SEXUALLY TRANSMITTED DESEASES (STDs)

Diseases or infections which are transmitted through

sexual intercourse with infected persons are
collectively called Sexually Transmitted Diseases
(STDs) or Venereal Diseases (VDs) or Reproductive
Tract Infections(RTIs).

Hepatitis B , gonorrhea ,syphilis ,chlamydiasis

,genital herpes ,genital warts ,trichomoniasis ,
chancroid , and HIV infection leading to AIDS are
common examples.
Mode of Transmission : Sexually transmitted
diseases are mainly transmitted by sexual intercourse
with infected person .But HIV can also spread by the
use of same syringes and surgical instruments without
proper sterilization , transfusion of infected blood and
from an infected mother.
Of all the sexually transmitted diseases , HIV infection
is the most dangerous .Except genital herpes and HIV
infections ,other STDs are completely curable if
detected early and treated properly .The early
symptoms of most of these diseases include itching
,fluid discharge ,slight pain ,swelling ,etc. in the genital
region .Infected females are generally asymptomatic
and may remain undetected for long.
The infected persons avoid going to the doctor for
an early detection and proper treatment . This may be
due to less significant symptoms in the early stages of
infection and the social stigma attached to STDs . This
may lead to complications which include pelvic
inflammatory diseases (PIDs), abortions, still births,
ectopic pregnancies, infertility or even cancer of the
reproductive tract. STDs are a major threat to a healthy
society . prevention or early detection and cure of
these probabilities of these diseases are very high
among persons in the age group of 15-24 years, but
can be avoided by adopting the following simple
principles:

1. Avoid sex with unknown partner/multiple

partners.
2. Use condoms during coitus with unknown persons
.
3. Whenever there is doubt , visit a qualified doctor
for early detection and complete treatment of the
disease.
Some Common Sexually transmitted Diseases
1. Hepatitis B or Serum Hepatitis:
 Causative Agents: Hepatitis B is caused by a DNA
virus ,referred as hepadnavirus (hepatitis-DNA-
virus).It causes acute viral hepatitis with severe
symptoms.
 The complete viral particles are called Dane
particles because these were first reported by D.S.
Dane in 1970.The surface of these particles has
antigenic protein particles called hepatitis B
surface antigen( HBsAg ) .These particles were
previously called Australia antigens.
 Transmission: Transmission of hepatitis B occurs
by contact with blood-contaminated needles used
for injection or for tattooing , acupuncture or ear-
piercing . Blood contaminated dental instruments ,
optic endoscopes and renal dialysis tubing may
also cause infection of hepatitis B. Saliva and
Semen are equally associated with its infection.
 Incubation Period : Hepatitis B has an incubation
period of 4 weeks to 6 months .Therefore ,it is a
long-incubation hepatitis.
 Symptoms : Initial symptoms of hepatitis B are loss
of appetite ,fatigue and taste change . Colour of
urine and stool changes even before onset of
jaundice .
Recovery usually occurs in about 3 to 4 months
but patient remains carrier for several months .In
5 to 10% infected people hepatitis B becomes
chronic.
 Diagnosis : Hepatitis B is diagnosed by HBsAg
antigens in the serum .Liver function tests and
symptoms help in diagnosis at first stage.
 Treatment : Treatment with Lamivudine
(3TC,Epivir) a base analog is used for
chemotherapy .Injections of α-interferons(Intron-
A) and injections of hepatitis B immune globulin
are also used.
 Preventions :Desease can be prevented by
immunisation with hepatitis B vaccine. It is
produced from genetically engineered yeast cells
and consists of HBsAg. Its commercial name is
Recombivax HB or Engerix-B. It can be given to
persons of all age groups.
2. Syphilis :
Causative Agents :
Syphilis is chronic
infectious disease
caused by the
spirochaete Treponema
pallidum.

Fig: 1.Treponema pallidum.

Transmission : It is usually transmitted by sexual
contact or from mother to infant , although
endemic syphilis is transmitted by non-sexual
contact in communities living under poor hygiene
conditions.
Incubation Period : Incubation period is 10-90
days.
 Symptoms : Syphilis progresses through three
stages .In the primary or first stage , painless ulcer
or chancre appears around vaginal opening , penis
, mouth or anus with swelling of local lymph glands
. In the secondary or second stage , lesions on the
lips ,mouth and genitalia appear .Other symptoms
include skin lesions ,rashes ,hair losses and swollen
joints .In the tertiary or third stage ,chronic ulcers
 Appear on palate ,nose and lower legs .In case of
chronic infection ,there can be paralysis ,brain
damage ,blindness ,heart trouble and aortic
impairment.
 Diagnosis : Syphilis can be diagnosed by testing
samples of Blood .Blood test can confirm the
presence of antibodies that the body produces to
fight infection. The antibodies to the syphilis-
causing bacteria remain in the body for years, so
the test can be used to determine a current or
past infection.
 Treatment : Penicillin and Tetracycline are
effective drugs during pregnancy or at the time of
birth .In children ,it is called congenital syphilis.
 Preventions : The best way to prevent syphilis is to
practice safe sex .Use condoms during any type of
sexual contact .In addition ,it may be helpful to:
 Use a dental dam or condoms during oral
sex.
 Avoid sharing sex toys.
 Get screened for STIs and talk to your
partners about their result.
3.Gonorrhea :
Causative Agents : Gonorrhea is caused by the
bacterium Neisseria gonorrhoeae .The gonorrhea
bacteria are most often passed from one person to
another during sexual contact ,including oral ,anal or
vaginal intercourse.
Fig: 2. Neisseria gonorrhoeae

Transmission : Gonorrhea is transmitted through

sexual contact with the penis ,vagina ,mouth ,or anus
of an infected partner .Ejaculation does not have to
occur for Gonorrhea to be transmitted or acquired.
Gonorrhea can also be spread perinatally from
mother to baby during childbirth.
Incubation Period : The incubation period ranges
from 1 to 14 days , with most men becoming
symptomatic within 2 to 5 days after exposure.
Symptoms : The Bacterium lives in genital ducts
producing a pus-containing discharge ,pain over
genitalia and burning during urination .It may lead to
arthritis and eye infection.
In men:
 Greater frequency or urgency of urination.
 A pus-like discharge from the penis
 Swelling or pain in the testicles.
 Swelling or redness at the opening of the
penis.
 A persistent sore throat.
In Women :

 discharge from the vagina

 pain or burning sensation while urinating.
 The need to urinate more frequently.
 Heavier period
 Sharp pain in the lower abdomen.

Diagnosis : To determine whether you have

gonorrhea ,your doctor will analyze a sample of
cells be collected by:
 Urine test. To identify bacteria in your urethra
  Swab of affected area. A swab of your throat
,urethra ,vagina or rectum can collect bacteria
that can be identified in a lab.
Treatment : Adult with gonorrhea are treated with
antibiotics .Due to emerging strains of drug-
resistant Neisseria gonorrhoeae ,the Centers for
Disease Control and Prevention recommends that
uncomplicated gonorrhea be treated with the
antibiotic ceftriaxone –given as injection with oral
azithromycin(Zithromycin).
Preventions :
 Use condoms if you have sex.
 Limit your number of sex partners.
 Be sure you and your partner are tested for
sexually transmitted infections.
 Don’t have sex with someone who appear to
have a sexually transmitted infections.
 Consider regular gonorrhea screening.
4. Genital Herpes :
Causative Agents :Genital Herpes is a common
sexually transmitted infection caused by the
Herpes simplex.

Fig : 3.Herpes simplex

Transmission : The Herpes virus can be spread

from person to person by direct skin to skin
contact ,especially during intimate sexual contact
with an infected person. This include kissing, oral
sex and contact with genital or anus.
Incubation Period :The average incubation period
for an initial herpes infection is 4 days (ranges 2-
12) after exposure .The vesicles break and leave
 painful ulcers that may take 2-4 weeks to heal
after the initial herpes infection.
 Symptoms : The most common symptoms is a
group of itchy or painful blisters on vagina, vulva,
cervix, penis, butt, anus or the inside of the thighs.
The blisters break and turn into sores. It may have
some other symptoms too like : Burning while
peeing when the urine touches the herpes sores.
The clusters of reddish ulcers over genitalia and
perianal areas, swelling of inguinal lymph nodes,
pain, vaginal and urethral discharge,
dysuria(painful or difficulty in urination), headache
and malaise (general discomfort and uneasyness).
 Diagnosis : Doctor usually can diagnose genital
herpes based on a physical exam and the result of
certain laboratory test :
 Viral culture : This test involves taking a tissue
sample or scraping of the sores for the
examination in the laboratory .
 Polymerase chain reaction (PCR) test .
 Blood test.
 Treatment : There are three major drugs
commonly used to treat genital herpes symptoms:
acyclovir (Zovirax) , famcyclovir (Famvir) and
 valacyclovir (Valtrex). These all are taken pill form.
Severe cases may be treated with the intravenous
(IV) drugs acyclovir.
 Preventions : Always use condoms and dental
dams during oral, anal and vaginal sex. Talk with
your doctor about taking herpes medication every
day which can lower the chances of spreading
herpes . Don’t have sex during herpes outbreak ,
even with a condom.
5. Genital Warts :
 Causative Agents : Genital Warts are soft growths
on the moist skin of genitalia or around anus.
These are sexually transmitted infection by
Human Papilloma Virus (HPV). They cause pain,
discomfort and itching and are specially dangerous
in women because some types of HPV can also
cause cancer of cervix and vulva.

 Transmission :The HPV virus is usually transmitted

by close contact, mostly through genital, oral or
anal intercourse. Babies may develop infection of
the respiratory tract during passage through the
birth canal of an infected mother.
 Incubation Period : 2 to 3 months, with a range of
1 to 20 months for genital warts. It can take up to
 10 years for a high-risk HPV infection to develop
into cancer.
 Symptoms :More than 70 different types of HPV
affect genital, and the most of the time their
infection produces no symptoms and the infection
clears off its own after viral cycle is completed but
by some infection, genital warts appears as
clusters of skin- coloured very small outgrowths on
penis, scrotum, groin, thighs, inside and around
anus. In women, these warts appear inside or
outside vagina or anus or cervix. Genital warts
cause itching, bleeding or burning and vaginal
discharge. Warts may also appear on hands, lips,
mouth, tongue or throat.
 Diagnosis : Diagnosis of genital warts is made by a
doctor based on the history and clinical
examination .A Cervical Screening Test may show
changes in cells of the cervix caused by HPV
infection
 Treatment :Virus cannot cannot be eliminated
from the blood. Anti-viral drugs can be used to
control repeated outbreak. Topical preparation
can help in healing the warts. Use of cream, gel
 and solution provides immediate comfort and
warts may disappear but not the virus.
 Preventions :Not having sex (abstinence) is the
only sure way to avoid infection .Latex or
polyurethane condoms should be used each time
you have oral, vaginal or anal sex. Another option
is using a female condom during vaginal sex or
dental dams during oral sex.
6. Acquired Immune Deficiency Syndrome :
 Causative Agents : AIDS is
caused by a retrovirus(RNA
virus) called human
immune -deficiency virus
(HIV).It is disorder which
damages immune system
of human body. The virus
multiplies inside T4
lymphocytes or helper cells
and break down immune system.
 Transmission :AIDS is a blood-borne disease. It
spread through either by intercourse between
heterosexuals or homosexuals , or through using
same needle-syringes for intravenous injection
through infected blood or from mother to baby
through placenta or through breast milk.
 Incubation Period :The period from infection to
the primary seroconversion illness is usually 1 to 4
weeks. The period from infection to development
of anti-HIV antibodies is usually less than 1 month
but may be up to 3 month .The interval from HIV
infection to the diagnosis of AIDS ranges from
about 9 months to 20 years or longer.
 Symptoms : AIDS-related complex (ARC) develops
in about 25% HIV infected people. The symptoms
include loss of appetite, loss of weight, persistent
dry cough, fever, pneumonia, shingles, lymphoma,
tuberculosis or severe diarrhea .The virus remains
dormant for about 6 years after infection.
 Diagnosis :Test for HIV and AIDS .Blood tests are
the most common way to diagnose the human
immune deficiency virus (HIV), the virus that
causes acquired immune deficiency syndrome
(AIDS).These test look for antibodies to the virus
that are present in the blood of infected
individuals. Some more tests include :
 ELISA Test
 Home test
 Saliva test
 Viral Load Test
 Western blot
 Treatment :Being a viral infection, successful
treatment of AIDS is not available at present .
Drugs have been developed to stop the growth of
virus and treat secondary infection.
Azidothymidine (AZT), Zalcitabine, Ribavirin and
glycyrrhizin are drugs being tried against HIV. The
 best solution is to improve or strengthen the
damaged immune system.
 Preventions :
 Public education must be provided on the use
condoms and the safer sex practices.
 Unprotected sexual intercourse with people
with known or suspected HIV infection should
be avoided.
 Care should be taken when handling , using
and disposing of needle or other sharp items.
 Use or needle exchange program by injecting
drug users should be facilitated.
7. Chlamydiasis :
 Causative Agent :It is caused by the bacterium ,
Chlamydia trachomatis found in semen and
vaginal fluid .It infects cervix and urethra and can
live in rectum or even in throat.

 Transmission :Chlamydia is passed primarily

during anal or vaginal sex. It is less likely to be
transmitted through oral sex .It can be passed
when the mucous membrane, the soft skin
covering all the opening of the body , comes into
contact with the mucous membrane secretions or
semen of an infected person.
 Incubation Period :Although many people never
have any symptoms , when symptoms do appear it
is usually one to three weeks after the exposure to
the bacteria. Even asymptomatic patients with
 chlamydia can have complication , however, so it is
important to be regularly screened by your
physician.
 Symptoms :It is a human pathogen that causes
trachoma and perinatal infection. Chlamydia
trachomatis is a obligate intracellular pathogen
that causes urethritis, epididymitis, mucopurulent
(with yellowish mucus and pus), cervicitis
inflammation of fallopian tube, rectal pain with
mucus and occasional bleeding .It causes severe
pelvic inflammatory disease and increases risk of
cervix cancer.
It has later Symptoms :
 Symptoms in men include red sore tip of
penis , itching and burning of testicles ,
burning sensation during urination and
white, watery discharge from penis.
 Symptoms in women are mucus-like
discharge from vagina, pain and burning
sensation during urination and abdominal
pain.
 Diagnosis : Screening and diagnosis of chlamydia is
relatively simple. Test includes:
 Urine test
  A swab
 Treatment : Both chlamydia and gonorrhea can be
treated effectively with antibiotics. They are both
curable and unlikely to cause long-term issues if
treated quickly.
 Preventions :
 Using male or female condoms and dental dams
during sex will help to protect you from getting
chlamydia.
 Chlamydia is often symptomless however if left
untreated it can lead to long-term health
problem.
 Chlamydia is easily treated with antibiotics.
 Chlamydia can be passed on from mother to
child during pregnancy , so it is important for
pregnant women to get tested.
8. Trichomoniasis :
Causative Agent : It is caused by protozoan ,
Trichomonas vaginalis . It travel from person to
person during genital contact during sex. Once the
infection begins ,it can easily be spread through
unprotected genital contact.

 Transmission :Trichomoniasis is easily passed on

through unprotected vaginal sex (When the oenis
goes into the vagina) with someone who has the
infection –even if they don’t have symptoms .
Trichomoniasis can’t be passed on through oral or
anal sex, kissing or hugging.
 Incubation Period : Although most man never
have symptoms of trichomoniasis, in women
 symptoms usually appear between 5 to 28 days
after exposure.
 Symptoms :Parasites infects both male and
females. In males, it causes urethritis, epididymitis
and prostatitis resulting in pain and burning
sensation an urge to urinate frequently . In
females, it causes vaginitis with foul smelling,
yellow vaginal discharge ,vaginal spotting and
bleeding and burning sensation.
 Diagnosis : It can’t be diagnosed by symptoms
alone .Trichomoniasis can be diagnosed by looking
at a sample of vaginal fluid for women or urine for
men under a microscope .If the parasite can be
seen under the microscope ,no further tests are
needed. If this test isn’t conclusive, tests called
rapid antigen test and nucleic acid amplification
may be used.
 Treatment :Trichomoniasis can be cured with a
single dose of prescription antibiotic medication
(either metronidazole or tinidazole ),pills which
can be taken by mouth. It is okay for pregnant
women to take this medication. Some people who
drink alcohol within 24 hours after taking this kind
of antibiotic can have uncomfortable side effects.
 Preventions : Some steps to prevent it are:
 Use condoms (male or female) every time you
have vaginal or anal sex.
 If you have oral sex cover your penis with a
condom or the female genitals with a latex or
polyurethane square (a dam).
 Avoid sharing sex toys-If you do share them,
wash them or cover them with a new condom
before anyone else uses them
9. Chancroid :
Causative Agent : Haemophilus ducreyi is the
causative agent of chancroid , one of the genital
ulcerative diseases, H. ducreyi is the major cause
of genital ulcer disease in Africa and Southeast
Asia and is of increasing concern in the United
States.

Transmission : Chancroid is transmitted in two

ways they are :
 Sexual transmission through skin-to-skin
contact with open sore(s).
 Non sexual transmission when pus-like fluid
from the ulcer is moved to other parts of the
body or to another person.
Incubation Period : After the incubation period of
3-7 days, the patient develops painful,
 erythematous papules at the site of contact. The
chancroid papules become pustular and then
rupture, usually forming 1-3 painful ulcers.
Symptoms :The sign or symptoms of chancroid
are:
 The ulcer can be very painful in men but
women are often unaware of them.
 Painful lymph glands may occur in the groin
,usually only on one side; However ,they can
occur on both sides.
 The ulcer begins as a tender, elevated bump,
or papule, that becomes a pus-filled, open
sore with eroded or ragged edges.
Diagnosis : Diagnosis is made by isolating the
bacteria H. ducreyi in a culture from a genital ulcer
.A gram stain to identify H.ducreyi is possible but
can be misleading because of other organisms
found in most genital ulcers
Treatment : Successful treatment for chancroid
cures the infection, resolves the clinical symptoms,
and prevents transmission to others. In advanced
cases scarring can result despite successful
therapy.
 Azithromycin 1g orally in a single dose.
  Ceftriaxone 250 mg IM in a single dose .
 Ciprofloxacin base 500 mg orally twice a day
for 3 days.
 Erythromycin base 500 mg orally three times a
day for 7 days.
Preventions : One can avoid getting this disease by
using condoms during sexual contact. Other
preventive measures include:
 Limiting the number of sexual partners and
practicing safe sex.
 Avoiding high-risk activities that may lead to
getting chancroid.
 Alerting all partners if you develop the
condition so that they may e tested and
treated as well.
10. Scabies :
Causative Agent : Scabies is skin disease caused by
the mite Sarcoptes scabiei ,which is a parasite that
burrows into, resides and reproduces in human
skin. It affects people of all ages ,but the elderly or
people with weakened immunity are more
susceptible.

Transmission :Scabies is spread by prolonged skin-

to-skin contact with a person who has scabies.
Scabies sometimes also can be spread by contact
with the items such as clothing, bedding, or towels
that has been used by a person with Scabies, but
such spread is very uncommon unless the infested
person has crusted scabies.
Incubation Period : It may take 2-6 weeks before
itching occurs in a person not previously exposed
 to scabies .Symptoms develop much more quickly
if a person is re-exposed , often within 1-4 days
.The incubation period may be shorter if
infestation is acquired from a person with crusted
scabies
Symptoms : The sign and symptoms are:
 Itching ,often severe and usually worse at
night.
 Thin, irregular burrow tracks made up of tiny
blisters or bumps on your skin.

Diagnosis : To diagnose the scabies, doctor

examines the skin, looking for signs of mites,
including the characteristic burrows. When the
doctor locate the mite burrow ,he or she may take
a scraping from that area of the skin to examine
under a microscope.
Treatment : Some common medicine used to treat
scabies include :
 5% permethrin cream
 25% benzyl benzoate lotion
 10% sulfer ointment
 10% crotamiton cream
1% lindane lotion
Preventions : The best way to prevent getting
scabies is to avoid direct skin-to-skin contact with
a person known to have scabies. It is also best to
avoid in washed clothing and bedding that has
been used by a person infested with scabies.