Sexually transmitted disease: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
==Prevention== | ==Prevention== | ||
The most effective way to prevent sexual transmission of STIs is to avoid ''contact'' of body parts or fluids which can lead to transfer. ''Abstinence is one method of avoiding contact''. Ideally, both partners should get tested for STIs before initiating sexual contact, ''or if a partner engaged in contact with someone else''. | |||
===Vaccines=== | |||
Vaccines are available that protect against some viral STIs, such as Hepatitis A, Hepatitis B, Herpes simplex vaccine (both Herpevac and ImmunoVex), and some types of HPV. Vaccination before initiation of sexual contact is advised to assure maximal protection. | |||
===Barrier Protection=== | |||
[[Condoms]] only provide protection '''when used properly as a barrier''' and to and from the area that it covers. ''Uncovered areas are still susceptible to many STD's''. In the case of HIV, sexual transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin, thus ''properly shielding the insertive penis with a properly worn condom from the vagina and anus effectively stops HIV transmission''. An infected fluid to broken skin borne direct transmission of HIV would not be considered "sexually transmitted", but can still theoretically occur during sexual contact, this can be avoided simply by not engaging in sexual contact when having open bleeding wounds. | |||
Condoms are designed, tested, and manufactured to never fail if used properly. There has not been any documented case of an HIV transmission due to an improperly manufactured condom. However, there have been cases of condom recall, as in a case in South Africa. | |||
Proper usage entails: | |||
*Not putting the condom on too tight at the end, and leaving 1.5 cm (3/4 inch) room at the tip for [[ejaculate]]. Putting the condom on snug can and often does lead to failure. | |||
*Wearing a condom too loose can defeat the barrier. | |||
*Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not. | |||
*Avoiding condoms made of substances other than latex or polyurethane, as they don't protect against HIV. | |||
*Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms, as oil can cause thinning and perforation of the material. | |||
Not following the five guidelines above perpetuates the common misconception that condoms are not appropriately designed or tested. | |||
In order to best protect oneself and the partner from STI's, a condom used by an infected individual and its contents should be assumed to be still infectious. Therefore the used condom must be properly disposed off. A new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the primary purpose as a barrier and increases risk of disease transmission. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 22:10, 19 October 2016
For patient information click here
Sexually transmitted disease Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Sexually transmissible disease; STD; VD; STI; sexually transmitted infection; venereal disease.
For patient information click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [3]
Overview
Classification
Transmission | Clinical Presentation | Disease | Diagnosis | Mother to Child Transmission | Most Serious Complications | ||
---|---|---|---|---|---|---|---|
Laboratory studies | Clinical Diagnosis | Vertical Transmission | Trans-vaginal transmission | ||||
Primarily sexually transmitted | Genital Dermatological Manifestation (e.g., ulcers, chancre, vesicles, warts, sores, balanitis etc.) |
HPV | ✔ | ✔ | Cervical Cancer | ||
HSV | ✔ | ✔ | ✔ | ✔ | Severe pruritis/discomfort | ||
Syphilis | ✔ | ✔ | ✔ | Neurosyphilis Cardiosyphilis | |||
Scabies | ✔ | ✔ | Moderate to Severe pruritis/discomfort | ||||
Pubic lice | ✔ | ✔ | Moderate to Severe pruritis/discomfort | ||||
Candidiasis (in males) |
✔ | Mild to moderate pruritis/discomfort | |||||
Generalized Symptoms (e.g. constitutional symptoms) |
HIV | ✔ | ✔ | Primary CNS Lymphoma Immunosuppression (AIDS) | |||
Syphilis | ✔ | ✔ | ✔ | Neurosyphilis Cardiosyphilis | |||
Urogenital infections (e.g.,Vaginitis, Urethritis, Cervicitis, and PID) |
Gonorrhea | ✔ | ✔ | ✔ | PID | ||
Chlamydia | ✔ | ✔ | ✔ | PID | |||
Syphilis | ✔ | ✔ | ✔ | Neurosyphilis Cardiosyphilis | |||
Mycoplasma genitalium | ? | ? | ? | ? | ?????? | ||
Trichomonas vaginalis | ✔ | ✔ | Mild to moderate pruritis/discomfort | ||||
Less frequently sexually transmitted | Generalized Symptoms (e.g. constitutional symptoms) |
Zika Virus | ✔ | ✔ | Vertical transmission and Congenital abnormalities | ||
Hepatitis B | ✔ | ✔ | ✔ | Liver cirrhosis | |||
Hepatitis C | ✔ | ✔ | ✔ | Hepatocellular Carcinoma | |||
Urogenital Infections (e.g.,Vaginitis, Urethritis, Cervicitis, and PID) |
Gardnerella vaginalis | ✔ | ✔ | Moderate to severe discomfort | |||
Candidiasis (in females) |
✔ | Moderate to severe pruritis/discomfort | |||||
Ureaplasma urealyticum | ✔ | ✔ | Moderate to severe pruritis/discomfort |
Symptoms
Risk Factors
Prevention
The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which can lead to transfer. Abstinence is one method of avoiding contact. Ideally, both partners should get tested for STIs before initiating sexual contact, or if a partner engaged in contact with someone else.
Vaccines
Vaccines are available that protect against some viral STIs, such as Hepatitis A, Hepatitis B, Herpes simplex vaccine (both Herpevac and ImmunoVex), and some types of HPV. Vaccination before initiation of sexual contact is advised to assure maximal protection.
Barrier Protection
Condoms only provide protection when used properly as a barrier and to and from the area that it covers. Uncovered areas are still susceptible to many STD's. In the case of HIV, sexual transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin, thus properly shielding the insertive penis with a properly worn condom from the vagina and anus effectively stops HIV transmission. An infected fluid to broken skin borne direct transmission of HIV would not be considered "sexually transmitted", but can still theoretically occur during sexual contact, this can be avoided simply by not engaging in sexual contact when having open bleeding wounds.
Condoms are designed, tested, and manufactured to never fail if used properly. There has not been any documented case of an HIV transmission due to an improperly manufactured condom. However, there have been cases of condom recall, as in a case in South Africa.
Proper usage entails:
- Not putting the condom on too tight at the end, and leaving 1.5 cm (3/4 inch) room at the tip for ejaculate. Putting the condom on snug can and often does lead to failure.
- Wearing a condom too loose can defeat the barrier.
- Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not.
- Avoiding condoms made of substances other than latex or polyurethane, as they don't protect against HIV.
- Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms, as oil can cause thinning and perforation of the material.
Not following the five guidelines above perpetuates the common misconception that condoms are not appropriately designed or tested.
In order to best protect oneself and the partner from STI's, a condom used by an infected individual and its contents should be assumed to be still infectious. Therefore the used condom must be properly disposed off. A new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the primary purpose as a barrier and increases risk of disease transmission.
References