SEXUALLY TRANSMITTED INFECTIONS

Nursing school

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 Table of content
Chlamydia ------------------------------------------------------------ 2- 4
Gonorrhea ------------------------------------------------------------ 5- 8
Herpes ---------------------------------------------------------------- 9- 11
Bacterial Vaginosis ------------------------------------------------- 12- 13
Human Papillomavirus --------------------------------------------- 14- 16
Pelvic Inflammatory Disease --------------------------------------- 17-18
Syphilis ---------------------------------------------------------------- 19- 22
Trichomoniasis------------------------------------------------------- 23- 25
Reference ------------------------------------------------------------ 26

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 Chlamydia

What is chlamydia?

Chlamydia is a common STD that can cause infection among both men and women. It can cause
permanent damage to a woman’s reproductive system. This can make it difficult or impossible to
get pregnant later. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy
that occurs outside the womb).

How is chlamydia spread?

You can get chlamydia by having vaginal, anal, or oral sex with someone who has chlamydia.
Also, you can still get chlamydia even if your sex partner does not ejaculate (cum). A pregnant
person with chlamydia can give the infection to their baby during childbirth.

How can I reduce my risk of getting chlamydia?

The only way to completely avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, the following things can lower your chances of getting chlamydia:

 Being in a long-term mutually monogamous relationship with a partner who has been
tested and does not have chlamydia; and
 Using condoms the right way every time you have sex.

Am I at risk for chlamydia?

Sexually active people can get chlamydia through vaginal, anal, or oral sex without a condom
with a partner who has chlamydia.

Sexually active young people are at a higher risk of getting chlamydia. This is due to behaviors
and biological factors common among young people. Gay and bisexual men are also at risk since
chlamydia can spread through oral and anal sex.

If you are sexually active, have an honest and open talk with your healthcare provider. Ask them
if you should get tested for chlamydia or other STDs. Gay or bisexual men and pregnant people
should also get tested for chlamydia. If you are a sexually active woman, you should get tested
for chlamydia every year if you are:

 Younger than 25 years old.

 25 years and older with risk factors, such as new or multiple sex partners, or a sex partner
who has a sexually transmitted infection.

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I’m pregnant. How does chlamydia affect my baby?

If you are pregnant and have chlamydia, you can give the infection to your baby during delivery.
This can cause an eye infection or pneumonia in your baby. Having chlamydia may also make it
more likely to deliver your baby early.

If you are pregnant, you should receive testing for chlamydia at your first prenatal visit. Talk to
your healthcare provider about getting the correct examination, testing, and treatment. Testing
and treatment are the best ways to prevent health problems.

How do I know if I have chlamydia?

Chlamydia often has no symptoms, but it can cause serious health problems, even without
symptoms. If symptoms occur, they may not appear until several weeks after having sex with a
partner who has chlamydia.

Even when chlamydia has no symptoms, it can damage a woman’s reproductive system. Women
with symptoms may notice:

 An abnormal vaginal discharge; and

 A burning sensation when peeing.
Symptoms in men can include:

 A discharge from their penis.

 A burning sensation when peeing; and
 Pain and swelling in one or both testicles (although this is less common).
Men and women can also get chlamydia in their rectum. This happens either by having receptive
anal sex, or by spread from another infected site (such as the vagina). While these infections
often cause no symptoms, they can cause:

 Rectal pain.
 Discharge; and
 Bleeding.
See a healthcare provider if you notice any of these symptoms. You should also see a provider if
your partner has an STD or symptoms of one. Symptoms can include:

 An unusual sore.
 A smelly discharge.
 Burning when peeing; or
 Bleeding between periods.

How will my healthcare provider know if I have chlamydia?

Laboratory tests can diagnose chlamydia. Your healthcare provider may ask you to provide a
urine sample for testing, or they might use (or ask you to use) a cotton swab to get a vaginal
sample.

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Is there a cure for chlamydia?

Yes, the right treatment can cure chlamydia. It is important that you take all of the medicine your
healthcare provider gives you to cure your infection. Do not share medicine for chlamydia with
anyone. When taken properly it will stop the infection and could decrease your chances of
having problems later. Although medicine will stop the infection, it will not undo any permanent
damage caused by the disease.

Repeat infection with chlamydia is common. You should receive testing again about three
months after your treatment, even if your sex partner(s) receives treatment.

When can I have sex again after my chlamydia treatment?

You should not have sex again until you and your sex partner(s) complete treatment. If given a
single dose of medicine, you should wait seven days after taking the medicine before having sex.
If given medicine to take for seven days, wait until you finish all the doses before having sex.

If you’ve had chlamydia and took medicine in the past, you can still get it again. This can happen
if you have sex without a condom with a person who has chlamydia.

What happens if I don’t get treated?

The initial damage that chlamydia causes often goes unnoticed. However, chlamydia can lead to
serious health problems.

In women, untreated chlamydia can cause pelvic inflammatory disease (PID). Some of the
complications of PID are:

 Formation of scar tissue that blocks fallopian tubes;

 Ectopic pregnancy (pregnancy outside the womb).
 Infertility (not being able to get pregnant); and
 Long-term pelvic/abdominal pain.
Men rarely have health problems from chlamydia. The infection can cause a fever and pain in the
tubes attached to the testicles. This can, in rare cases, lead to infertility.

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 Gonorrhea

What is gonorrhea?

Gonorrhea is a sexually transmitted disease (STD) caused by infection with the Neisseria
gonorrhoeae bacterium. N. gonorrhoeae infects the mucous membranes of the reproductive tract,
including the cervix, uterus, and fallopian tubes in women, and the urethra in women and
men. N. gonorrhoeae can also infect the mucous membranes of the mouth, throat, eyes, and
rectum.

How common is gonorrhea?

Gonorrhea is a very common infectious disease. CDC estimates that approximately 1.6 million
new gonococcal infections occurred in the United States in 2018, and more than half occur
among young people aged 15-24.1 Gonorrhea is the second most commonly reported bacterial
sexually transmitted infection in the United States.2 However, many infections are asymptomatic,
so reported cases only capture a fraction of the true burden.

How do people get gonorrhea?

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.

People who have had gonorrhea and received treatment may be reinfected if they have sexual
contact with a person infected with gonorrhea.

Who is at risk for gonorrhea?

Any sexually active person can be infected with gonorrhea. In the United States, the highest
reported rates of infection are among sexually active teenagers, young adults, and African
Americans 2.

What are the signs and symptoms of gonorrhea?

Many men with gonorrhea are asymptomatic 3, 4. When present, signs and symptoms of urethral
infection in men include dysuria or a white, yellow, or green urethral discharge that usually
appears one to fourteen days after infection 5. In cases where urethral infection is complicated by
epididymitis, men with gonorrhea may also complain of testicular or scrotal pain.

Most women with gonorrhea are asymptomatic 6, 7. Even when a woman has symptoms, they are
often so mild and nonspecific that they are mistaken for a bladder or vaginal infection 8, 9. The

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initial symptoms and signs in women include dysuria, increased vaginal discharge, or vaginal
bleeding between periods. Women with gonorrhea are at risk of developing serious
complications from the infection, regardless of the presence or severity of symptoms.

Symptoms of rectal infection in both men and women may include discharge, anal itching,
soreness, bleeding, or painful bowel movements 10. Rectal infection also may be asymptomatic.
Pharyngeal infection may cause a sore throat, but usually is asymptomatic 11, 12.

What are the complications of gonorrhea?

Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea can spread into the uterus or fallopian tubes and cause pelvic inflammatory
disease (PID). The symptoms may be quite mild or can be very severe and can include
abdominal pain and fever 13. PID can lead to internal abscesses and chronic pelvic pain. PID can
also damage the fallopian tubes enough to cause infertility or increase the risk of ectopic
pregnancy.

In men, gonorrhea may be complicated by epididymitis. In rare cases, this may lead to
infertility 14.

If left untreated, gonorrhea can also spread to the blood and cause disseminated gonococcal
infection (DGI). DGI is usually characterized by arthritis, tenosynovitis, and/or dermatitis 15.
This condition can be life threatening.

What about gonorrhea and HIV?

Untreated gonorrhea can increase a person’s risk of acquiring or transmitting HIV, the virus that
causes AIDS 16.

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. This can cause blindness, joint infection, or a life-
threatening blood infection in the baby 17. Treatment of gonorrhea as soon as it is detected in
pregnant women will reduce the risk of these complications. Pregnant women should consult a
health care provider for appropriate examination, testing, and treatment, as necessary.

Who should be tested for gonorrhea?

Any sexually active person can be infected with gonorrhea. Anyone with genital symptoms such
as discharge, burning during urination, unusual sores, or rash should stop having sex and see a
health care provider immediately.

Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with an
STD should see a health care provider for evaluation.

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Some people should be tested (screened) for gonorrhea even if they do not have symptoms or
know of a sex partner who has gonorrhea 18. Anyone who is sexually active should discuss his or
her risk factors with a health care provider and ask whether he or she should be tested for
gonorrhea or other STDs.

CDC recommends yearly gonorrhea screening for all sexually active women younger than 25
years, as well as older women with risk factors such as new or multiple sex partners, or a sex
partner who has a sexually transmitted infection.

People who have gonorrhea should also be tested for other STDs.

How is gonorrhea diagnosed?

Urogenital gonorrhea can be diagnosed by testing urine, urethral (for men), or endocervical or
vaginal (for women) specimens using nucleic acid amplification testing (NAAT) 19. It can also be
diagnosed using gonorrhea culture, which requires endocervical or urethral swab specimens.

FDA-cleared rectal and oral diagnostic tests for gonorrhea (as well as chlamydia) have been
validated for clinical use 20.

What is the treatment for gonorrhea?

Gonorrhea can be cured with the right treatment. CDC now recommends a single 500 mg
intramuscular dose of ceftriaxone for the treatment of gonorrhea. Alternative regimens are
available when ceftriaxone cannot be used to treat urogenital or rectal gonorrhea. 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 21. A test-of-cure – follow-up testing to be sure the
infection was treated successfully – is not needed for genital and rectal infections; however, if a
person’s symptoms continue for more than a few days after receiving treatment, he or she should
return to a health care provider to be reevaluated. A test-of-cure is needed 7-14 days after
treatment for people who are treated for pharyngeal (infection of the throat) gonorrhea.

Because re-infection is common, men and women with gonorrhea should be retested three
months after treatment of the initial infection, regardless of whether they believe that their sex
partners were successfully treated.

Healthcare providers and health departments can report suspected gonorrhea cephalosporin
treatment failure or any N. gonorrhoeae specimen with decreased cephalosporin susceptibility
through the Suspected Gonorrhea Treatment Failure Consultation Form.

What about partners?

If a person has been diagnosed and treated for gonorrhea, he or she should tell all recent anal,
vaginal, or oral sex partners so they can see a health provider and be treated 20. This will reduce
the risk that the sex partners will develop serious complications from gonorrhea and will also

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reduce the person’s risk of becoming reinfected. 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. For tips on talking to partners about sex and STD testing,
visit http://www.gytnow.org/talking-to-your-partner.

How can gonorrhea be prevented?

Latex condoms, when used consistently and correctly, can reduce the risk of transmission of
gonorrhea 22. The surest way to avoid transmission of gonorrhea or other STDs is to abstain from
vaginal, anal, and oral sex, or to be in a long-term mutually monogamous relationship with a
partner who has been tested and is known to be uninfected.

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 Herpes
Herpes simplex virus (HSV), known as herpes, is a common infection that can cause painful
blisters or ulcers. It primarily spreads by skin-to-skin contact. It is treatable but not curable.

There are two types of herpes simplex virus.

Type 1 (HSV-1) mostly spreads by oral contact and causes infections in or around the mouth
(oral herpes or cold sores). It can also cause genital herpes. Most adults are infected with HSV-1.

Type 2 (HSV-2) spreads by sexual contact and causes genital herpes.

Most people have no symptoms or only mild symptoms. The infection can cause painful blisters
or ulcers that can recur over time. Medicines can reduce symptoms but can’t cure the infection.

Recurrent symptoms of both oral and genital herpes may be distressing. Genital herpes may also
be stigmatizing and have an impact on sexual relationships. However, in time, most people with
either kind of herpes adjust to living with the infection.

Symptoms

Most people with herpes have no symptoms or only mild symptoms. Many people aren’t aware
they have the infection and can pass along the virus to others without knowing.

Symptoms can include painful, recurring blisters or ulcers. New infections may cause fever,
body aches and swollen lymph nodes.

Symptoms may be different during the first episode (or ‘outbreak’) of infection than during a
recurrent episode. If symptoms occur, they often begin with tingling, itching or burning near
where the sores will appear.

Common oral herpes symptoms include blisters (cold sores) or open sores (ulcers) in or around
the mouth or lips.

Common genital herpes symptoms include bumps, blisters, or open sores (ulcers) around the
genitals or anus.

These sores and blisters are typically painful. Blisters may break open, ooze and then crust over.

During their first infection, people may experience:

 fever
 body aches
 sore throat (oral herpes)
 headache

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  swollen lymph nodes near the infection.

People can have repeated outbreaks over time (‘recurrences’). These are usually shorter and less
severe than the first outbreak.

Treatment

Medicines are often used to treat first or recurrent episodes of herpes. They can decrease how
long symptoms last and how severe they are, but they can’t cure the infection.

Treatment for recurrent episodes is most effective when started within 48 hours of when
symptoms begin.

Antiviral medicines commonly given include acyclovir, famciclovir and valacyclovir.

Taking a lower daily dose of one of these medicines can also decrease how often symptoms
occur (‘outbreaks’).

Treatment is often recommended for people who get very painful or frequent recurrent episodes
or who want to lower the risk of giving herpes to someone else.

Medicines to help with pain related to sores include paracetamol (acetaminophen), naproxen or
ibuprofen. Medicines that can be applied to numb the affected area include benzocaine and
lidocaine.

Herpes simplex virus lives inside of nerve cells and alternates between being inactive and active.
Certain triggers can make the virus active including:

 illness or fever
 sun exposure
 menstrual period
 injury
 emotional stress
 surgery.

For people whose oral herpes is activated by sunlight, avoiding sun exposure and wearing
sunscreen can lower the risk of recurrences.

To decrease symptoms of oral herpes, people can:

 drink cold drinks or suck on popsicles

 use over-the-counter pain medicines.

For genital herpes, people can:

 sit in a warm bath for 20 minutes (without soap)

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  wear loose fitting clothes
 use over-the-counter pain medicines.

There are ways to lower the risk of spreading herpes including:

 talk to your partner about having herpes

 don’t have sex if you have symptoms and always wear a condom
 don’t share items that touched saliva (oral herpes).

Talk to your healthcare provider if you are pregnant, because there is a risk of passing herpes to
your baby.

Scope of the problem

In 2016 (last available estimates), 3.7 billion people under the age of 50, or 67% of the global
population, had HSV-1 infection (oral or genital). Most HSV-1 infections are acquired during
childhood.

Genital herpes caused by HSV-2 affects an estimated 491 million (13%) people aged 15–49
years worldwide (2016 data). HSV-2 infects women almost twice as often as men because sexual
transmission is more efficient from men to women. Prevalence increases with age, though the
highest number of new infections are in adolescents.

Transmission

HSV-1 is mainly transmitted via contact with the virus in sores, saliva or surfaces in or around
the mouth. Less commonly, HSV-1 can be transmitted to the genital area through oral-genital
contact to cause genital herpes. It can be transmitted from oral or skin surfaces that appear
normal; however, the greatest risk of transmission is when there are active sores. People who
already have HSV-1 are not at risk of reinfection, but they are still at risk of acquiring HSV-2.

HSV-2 is mainly transmitted during sex through contact with genital or anal surfaces, skin, sores
or fluids of someone infected with the virus. HSV-2 can be transmitted even if the skin looks
normal and is often transmitted in the absence of symptoms.

In rare circumstances, herpes (HSV-1 and HSV-2) can be transmitted from mother to child
during delivery, causing neonatal herpes.

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 Bacterial Vaginosis
What is bacterial vaginosis (BV)?

Bacterial vaginosis (BV) is a condition that happens when there is too much of certain bacteria in
the vagina. This changes the normal balance of bacteria in the vagina.

How common is BV?

BV is the most common vaginal condition in women ages 15-44.

How is BV spread?

Researchers do not know the cause of BV. However, we do know the condition most often
occurs in those who are sexually active. BV is a result of an imbalance of “good” and “harmful”
bacteria in a vagina. Douching, not using condoms, and having new or multiple sex partners can
upset the normal balance of vaginal bacteria, increasing your risk for getting BV.

We also do not know how sex causes BV. There also is no research to show that treating a sex
partner affects whether someone gets BV. Having BV can increase your chances of getting other
STDs.

BV rarely affects those who have never had sex.

You cannot get BV from toilet seats, bedding, or swimming pools.

How can I avoid getting BV?

Healthcare providers and scientists do not completely understand how BV spreads or know how
best to prevent it.

The following basic prevention steps may help lower your risk of getting BV:

 Not having sex.

 Limiting your number of sex partners;
 Not douching; and
 Using condoms the right way every time you have sex.

I’m pregnant. How does BV affect my baby?

Treating BV during pregnancy is very important. If you are pregnant and have BV, your baby is
more likely to be born early (premature) or at a low birth weight. Low birth weight means having
a baby that weighs less than 5.5 pounds at birth.

How do I know if I have BV?

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Many people with BV do not have symptoms. If you do have symptoms, you may notice:

 A thin white or gray vaginal discharge.

 Pain, itching, or burning in the vagina.
 A strong fish-like odor, especially after sex.
 Burning when peeing; and
 Itching around the outside of the vagina.

How will my healthcare provider know if I have BV?

A healthcare provider will examine your vagina for signs of discharge. They also can test a
sample of vaginal fluid to determine if BV is present.

Is there a cure for BV?

A healthcare provider can treat BV with antibiotics. If you have symptoms, you should be
checked and treated by a healthcare provider. It is important to take all the medicine your
provider prescribes, even if your symptoms go away. Treatment also may reduce the risk of
getting other STDs. BV can return even after treatment.

Male sex partners of women with BV do not need treatment. However, BV can spread between
female sex partners.

What happens if I don’t receive treatment?

At times, BV will go away without treatment. However, treatment can help avoid the increased
chance of some serious health risks associated with BV, including:

 Getting or transmitting HIV;

 Delivering your baby too early if you have BV while pregnant; and
 Getting other STDs like chlamydia and gonorrhea. These bacteria can cause pelvic
inflammatory disease (PID), which can make it difficult for you to have children.

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 Human papillomavirus.
What is HPV?

HPV stands for human papillomavirus.

HPV is a common sexually transmitted infection which usually shows no symptoms and goes
away by itself but can sometimes cause serious illness.

HPV is responsible for:

 almost all cases of genital warts and cervical cancer

 90% of anal cancers
 78% of vaginal cancers
 25% of vulvar cancers
 50% of penile cancers
 60% of oropharyngeal cancers (cancers of the back of the throat, including the base of the
tongue and tonsils). 1

The virus is spread through intimate contact with genital skin and can infect both men and
women. Condoms offer some but not total protection from HPV as they do not cover all of the
genital skin. You can be exposed to HPV the first-time sexual activity occurs or from only one
sexual partner.

HPV and cancer

There are different HPV types - some are considered "low-risk" and others "high-risk". Low-risk
HPV types cause genital warts and do not cause cancer. Some high-risk HPV types can cause
serious illness including cancer.

In most cases the immune system clears HPV from the body. However, there are times when the
body does not clear HPV: usually when the infection is with high-risk types. We call this
'persistent' HPV infection.

Persistent HPV infection can cause abnormal cells to develop on the cervix which may develop
into cervical cancer if left untreated. Cervical cancer is the most common type of cancer caused
by HPV, persistent infection also causes less common cancers affecting men and women,
including anal, vulvar, vaginal, mouth/throat and penile cancers.
HPV vaccine

Gardasil

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The human papillomavirus (HPV) vaccine used in Australia is called Gardasil ®9 and protects
you against nine types of HPV that are responsible for most HPV-related illnesses.

The HPV vaccine provides fully vaccinated people with protection against nine types of HPV,
including:

 Types 16 and 18: these are the two types of HPV that cause most HPV-related cancers.
 The five next most common HPV types associated with cervical cancer (types 31, 33, 45,
52 and 58).
 Two non-cancer-causing HPV types (types 6 and 11), which cause 90 per cent of genital
warts.

The Gardasil ®9 vaccine is made from tiny proteins that look like the outside of a real HPV cell.
The vaccine does not contain any live virus, killed virus or DNA from the virus so it cannot
cause cancer or other HPV-related illnesses.

Who should have the HPV vaccine?

The HPV vaccine is recommended for all people living in Australia aged 9 to 25 and is free for
anyone aged between 12 and 25 years of age under the National Immunization Program.

The HPV vaccine is offered to all Australian children aged about 12-13 for free through the
Secondary School Immunization Program as part of the National Immunization Program.

The HPV vaccine is also recommended for people at higher risk of developing HPV-related
diseases, such as people living with HIV, significantly immunocompromised groups and men
who have sex with men. Speak to your doctor or immunization nurse to find out more.

If you are aged over 26 and wish to have the HPV vaccine speak to your doctor and seek their
advice.

If you’ve moved to Australia after the age of 12 or 13 and aren’t sure if you’ve been vaccinated
against HPV, you can check your vaccination status with your home country's relevant
immunization service or health department.

Since February 6, 2023, only one dose of the HPV vaccine is required for everyone under 26,
unless they are immunocompromised.

Testing for HPV to prevent cervical cancer.

Australia has one of the world's lowest rates of cervical cancer mortality, thanks to the
effectiveness of our National Cervical Screening Program, introduced in 1991.

The Pap test was replaced with a Cervical Screening Test that checks for HPV in 2017. The
Cervical Screening Test can detect high-risk HPV infections in cervical cells, sometimes before

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they cause abnormal cells to develop. Women aged 25-74 are invited to take the Cervical
Screening Test every five years, instead of a Pap test every two years.

Cervical cancer is extremely rare in women under the age of 25 and the introduction of the HPV
vaccine has been an effective means of protecting women against some of the leading causes of
cervical cancer.

Cancer Council recommends that women of any age who have symptoms should see their doctor
immediately.

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 Pelvic inflammatory disease
What is a PID?

Pelvic inflammatory disease is an infection of a woman’s reproductive organs. It is a

complication often caused by some STDs, like chlamydia and gonorrhea. Other infections that
are not sexually transmitted can also cause PID.

How do I get PID?

You are more likely to get PID if you.

 Have an STD and do not get treated.

 Have more than one sex partner.
 Have a sex partner who has sex partners other than you.
 Have had PID before.
 Are sexually active and are age 25 or younger.
 Douche.
 Use an intrauterine device (IUD) for birth control. However, the small increased risk is
mostly limited to the first three weeks after the IUD is placed inside the uterus by a
doctor.

How can I reduce my risk of getting PID?

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting PID:

 Being in a long-term mutually monogamous relationship with a partner who has been
tested and has negative STD test results.
 Using latex condoms the right way every time you have sex.

How do I know if I have PID?

There are no tests for PID. A diagnosis is usually based on a combination of your medical
history, physical exam, and other test results. You may not realize you have PID because your
symptoms may be mild, or you may not experience any symptoms. However, if you do have
symptoms, you may notice:

 Pain in your lower abdomen.

 Fever.
 An unusual discharge with a bad odor from your vagina.
 Pain and/or bleeding when you have sex.
 Burning sensation when you urinate; or
 Bleeding between periods.
You should

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  Be examined by your doctor if you notice any of these symptoms.
 Promptly see a doctor if you think you or your sex partner(s) have or were exposed to an
STD.
 Promptly see a doctor if you have any genital symptoms such as unusual soreness, a
smelly discharge, burning when peeing, or bleeding between periods.
 Get a test for chlamydia and gonorrhea every year if you are sexually active and younger
than 25 years of age.
 Have an honest and open talk with your health care provider if you are sexually active
and ask whether you should be tested for other STDs.

Can PID be cured?

Yes, if PID is diagnosed early, it can be treated. However, treatment won’t undo any damage that
has already happened to your reproductive system. The longer you wait to get treated, the more
likely it is that you will have complications from PID. While taking antibiotics, your symptoms
may go away before the infection is cured. Even if the symptoms go away, you should finish
taking all of your medicine. Be sure to tell your recent sex partner(s), so they can get tested and
treated for STDs, too. It is also very important that you and your partner both finish your
treatment before having any kind of sex so that you don’t re-infect each other.

You can get PID again if you get infected with an STD again. Also, if you have had PID before,
you have a higher chance of getting it again.

What happens if I don’t get treated?

If diagnosed and treated early, the complications of PID can be prevented. Some of the
complications of PID are:

 formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal
blockage.
 Ectopic pregnancy (pregnancy outside the womb).
 Infertility (inability to get pregnant).
 Long-term pelvic/abdominal pain.

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 Syphilis
What is syphilis?

Syphilis is a sexually transmitted infection (STI) that can cause serious health problems without
treatment. Infection develops in stages (primary, secondary, latent, and tertiary). Each stage can
have different signs and symptoms.

How does syphilis spread?

You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex.

Syphilis can spread from a mother with syphilis to her unborn baby.

You cannot get syphilis through casual contact with objects, such as:

 toilet seats
 doorknobs
 swimming pools
 hot tubs
 bathtubs
 sharing clothing, or eating utensils

How can I reduce my risk of getting syphilis?

The only way to completely avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting
syphilis:

 Being in a long-term mutually monogamous relationship with a partner who has been
tested and does not have syphilis.
 Using condoms the right way every time you have sex.
Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores
occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.

Am I at risk of syphilis?

Sexually active people can get syphilis through vaginal, anal, or oral sex without a condom with
a partner who has syphilis. If you are sexually active, have an honest and open talk with your
healthcare provider. Ask them if you should get tested for syphilis or other STDs.

You should get tested regularly for syphilis if you are sexually active and

 are a gay or bisexual man;

 have HIV.

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  are taking pre-exposure prophylaxis (PrEP) for HIV prevention; or
 have partner(s) who have tested positive for syphilis.
All pregnant people should receive syphilis testing at their first prenatal visit. Some pregnant
people need to receive syphilis testing again during the third trimester at 28 weeks and at
delivery.

I’m pregnant. How does syphilis affect my baby?

If you are pregnant and have syphilis, you can give the infection to your unborn baby. Having
syphilis can lead to a low-birth-weight-baby. It can make it more likely you will deliver your
baby too early or stillborn (a baby born dead). To protect your baby, you should receive syphilis
testing at least once during your pregnancy. Receive treatment right away if you test positive.

At birth, a baby with a syphilis infection may not have signs or symptoms of disease. However,
if the baby does not receive treatment right away, the baby may develop serious problems within
a few weeks. These babies can have health problems, such as cataracts, deafness, or seizures, and
can die.

What are the signs and symptoms of syphilis?

There are four stages of syphilis (primary, secondary, latent, and tertiary). Each stage has
different signs and symptoms.

Primary Stage
During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The
sore is the location where syphilis entered your body. These sores usually occur in, on, or around
the

 penis.
 vagina.
 anus.
 rectum; and
 lips or in the mouth.
Sores are usually (but not always) firm, round, and painless. Because the soreness is painless,
you may not notice it. The sore usually lasts 3 to 6 weeks and heals regardless of whether you
receive treatment. Even after the sore goes away, you must still receive treatment. This will stop
your infection from moving to the secondary stage.

Secondary Stage
During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or
anus. This stage usually starts with a rash on one or more areas of your body. The rash can show
up when your primary sore is healing or several weeks after the sore has healed. The rash can be
on the palms of your hands and/or the bottoms of your feet and look:

 rough.
 red; or

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  reddish-brown.
The rash usually won’t itch, and it is sometimes so faint that you won’t notice it. Other
symptoms may include:

 fever.
 swollen lymph glands.
 sore throat.
 patchy hair loss.
 headaches.
 weight loss.
 muscle aches; and
 fatigue (feeling very tired).
The symptoms from this stage will go away whether you receive treatment. Without the right
treatment, your infection will move to the latent and possibly tertiary stages of syphilis.

Latent Stage
The latent stage of syphilis is a period when there are no visible signs or symptoms. Without
treatment, you can continue to have syphilis in your body for years.

Tertiary Stage
Most people with untreated syphilis do not develop tertiary syphilis. However, when it does
happen, it can affect many different organ systems. These include the heart and blood vessels,
and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years
after your infection began. In tertiary syphilis, the disease damages your internal organs and can
result in death. A healthcare provider can usually diagnose tertiary syphilis with the help of
multiple tests.

Neurosyphilis, Ocular Syphilis, and Otosyphilis

Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye
(ocular syphilis), or the ear (otosyphilis). This can happen during any of the stages described
above.

Signs and symptoms of neurosyphilis can include:

 severe headache.
 muscle weakness and/or trouble with muscle movements; and
 changes to your mental state (trouble focusing, confusion, personality change) and/or
dementia (problems with memory, thinking, and/or decision making).
Signs and symptoms of ocular syphilis can include:

 eye pain and/or redness; and

 changes in your vision or even blindness.
Signs and symptoms of otosyphilis may include:

 hearing loss.
 ringing, buzzing, roaring, or hissing in the ears (“tinnitus”); and

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  dizziness or vertigo (feeling like you or your surroundings are moving or spinning).

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 Trichomoniasis
What is trichomoniasis?

Trichomoniasis (or “trich”) is a very common STD caused by infection with Trichomonas
vaginalis (a protozoan parasite). Although symptoms vary, most people who have a trich cannot
tell they have it.

How common is trichomoniasis?

In the United States, CDC estimates that there were more than two million trichomoniasis
infections in 2018. However, only about 30% develop any symptoms of trich. Infection is more
common in women than in men. Older women are more likely than younger women to have the
infection.

How does trichomoniasis spread?

Sexually active people can get trich by having sex without a condom with a partner who has
trich.

In women, the infection is most found in the lower genital tract (vulva, vagina, cervix, or
urethra). In men, the infection is most found inside the penis (urethra). During sex, the parasite
usually spreads from a penis to a vagina, or from a vagina to a penis. It can also spread from one
vagina to another vagina.

It is not common for the parasite to infect other body parts, like the hands, mouth, or anus. It is
unclear why some people with the infection get symptoms while others do not. It probably
depends on factors like a person’s age and overall health. People with trich can pass the infection
to others, even if they do not have symptoms.

What are the signs and symptoms of trichomoniasis?

About 70% of people with the infection do not have any signs or symptoms. When trich does
cause symptoms, they can range from mild irritation to severe inflammation. Some people get
symptoms within 5 to 28 days after getting the infection. Others do not develop symptoms until
much later. Symptoms can come and go.

Men with trich may notice:

Itching or irritation inside the penis.

Burning after peeing or ejaculating; and
Discharge from the penis.
Women with trich may notice:

 Itching, burning, redness or soreness of the genitals.

 Discomfort when peeing; and

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  A clear, white, yellowish, or greenish vaginal discharge (i.e., thin discharge or increased
volume) with a fishy smell.
Having trich can have sex feel unpleasant. Without treatment, the infection can last for months or
even years.

What are the complications of trichomoniasis?

Trich can increase the risk of getting or spreading other sexually transmitted infections. For
example, trich can cause genital inflammation, making it easier to get HIV, or pass it to a sex
partner.

How does trichomoniasis affect a pregnant person and her baby?

Pregnant people with trich are more likely to have their babies early. Also, their babies are more
likely to have a low birth weight (less than 5.5 pounds).

How do healthcare providers diagnose trich?

It is not possible to diagnose trich based on symptoms alone. Your healthcare provider
can examine you and a laboratory test will confirm the diagnosis.

What is the treatment for trichomoniasis?

Trich is the most common curable STD. A healthcare provider can treat the infection with
medication (pills) taken by mouth. This treatment is also safe for pregnant people.

If you receive and complete treatment for trich, you can still get it again. Reinfection occurs in
about 1 in 5 people within 3 months after receiving treatment. This can happen if you have sex
without a condom with a person who has trich. To avoid reinfection, your sex partners should
receive treatment at the same time.

You should not have sex again until you and your sex partner(s) complete treatment. You should
receive testing again about three months after your treatment, even if your sex partner(s)
received treatment.

How can I prevent trichomoniasis?

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting trich:

 Being in a long-term mutually monogamous relationship with a partner who has been
tested and does not have trich.
 Using condoms the right way every time you have sex.
Also, talk about the potential risk of STDs before having sex with a new partner. This can help
inform the choices you are comfortable taking with your sex life.

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If you are sexually active, have an honest and open talk with your healthcare provider. Ask them
if you should get tested for trich or other STDs.

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 References
https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm#:~:text=Chlamydia%20is%20a
%20common%20STD,that%20occurs%20outside%20the%20womb).
https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm#:~:text=Gonorrhea%20is
%20a%20sexually%20transmitted,urethra%20in%20women%20and%20men.
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm#:~:text=Bacterial%20vaginosis
%20(BV)%20is%20a,of%20bacteria%20in%20the%20vagina.
https://www.cancer.org.au/what-is-hpv
https://www.cdc.gov/std/pid/stdfact-pid.htm#:~:text=What%20is%20PID%3F,transmitted
%20can%20also%20cause%20PID.
https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm#:~:text=Syphilis%20is%20a%20sexually
%20transmitted,have%20different%20signs%20and%20symptoms.
https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm#:~:text=Trichomoniasis%20(or
%20%E2%80%9Ctrich%E2%80%9D),cannot%20tell%20they%20have%20it.

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