SEXUALLY TRANSMITTED INFECTION
preventable cause of infertility, particularly
Sexually transmitted infections (STI’s) and
their complications belong to the top five
disease categories for which adults seek
health care in developing countries,
according to WHO.
STI’s are a major global cause of:
- acute illness - infertility
- long term disability - death
with severe medical and psychological
consequences for millions of men, women,
and children.
Unlike HIV, many STI’s can be treated and
cured relatively easily and cheaply if
diagnosed early enough.
Most common treatable STI’s:
Chlamydia
Gonorrhea
Trichomonas
Syphilis – causes the most concern
The proven most important method to
prevent transmission of STI’s in risky sexual
encounters is the consistent and correct
use of condom.
KEY FACTS
448 million new infections of curable
sexually transmitted (syphilis, gonorrhoea,
chlamydia and trichomoniasis) infections
occur yearly (adults aged 15-49).
Some sexually transmitted infections exist
without symptoms.
In pregnant women with untreated early
syphilis, 25% of pregnancies result in
stillbirth and 14% in neonatal death.
Sexually transmitted infections are the main
in women.
WHO recommends a syndromic approach
to diagnosis and management of sexually
transmitted infections.
Infections and Transmission
Spread primarily through person-to-person
sexual contact.
There are more than 30 different sexually
transmissible bacteria, viruses and
parasites.
Several, in particular HIV and syphilis, can
also be transmitted from mother to child
during pregnancy and childbirth, and
through blood products and tissue transfer.
STIs Without Symptoms
Up to 70% of women and a significant
proportion of men with gonococcal and/or
chlamydial infections experience no
symptoms at all.
Both symptomatic and asymptomatic
infections can lead to the development of
serious complications.
STIs Adversely Affect The Health of
Women
Untreated STIs can have critical
implications for reproductive, maternal and
newborn health.
STIs are the main preventable cause of
infertility, particularly in women.
10 - 40% of women with untreated
chlamydial infection develop symptomatic
pelvic inflammatory disease (PID).
Post-infection tubal damage is responsible STIs and HIV
for 30 - 40% of cases of female infertility.
The presence of untreated STIs increase
Women who have had pelvic inflammatory the risk of both acquisition and transmission
disease are 6 - 10 times more likely to of HIV.
develop an ectopic (tubal) pregnancy than
those who have not, and 40 - 50% of STI Syndromes
ectopic pregnancies can be attributed to - urethral discharge
previous pelvic inflammatory disease. - genital ulcers
Infection with certain types of the human - inguinal swellings
papillomavirus (HPV) can lead to the - scrotal swelling
development of genital cancers, particularly - vaginal discharge
cervical cancer in women. - lower abdominal pain
-neonatal eye infections
STIs and Adverse Outcomes of (conjunctivitis of the newborn).
Pregnancy
STD Prevention
Untreated STIs are associated with
congenital and perinatal infections in The most effective means to avoid
neonates. becoming infected with or transmitting a STI
is:
In pregnant women with untreated early - to abstain from sexual intercourse.
syphilis, 25% of pregnancies result in - to have sexual intercourse only within a
stillbirth and 14% in neonatal death – an long-term, mutually monogamous
overall perinatal mortality of about 40%. relationship with an uninfected partner.

Up to 35% of pregnancies among women Male latex condoms, when used

with untreated gonococcal infection result in consistently and correctly, are highly
spontaneous abortions and premature effective in reducing the transmission of
deliveries, and up to 10% in perinatal HIV and other sexually transmitted
deaths. infections.

In the absence of prophylaxis, 30 - 50% of COMMON STIs

infants born to mothers with untreated
gonorrhoea and up to 30% of infants born 1. Gonorrhea
to mothers with untreated chlamydial 2. Syphilis
infection will develop a serious eye infection 3. Chlamydia
(ophthalmia neonatorum), which can lead to 4. Trichomoniasis
blindness if not treated early. 5. Hepatitis B
Worldwide, 1000 - 4000 newborn babies 6. HIV/AIDS
become blind every year because of this 7. Genital Herpes
condition. 8. Genital Warts
9. HPV
 GONORRHEA Who is at risk for gonorrhea?

Gonorrhea is caused by infection with Any sexually active person can be infected
the Neisseria gonorrhoeae bacterium. with gonorrhea.

It infects the mucous membranes of the What are the signs and symptoms?
reproductive tract, including the cervix,
uterus, and fallopian tubes in women, and Many men with gonorrhea are
the urethra in women and men. asymptomatic. When present, (urethral
infection):
N. gonorrhoeae can also infect the mucous - dysuria or a white, yellow, or green
membranes of the mouth, throat, eyes, and urethral discharge that usually
anus. appears 1 to 14 days after infection.

Incubation period: 2 – 10 days, possibly 3 Most women with gonorrhea are

days or more asymptomatic.
Mild and nonspecific that they are mistaken
How common is gonorrhea? for a bladder or vaginal infection.
Gonorrhea is a very common infectious - Dysuria
disease. - increased vaginal discharge
- vaginal bleeding between periods
An estimated 200 million new cases of
gonorrhea occur annually. (Globally) Symptoms of rectal infection in both men
and women:
CDC estimates that, annually, more than - discharge
700,000 people in the United States get - anal itching
new gonorrheal infections. - soreness
- bleeding
How do people get gonorrhea?
- or painful bowel movements
Gonorrhea is transmitted through sexual may be asymptomatic
contact with the penis, vagina, mouth, or
Pharyngeal infection may cause a sore
anus of an infected partner.
throat, but usually is asymptomatic.
Ejaculation does not have to occur
What are the complications of
for gonorrhea to be transmitted or acquired.
gonorrhea?
Gonorrhea can also be spread perinatally
Women:
from mother to baby during childbirth.
Bartholin’s Abscess
People who have had gonorrhea and Pelvic inflammatory disease (PID) (women)
received treatment may be reinfected if they
have sexual contact with a person infected Men: Epididymitis
with gonorrhea.
Both men and women:
Disseminated gonococcal infection (DGI)
 What about Gonorrhea and HIV?
Untreated gonorrhea can increase a
person’s risk of acquiring or transmitting
HIV, the virus that causes AIDS.
How does gonorrhea affect a
pregnant woman and her baby?
If a pregnant woman has gonorrhea, she
may give the infection to her baby as the
baby passes through the birth canal during
delivery.
- blindness
- joint infection
- or a life-threatening blood infection
in the baby
Who should be tested for gonorrhea?
- Anyone with genital symptoms.
If a person has had oral and/or anal sex,
pharyngeal and/or rectal swab specimens
should be collected either for culture or for
NAAT.
What is the treatment for gonorrhea?
Gonorrhea can be cured with the right
treatment.
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.

- Anyone with an oral, anal, or vaginal sex If a person’s symptoms continue for more
partner who has been recently diagnosed than a few days after receiving treatment,
with an STD. he or she should return to a health care
provider to be reevaluated.
- Some people should be tested
for gonorrhea even if they do not have Patients infected with N.
symptoms or know of a sex partner who gonorrhoeae frequently are coinfected
has gonorrhoea. with C. trachomatis.

- Anyone who is sexually active with high Most gonococci are susceptible to
risk behaviour. doxycycline and azithromycin, routine
cotreatment might also hinder the
- People who have gonorrhea should also development of antimicrobial-
be tested for other STDs. resistant N. gonorrhoeae.
How is gonorrhea diagnosed? What about partners?
Nucleic Acid Amplification Testing (NAAT) If a person has been diagnosed and treated
- urine, urethral (for men) for gonorrhea, he or she should tell all
- or endocervical or vaginal (for recent anal, vaginal, or oral sex partners (all
women) specimens sex partners within 60 days before the
Gonorrhea Culture onset of symptoms or diagnosis) so they
- endocervical can see a health provider and be treated.
- urethral swab specimens
A person with gonorrhea and all of his or
her sex partners must avoid having sex
until they have completed their treatment
for gonorrhea and until they no longer have
symptoms.
How can gonorrhea be prevented?
Latex condoms, when used consistently
and correctly, can reduce the risk of
transmission.
The surest way to avoid transmission is to
abstain from sexual intercourse.
Or to be in a long-term mutually
monogamous relationship with a partner
who has been tested and is known to be
uninfected.
SYPHILIS
Syphilis is caused by the
bacterium Treponema pallidum.
Syphilis can cause long-term complications
and/or death if not adequately treated.
Incubation period – 10 days to 3 months,
with average of 21 days
Syphilis is easy to cure in its early stages.
Syphilis is most common during the years
of peak sexual activity.
Most new cases occur in men and women
aged 15-40 years.
Men are affected more frequently with
primary or secondary syphilis than women.
Syphilis remains prevalent in many
developing countries and in some areas of
North America, Asia, and Europe,
especially Eastern Europe.
The highest rates are in South and
Southeast Asia, followed closely by sub-
Saharan Africa.
How common is syphilis?
Preliminary 2007 syphilis data showed that
the US rate of primary and secondary
syphilis increased 12% between 2006 and
2007, from 3.3 to 3.7 cases per 100,000
population.
A total of 11,466 cases were reported in
2007. (USA)
How do people get syphilis?
Syphilis is transmitted from person to
person by direct contact with a syphilitic
sore, known as a chancre.
Chancres occur mainly on the external
genitals, vagina, anus, or in the rectum.
Chancres also can occur on the lips and in
the mouth.
Transmission of syphilis occurs during
vaginal, anal, or oral sex.
Pregnant women with the disease can
transmit it to their unborn child.
Signs and symptoms in adults
Syphilis has been called “The Great
Pretender”, as its symptoms can look like
many other diseases.
Syphilis typically follows a progression
of stages that can last for weeks, months,
or even years: primary, secondary, latent
and late stages.
Primary Stage
- A painless sore called a chancre may be
located on the genitals, lips, anus, or other
area of direct contact.
- The chancre lasts 3 to 6 weeks and heals
regardless of whether a person is treated or
not.
- Inadequate treatment could lead to
secondary stage.
Secondary Stage
- Skin rashes and/or mucous membrane
lesions (sores in the mouth, vagina, or
anus)
- The rash usually does not cause itching.
- The characteristic rash of secondary
syphilis may appear as rough, red,
or reddish brown spots both on the palms of
the hands and the bottoms of the feet.
- Large, raised, gray or white lesions,
known as condyloma lata, may develop in
warm, moist areas such as the mouth,
underarm or groin region.
- fever, swollen lymph glands, sore
throat, patchy hair loss, headaches, weight
loss, muscle aches, and fatigue.
The symptoms of secondary syphilis will go
away with or without treatment, but without
treatment, the infection will progress to
the latent and possibly late stages of
disease.
Latent and Late Stages
- The latent (hidden) stage of syphilis
begins when primary and secondary
symptoms disappear.
- Without treatment, the infected person will
continue to have syphilis infection in their
body even though there are no signs or
symptoms.
Early latent syphilis (occurred within the
past 12 months)
Late latent syphilis (occurred more than 12
months ago)
Latent syphilis can last for years.
Symptoms:
- difficulty coordinating muscle movements
- paralysis, numbness, gradual blindness,
and dementia
Neurosyphilis
- Syphilis can invade the nervous system
at any stage of infection.
- Asymptomatic/symptomatic
- headache, altered behavior, and
movement problems
Effects to a pregnant woman and her
baby
The syphilis bacterium can infect the baby
of a woman during her pregnancy.
- high risk of having a stillbirth
- Untreated babies may become
developmentally delayed, have seizures, or
die.
- For pregnant women only penicillin
therapy can be used to treat syphilis and
prevent passing the disease to her baby.
- Treatment with penicillin is extremely
effective (success rate of 98%) in
preventing mother-to-child transmission.
How is syphilis diagnosed?
Darkfield microscopy - rarely performed
today because it is a technologically difficult
method.
Blood test
o nontreponemal tests (VDRL
and RPR) - produce false-
positive results
o treponemal tests
(confirmatory) - antibodies
 usually remain detectable for How can syphilis be prevented?
life
Correct and consistent use of latex
II. SYPHILIS condoms

What is the treatment for syphilis? Syphilis sore outside of the area covered by
a latex condom can still allow transmission.
There are no home remedies or over-the-
counter drugs that will cure syphilis, but abstain from sexual contact
syphilis is easy to cure in its early stages.
Mutually monogamous relationship
A single intramuscular injection of long (uninfected)
acting Benzathine penicillin G (2.4 million
units administered intramuscularly) will cure II. SYPHILIS
(primary, secondary, early latent syphilis) How can syphilis be prevented?
II. SYPHILIS Transmission of an STD, including syphilis,
What is the treatment for syphilis? cannot be prevented by washing the
genitals, urinating, and/or douching after
Three doses of long acting Benzathine sex.
penicillin G (2.4 million units administered
intramuscularly) at weekly intervals (late Avoiding alcohol and drug use may also
latent syphilis or latent syphilis of unknown help prevent transmission of syphilis
duration) because these activities may lead to risky
sexual behavior.
II. SYPHILIS
II. SYPHILIS
What is the treatment for syphilis?
What is Chlamydia?
Persons who receive syphilis treatment
must abstain from sexual contact with new Chlamydia is a common sexually
partners until the syphilis sores are transmitted disease (STD) caused by the
bacterium, Chlamydia trachomatis, which
completely healed.
can damage a woman's reproductive
Persons with syphilis must notify their sex organs.
partners so that they also can be tested
and receive treatment if necessary. Symptoms of chlamydia are usually mild
or absent.
II. SYPHILIS
III. CHLAMYDIA
Will syphilis recur?
What is Chlamydia?
Syphilis does not recur.
Serious complications that cause
Having syphilis once does not protect a irreversible damage, including infertility, can
person from becoming infected again. occur "silently“.

II. SYPHILIS
Can cause discharge from the penis of an
infected man.
Incubation: 2-3 weeks for males; usually no
symptoms in female
III. CHLAMYDIA
How common is chlamydia?
According to WHO, there were more than
140 million cases of Chlamydia
trachomatis infection worldwide.
prevalent in persons aged 15-24 years
Acquisition rates are comparable for the 2
sexes.
III. CHLAMYDIA
How common is chlamydia?
Women are more likely to be asymptomatic
than men (80% vs 50%)
Women are also more likely to develop
long-term complications (eg, PID and
infertility).
III. CHLAMYDIA
How do people get chlamydia?
Chlamydia can be transmitted during
vaginal, anal, or oral sex.
Chlamydia can also be passed from
an infected mother to her baby during
vaginal childbirth.
Men who have sex with men are also at risk
for chlamydial infection.
III. CHLAMYDIA
Signs and symptoms of chlamydia
Chlamydia is known as a "silent" disease
because the majority of infected people
have no symptoms.
Women: initial infection (cervix & urethra)
o abnormal vaginal discharge
o burning sensation when
urinating
o lower abdominal pain
o low back pain, nausea, fever
III. CHLAMYDIA
Signs and symptoms of chlamydia
Women: initial infection (cervix & urethra)
o bleeding between menstrual
periods
o infection of the cervix can
spread to the fallopian tube
and rectum
III. CHLAMYDIA
Signs and symptoms of chlamydia
Men:
o discharge from their penis
o or a burning sensation
when urinating
o burning and itching around
the opening of the penis
o Pain and swelling in the
testicles are uncommon
III. CHLAMYDIA
Signs and symptoms of chlamydia
 Men or women who have receptive anal Persons with chlamydia should abstain
intercourse may acquire chlamydial from sexual intercourse for 7 days after
infection in the rectum: single dose or until completion of a 7-day
course of antibiotics.
o rectal pain, discharge, or
bleeding III. CHLAMYDIA

Chlamydia can also be found in the throats
(oral sex)
III. CHLAMYDIA
What complications can result from
Pelvic inflammatory disease (PID)
Infertility
Potentially fatal ectopic pregnancy
Increase risk of becoming infected with HIV
How can chlamydia be prevented?
Similar to other STD prevention
III. CHLAMYDIA
What is trichomoniasis?
Trichomoniasis (or “trich”) is a very
common sexually transmitted disease
(STD) that is caused by infection with a
protozoan parasite called Trichomonas
vaginalis.

Epididymitis - swollen and tender testicles
untreated chlamydia?
How does chlamydia affect a pregnant
premature delivery
early infant pneumonia and conjunctivitis
(pink eye) in newborns
Most women and men who have the
parasite cannot tell they are infected.
IV. TRICHOMONIASIS
How common is trichomoniasis?
Estimates of the worldwide prevalence of
trichomoniasis range from 170-180 million
cases annually.

woman and her baby? The World Health Organization estimates

the worldwide incidence of trichomonas
How is chlamydia diagnosed?
infection at over 170 million cases annually.
Urine test
IV. TRICHOMONIASIS
Chlamydia culture
How common is trichomoniasis?
III. CHLAMYDIA
It is typically found in sexually active
What is the treatment for chlamydia? adolescents and adults.

Chlamydia can be easily treated and cured
with antibiotics.
A single dose of azithromycin or a week of
doxycycline (twice daily).
Prevalence of 2.3% among adolescents
aged 18-24 years and 4% among adults 25
years and older
Symptomatic trichomoniasis is more
common in women than in men.
IV. TRICHOMONIASIS Without treatment, the infection can last for
months or even years.
How do people get trichomoniasis?
IV. TRICHOMONIASIS
Usually passed by direct sexual contact
What are the complications of
In women, the most commonly infected part trichomoniasis?
of the body is the lower genital tract (vulva,
vagina, or urethra). Trichomoniasis can increase the risk of
getting or spreading other sexually
In men, the most commonly infected body transmitted infections.
part is the inside of the penis (urethra).
IV. TRICHOMONIASIS
IV. TRICHOMONIASIS
How does trichomoniasis affect a pregnant
Signs and symptoms woman and her baby?
About 70% of infected people do not have preterm delivery
any signs or symptoms.
low birth weight (less than 5.5 pounds)
Incubation: 4 – 20 days, average 7 days
How is trichomoniasis diagnosed?
MEN:
 Flagellated, motile trichomonads on
o itching or irritation inside the wet mount
penis
 Vaginal pH > 4.5
o burning after urination or
ejaculation  Diagnosis confirmed by microscopy

o or some discharge from the  Culture test

penis
IV. TRICHOMONIASIS
IV. TRICHOMONIASIS
What is the treatment for trichomoniasis?
Signs and symptoms
Can be cured with a single dose of
WOMEN: prescription antibiotic medication (either
metronidazole or tinidazole) – taken orally
o itching, burning, redness or
soreness of the genitals People who have been treated for
trichomoniasis can get it again.
o discomfort with urination
How can trichomoniasis be prevented?
o or a thin discharge with an
unusual smell that can be Similar to syphilis prevention
clear, white, yellowish, or
greenish What is Hepatitis B?
Hepatitis B is caused by infection with the
Hepatitis B virus (HBV).
The incubation period from the time of
exposure to onset of symptoms is 6 weeks
to 6 months.
V. HBV
What is Hepatitis B?
HBV is found in highest concentrations in
blood and in lower concentrations in other
body fluids (e.g., semen, vaginal secretions,
and wound exudates).
HBV infection can be self-limited or chronic.
V. HBV
How common is hepatitis B?
The HBV carrier rate variation is 1-20%
worldwide.
High-prevalence areas (rate of 10-20%)
include China, Indonesia, sub-Saharan
Africa, the Pacific Islands, and Southeast
Asia
More cases of HBV disease occur in males
than in females.
V. HBV
How is HBV transmitted?
Sex with an infected partner
Injection drug use that involves sharing
needles, syringes, or drug-preparation
equipment
Birth to an infected mother
V. HBV
How is HBV transmitted?
Contact with blood or open sores of an
infected person
Needle sticks or sharp instrument
exposures
Sharing items such as razors or
toothbrushes with an infected person
V. HBV
How is HBV transmitted?
HBV is not spread through food or water,
sharing eating utensils, breastfeeding,
hugging, kissing, hand holding, coughing,
or sneezing.
V. HBV
How long does HBV survive outside the
body?
HBV can survive outside the body at least 7
days and still be capable of causing
infection.
What should be used to remove HBV from
environmental surfaces?
Any blood spills — including dried blood,
which can still be infectious — should be
cleaned using 1:10 dilution of one part
household bleach to 10 parts of water for
disinfecting the area.
Gloves should be used when cleaning up
any blood spills.
Who is at risk for HBV infection?
Infants born to infected mothers
Sex partners of infected persons
Sexually active persons who are not in a
long-term, mutually monogamous
relationship (e.g., >1 sex partner during the
previous 6 months)
V. HBV
Who is at risk for HBV infection?
Men who have sex with men
Injection drug users
Household contacts of persons with chronic
HBV infection
Hemodialysis patients
V. HBV
Who is at risk for HBV infection?
Health care and public safety workers at
risk for occupational exposure to blood or
blood-contaminated body fluids
Residents and staff of facilities for
developmentally disabled persons
V. HBV
What are the signs and symptoms of HBV
infection?
Most children under age 5 years and newly
infected immunosuppressed adults are
asymptomatic.
Whereas 30%–50% of persons aged ≥5
years have initial signs and symptoms.
What are the signs and symptoms of HBV
infection?
Fever
Fatigue
Loss of appetite
Nausea
Vomiting
What are the signs and symptoms of HBV
infection?
Abdominal pain
Dark urine
Clay-colored bowel movements
Joint pain
Jaundice
When symptoms of acute Hepatitis B occur,
how long do they usually last?
Symptoms typically last for several weeks
but can persist for up to 6 months.
How serious is acute HBV infection?
Acute infection ranges from asymptomatic
or mild disease to — rarely — fulminant
hepatitis.
Disease is more severe among adults aged
>60 years.
The fatality rate among acute cases
reported to CDC is 0.5%–1%.
How serious is chronic HBV infection?
Chronically infected after childhood die
prematurely from cirrhosis or liver cancer.
Majority remain asymptomatic until onset of
cirrhosis or end-stage liver disease.
How is HBV infection treated?
For acute infection, no medication is
available; treatment is supportive.
For chronic infection, several antiviral drugs
(adefovir dipivoxil, interferon alfa-2b,
pegylated interferon alfa-2a, lamivudine,
entecavir, and telbivudine) are available.
V. HBV
Can Hepatitis B be prevented?
Yes. The best way to prevent Hepatitis B is
by getting the Hepatitis B vaccine.
The Hepatitis B vaccine is safe and
effective and is usually given as 3-4 shots
over a 6-month period.
V. HBV
KEY FACTS
HIV continues to be a major global public
health issue, having claimed more than 25
million lives over the past three decades.
There were approximately 34 [31.4–35.9]
million people living with HIV in 2011.
VI. HIV/AIDS
KEY FACTS
Sub-Saharan Africa is the most affected
region, with nearly 1 in every 20 adults
living with HIV. Sixty nine per cent of all
people living with HIV are living in this
region.
HIV infection is usually diagnosed through
blood tests detecting the presence or
absence of HIV antibodies.
VI. HIV/AIDS
KEY FACTS
There is no cure for HIV infection. However,
effective treatment with antiretroviral drugs
can control the virus so that people with
HIV can enjoy healthy and productive lives.
VI. HIV/AIDS
KEY FACTS
In 2011, more than 8 million people living
with HIV were receiving antiretroviral
therapy (ART) in low- and middle-income
countries. Another 7 million people need to
be enrolled in treatment to meet the target
of providing ART to 15 million people by
2015.
VI. HIV/AIDS
Human Immunodeficiency Virus (HIV)
HIV targets the immune system and
weakens people's surveillance and defense
systems against infections and some types
of cancer.
Immune function is typically measured by
CD4 cell count.
Human Immunodeficiency Virus (HIV)
The most advanced stage of HIV infection
is Acquired Immunodeficiency Syndrome
(AIDS), which can take from 2 to 15 years
to develop depending on the individual.
AIDS is defined by the development of
certain cancers, infections, or other severe
clinical manifestations.
Signs and symptoms
The first few weeks after initial infection:
o no symptoms or an influenza-
like illness including fever,
headache, rash or sore throat.
The following may be warning signs of
advanced HIV infection:
o rapid weight loss
o dry cough
 o recurring fever or profuse
night sweats
VI. HIV/AIDS
Signs and symptoms
The following may be warning signs of
advanced HIV infection:
o profound and unexplained
fatigue
o swollen lymph glands in the
armpits, groin, or neck
o diarrhea that lasts for more
than a week
o white spots or unusual
blemishes on the tongue, in
the mouth, or in the throat
VI. HIV/AIDS
Signs and symptoms
The following may be warning signs of
advanced HIV infection:
o Pneumonia
o red, brown, pink, or purplish
blotches on or under the skin
or inside the mouth, nose, or
eyelids
o memory loss, depression, and
other neurological disorders
VI. HIV/AIDS
Kaposis sarcoma in AIDS
Oral leukoplakia in AIDS
Leukoplakia- white state of tongue which
may precede cancer
Oral candidiasis
Seborrheic dermatitis in AIDS
Seborrheic-excessive secretion of the
sebaceous(oil) gland
Dermatitis- inflammation of the skin
Herpes zoster
Transmission
HIV can be transmitted via the exchange of
a variety of body fluids from infected
individuals, such as blood, breast milk,
semen and vaginal secretions.
Individuals cannot become infected through
ordinary day-to-day contact such as kissing,
hugging, shaking hands, or sharing
personal objects, food or water.
VI. HIV/AIDS
Risk factors
having unprotected anal or vaginal sex;
having another sexually transmitted
infection such as syphilis, herpes,
chlamydia, gonorrhoea, and bacterial
vaginosis;
VI. HIV/AIDS
Risk factors
sharing contaminated needles, syringes
and other injecting equipment and drug
solutions when injecting drugs;
receiving unsafe injections, blood
transfusions, medical procedures that
involve unsterile cutting or piercing; and
experiencing accidental needle stick
injuries, including among health workers.
VI. HIV/AIDS o ART as prevention

Diagnosis o Pre-exposure prophylaxis

(PrEP) for HIV-negative
An HIV test reveals infection status by partner
detecting the presence or absence of
antibodies to HIV in the blood. o Post-exposure prophylaxis for
HIV (PEP)
Most people have a "window period" of
usually 3 to 6 weeks during which  use of ARV drugs
antibodies to HIV are still being produced within 72 hours of
and are not yet detectable. exposure to HIV in
order to prevent
VI. HIV/AIDS infection
Diagnosis  administering of a 28-
Screening assays day course of
antiretroviral drugs with
o enzyme-linked follow-up care
immunoabsorbent assay
(ELISA) VI. HIV/AIDS

o Western blot assays or similar Prevention

specific assay Antiretroviral therapy (ARV) based
(CONFIRMATORY) prevention
VI. HIV/AIDS o Harm reduction for injecting
Prevention drug users

Male and female condom use o Elimination of mother-to-child

Testing and counselling for HIV and STIs
Voluntary medical male circumcision
o Male circumcision reduces the
risk of female-to-male sexual
transmission of HIV by around
60%.
transmission of HIV (eMTCT)
VI. HIV/AIDS
Treatment
HIV can be suppressed by combination
antiretroviral therapy (ART) consisting of
three or more antiretroviral (ARV) drugs.

VI. HIV/AIDS With ART, people living with HIV can live
healthy and productive lives.
Prevention
VI. HIV/AIDS
Antiretroviral therapy (ARV) based
prevention KEY FACTS
Genital herpes is a common STD, and most
people with genital herpes infection do not
know they have it.
o You can get genital herpes
even if your partner shows no
signs of the infection.
o If you have any symptoms
(like a sore on your genitals,
especially one that
periodically recurs) laboratory
tests can help determine if
you have genital herpes.
VII. GENITAL HERPES
KEY FACTS
o There is no cure for herpes,
but treatment is available to
reduce symptoms and
decrease the risk of
transmission to a partner.
VII. GENITAL HERPES
What is genital herpes?
Genital herpes is a sexually transmitted
disease (STD) caused by the herpes
simplex viruses type 1 (HSV-1) or type 2
(HSV-2).
VII. GENITAL HERPES
How common is genital herpes?
HSV is well distributed worldwide. An
increase in seroprevalence of antibodies to
HSV-2 has been documented throughout
the world (including the United States) over
the last 20 years.
VII. GENITAL HERPES
How common is genital herpes?
Globally, the large majority of cases are
caused by HSV-2; infection is common in
both the industrialized and developing
worlds, and HSV-2 uncommonly causes
infection by non-sexual means.
VII. GENITAL HERPES
How common is genital herpes?
HSV-1 is usually acquired in childhood by
contact with oral secretions that contain the
virus.
Seropositivity to antibodies to HSV-2 is
more common in women (25%) than in men
(17%).
VII. GENITAL HERPES
How common is genital herpes?
The mortality rate associated with herpes
simplex infections is related to 3
situations: perinatal infection, encephalitis,
and infection in the immunocompromised
host.
VII. GENITAL HERPES
How common is genital herpes?
2 types of HSV:
o HSV-2 causes most genital
infections.
o HSV-1 causes oral infections
(cold sores, fever blisters) and
some genital infections.
VII. GENITAL HERPES
How do people get genital herpes?
Infections are transmitted through contact
with lesions, mucosal surfaces, genital
secretions, or oral secretions.
HSV-1 and HSV-2 can also be shed from
skin that looks normal.
VII. GENITAL HERPES
What are the signs & symptoms?
Most individuals infected with HSV-1 or
HSV-2 are asymptomatic, or have very mild
symptoms that go unnoticed or are
mistaken for another skin condition.
The average incubation period after
exposure is 4 days (range, 2 to 12).
VII. GENITAL HERPES
What are the signs & symptoms?
Signs & symptoms (typical):
o one or more vesicles on or
around the genitals, rectum or
mouth
o The vesicles break and leave
painful ulcers that may take
two to four weeks to heal.
VII. GENITAL HERPES
What are the signs & symptoms?
Signs & symptoms (first infection):
o longer duration of herpetic
lesions
o increased viral shedding
(making HSV transmission
more likely)
o fever, body aches, swollen
lymph nodes, and headache
VII. GENITAL HERPES
What are the signs & symptoms?
Prodromal symptoms (recurrence):
o mild tingling or shooting pains
in the legs, hips and buttocks
occurring hours to days
before eruption of herpetic
lesions
o typically shorter in duration
and less severe
o episodes tends to decrease
over time
o Recurrences are much less
frequent for genital HSV-1
infection than for genital HSV-
2 infection.
VII. GENITAL HERPES
What are the complications?
rare but serious complications:
o blindness
o encephalitis
o aseptic meningitis
o extragenital lesions in the
buttocks, groin, thigh, finger,
and eye
VII. GENITAL HERPES
How does genital herpes affect a pregnant
woman and her baby?
Herpes infection can be passed from
mother to child.
fatal infection (neonatal herpes)
If herpes symptoms are present a cesarean
delivery is recommended to prevent HSV
transmission to the infant.
How is genital herpes diagnosed?
Viral culture is currently the reference
standard for diagnosing genital herpes.
PCR (Direct/virologic test)
Indirect/serologic test - ELISA
VII. GENITAL HERPES
Is there a cure or treatment for herpes?
There is no cure for herpes.
Antiviral medications can, however, prevent
or shorten outbreaks during the period of
time the person takes the medication.
Antiviral can reduce the likelihood of
transmission.
no commercially available vaccine
How can herpes be prevented?
Correct and consistent use of latex
condoms can reduce the risk of genital
herpes.
Outbreaks can occur in areas that are not
covered by a condom.
The surest way to avoid transmission is to
abstain from sexual contact.
VII. GENITAL HERPES
How can herpes be prevented?
Long-term mutually monogamous
relationship with a partner who has been
tested and is known to be uninfected.
Even if a person does not have any
symptoms, he or she can still infect sex
partners.
VII. GENITAL HERPES
How can herpes be prevented?
Persons with herpes should abstain from
sexual activity with partners when sores or
other symptoms of herpes are present.
VII. GENITAL HERPES
What is genital HPV infection?
Genital human papillomavirus (also called
HPV) is the most common sexually
transmitted infection (STI).
There are more than 40 HPV types that can
infect the genital areas of males and
females.
VIII. HPV/GENITAL WARTS
What is genital HPV infection?
These HPV types can also infect the mouth
and throat.
Most people who become infected with
HPV do not even know they have it.
VIII. HPV/GENITAL WARTS
What is genital HPV infection?
HPV is not the same as herpes or HIV (the
virus that causes AIDS).
These are all viruses that can be passed on
during sex, but they cause different
symptoms and health problems.
VIII. HPV/GENITAL WARTS
What are the signs, symptoms and potential
health problems of HPV?
Most people with HPV do not develop
symptoms or health problems from it.
In 90% of cases, the body’s immune
system clears HPV naturally within two
years.
What are the signs, symptoms and potential
health problems of HPV?
But, sometimes, HPV infections are not
cleared and can cause:
Genital warts
Rarely, warts in the throat
Cervical cancer and other, less common
but serious cancers, cancers of the vulva,
vagina, penis, anus, and oropharynx
What are the signs, symptoms and potential
health problems of HPV?
The types of HPV that can cause genital
warts are not the same as the types that
can cause cancers.
How do people get HPV?
HPV is passed on through genital contact,
most often during vaginal and anal sex.
HPV may also be passed on during oral sex
and genital-to-genital contact.
VIII. HPV/GENITAL WARTS
How do people get HPV?
HPV can be passed on between straight
and same-sex partners—even when the
infected partner has no signs or symptoms.
A person can have HPV even if years have
passed since he or she had sexual contact
with an infected person.
VIII. HPV/GENITAL WARTS
How does HPV cause genital warts and
cancer?
HPV can cause normal cells on infected
skin to turn abnormal.
Warts can appear within weeks or months
after getting HPV.
Cancer often takes years to develop after
getting HPV.
How common are HPV?
Globally, HPV infection is the most common
STD. Genital warts have affected as many
as 30 million individuals worldwide.
In US, 50% of sexually active men and
women get HPV at some point in their lives.
VIII. HPV/GENITAL WARTS
How can people prevent HPV?
Vaccines can protect males and females
against some of the most common types of
HPV that can lead to disease and cancer.
The vaccines are most effective when given
at 11 or 12 years of age.
VIII. HPV/GENITAL WARTS
How can people prevent HPV?
Consistent and correct use of condom
Mutually monogamous relationship with an
uninfected partner.
Avoid sexual activity.
VIII. HPV/GENITAL WARTS
Is there a test for HPV?
There is no general test for men or women
to check one’s overall "HPV status“
Regular Pap smear for females
VIII. HPV/GENITAL WARTS
Is there a treatment for HPV or related
diseases?

There is no treatment for the virus itself, but

there are treatments for the diseases that
HPV can cause.