DPH STI Overview


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Overview of the most common STIs

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DPH STI Overview

  1. 1. The 8 Most Common STIs: An Overview San Francisco Department of Public Health STD Prevention and Control Unit
  2. 2. STD vs. STI STD – sexually transmitted disease A disease is any condition of the body or mind that displays some type of symptom. In other words your body tells you that you are unwell. The term sexually transmitted disease implies that sex was the cause of the disease. However, the organism is the cause of the disease, not sex itself. STI – sexually transmitted infection The organism (virus/bacteria) is the cause of the infection/disease, not sex itself. Infection means that a bacteria, parasite or virus is present in the body. Someone who is an infected person may not have any symptoms, meaning that they might be unaware that they infected.
  3. 3. Infecting Organisms Two Main Categories Bacteria Virus
  4. 4. Characteristics of Viruses Viruses cannot be cured. Medications are available to reduce the frequency and severity of outbreaks of certain viruses like HSV, but no “cure” has been found for these diseases. Some viruses are like Chickenpox; they infect you once and then go away. (i.e. Hepatitis A)
  5. 5. Infecting Organisms Viruses     Human Papiloma Virus (HPV) Herpes Simplex (1,2) Hepatitis (A,B & C) Human Immunodeficiency Virus (HIV) Bacteria
  6. 6. Human Papilloma Virus (HPV) Most common STI Can be passed by skin-to-skin contact during oral, anal and vaginal sex There are 100 types of HPV, only some of them cause genital warts
  7. 7. Human Papilloma Virus (HPV) Warts may appear as wart-like growths, may be flat, slightly raised single or multiple small or large. Warts usually do not cause itching or burning.
  8. 8. Treatment Genital warts can be treated with medicine, removed (surgery), or frozen off. But warts often come back within a few months after treatment—so several treatments may be needed
  9. 9. Herpes Simplex Virus (HSV-I & HSV-II) HSV-I:Oral HSV-II:Genital Common STI. Symptoms include painful sores with itching, tingling, etc. Treatment involves addressing and preventing symptoms with medication, there is no cure.
  10. 10. Transmission Herpes is transmitted by skin-to-skin contact. It can be transmitted to others without a sore present.
  11. 11. Hepatitis A, B, C The word "hepatitis" means inflammation of the liver and also refers to a group of viral infections that affect the liver. The most common types are Hepatitis A, Hepatitis B, and Hepatitis C. Symptoms of all types of viral hepatitis are similar and can include one or more of the following: Fever, fatigue, loss of appetite, vomiting, abdominal pain, clay-colored bowel movements, joint pain, jaundice (yellowing of skin and eyes)
  12. 12. Hepatitis A Think A for “Anal” Hepatitis A is transmitted through consuming feces (even microscopic amounts) Risk Reduction: vaccination, hand washing, using barriers when rimming, washing genitals after anal sex.
  13. 13. Hepatitis B Think B for “Blood” Hepatits B is transmitted through contact with infectious blood, semen, pre-cum, vaginal Fluids primarily through: Sexual contact with an infected person Sharing of contaminated needles, syringes or other injection drug equipment Needle sticks or other sharp instrument injuries Risk reduction: Vaccination, barriers during oral vaginal and anal sex, using clean needles and other injection drug equipment
  14. 14. Hepatitis C Think C for “Cooker” (used for cooking heroin before injection). Hepatitis C is transmitted primarily through contact with infectious blood through: Sexual contact with an infected person Sharing of contaminated needles, syringes or other injection drug equipment Needle sticks or other sharp instrument injuries Risk Reduction: Condoms and barriers during oral, vaginal and anal sex. Blood awareness during rough sex. Using clean needles and works.
  15. 15. Infecting Organisms Viruses Bacteria     Syphilis Chlamydia Gonorrhea NGU
  16. 16. Characteristics of Bacteria Usually can be quickly treated and CURED with antibiotics Although treatment is brief, those who test positive need to abstain from sexual contact for 7-10 days Re-infection by untreated partners without symptoms is common, so BOTH partners need to be treated even if they have no symptoms Re-testing is recommended, 3 months after treatment
  17. 17. Primary Syphilis Lesions first appear 10 to 90 days after infection Most often painless Last 1-2 weeks Can be spread even after lesion is gone
  18. 18. Secondary syphilis Can occur after primary infection if not treated Rashes on hands, feet and torso In addition to rashes, second-stage symptoms can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and tiredness.
  19. 19. Latent Syphilis The latent (hidden) stage of syphilis begins when the secondary symptoms disappear. Without treatment, the infected person still has syphilis even though there are no signs or symptoms.  Damage can affect the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Late stage signs and symptoms include not being able to coordinate muscle movements, paralysis, numbness, gradual blindness and dementia. This damage may be serious enough to cause death.
  20. 20. Transmission Through direct contact with a syphilis sore. During vagina, anal, or oral sex Pregnant women with the disease can pass it to their babies
  21. 21. Gonorrhea
  22. 22. Gonorrhea Gonorrhea is a bacteria that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and in the urethra in women and men. The bacteria can also grow in the mouth, throat, eyes, and anus. Has been labeled as a major driver in new HIV cases
  23. 23. Symptoms some men have signs or symptoms that appear two to five days after infection; burning sensation when urinating, or a white, yellow, or green discharge from the penis. Sometimes men with gonorrhea get painful or swollen testicles. signs in women include a painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods.
  24. 24. Transmission During vaginal, anal, or oral sex, Ejaculation does not have to occur Mother to her baby during childbirth
  25. 25. Chlamydia
  26. 26. Chlamydia Chlamydia is a common STI caused by a bacteria which can damage a woman's reproductive organs. Even though symptoms of Chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, Chlamydia is known as a "silent" disease because the majority of infected people have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure.
  27. 27. Symptoms In women: discharge or a burning sensation when urinating. lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. In men: discharge from their penis or a burning sensation when urinating. Men or women who have anal sex may have: rectal pain, discharge, or bleeding
  28. 28. Transmission During vaginal, anal, or oral sex Mother to baby during childbirth
  29. 29. Non Gonococcal Urethritis (NGU) NGU is an infection of the urethra caused by bacteria other than gonorrhea, most often chlamydia. Sexually, NGU can be transmitted with direct mucous membrane contact vaginally, anally, or orally, even if body fluids are not exchanged. Non-sexually, NGU may be caused by urinary tract infections, an inflamed prostate gland, a tightening of the foreskin, or a tightening or closing of the urethal tube in the penis.
  30. 30. Pelvic inflammatory Disease (PID) Chlamydia, Gonorrhea and NGU are common causes of PID. PID can damage the fallopian tubes and tissues in and near the uterus and ovaries. PID can lead to serious consequences including infertility, ectopic pregnancy (a pregnancy in the fallopian tube or other places outside of the womb), abscess formation, and chronic pelvic pain
  31. 31. Pharyngitis Gonorrhea Chlamydia NGU All can occur in the throat if you have oral sex and often won’t have symptoms. Talk to your provider about having an oral swab.
  32. 32. Risk Factors for STIs Not using protection Multiple sex partners Casual, anonymous hook-ups Drinking and using drugs Not knowing status Having an STI Trading sex for money/drugs Injection drug use
  33. 33. Prevention & Risk Reduction Condoms and barriers, correct and regular use can dramatically reduce your risk of getting a STI. Remember that some STIs may occur on parts of the body not covered by condoms. Getting Tested every 3 – 6 months Communication   Ask about testing history But do not assume “clean means clean” Partner Reduction  Greater the number of partners the more often you are potentially exposed.
  34. 34. Prevention & Risk Reduction Partner Notification   www.InSpot.org City Clinic staff (for Syphilis and HIV) Washing hands and genitals before and after sex Setting limits for what you’re OK and not OK with Limiting drug and alcohol use Discretion  If it’s a sore, don’t touch it. Don’t convince yourself it’s a zipper cut, etc. Get checked or encourage partner to get checked.
  35. 35. Tips on Talking to Partners About Status 1. Pick a time when you won't be interrupted. 2. Pick a neutral place to chat (not the bedroom, or in the throes of passion). 3. Be sober. 4. Be open to the possibilities. 5. Have a sense of humor and use it— remember sex is about having fun
  36. 36. Testing Locations & Methods San Francisco City Clinic 356 - 7th Street (between Harrison and Folsom St; 487-5500). www.SFcityclinic.org Confidential, free/low-cost, comprehensive STD/HIV and family planning services Services provided to patients age 12 and up – parental consent is not required, per California law. We offer testing via  Oral swab for gonorrhea and Chlamydia  Urine collections for gonorrhea and Chlamydia  Vaginal and rectal swab for gonorrhea and Chlamydia  Blood draw for Syphilis/HSV/HIV Monday, Wednesday, Friday:  Open 8:00 -4:00  We will accept provider referrals until 4:00; call 487-5595 Tuesday:1:00pm - 6:00pm Thursday 1:00pm - 4:00pm *Clinic may be unable to see patients without symptoms if maximum capacity has been reached. Urge your referrals to visit earlier during clinic hours.
  37. 37. Post Exposure Prophylaxis (PEP) for HIV Is available at San Francisco City Clinic to prevent HIV after a sexual or needle-sharing exposure.     Must begin with 72 hours, the sooner the better Comprises 2 HIV medications taken for 28 days All patients are evaluated by a clinician and if eligible for PEP are given a 2 day supply of medication. San Francisco residents without insurance may be eligible for low cost PEP via SFGH pharmacy if referred by SFCC.
  38. 38. SFCC PEP Procedure Intake Meet with medical provider to discuss PEP and receive a standard STD work-up Rapid HIV Test. To determine baseline status PEP Counseling PEP Case Management Follow-up HIV Test at end of PEP
  39. 39. Where to refer folks for PEP Contact Andrew Reynolds, Andrew.Reynolds@sfdph.org San Francisco City Clinic, 356 – 7th Street (between Folsom and Harrison): PEP Hotline: 415.487.5538 (Checked hourly Monday-Friday) SFGH Urgent Care Clinic (4th Floor) or SFGH Emergency Room after hours or on weekends.
  40. 40. You can always find resources online…  San Francisco City Clinic www.SFCityClinic.org  Online Partner Notification www.Inspot.org  STD Q&A www.AskDrK.org
  41. 41. Thank You! Travis Tuohey 415.355.2003 Travis.Tuohey@sfdph.org Brandon Ivory 415.355.2033 Brandon.Ivory@sfdph.org