This document provides information on sexually transmitted infections (STIs), including their causes, symptoms, and prevention. It discusses the main categories of bacterial and viral STIs such as chlamydia, gonorrhea, hepatitis A/B/C, herpes, HIV, human papillomavirus, and syphilis. Key points covered include how STIs can be transmitted and increase HIV risk, the importance of getting tested regularly, and strategies for prevention through condom and barrier use, partner communication, and limiting sexual partners. Resources for testing and treatment in San Francisco are also listed.

1. The 8 Most Common

2. STD vs STI
STD – sexually transmitted disease
• A disease is any condition of the body or mind that displays
some type of symptom.
STI – sexually transmitted infection
• Infection means that a bacteria, parasite or virus is present
in the body.
• Symptoms may not be present and the person may be
unaware that she/he is infected.

3. Infecting Organisms
Two Main Categories
Bacterial Viral

4. Infecting Organisms
Viruses
Bacteria
 Syphilis
 Chlamydia
 Gonorrhea
 NGU

5. 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-testing is recommended, 3 months after treatment

6. Syphilis

7. Syphilis
Can be passed by skin-to-skin contact
during oral, anal and vaginal sex
Is often called “The Great Imitator”
because its symptoms often are mistaken
for those of other infections

8. 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

9. Secondary syphilis
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
 tiredness.

10. Latent Syphilis
Without treatment, the infected person still has
syphilis even though there are no signs or
symptoms.
 Damage can affect:

11. Gonorrhea, Chlamydia & Non-

12. Gonorrhea

13. Gonorrhea
Gonorrhea is a bacteria
that can grow and multiply
easily in the warm, moist
areas of the reproductive
tract :
 Urethra (urine canal) in men
and women
 Cervix (opening to the womb)
 Uterus (womb)
 Fallopian tubes (egg canals)

14. Gonorrhea
The bacteria can also grow in the mouth, throat, eyes,
and anus.
Gonorrhea can be transmitted to both male and female
partners during vaginal, anal and oral sex from a partner
infected in his or her throat, vagina, urethra or anus.
Has been labeled as a major driver in new HIV cases

15. Gonorrhea
Most men develop symptoms of gonorrhea
within 2-5 days and up to 30 days after being
exposed.
Most women do not have symptoms, for those
who do have symptoms, they usually appear
within 10 days after being exposed.
Common symptoms:
• Discharge from genitals or anus
• Pain or itching in head of the penis
• Pain or burning when urinating
• Lower abdominal pain (women)

16. Chlamydia

17. Chlamydia
Chlamydia is a common STI caused by a
bacteria.
Symptoms are usually mild or absent, serious
complications that cause irreversible damage

18. Chlamydia
Symptoms usually appear from
one to three weeks after
infection
 In men, untreated chlamydia
infections can lead to
inflammation of the prostate
gland, urethral scarring, infertility,
or epididymitis (inflammation of
the cord-like structure at the back
of the testes).

19. Chlamydia
Women may experience
pain and itching of the
vulva or vagina; vaginal
discharge; unusual
vaginal or anal bleeding;
pain with urination; and/or
pain when having sex.
Untreated chlamydia in
women can cause pelvic
inflammatory disease
(PID) and lead to
infertility.

20. Lymphogranuloma Venereum
(LGV)
Sexually transmitted disease caused by three
strains of the bacterium of chlamydia transmitted
through unprotected oral, vaginal and anal sex.
Symptoms include raised bumps, swelling of the
lymph glands. Rectal ulcers, bleeding and
discharge are also common.
Treated with antibiotics over a 21-day period

21. Non Gonococcal Urethritis
(NGU)
NGU is an infection of the male urethra caused
by bacteria other than gonorrhea, most often
chlamydia or another type of bacteria
Usually transmitted with direct mucous
membrane contact during oral, vaginal or anal
sex even if body fluids are not exchanged.
Non-sexually, NGU may be caused by urinary
tract infections
Symptoms are similar to those experienced with
gonorrhea and chlamydia

22. Pharyngitis
Gonorrhea
Chlamydia
NGU
All can occur in the throat
if you have oral sex and
often won’t have
symptoms.

23. Infecting Organisms
Viruses
 Human Papilloma Virus (HPV)
 Herpes Simplex (1,2)
 Hepatitis (A,B & C)
 Human Immunodeficiency Virus (HIV)
Bacteria

24. Characteristics of Viruses
Viruses cannot be cured.
 Medications are available to reduce the
frequency and severity of outbreaks..
 Some viruses are like Chickenpox; they infect
you once and then go away.

25. Human Papilloma Virus

26. 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 and other types can cause various types of
cancer

27. Human Papilloma Virus (HPV)
Warts usually appear
as painless growths
 Flat
 Raised
 Cauliflower-shaped
Warts may appear
within weeks or
months after sexual
contact with an
infected person

28. Herpes Simplex Virus

29. Herpes Simplex Virus
(HSV-I & HSV-II)
There are two types of HSV
 HSV-I: Oral
 HSV-II: Genital
Can be passed by skin-to-skin contact during oral,
anal and vaginal sex
 Herpes can be transmitted to others without sores
present.

30. Herpes
Common symptoms include:
 tingling
 painful/itchy sores
Treatment involves
medication to address
frequency and severity
symptoms. There is no cure

31. Hepatitis A, B, C

32. 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.
Symptoms of all types of viral hepatitis are
similar and can include one or more of the
following:

33. Hepatitis A
Think A for “Anal”
Hepatitis A is transmitted through consuming
feces (even microscopic amounts)
Risk Reduction: vaccination, hand washing,
barriers when rimming, washing genitals and
anus before and after anal sex.

34. Hepatitis B
Think B for “Body Fluids”
Hepatitis B is transmitted through contact with
infectious blood, semen, are found in blood,
semen, vaginal secretions, and saliva primarily
through:
 Sexual contact with an infected person
 Sharing of contaminated needles, syringes or other
injection drug equipment
 Needlesticks or other sharp instrument injuries
Risk reduction: Vaccination, barriers during oral

35. Hepatitis C
Think C for “cooker” (used for cooking heroin
before injection). Hepatitis C is transmitted
through contact with infectious blood, semen,
and other body fluids, primarily through:
 Sexual contact with an infected person
 Sharing of contaminated needles, syringes or other
injection drug equipment
 Needlesticks or other sharp instrument injuries
Risk Reduction: Condoms and barriers during oral,
vaginal and anal sex. Blood awareness during

36. HIV & STI Relationship
Having an STI increases the risk for
getting HIV
Getting an STI for people with HIV can
increase viral load and chance of
transmitting HIV/STIs to others
Risk reduction: Using barriers for oral,
vaginal and anal sex. Getting tested.
Talking about status with partners. Using
clean needles and equipment.

37. Prevention & Risk Reduction
Condoms and barriers, correct and consistent 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
 Do not assume “clean means clean”
Partner Reduction
 Greater the number of partners the more often you are
potentially exposed.

38. Prevention & Risk Reduction
Partner Notification
 www.InSpot.org
 City Clinic staff (for Syphilis and HIV)
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.

39. 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

40. 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.
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

41. You can always
find resources online…
 San Francisco City Clinic www.SFCityClinic.org
 Online Partner Notification www.InSpot.org
 Center For Disease Control (CDC) www.cdc.gov

42. Thank You!
Brandon Ivory
415.355.2033
Brandon.Ivory@sfdph.org