Sexually Transmitted Infections

Chlamydia

Transmission:

  • Vaginal, anal, or oral sex
  • Mother to baby during vaginal birth

Symptoms:

  • Typically appear 1-3 weeks after exposure
  • Most do not have symptoms
  • Can cause infection of the throat or rectum
  • Women:
  • Abnormal vaginal discharge
  • Burning with urination
  • Lower abdominal/back pain
  • Nausea or fever
  • Painful intercourse
  • Spotting between periods
  • Men:
  • Discharge from penis
  • Burning with urination
  • Itching near opening of penis

CDC’s Testing Guidelines:

  • All pregnant women
  • Annual for all sexually active women under 26
  • Annual for older women with new or multiple sex partners
  • Annual for sexually active gay men, bisexual men, and other men who have sex with men

Testing:

  • Urine sample

Treatment:

  • Curable with antibiotics

Complications:

  • Women:
  • Pelvic inflammatory disease
  • Infection of reproductive organs
  • Men:
  • Less common
  • Epididymitis: infection of the tubes that transport the sperm from the testes, which can cause infertility
  • Prostatitis: infection of the prostate gland

Statistics:

  • CDC estimates 2.8 million infections occur each year in the U.S.
  • 9,406 reported infections in Iowa in 2009 (IDPH)

This STI is tracked by the Iowa Department of Public Health and Johnson County Department of Public Health. If you test positive for this STI, we are required by law to report it to the appropriate Department of Public Health, and you may be contacted by that DPH.

Gonorrhea

Transmission:

  • Vaginal, anal, or oral sex
  • Mother to baby during vaginal birth

Symptoms:

  • Symptoms may appear 2-30 days after infection
  • May not have any symptoms, particularly in women
  • Can cause infection of the mouth, throat, eyes, or anus
  • Women:
  • Increased vaginal discharge
  • Burning/pain with urination
  • Lower abdominal/back pain
  • Nausea or fever
  • Painful intercourse
  • Spotting between periods
  • Men:
  • Discharge from penis
  • Burning with urination
  • Painful or swollen testicles

CDC’s Testing Guidelines:

  • Pregnant women at-risk
  • Annual for sexually active women under 25
  • Annual for women with new or multiple sex partners
  • Annual for women in communities with high disease prevalence
  • Annual for sexually active gay men, bisexual men, and other men who have sex with men

Testing:

  • Urine sample

Treatment:

  • Curable with antibiotics

Complications:

  • Women:
  • Pelvic inflammatory disease
  • Infection of reproductive organs
  • Permanent damage to reproductive organs leading to infertility
  • Men:
  • Less common
  • Epididymitis: infection of the tubes that transport the sperm from the testes, which can cause infertility

Statistics:

  • 301,174 reported infections in the U.S. in 2009 (CDC)
  • 1,658 reported infections in Iowa in 2009 (IDPH)

This STI is tracked by the Iowa Department of Public Health and Johnson County Department of Public Health. If you test positive for this STI, we are required by law to report it to the appropriate Department of Public Health, and you may be contacted by that DPH.

Herpes Simplex Virus Type 2

Transmission:

  • Vaginal, anal, or oral sex
  • Mother to baby during vaginal birth
  • Acquiring infection during late pregnancy increase risk of transmission to baby
  • Can occur even when no sore is visible
  • More likely from infected male to his female partner

Symptoms:

  • Most do not have symptoms.
  • First symptoms usually appear 2 weeks after exposure
  • Can cause infection of the mouth or rectum
  • Most common sign is blisters on or around the genitals/rectum
  • Broken blisters develop into sores that can take 2-4 weeks to heal
  • After the first outbreak, further outbreaks can occur weeks or months later
  • The frequency of outbreaks typically decreases over time
  • Other symptoms: fever, swollen glands

Testing:

  • Blood sample, visual exam, culture of active lesion

Treatment:

  • No cure
  • Antiviral medications can temporarily shorten/prevent outbreaks
  • Daily suppressive therapy can decrease transmission to partners

Complications:

  • Repeated outbreaks of painful genital sores
  • Psychological/emotional distress

Statistics:

  • 1 out of 6 people age 14-49 in the U.S. has HSV-2 (CDC)
  • More common in women: 1 out of 5 in women vs. 1 out of 9 in men (CDC)

HPV (Human papillomavirus)


Transmission:

  • Vaginal, anal, or oral sex
  • Mother to baby during vaginal birth

Symptoms:

  • Most do not develop symptoms
  • More than 40 types of HPV
  • Genital warts:
    • Small bump or group of bumps in genital area that can vary in size and shape
    • Can appear within weeks or months after exposure
    • Do not turn into cancer
  • Warts in the throat: recurrent respiratory papillomatosis (RRP)

Testing:

  • Pap Smear, visual exam
  • 90% of cases cleared by body’s immune system within 2 years
  • No medical cure for virus
  • Treatment available for some diseases caused by HPV
  • Genital warts: treatable with medications or by health care provider
  • Cervical cancer: treatable if diagnosed early
  • RRP: treatable with surgery/medications, but may take years to cure

Complications:

  • Cancer: cervical, vulvar, vaginal, penile, anal, and head and neck

Prevention:

  • Vaccines available to protect against a few types of HPV, but not all types of HPV (Gardasil for males; Gardasil & Cervarix for females)

Statistics:

  • Estimated 20 million people currently infected in the U.S. (CDC)
  • About 12,000 women get cervical cancer each year in the U.S. (CDC)

Syphilis

Transmission:

  • Direct contact with a syphillis sore through vaginal, anal, or oral sex
  • Mother to baby during pregnancy

Symptoms:

  • Caused by a type of bacteria called treponema pallidum
  • Many do not have any symptoms for years
  • Primary stage:
    • Chancre: a firm, round, small, painless sore in area of initial infection
    • Typically appear 10-90 days after exposure
    • Heals within 3-6 weeks without treatment and often go away unrecognized
  • Secondary stage:
    • Skin rash: characteristically rough, red to reddish brown spots on palms and bottoms of feet, but may also appear differently on other parts of body
    • typically appears either while chancre is healing or several weeks after chancre healed
    • Fever, swollen glands, sore throat, headaches, weight loss, muscle aches, fatigue, patchy hair loss
    • Can also cause infection of the mouth, throat, or anus

CDC’s Testing Guidelines:

  • All pregnant women
  • Annual for sexually active gay men, bisexual men, and other men who have sex with men

Testing:

  • Blood test

Treatment:

  • Curable with antibiotics in early stage

Complications:

  • Latent stage: symptoms disappear, but infection remains—can last years
  • Late stage: Permanent damage to internal organs
  • Can appear 10-20 yrs after infection and develop in about 15% of untreated cases
  • Difficulty coordinating movement, paralysis, numbness, blindness, dementia

Statistics:

  • Over 36,000 reported cases in the U.S. in 2006 (CDC)
  • 65 reported infections in Iowa in 2009 (IDPH)

This STI is tracked by the Iowa Department of Public Health and Johnson County Department of Public Health. If you test positive for this STI, we are required by law to report it to the appropriate Department of Public Health, and you may be contacted by that DPH.

HIV/AIDS

Transmission:

  • Vaginal, anal, or oral sex
  • Mother to baby during pregnancy, birth, or breast-feeding
  • Sharing needles, syringes, or other illegal IV drug use equipment

Symptoms:

  • May not have any symptoms for several years
  • May have flu-like symptoms, which occur within a few weeks of infection and last for 1-2 weeks
  • The virus damages CD4+ T cells, which are vital to the body’s defense system against diseases

CDC’s Testing Guidelines:

  • All pregnant women
  • Annual for injection drug users and their sex partners
  • Annual for persons who have sex for money or drugs
  • Annual for sex partners of HIV-infected persons
  • Annual for Individuals who themselves or whose sex partners have had more than one sex partner since their last HIV test
  • Annual for sexually active gay men, bisexual men, and other men who have sex with men

Testing:

  • Blood test for HIV antibodies
  • 97% develop detectable antibodies within 3 months of infection
  • Although rare, it can take up to 6 months to develop antibodies

Treatment:

  • No cure
  • Medications can slow disease progression, but are costly, must be taken daily for life, and have potential side effects

Complications:

  • Regardless of treatment, HIV eventually progresses to AIDS
  • AIDS (Acquired Immune Deficiency Syndrome) results when the number of healthy CD4+ T cells is so low that the body struggles to fight diseases and cancers

Statistics:

  • 35,962 AIDS diagnoses in the U.S. in 2007 (CDC)
  • 127 new HIV and 88 new AIDS diagnoses in Iowa in 2009 (IDPH)
  • 1,748 Iowa residents living with HIV/AIDS as of 2009 (IDPH)

This STI is tracked by the Iowa Department of Public Health and Johnson County Department of Public Health. If you test positive for this STI, we are required by law to report it to the appropriate Department of Public Health, and you may be contacted by that DPH.

Hepatitis C

Transmission:

  • Primarily through contact with blood of an infected individual
  • Lower risk through sexual contact and risks increased by having multiple sex partners, rough intercourse, or other STI/HIV infection.
  • Mother to baby during pregnancy

Symptoms:

  • Viral infection that affects the liver
  • Severity of disease varies from an acute to chronic infection
  • Acute:
    • 70-80% do not have any symptoms (CDC)
    • Symptoms can appear 2 weeks to 6 months after exposure
    • Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, jaundice (yellowing of skin/eyes), joint pain
    • 75%-85% of people infected develop chronic Hepatitis C (CDC)
  • Chronic:
    • Most do not have symptoms until significant liver damage has developed

CDC’s Testing Guidelines:

  • All pregnant women

Testing:

  • Blood test

Treatment:

  • In 15-25% of people the virus is cleared by the body without treatment
  • Acute: no medication available– rest, hydration, and proper nutrition
  • Chronic: Medications, such as interferon and ribavirin available, but can cause serious side effects and not always effective

Complications:

  • Chronic liver disease, cirrhosis (scarring of the liver), liver cancer

Statistics:

  • Estimated 17,000 new infections in the U.S. in 2007 (CDC)
  • As of 2009, approximately 10,630 cases identified in Iowa by the IDPH

Trichomoniasis

Transmission:

  • Caused by Trichomonas vaginalis, a parasite
  • Penis-to-vagina or vulva-to-vulva (female genital area) intercourse

Symptoms:

  • Women:
  • May not have any symptoms
  • Appear within 5-28 days of exposure
  • Vaginal discharge: frothy, yellow/green, strong odor
  • Discomfort with intercourse/urination
  • Itching/irritation in genital area
  • Men:
  • Most do not have symptoms
  • Mild penile discharge
  • Slight burning after urination/ejaculation

Testing:

  • Physical examination by health care provider
  • Microscopic examination of vaginal or urethral fluid sample

Treatment:

  • Prescription medication, typically either metronidazole or tinidazole
  • All partners should be treated at the same time
  • Abstinence until treatment complete and symptoms resolved

Complications:

  • Female genital inflammation while infected may increase risk of:
    • Acquiring HIV infection if exposed
    • Transmitting HIV infection to sexual partners

Statistics:

  • Estimated 7.4 million new cases each year (CDC)

This document was developed for educational use at Informed Choices Medical Clinic by Tonia Zwart, RN, BSN
References and image credits