Sexually Transmitted Infections (STI)
•   HIV can be categorised as a sexually transmitted infection as this is its main mode of
       transmission. However, it has been shown that the risk of contracting HIV increases (2-5
       times) should the person have an existing sexually transmitted infection. Also, if a person
       infected with HIV also has an STI, they are more likely to transmit HIV to their partner.
   •   There are more than 30 different sexually transmissible bacteria, viruses and parasites some
       of these include: Gonorrhoea, syphilis, Chlamydia, Herpes, Human Papillomavirus (HPV),
       vaginal trichomoniasis, etc...
   •   Some of these infections, like chlamydia and HIV in some cases, can be present but without
       any symptoms and if left untreated can have dire implications on maternal, reproductive
       and new born health.
   •   Consequently it is important to go for regular testing and to practise safe sex i.e. use of
       female and/or male condoms.
Gonorrhoea
   •   Is caused by Neisseria gonorrhoeae.
   •   Is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have
       to occur for gonorrhoea to be transmitted or acquired.
   •   Some men do not get symptoms, but these normally appear 1-14 days post infection
   •   Symptoms and signs include a burning sensation when urinating, or a white, yellow, or
       green discharge from the penis, sometimes painful or swollen testicles.
  •   In women, the symptoms of gonorrhoea are often mild, but most women who are infected
      have no symptoms.
  •   The initial symptoms and signs include a painful or burning sensation when urinating,
      increased vaginal discharge, or vaginal bleeding between periods. Women with gonorrhoea
      are at risk of developing serious complications from the infection.
  •   Antibiotics can successfully cure gonorrhoea, excluding resistant strains.
Herpes
  •   Is caused by the herpes simplex viruses type 1 (HSV-1) –causes oral herpes or type 2 (HSV-
      2)-causes genital herpes.
  •   Signs typically appear as one or more blisters on or around the genitals or rectum. The
      blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first
      time they occur. The blisters are likely to return weeks to months after first appearing but
      for a shorter period and not as severely.
  •   Other than the sores, primary signs of infection include flu-like symptoms, such as fever
      and swollen glands.
  •   Herpes stays in the body indefinitely although the number of outbreaks decreases over
      years.
  •   The virus is found in and released from the sores but also between outbreaks where the
      skin does not appear to have sores.
   •   There is no treatment that can cure herpes, but antiviral medications can shorten and
       prevent outbreaks during the period of time the person takes the medication.
Syphilis
   •   Syphilis is passed from person to person through direct contact with a syphilis sore.
   •   Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can
       occur on the lips and in the mouth. There is usually only one but multiple sores can occur.
   •   Transmission of the organism occurs during vaginal, anal, or oral sex.
   •   Many people infected with syphilis do not have any symptoms for years, yet remain at risk
       for late complications if they are not treated.
   •   The primary stage of syphilis is usually marked by the appearance of a single sore (called
       a chancre), but there may be multiple sores.
   •   Skin rash and mucous membrane lesions characterize the secondary stage. This stage
       typically starts with the development of a rash on one or more areas of the body. The rash
       usually does not cause itching. Rashes associated with secondary syphilis can appear as the
       chancre is healing or several weeks after the chancre has healed.
   •   The latent (hidden) stage of syphilis begins when primary and secondary symptoms
       disappear.
   •   This latent stage can last for years. The late stages 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 first acquired.
   •   In the late stages of syphilis, the disease may subsequently damage the internal organs,
       including the brain, nerves, eyes, heart, liver, bones, and joints. Signs and symptoms of the
       late stage of syphilis include difficulty coordinating muscle movements, paralysis,
       numbness, gradual blindness, and dementia. This damage may be serious enough to cause
       death.
   •   Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin, an
       antibiotic, will cure a person who has had syphilis for less than a year. Additional doses
       are needed to treat someone who has had syphilis for longer than a year.
   •   Treatment will prevent the progression of the disease but will not reverse the damage
       already done.
Human Papillomavirus
   •   Genital human papillomavirus is the most common STI.
   •   There are more than 40 HPV types that can infect the genital areas of males and females.
   •   These HPV types can also infect the mouth and throat. Most people who become infected
       with HPV are asymptomatic.
   •   In 90% of cases, the body’s immune system clears HPV naturally within two years.
   •   If not cleared from the body, the infection can cause genital warts, warts in the throat
       (recurrent respiratory papillomatosis, or RRP) and Cervical cancer and other, less common
       but serious cancers, including cancers of the vulva, vagina, penis, anus, and oropharynx
       (back of throat including base of tongue and tonsils).
  •    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.
  •    Vaccines can protect males and females against some of the most common types of HPV
       that can lead to disease and cancer.
  •    Girls and women: Two vaccines, Cervarix and Gardasil, are given in three shots at the ages
       of 11 and 12 or between 13 and 26.
  •    Boys and men: One available vaccine, Gardasil, provides protection from genital warts and
       most HPV associated cancers for males between 9 and 26 years.
                            Adult        population   Infected         adults   Infected adults per   New
Region
                            (millions)                (millions)                1,000 population      (mill
North America               156                       3                         19                    14
Western Europe              203                       4                         20                    17
North Africa & Middle
                            165                       3.5                       21                    10
East
Eastern     Europe     &
                            205                       6                         29                    22
Central Europe
Sub-Saharan Africa          269                       32                        119                   69
South & Southeast Asia    955    48      50   151
East Asia & Pacfic        815    6       7    18
Australia    &      New
                          11     0.3     27   1
Zealand
Latin     America    &
                          260    18.5    71   38
Carribean
Total                     3040   116.5   -    340