the body is at below
200 4t-cells pre ML (drop) of
blood
• Body is vulnerable to
opportunistic infections.
• It is a late stage of the HIV
infections.
 HIV
Can experience “flu-like” symptoms (if any)
about 2-4 weeks after exposure:
Fever, Enlarged lymph nodes, Sore throat,
Rash

What Fluids Transmit HIV? How Can HIV Enter the Body?
 HIV TREATMENT
Treatment Extends Lives

BUT, medication can be: PrEP as Prevention

• Expensive
• Complicated – many pills at specific
times of day
• Toxic – side effects are common
• Ineffective – not all strains of HIV
respond
Pre-Exposure Prophylaxis (PrEP): daily
medicine that can stop HIV from replicating inside the
body
 PrEP is only prescribed for HIV-negative individuals
who are at ongoing substantial risk of getting HIV
 PrEP reduces the risk of getting HIV
when taken consistently
 more than 90% from sexual contact
 more than 70% among IDUs
 PARASITIC INFECTIONS
 Infections caused by
parasite can be transmitted
sexually and non-sexually
 Treatment does not protect
 Against future infection
TRANSMISSION:
• Sexual contact
• Prolonged contact (household
members
• Sharing towels and sheets(
parasites live up to 3 days without
human host.
TESTING:
• Examination of suspicious area
• Further diagnosis done with
skin biopsy, and topical
solution.
• Culture testing ( for
Trichomoniasis
PUBIC LICE
PUBIC LICE
PUBIC LICE
organism called PTHIRUS PUBIS

 The “crab louse or pubic louse” is an insect that is an

obligate ectoparasite of humans, feeding exclusively on
blood.

 The crab louse usually is found in the person's pubic hair.

Although the louse cannot jump, it can also live in other
areas of the body that are covered with coarse hair, such
as the eyelashes.

 The lice attach their eggs to the pubic hair and feed on
human blood.
PUBIC LICE SYMTOMS AND TREATMENTS
SYMPTOMS:
 Persistent itching around
becomes worse at night
 Low grade fever
 Irritability
 Lack of energy
 Pale bluish spots near at
bites
TREATMENT:
 Decontaminating yourself, your
clothes, and your bedding
 You might need stronger medicine if
the lice survive this effort.:
 MALATHION (OVIDE)
 IVERMECTIN (STROMECTOL)
 LINDANE
SCABIES
SCABIES are teensy tiny skin mites known as Sarcoptes scabies
-an eight-legged microscopic mite.

Scabies is contagious and can spread very easily from person to person through
close physical contact. Is one of several skin conditions that can cause itching and
rashes.

The scabies mite

• Scabies is caused by a mite that burrows into the skin. It burrows using its
mouth parts and front legs.

• They take 25 to 60 minutes to burrow into the skin.

• Sexual contact or bedding
• Pimple like irritations, mite burrows in zigzag pattern
 FAST FACTS ON SCABIES

 Here are some key points about scabies. More detail and supporting
information is in the main article.

 While the scabies mite needs skin to feed and survive, it can live without a
human host for 48 to 72 hours.

 The rash and itching experienced by those with scabies is a result of the
body's allergic reaction to the mites, their eggs, and their waste.

 The average person infested with scabies will have 15 to 20 mites present.

 Those at highest risk of developing crusted scabies include the

immunocompromised, the elderly, and those housed in institutional settings.
SIGNS AND SYMPTOMS OF SCABIES INCLUDE:

 Itching: This is often worse at night and can be severe and intense. Itching is one of
the most common scabies symptoms.

 Rash: When the mite burrows into the skin, it forms burrow tracks, or lines, which
are most commonly found in skin folds, and resemble hives, bites, knots, pimples,
or patches of scaly skin. Blisters may also be present.

 Sores: These occur in infested areas where a person has scratched at the skin.
Open sores can lead to impetigo, commonly caused by secondary infection with
Staphylococcus aureus.

 Thick crusts: Crusted scabies, also known as Norwegian scabies, is a form of

severe scabies in which hundreds to thousands of mites and mite eggs are
harbored within skin crusts, causing severe skin symptoms.
 THE MOST COMMON SITE OF
INFESTATION:
Adults and older children include: Infants and young children:
 in between the fingers  scalp
 around fingernails  face
 armpits  neck
 waistline  palms of the hands
 inner parts of the wrists  soles of the feet
 inner elbow
 soles of the feet
 the breasts, particularly the areas around the At times, children can present with a widespread
nipples infestation, covering a majority of the body. Infants who
 male genitalia are infested with scabies tend to exhibit symptoms of
 buttocks irritability, and sleeping and eating difficulties.
 knees
 shoulder blades
 SCABIES TREATMENT
Scabies is generally treated with topical medications such as:

• 5 percent permethrin cream,

• crotamiton cream
• or lindane lotion.
• In some cases, a 25 percent benzyl benzoate lotion or 10 percent
sulfur ointment may be used.

Most topical preparations are applied at night and washed off in the
morning.

Other medications such

• as antihistamines,
• anti-itching lotions like Pramoxine lotion,
• antibiotics, and
• steroid creams might be prescribed to offer relief from symptoms.
 “TRICH”

“TRICH”
 TRICHOMONIASIS
TRICHOMONIASIS (or “trich”) is a very common sexually transmitted disease (STD). It is
caused by infection with a protozoan parasite called Trichomonas vaginalis. Although
symptoms of the disease vary, most people who have the parasite cannot tell they are infected.

Estimated 3.7 million in 2016

Parasite passed during vaginal sex

70% of infected people have no signs/symptoms

Possible symptoms include:

 Itching, burning, redness or soreness of the genitals
 Burning with urination or ejaculation
 Thin discharge: can be clear, white, yellowish, or greenish
 Can produce unusual or foul smell

Infection usually occurs:

Lower genital tract (vulva, vagina, penis or urethra)

Greatly increases the risk of getting/spreading other STIs!

 TRICHOMONIASIS: CLINICAL
PRESENTATION
Signs and symptoms:
 Vulvar irritation
 Dysuria
 Dyspareunia
 Pale yellow, malodorous - gray/green frothy
discharge
 Strawberry cervix, inflamed and friable
 TRICHOMONIASIS: DIAGNOSIS
 Flagellated, motile trichomonads on wet mount

 Vaginal pH > 4.5

 Diagnosis confirmed by microscopy

 Other FDA approved tests:

 OSOM Trichomonas Rapid Test
 Affirm VP III
 TRICHOMONIASIS: TREATMENT
CONSIDERATIONS

For HIV-infected women: same treatment as non-

HIV infected women

Metronidazole or Tinidazole

Sex partners have to be treated

SIGNS AND SYMPTOMS OF A PARASITIC
STD
Signs and symptoms:

 Intense itchiness
 Reddish rash
 Pain during sex or urination
 Vaginal discharge

How are parasitic STIs treated?

 Shampoo – special shampoo to kill lice or scabies

 Lotion - special shampoo to kill lice or scabies
 Ointment- special shampoo to kill lice or scabies
 Antibiotic – used to treat trich
FUNGAL

Candidiasis or "yeast infection"

 FUNGAL
Candidiasis or "yeast infection“
- is caused by a small fungus.

Healthy women normally have small numbers of them in the vagina.

Sometimes the numbers grow and cause such problems as:

 vaginal itching
 burning
 a heavy
 Curdy
 white discharge
 and pain when having sex.
 FUNGAL
TRANSMISSION: How is it treated ?
• Tight clothing Antifungal cream
• severe obesity tablet or suppositories
• warm weather -available in pharmacies without
• stress prescription. Insert these into the vagina for
• antibiotics the number of days stated on the product.
• birth control pills Take the treatment even if you are having
• Pregnancy your period. Do not douche while you are
• diabetes and taking the treatment.
• steroids can all cause increased numbers
of yeast. The infection is not usually
spread by sexual contact.
 FUNGAL: REMEMBER
Yeast is a nuisance infection. To avoid problems :

 Don't douche (especially with store preparations) unless your doctor or

clinic asks you to and tells you what to use;
 Wipe from front to back after bowel movements. This avoids spreading
germs from the anus to the vagina;
 Wear cotton underwear and loose clothing. This keeps the vaginal area dry
and helps healing;
 Take treatment as directed until it is finished;
 Use condoms to lower the chance of infections in future.
 If your are still worried or have more questions
 Pelvic inflammatory disease (PID)
 What are some
reasons to not engage
in sexual activity?
Sexual health and decision making

 Concept of consent
Should I have Sex
 Communication in a
relationship
What is the only 100
% effective way of
preventing STDs and
pregnancy?
 WHAT DOES ABSTINENCE MEAN?
 Abstinence means to not do something

 Sexual abstinence means to abstain from different levels

of sexual activity

 Possible choices for sexual abstinence between two

people could be:

• Avoiding vaginal and anal intercourse

• Avoiding oral-genital contact
• Avoiding genital contact
 EFFECTIVE STRATEGIES FOR REDUCING
STD RISK INCLUDE:
 ABSTINENCE # 1 EFFECTIVE

 VACCINATION
Vaccines are safe, effective, and recommended ways to prevent hepatitis B and HPV. HPV
vaccines for males and females can protect against some of the most common types of HPV. It
is best to get all three doses (shots) before becoming sexually active. However, HPV vaccines
are recommended for all teen girls and women through age 26 and all teen boys and men
through age 21, who did not get all three doses of the vaccine when they were younger. You
should also get vaccinated for hepatitis B if you were not vaccinated when you were younger.

 REDUCE NUMBER OF SEX PARTNERS

Reducing your number of sex partners can decrease your risk for STDs. It is still important
that you and your partner get tested, and that you share your test results with one another.
 MUTUAL MONOGAMY
Mutual monogamy means that you agree to be sexually active with only one
person, who has agreed to be sexually active only with you. Being in a long-term
mutually monogamous relationship with an uninfected partner is one of the most
reliable ways to avoid STDs. But you must both be certain you are not infected with
STDs. It is important to have an open and honest conversation with your partner.

 USE CONDOMS
Correct and consistent use of the male latex condom is highly effective in
reducing STD transmission. Use a condom every time you have anal, vaginal, or oral
sex.

If you have latex allergies, synthetic non-latex condoms can be used. But it is
important to note that these condoms have higher breakage rates than latex
condoms. Natural membrane(lambskin) condoms are not recommended for STD
prevention.
 MALE CONDOMS
More than 98% effective when used correctly and consistently

Latex (most common and effective)

“Non-Latex”: Polyurethane, Polyisoprene
Natural Membrane: Lambskin*
MALE CONDOM USE
 MALE CONDOM USE
Do’s:
• DO keep condoms in a cool, dry
place
• DO put the condom on an erect
(hard) penis before any genital
contact
• DO hold the condom in place at
the base of the penis before
withdrawing (pulling out) after sex
• DO throw the condom away after
it’s been used
• DO use water-based lubrication
(vaginal sex) or silicone-based
(anal
Don’ts:
• DON’T use expired condoms
• DON’T unroll the condom before putting it
on the penis
• DON’T leave condoms in hot places
(wallet, car, etc.)
• DON’T use oil-based products (baby or
cooking oils, hand lotion, Vaseline, etc.) as
lubricants with latex condoms
• DON’T use your fingernails or teeth while
opening the condom wrapper.
• DON’T reuse a condom or use more than
one condom at a time (‘double wrapping’)
 MORE PROTECTION

FEMALE CONDOMS DENTAL DAM

 Get yourself tested
 Seeking Help
 Education

 Respect!
 POINTS TO REMEMBER:

 Every person body is different

 Never be embarrassed to consult with

your clinician about STD”s

 STD”s do not DISCRIMINATE!

THANK YOU !!!!!!!!!!!!!!!!!!!