This document discusses sexually transmitted infections (STIs), including that over 25 STIs can be passed through sexual contact, with bacterial STIs often curable but viral STIs not curable. It notes that the US has the highest STI rates among industrialized nations and discusses factors that contribute to STI transmission like early sexual initiation, multiple partners, and inconsistent condom use. The document outlines principal bacterial and viral STIs like chlamydia, gonorrhea, HPV and herpes. It also discusses the disparate impact of STIs and increased susceptibility among women.

1. Chapter Fifteen Sexually Transmitted Infections

2. Sexually Transmitted Infections More than 25 sexually transmitted infectious organisms can be passed from person to person through sexual activities Bacterial STIs are often curable Viral STIs are not curable

3. The STI Epidemic STIs are the most common infections reported in the U.S. STIs comprise 87% of the cases of infectious diseases reported to CDC U.S. has the highest STI rates among industrialized nations By age 24, 1 in 3 sexually active people has had an STI Incidence Prevalence

4. Who Is Affected: Disparities Among Groups Gender disparities Age disparities Racial and ethnic disparities

5. Behavioral Factors Contributing to STI Transmission Early initiation of intimate sexual activity Numerous sex partners High-risk sex partners High risk sexual behavior Inconsistent and incorrect condom use Substance abuse Sexual coercion Lack of knowledge of and concern about STIs

6. Social Factors Contributing to STI Transmission Poverty and marginalization Access to health care Secrecy and moral conflict about sexuality

7. Biological Factors Contributing to STI Transmission Asymptomatic nature Resistance to treatment or lack of a cure Other: douching, immature cervix, uncircumcised penis

8. Consequences of STIs Women, men, and infants affected Presence of STIs increases HIV risk Untreated STIs have serious consequences Infertility/ sterility Untreated Pelvic Inflammatory Disease (PID) causes 15% of women’s infertility Ectopic pregnancy, miscarriage Blindness Cancer, heart disease

9. Principal Bacterial STIs Chlamydia Responsible for 80% of women’s tubal infertility Infects 2.8 million Americans each year Gonorrhea 700,000 Americans contract gonorrhea each year Can cause sterility in both men and women Syphilis Infection has stages that indicate progression of infection Can lead to brain damage and death in newborns Urinary tract infections Caused by several different bacteria

10. Sexually Transmitted Infections Bacterial STIs are often curable Viral STIs are not curable

11. Principal Viral STIs Human Papillomavirus (HPV) 20 million carriers, 5.5 million new cases yearly Treatment and vaccine Herpes Simplex Virus (HSV) 45 million Americans infected Managing symptoms Hepatitis A, B, C Viral disease of liver One third of Americans show evidence of past infection

12. Other Infections Bacterial vaginosis Caused by overabundance of Gardnerella bacteria Treat with antibiotics Candidiasis: Yeast Infections Many factors contribute to infection Men and women can carry the organism Trichomoniasis Most common curable STI in young women Men and women can carry the organism

13. Other STIs Chancroid Cytomegalovirus Enteric infections Granuloma inguinale Lymphogranuloma venereum Molluscum contagiosum

14. Parasites Pubic lice: Phthirus pubis; commonly known as crabs Scabies: mite Sarcoptes scabiei Both can be transmitted non-sexually via clothes, towels, bedding

15. STIs and Women Women’s anatomy increases susceptibility Pelvic inflammatory disease - PID Infection of fallopian tubes spreads One of the leading causes of female infertility Caused by some types of STI bacteria Cystitis : bladder infection Often related to sexual activity; not an STI Can create pain and damage kidneys

16. Avoiding STIs Practice abstinence Practice sexual exclusivity Reduce risk during sexual activity Select partners carefully Avoid multiple partners Avoid injecting drugs Get vaccinated Protect babies Be a good communicator

17. Treating STIs Recognize STI symptoms Seek treatment Get partners to treatment

18. Summary STIs are epidemic STIs are linked to behavior Principle STIs STIs and women Preventing STIs