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{{ClinPsy}}
 
{{ClinPsy}}
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{{Psyperspective}}
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{{Infobox disease
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| Name = Sexually transmitted infection
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| Image =SheMayLookCleanBut.jpg
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| Caption = U.S. propaganda poster targeted at [[World War II]] soldiers and sailors appealed to their patriotism in urging them to protect themselves. The text at the bottom of the poster reads, "You can't beat the [[Axis powers|Axis]] if you get VD." Images of women were used to catch the eye on many VD posters.
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| DiseasesDB = 27130
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| ICD10 = {{ICD10|A|64||a|50}}
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| ICD9 = {{ICD9|099.9}}
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| ICDO =
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| OMIM =
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| MedlinePlus =
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| eMedicineSubj =
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| eMedicineTopic =
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| MeshID = D012749
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}}
   
A '''sexually transmitted disease''' ('''STD''') is an illness caused by an infectious pathogen that has a significant probability of transmission between [[human]]s by means of [[sexual contact]], including [[sexual intercourse|vaginal intercourse]], [[oral sex]], and [[anal sex]]. Increasingly, the term '''sexually transmitted infection''' ('''STI''') is used, as it has a broader range of meaning; a person may be ''infected'', and may potentially infect others, without showing signs of ''disease''. In addition, "disease" seems to have much more of a negative connotation than "infection." Some STIs can also be transmitted via the needles used in [[IV drug use]], as well as through [[childbirth]] or [[breastfeeding]]. Sexually transmitted diseases have been well-known for hundreds of years.
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'''Sexually transmitted diseases''' ('''STD'''), also referred to as '''sexually transmitted infections''' ('''STI''') and '''venereal diseases''' ('''VD'''), are illnesses that have a significant probability of transmission between [[human]]s by means of [[human sexual behavior]], including [[sexual intercourse|vaginal intercourse]], [[oral sex]], and [[anal sex]]. While in the past, these illnesses have mostly been referred to as STDs or VD, in recent years the term ''sexually transmitted infections'' (''STIs'') has been preferred, as it has a broader range of meaning; a person may be ''infected'', and may potentially infect others, without having a ''disease''. Some STIs can also be transmitted via the use of [[Drug injection|IV drug]] [[Hypodermic needle|needle]]s after its use by an infected person, as well as through [[childbirth]] or [[breastfeeding]]. Sexually transmitted infections have been well known for hundreds of years, and [[venereology]] is the branch of medicine that studies these diseases.
   
==Classification and terminology==
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== Classification ==
Until the 1990s, such afflictions were commonly known as ''venereal diseases'': ''Veneris'' is the Latin [[genitive]] (possessive) from of the name Venus, the Roman goddess of love. ''Social disease'' was another euphemism. [[Public health]] officials originally introduced the term ''sexually transmitted disease'', which clinicians are increasingly using alongside the term ''sexually transmitted infection'' in order to distinguish it from the former. According to [http://www.etharc.org http://www.etharc.org]:"Sometimes the terms STI and STD are used interchangeably. This can be confusing and not always accurate, so it helps first to understand the difference between infection and disease. Infection simply means that a germ – [[virus]], [[bacteria]], or [[parasite]] – that can cause disease or sickness is present inside a person’s body. An infected person does not necessarily have any symptoms or signs that the virus or bacteria is actually hurting his or her body (they do not necessarily feel sick). A disease means that the infection is actually causing the infected person to feel sick, or to notice something is wrong. For this reason, the term STI – which refers to infection with any germ that can cause an STD, even if the infected person has no symptoms – is a much broader term than STD.''"<br>
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[[File:"VD CAN BE CURED BUT THERE'S NO MEDICINE FOR REGRET" - NARA - 515957.jpg|thumb|A poster from the [[Office for Emergency Management]]. [[Office of War Information]], 1941-1945]]
The distinction being made, however, is closer to that between a ''colonization'' and an ''infection'', rather than between an ''infection'' and a ''disease''.
 
   
Specifically, the term STD refers only to [[infection]]s that are causing [[symptom]]s. Because most of the time people do not know that they are infected with an STD until they start showing symptoms of [[disease]], most people use the term STD, even though the term STI is also appropriate in many cases.
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Until the 1990s, STIs were commonly known as ''venereal diseases'', the word venereal being derived from the Latin word venereus, and meaning relating to sexual intercourse or desire, ultimately derived from [[Venus (mythology)|Venus]], the [[Roman mythology|Roman goddess]] of love.<ref name="Venereal">{{cite web|title=Venereal|publisher=dictionary.reference.com|accessdate=June 18, 2013|url=http://dictionary.reference.com/browse/venereal}}</ref> ''Social disease'' was a phrase used as a euphemism.
   
Moreover, the term ''sexually transmissible disease'' is sometimes used since it is less restrictive in consideration of other factors or means of transmission. For instance, [[meningitis]] is transmissible by means of sexual contact but is not labeled as an STI because sexual contact is not the primary [[Vector (biology)|vector]] for the [[pathogen]]s that cause meningitis. This discrepancy is addressed by the probability of infection by means ''other than sexual contact''. In general, an STI is an infection that has a negligible probability of transmission by means other than sexual contact, but has a realistic means of transmission by sexual contact (more sophisticated means&mdash;[[blood transfusion]], sharing of [[hypodermic needle]]s&mdash;are not taken into account). Thus, one may presume that, if a person is infected with an STI (e.g., [[chlamydia]], [[gonorrhea]], [[genital herpes]]), it was transmitted to him/her by means of sexual contact.
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''Sexually transmitted infection'' is a broader term than ''sexually transmitted disease.''<ref name="PLWHA">{{cite web|title=Sexually transmitted diseases (STDs)?|publisher=PLWHA/National AIDS Resource Center|accessdate=March 25, 2013|url=http://plwha.etharc.org/faq/4-frequently-asked-questions-faq-about-sexually-transmitted-diseases-stds/22-sexually-transmitted-diseases-stds|quote=Sometimes the terms STI and STD are used interchangeably. This can be confusing and not always accurate, so it helps first to understand the difference between infection and disease. Infection simply means that a [[Microorganism|germ]]—[[virus]], [[bacteria]], or [[parasite]]—that can cause disease or sickness is present inside a person's body. An infected person does not necessarily have any symptoms or signs that the virus or bacteria is actually hurting his or her body; they do not necessarily feel sick. A disease means that the infection is actually causing the infected person to feel sick, or to notice something is wrong. For this reason, the term STI—which refers to infection with any germ that can cause an STD, even if the infected person has no symptoms—is a much broader term than STD.}}</ref> An [[infection]] is a colonization by a parasitic species, which may not cause any adverse effects. In a [[disease]], the infection leads to impaired or abnormal function. In either case, the condition may not exhibit signs or symptoms. Increased understanding of infections like [[HPV]], which infects most sexually active individuals but cause disease in only a few has led to increased use of the term STI. [[Public health]] officials originally introduced the term ''sexually transmitted infection'', which clinicians are increasingly using alongside the term ''sexually transmitted disease'' in order to distinguish it from the former.<ref> {{cite book|author=K. Madhav Naidu|title=Community Health Nursing|publisher=Gyan Publishing House (2010)|chapter=Epidemiology and Management|page=248}}</ref>
   
The English language has short words for two of the most common: the "pox" ([[syphilis]]) and "the clap" ([[gonorrhea]]).
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STD may refer only to infections that are causing diseases, or it may be used more loosely as a synonym for STI. Most of the time, people do not know that they are infected with an STI until they are tested or start showing symptoms of disease.
   
== Pathology ==
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Moreover, the term ''sexually transmissible disease'' is sometimes used since it is less restrictive in consideration of other factors or means of transmission. For instance, [[meningitis]] is transmissible by means of sexual contact but is not labeled as an STI because sexual contact is not the primary [[Vector (epidemiology)|vector]] for the [[pathogen]]s that cause meningitis. This discrepancy is addressed by the probability of infection by means ''other than sexual contact''. In general, an STI is an infection that has a negligible probability of transmission by means other than sexual contact, but has a realistic means of transmission by sexual contact (more sophisticated means—[[blood transfusion]], sharing of [[hypodermic needle]]s—are not taken into account). Thus, one may presume that, if a person is infected with an STI, e.g., [[Chlamydia infection|chlamydia]], [[gonorrhea]], [[genital herpes]], it was transmitted to him/her by means of sexual contact.
Many [[STI]]s are (more easily) transmitted through the [[mucous membrane]]s of the [[penis]], [[vulva]], and (less often) the [[mouth]]. The visible membrane covering the [[glans|head of the penis]] is a mucous membrane, though it produces no [[mucus]] (similar to the [[lip]]s of the mouth). Mucous membranes differ from [[skin]] in that they allow certain pathogens into the body.
 
   
This is one reason that the probability of transmitting many infections is far higher from sex than by more casual means of transmission, such as non-sexual contact&mdash;touching, hugging, shaking hands&mdash;but it is not the only reason. Although [[mucous membrane]]s exist in the mouth as in the genitals, many STIs seem to be easier to transmit through oral sex than through deep kissing. According to this chart [http://www.tinynibbles.com/safesexchart.html], many infections that are easily transmitted from the mouth to the genitals or from the genitals to the mouth, are much harder to transmit from one mouth to another. With [[HIV]], [[genital]] fluids happen to contain much more of the [[pathogen]] than [[saliva]]. Some infections labeled as STIs can be transmitted by direct [[skin]] contact. [[Herpes simplex]] and [[HPV]] are both examples. [[KSHV]], on the other hand, may be transmitted by deep-kissing but also when saliva is used as a sexual lubricant, which is common among gay men engaging in anal intercourse.
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The diseases on this list are most commonly transmitted solely by sexual activity. Many infectious diseases, including the [[common cold]], [[influenza]], [[pneumonia]], and most others that are transmitted person-to-person can also be transmitted during sexual contact, if one person is infected, due to the close contact involved. However, even though these diseases may be transmitted during sex, they are not considered STIs.
   
Depending on the STD, a person may still be able to spread the infection if no signs of disease are present. For example, a person is much more likely to spread [[herpes]] infection when [[blister]]s are present (STD) than when they are absent (STI). However, a person can spread [[HIV]] infection (STI) at any time, even if he/she has not developed symptoms of [[AIDS]] (STD).
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== Cause ==
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=== Bacterial ===
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* [[Chancroid]] (''[[Haemophilus ducreyi]]'')
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* [[Chlamydia infection|Chlamydia]] (''[[Chlamydia trachomatis]]'')
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* [[Gonorrhea]] (''[[Neisseria gonorrhoeae]]''), colloquially known as "the clap"
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* [[Granuloma inguinale]] or (''[[Klebsiella granulomatis]]'')
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* [[Syphilis]] (''[[Treponema pallidum]]'')
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=== Fungal ===
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*[[Candidiasis]] (yeast infection)
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=== Viral ===
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[[File:Herpes simplex virus pap test.jpg|thumb|[[Micrograph]] showing the viral [[cytopathic effect]] of herpes (ground glass nuclear inclusions, multi-nucleation). [[Pap test]]. [[Pap stain]].]]
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*[[Viral hepatitis]] ([[Hepatitis B virus]])—saliva, venereal fluids.<br />(Note: [[Hepatitis A]] and [[Hepatitis E]] are transmitted via the [[fecal-oral route]]; [[Hepatitis C]] is rarely sexually transmittable,<!--
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--><ref name=Workowski>{{cite journal |author=Workowski K, Berman S |title=Sexually transmitted diseases treatment guidelines, 2006. |journal=MMWR Recomm Rep |volume=55 |issue=RR–11 |pages=1–94 |year=2006 |pmid=16888612 |url=http://www.cdc.gov/mmwr/PDF/rr/rr5511.pdf}}</ref><!--
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--> and the route of transmission of [[Hepatitis D]] (only if infected with B) is uncertain, but may include sexual transmission.<ref>{{cite journal |author=Wu J, Chen C, Sheen I, Lee S, Tzeng H, Choo K |title=Evidence of transmission of hepatitis D virus to spouses from sequence analysis of the viral genome |journal=Hepatology |volume=22 |issue=6 |pages=1656–60 |year=1995 | doi=10.1002/hep.1840220607 |pmid=7489970}}</ref><ref>{{cite journal |author=Farci P |title=Delta hepatitis: an update |journal=J Hepatol |volume=39 |issue=Suppl 1 |pages=S212–9 |year=2003 |pmid=14708706 |doi=10.1016/S0168-8278(03)00331-3}}</ref><ref>{{cite journal |author=Shukla N, Poles M |title=Hepatitis B virus infection: co-infection with hepatitis C virus, hepatitis D virus, and human immunodeficiency virus |journal=Clin Liver Dis |volume=8 |issue=2 |pages=445–60, viii |year=2004 |pmid=15481349 |doi=10.1016/j.cld.2004.02.005}}</ref>)
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*[[Herpes simplex]] ([[Herpes simplex virus]] 1, 2) skin and mucosal, transmissible with or without visible blisters
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*[[HIV]] (''Human Immunodeficiency Virus'')—venereal fluids, semen, breast milk, blood
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*[[HPV]] (''Human Papillomavirus'')—skin and mucosal contact. 'High risk' types of HPV cause almost all [[cervical cancer]]s, as well as some [[anal cancer|anal]], [[penile cancer|penile]], and [[vulvar cancer]]. Some other types of HPV cause [[genital warts]].
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*[[Molluscum contagiosum]] ([[molluscum contagiosum virus]] MCV)—close contact
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=== Parasites ===
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*[[Crab louse]], colloquially known as "crabs" or "pubic lice" (''[[Pthirus pubis]]'')
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*[[Scabies]] (''[[Sarcoptes scabiei]]'')
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=== Protozoal ===
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*[[Trichomoniasis]] (''[[Trichomonas vaginalis]]''), colloquially known as "trich"
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=== Transmission probabilities ===
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The risks and transmission probabilities of sexually transmitted diseases are summarized by act in the table below.<ref>Department of Public Health, City & County of San Francisco (2011). [http://www.sfcityclinic.org/stdbasics/stdchart.asp STD Risks Chart]</ref><ref name="Varghese">{{cite journal |author=Varghese B, Maher JE, Peterman TA, Branson BM,Steketee RW |title=Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use |journal=Sex. Transm. Dis. |year=2002 |pages=38–43 |volume=29 |issue=1 |pmid=11773877 |doi=10.1097/00007435-200201000-00007
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}}</ref><ref name="Jin_et_al">{{cite journal |author=Jin F ''et al.'' |title=Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART|journal=AIDS |volume=24 |issue=6|pages=907–913 |year=2010 |month=March |pmid=20139750 |doi= 10.1097/QAD.0b013e3283372d90 |pmc=2852627
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}}</ref><ref name="Hoare">Hoare A (2010). [http://unsworks.unsw.edu.au/fapi/datastream/unsworks:9027/SOURCE02 models of HIV epidemics in Australia and Southeast Asia]</ref><ref name="Burchell_et_al">{{cite journal |author=Burchell A ''et al.'' |title=Modeling the Sexual Transmissibility of Human Papillomavirus Infection using Stochastic Computer Simulation and Empirical Data from a Cohort Study of Young Women in Montreal, Canada|journal=American Journal of Epidemology |volume=169 |issue=3 |pages=534–543 |year=2006 |month=March|pmid= 16421235|doi= 10.1093/aje/kwj077 |pmc=}}</ref><ref name="ashm">Australasian contact tracing manual. [http://ctm.ashm.org.au/Default.asp?PublicationID=6&ParentSectionID=694&SectionID=670 Specific infections where contact tracing is generally recommended]</ref><ref name="bryan">Bryan C (2011)[http://pathmicro.med.sc.edu/infectious%20disease/sexually%20transmitted%20diseases.htm INFECTIOUS DISEASE CHAPTER EIGHT SEXUALLY TRANSMITTED DISEASES]</ref>
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<ref name="Mahiane_et_al">{{cite journal |author=Mahiane, Séverin-Guy ''et al.'' |title=
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Transmission probabilities of HIV and herpes simplex virus type 2, effect of male circumcision and interaction: a longitudinal study in a township of South Africa |volume=23 |issue=3 |pages=377–383 |year=2009 |month=January|pmid= |doi= 10.1097/QAD.0b013e32831c5497 |pmc=}}</ref>
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<ref name="Holmes_et_al">{{cite journal |author=Holmes, King ''et al.'' |title=
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An estimate of the risk of men acquiring gonorrhea by sexual contact with infected females |volume=91 |issue=2 |pages=170–174 |year=1970 |month= |pmid= |doi= |pmc=}}</ref>
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<ref name="Platt_et_al">{{cite journal |author=Platt, Richard ''et al.'' |title=
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Risk of Acquiring Gonorrhea and Prevalence of Abnormal Adnexal Findings Among Women Recently Exposed to Gonorrhea |journal=JAMA|volume=250 |issue=23 |pages=3205–3209 |year=1983 |month= |pmid= |doi= |pmc=}}</ref>
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<ref name="Edwards_and_Carn">{{cite journal |author=
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Sarah Edwards, Chris Carn |title=
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Oral sex and the transmission of non-viral STIs |journal=
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Sex Transm In|volume=74 |issue=1 |pages=95–100 |year=1998 |month= |pmid= |doi= |pmc= |url=http://sti.bmj.com/content/74/2/95.full.pdf+html}}</ref>
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{| class="wikitable" style = "margin-left:15px; text-align:center"
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! colspan="4" style="background-color:lightgray;font-size:120%;" | Odds of transmission per unprotected sexual act with an infected person
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|-
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|
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! scope="col" | Known risks
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! scope="col" | Possible or unknown risks
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|-
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! scope="row" | [[Fellatio|Performing oral sex on a man]]
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|
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*[[Pharyngeal chlamydia|Throat chlamydia]] <ref name="Edwards_and_Carn" />
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*[[Pharyngeal gonorrhoea|Throat gonorrhea]] <ref name="Edwards_and_Carn" /> (25–30%)
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*[[Herpes simplex|Herpes]] (rare)
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*[[Human papillomavirus|HPV]]
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*[[Syphilis]] <ref name="Edwards_and_Carn" /> (1%)<ref name=Hoare />
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With [[ass to mouth|anal to oral]] practices:
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*[[Hepatitis A]]
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*[[Shigellosis|Shigella]]
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|
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*[[Hepatitis B]] (low risk)<ref name=ashm />
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*[[HIV]] (very low risk; 0.01%)<ref name=Varghese />
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*[[Hepatitis C]] (unknown)
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|-
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! scope="row" | [[Cunnilingus|Performing oral sex on a woman]]
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|
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*[[Herpes simplex|Herpes]]
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|
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*[[Pharyngeal gonorrhoea|Throat gonorrhea]] <ref name="Edwards_and_Carn" />
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*[[Pharyngeal chlamydia|Throat chlamydia]] <ref name="Edwards_and_Carn" />
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*[[Human papillomavirus|HPV]]
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|-
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! scope="row" | [[Fellatio|Receiving oral sex—man]]
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|
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*[[Chlamydia infection|Chlamydia]]
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*[[Gonorrhea]] <ref name="Edwards_and_Carn" />
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*[[Non-gonococcal urethritis]]
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*[[Herpes simplex|Herpes]]
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*[[Syphilis]] <ref name="Edwards_and_Carn" /> (1%)<ref name=Hoare />
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|
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*[[Human papillomavirus|HPV]]
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|-
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! scope="row" | [[Cunnilingus|Receiving oral sex—woman]]
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|
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*[[Herpes simplex|Herpes]]
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|
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*[[Human papillomavirus|HPV]]
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*[[Candidal vulvovaginitis|Vaginal thrush]] <ref name="Edwards_and_Carn" />
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*[[Bacterial Vaginosis]] <ref name="Edwards_and_Carn" />
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*[[Gonorrhea]] <ref name="Edwards_and_Carn" />
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|-
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! scope="row" | [[Sexual intercourse|Vaginal sex—man]]
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|
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*[[Chlamydia infection|Chlamydia]] (30–50%)<ref name="ashm" />
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*[[Crab louse|Crabs]]
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*[[Scabies]]
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*[[Gonorrhea]] (22%)<ref name="Holmes_et_al" />
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*[[Hepatitis B]]
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*[[Herpes simplex|Herpes]] (0.07% for [[Herpes simplex virus 2|HSV-2]])<ref name="Mahiane_et_al" />
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*[[HIV]] (0.05%)<ref name="Varghese" /><ref name="Mahiane_et_al" />
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*[[Human papillomavirus|HPV]] (high: around 40-50%)<ref name="Burchell_et_al" />
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*[[Non-gonococcal urethritis]]
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*[[Syphilis]]
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*[[Trichomoniasis]]
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|
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*[[Hepatitis C]]
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|-
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! scope="row" | [[Sexual intercourse|Vaginal sex—woman]]
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|
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*[[Chlamydia infection|Chlamydia]] (30–50%)<ref name="ashm" />
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*[[Crab louse|Crabs]]
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*[[Scabies]]
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*[[Gonorrhea]] (47%)<ref name="Platt_et_al" />
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*[[Hepatitis B]] (50–70%)
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*[[Herpes simplex|Herpes]]
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*[[HIV]] (0.1%)<ref name="Varghese" />
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*[[Human papillomavirus|HPV]] (high;<ref name="ashm" /> around 40-50%)<ref name="Burchell_et_al" />
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*[[Syphilis]]
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*[[Trichomoniasis]]
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|
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*[[Hepatitis C]]
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|-
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! scope="row" | [[Anal sex|Anal sex—insertive]]
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|
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*[[Chlamydia infection|Chlamydia]]
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*[[Crab louse|Crabs]]
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*[[Scabies]] (40%)
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*[[Gonorrhea]]
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*[[Hepatitis B]]
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*[[Herpes simplex|Herpes]]
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*[[HIV]] (0.62%)<ref name="Jin_et_al"/>
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*[[Human papillomavirus|HPV]]
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*[[Non-gonococcal urethritis]]
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*[[Syphilis]] (14%)<ref name="Hoare" />
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|
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*[[Hepatitis C]]
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|-
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! scope="row" | [[Anal sex|Anal sex—receptive]]
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|
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*[[Chlamydia infection|Chlamydia]]
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*[[Crab louse|Crabs]]
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*[[Scabies]]
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*[[Gonorrhea]]
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*[[Hepatitis B]]
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*[[Herpes simplex|Herpes]]
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*[[HIV]] (1.7%)<ref name="Jin_et_al"/>
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*[[Human papillomavirus|HPV]]
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*[[Syphilis]] (1.4%) <ref name="Hoare" />
  +
|
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*[[Hepatitis C]]
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|-
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! scope="row" | [[Anilingus]]
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|
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*[[Amebiasis]]
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*[[Cryptosporidiosis]] (1%)
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*[[Giardiasis]]
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*[[Hepatitis A]] (1%)
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*[[Shigellosis]] (1%)
  +
|
  +
*[[Human papillomavirus|HPV]] (1%)
  +
|-
  +
|}
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== Pathophysiology ==
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Many STIs are (more easily) transmitted through the [[mucous membrane]]s of the [[penis]], [[vulva]], [[rectum]], [[urinary tract]] and (less often—depending on type of infection) the [[mouth]], [[throat]], [[respiratory tract]] and [[Human eyes|eyes]].<ref> K. Madhav Naidu. ''Community Health Nursing'', Gen Next Publications, 2009, p.248 </ref> The visible membrane covering the [[glans penis|head of the penis]] is a mucous membrane, though it produces no [[mucus]] (similar to the [[lip]]s of the mouth). Mucous membranes differ from [[skin]] in that they allow certain pathogens into the body.<ref>[http://www.microbiologybytes.com/virology/VirPath.html Virus Pathogenesis], Microbiology Bytes</ref> The amount of contact with infective sources which causes infection varies with each pathogen but in all cases a disease may result from even light contact from fluid carriers like venereal fluids onto a mucous membrane.
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This is one reason that the probability of transmitting many infections is far higher from sex than by more casual means of transmission, such as non-sexual contact—touching, hugging, shaking hands—but it is not the only reason. Although [[mucous membrane]]s exist in the mouth as in the genitals, many STIs seem to be easier to transmit through [[oral sex]] than through deep kissing. According to a safe sex chart, many infections that are easily transmitted from the mouth to the genitals or from the genitals to the mouth are much harder to transmit from one mouth to another.<ref>[http://www.tinynibbles.com/safesexchart.html Safe Sex Chart], violet blue: open source sex</ref> With [[HIV]], [[genital]] fluids happen to contain much more of the [[pathogen]] than [[saliva]]. Some infections labeled as STIs can be transmitted by direct [[skin]] contact. [[Herpes simplex]] and [[HPV]] are both examples. [[Kaposi's sarcoma-associated herpesvirus|KSHV]], on the other hand, may be transmitted by deep-kissing but also when saliva is used as a sexual lubricant.
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  +
Depending on the STI, a person may still be able to spread the infection if no signs of disease are present. For example, a person is much more likely to spread [[herpes]] infection when [[blister]]s are present than when they are absent. However, a person can spread [[HIV]] infection at any time, even if he/she has not developed symptoms of [[AIDS]].
   
''All'' [[human sexual behavior|sexual behaviors]] that involve contact with another person or the bodily fluids of another person should be considered to contain some risk of transmission of sexually transmitted diseases. Most attention has focused on controlling [[HIV]], which causes [[AIDS]], but each STD presents a different situation.
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''All'' [[human sexual behavior|sexual behaviors]] that involve contact with the bodily fluids of another person should be considered to contain some risk of transmission of sexually transmitted diseases. Most attention has focused on controlling [[HIV]], which causes [[AIDS]], but each STI presents a different situation.
   
As may be noted from the name, sexually transmitted diseases are ''transmitted'' from one person to another by certain sexual activities rather than being actually ''caused by'' those sexual activities. [[Bacterium|Bacteria]], [[fungi]], [[protozoa]] or [[virus]]es are still the causative agents. It is not possible to catch any sexually transmitted disease from a sexual activity with a person who is not carrying a disease; conversely, a person who has an STD got it from contact (sexual or otherwise) with someone who had it, or his/her bodily fluids. Some STDs such as HIV can be transmitted from mother to child either during pregnancy or breastfeeding.
+
As may be noted from the name, sexually transmitted diseases are ''transmitted'' from one person to another by certain sexual activities rather than being actually ''caused by'' those sexual activities. [[Bacterium|Bacteria]], [[fungi]], [[protozoa]] or [[virus]]es are still the causative agents. It is not possible to catch any sexually transmitted disease from a sexual activity with a person who is not carrying a disease; conversely, a person who has an STI got it from contact (sexual or otherwise) with someone who had it, or his/her bodily fluids. Some STIs such as HIV can be transmitted from mother to child either during pregnancy or breastfeeding.
   
Although the likelihood of transmitting various diseases by various sexual activities varies a great deal, in general, all sexual activities between two (or more) people should be considered as being a two-way route for the transmission of STDs (i.e. "giving" or "receiving" are both risky).
+
Although the likelihood of transmitting various diseases by various sexual activities varies a great deal, in general, all sexual activities between two (or more) people should be considered as being a two-way route for the transmission of STIs, i.e., "giving" or "receiving" are both risky although receiving carries a higher risk.
   
Healthcare professionals suggest [[safer sex]], such as the use of [[condoms]], as the most reliable way of decreasing the risk of contracting sexually transmitted diseases during sexual activity, but safer sex should by no means be considered an absolute safeguard. The transfer of and exposure to bodily fluids, such as [[blood transfusion]]s and other blood products, sharing injection [[Intravenous therapy|needles]], needle-stick injuries (when medical staff are inadvertently jabbed or pricked with needles during medical procedures), sharing [[tattoo]] needles, and childbirth are other avenues of transmission. These different means put certain groups, such as doctors, [[haemophilia]]cs and drug users, particularly at risk.
+
Healthcare professionals suggest [[safer sex]], such as the use of [[condoms]], as the most reliable way of decreasing the risk of contracting sexually transmitted diseases during sexual activity, but safer sex should by no means be considered an absolute safeguard. The transfer of and exposure to bodily fluids, such as [[blood transfusion]]s and other blood products, sharing injection [[Intravenous therapy|needles]], needle-stick injuries (when medical staff are inadvertently jabbed or pricked with needles during medical procedures), sharing [[tattoo]] needles, and childbirth are other avenues of transmission. These different means put certain groups, such as medical workers, and [[haemophilia]]cs and drug users, particularly at risk.
   
 
Recent [[epidemiology|epidemiological]] studies have investigated the networks that are defined by sexual relationships between individuals, and discovered that the properties of [[sexual network]]s are crucial to the spread of sexually transmitted diseases. In particular, [[assortative mixing]] between people with large numbers of sexual partners seems to be an important factor.
 
Recent [[epidemiology|epidemiological]] studies have investigated the networks that are defined by sexual relationships between individuals, and discovered that the properties of [[sexual network]]s are crucial to the spread of sexually transmitted diseases. In particular, [[assortative mixing]] between people with large numbers of sexual partners seems to be an important factor.
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It is possible to be an [[symptom|asymptomatic]] carrier of sexually transmitted diseases. In particular, sexually transmitted diseases in women often cause the serious condition of [[pelvic inflammatory disease]].
 
It is possible to be an [[symptom|asymptomatic]] carrier of sexually transmitted diseases. In particular, sexually transmitted diseases in women often cause the serious condition of [[pelvic inflammatory disease]].
   
==Prevalence==
+
== Prevention ==
STD incidence rates remain high in most of the world, despite diagnostic and therapeutic advances that can rapidly render patients with many STDs noninfectious and cure most. In many cultures, changing sexual mores and oral contraceptive use have eliminated traditional sexual restraints, especially for women, and both physicians and patients have difficulty dealing openly and candidly with sexual issues. Funding to control STDs is almost uniformly inadequate. Additionally, worldwide dissemination of drug-resistant bacteria (eg, penicillin-resistant gonococci) reflects misuse of antibiotics and spread of resistant clones by mobile populations. The effect of travel is most dramatically illustrated by the rapid spread of the AIDS virus (HIV-1) from Africa to Europe and the Americas in the late 1970s.<ref name=AMN>{{cite journal | author = Mary-Ann Shafer, Anna-Barbara Moscicki | title = Sexually Transmitted Infections], 2006. | journal = | volume = | issue = | pages = 1-8 | year = 2006}}</ref>
+
[[File:Sanfranciscocityclinicnight.jpeg|thumb|[[San Francisco City Clinic]] a municipal STI testing center in [[San Francisco, California|San Francisco]].]]
  +
{{Main|Safe sex}}
  +
Prevention is key in addressing incurable STIs, such as HIV and herpes. [[Sexual health clinic]]s promote the use of condoms and provide outreach for at-risk communities.
   
Commonly reported prevalences of STIs among sexually active adolescent girls both with and without lower genital tract symptoms include [[chlamydia]] trachomatis (10 to 25%), Neisseria gonorrhoeae (3 to 18%), syphilis (0 to 3%), Trichomonas vaginalis (8 to 16%), and herpes simplex virus (2 to 12%).{{Fact|date=February 2007}} Among adolescent boys with no symptoms of urethritis, isolation rates include C. trachomatis (9 to 11%) and N. gonorrhoeae (2 to 3%).{{Fact|date=February 2007}}
+
The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which can lead to transfer with an infected partner. Not all sexual activities involve contact: [[cybersex]], [[phonesex]] or [[masturbation]] from a distance are methods of avoiding contact. Proper use of [[condom]]s reduces contact and risk. Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom.<ref>{{cite web |last=Villhauer |first=Tanya |title=Condoms Preventing HPV? |publisher=University of Iowa Student Health Service/Health Iowa |date=2005-05-20 |url=http://www.uistudenthealth.com/question/default.aspx?q=738 |accessdate=2009-07-26 }}</ref>
   
As early as 1996, [[WHO]] estimated that more than 1 million people were being infected daily. About 60% of these infections occur in young people <25 years of age, and of these 30% are <20 years. Between the ages of 14 and 19, STDs occur more frequently in girls than boys by a ratio of nearly 2:1; this equalizes by age 20.
+
Ideally, both partners should get tested for STIs before initiating sexual contact, or before resuming contact if a partner engaged in contact with someone else. Many infections are not detectable immediately after exposure, so enough time must be allowed between possible exposures and testing for the tests to be accurate. Certain STIs, particularly certain persistent viruses like HPV, may be impossible to detect with current medical procedures.
   
The most effective way to prevent sexual transmission of STIs is to avoid sexual activity with an infected partner. Ideally, both new partners should get tested for STIs before initiating sexual activity. If a person chooses to have sexual activity with a partner whose infection status is unknown or who is infected with HIV or another STI, a new condom should be used for each act of intercourse. Condom use is not completely protective against acquisition of STI because of the presence of pathogen outside the protected skin or condom breakage. Condoms do not offer complete protection against [[herpes]] and [[genital warts]], which are commonly found outside of areas covered by condoms.
+
Many diseases that establish permanent infections can so occupy the immune system that other diseases become more easily transmitted. The [[innate immune system]] led by [[defensins]] against HIV can prevent transmission of HIV when viral counts are very low, but if busy with other viruses or overwhelmed, HIV can establish itself. Certain viral STI's also greatly increase the risk of death for HIV infected patients.
   
==Testing==
+
=== Vaccines ===
{{main|STD testing}}
+
Vaccines are available that protect against some viral STIs, such as [[Hepatitis A vaccine|Hepatitis A]], [[Hepatitis B vaccine|Hepatitis B]], and some types of [[HPV vaccine|HPV]]. Vaccination before initiation of sexual contact is advised to assure maximal protection.
   
==Treatment==
+
=== Condoms ===
[[Image:SheMayLookCleanBut.jpg|thumb|right|280px|American poster propaganda targeted at [[World War II]] soldiers and sailors appealed to their patriotism in urging them to protect themselves. The text at the bottom of the poster reads, "You can't beat the Axis if you get VD." Images of women were used to catch the eye on many VD posters.]]
+
[[Condom]]s and [[female condom]]s only provide protection when used properly as a barrier, and only to and from the area that it covers. ''Uncovered areas are still susceptible to many STDs''. In the case of HIV, sexual transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin, thus ''properly shielding the insertive penis with a properly worn condom from the vagina or anus effectively stops HIV transmission''. An infected fluid to broken skin borne direct transmission of HIV would not be considered "sexually transmitted", but can still theoretically occur during sexual contact, this can be avoided simply by not engaging in sexual contact when having open bleeding wounds. Other STIs, even viral infections, can be prevented with the use of latex, polyurethane or polyisoprene condoms as a barrier. Some microorganisms and viruses are small enough to pass through the pores in natural skin condoms, but are still too large to pass through latex or synthetic condoms.
   
[[Image:Stdspain.jpg|thumb|right|280px|[[Spanish Civil War]] poster, produced by the Republican government, saying "Avoid venereal diseases... As dangerous as enemy bullets"]]
+
Proper usage entails:
  +
*Not putting the condom on too tight at the end, and leaving 1.5&nbsp;cm (3/4&nbsp;inch) room at the tip for [[ejaculation]]. Putting the condom on snug can and often does lead to failure.
  +
*Wearing a condom too loose can defeat the barrier.
  +
*Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not.
  +
*Avoiding condoms made of substances other than latex, polyisoprene or polyurethane that do not protect against HIV.
  +
*Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms, as oil can eat holes into them.
  +
*Using flavored condoms for oral sex only, as the sugar in the flavoring can lead to yeast infections if used to penetrate.
   
Prior to the invention of modern medicines, sexually transmitted diseases were generally incurable, and treatment was limited to treating the symptoms of the disease. The first voluntary hospital for venereal diseases was founded in [[1746]] at [[London Lock Hospital]].<ref name="AIM-Albert">Archives in London and the M25 area ([http://www.aim25.ac.uk/index.stm AIM25]) [http://www.aim25.ac.uk/cgi-bin/search2?coll_id=859&inst_id=9 London Lock Hospital records]</ref>
+
Not following the first five guidelines above perpetuates the common misconception that condoms are not tested or designed properly.{{citation needed|date=August 2011}}
   
The first effective treatment for a sexually transmitted disease was [[Arsphenamine|salvarsan]], a treatment for syphilis. With the discovery of [[antibiotic]]s, a large number of sexually transmitted diseases became easily curable, and this, combined with effective public health campaigns against STDs, led to a public perception during the 1960s and 1970s that they have ceased to be a serious medical threat.
+
In order to best protect oneself and the partner from STIs, the old condom and its contents should be assumed to be infectious. Therefore the old condom must be properly disposed of. A new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the effectiveness as a barrier.
   
During this period, the importance of [[contact tracing]] in treating STIs was recognized. By tracing the sexual partners of infected individuals, testing them for infection, treating the infected and tracing their contacts in turn, STI clinics could be very effective at suppressing infections in the general population.
+
=== Nonoxynol-9 ===
  +
Researchers had hoped that [[nonoxynol-9]], a vaginal microbicide would help decrease STI risk. Trials, however, have found it ineffective<ref>{{cite journal |author=Wilkinson D, Ramjee G, Tholandi M, Rutherford G |title=Nonoxynol-9 for preventing vaginal acquisition of sexually transmitted infections by women from men |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD003939 |year=2002 |pmid=12519623 |doi=10.1002/14651858.CD003939 |url= |editor1-last=Wilkinson |editor1-first=David}}</ref> and it may put women at a higher risk of HIV infection.<ref>Williams, M. ''Healthy Choices for Fertility Control''. CreateSpace, Scotts Valley, CA, 2009. ISBN 1-4486-6472-1</ref>
   
In the 1980s, first [[genital herpes]] and then [[AIDS]] emerged into the public consciousness as sexually transmitted diseases that could not be cured by modern medicine. AIDS in particular has a long asymptomatic period &ndash; during which time [[HIV]] (the human immunodeficiency virus, which causes AIDS) can replicate and the disease can be transmitted to others &ndash; followed by a symptomatic period, which leads rapidly to death unless treated. Recognition that AIDS threatened a global [[pandemic]] led to public information campaigns and the development of treatments that allow AIDS to be managed by suppressing the replication of HIV for as long as possible. Contact tracing continues to be an important measure, even when diseases are incurable, as it helps to contain infection.
+
== Diagnosis ==
  +
STI [[medical test|tests]] may test for a single infection, or consist of a number of individual tests for any of a wide range of STIs, including tests for [[syphilis]], [[trichomonas]], [[gonorrhea]], [[Chlamydia infection|chlamydia]], [[herpes]], [[hepatitis]] and [[HIV test]]s. No procedure tests for all infectious agents.
   
[http://std-gov.org/stds/treatment.htm Current STD Treatment (Cure)]
+
STI tests may be used for a number of reasons:
  +
* as a [[diagnostic test]] to determine the cause of symptoms or illness
  +
* as a [[screening test]] to detect asymptomatic or presymptomatic [[infection]]s
  +
* as a check that prospective sexual partners are free of disease before they engage in sex without [[safer sex]] precautions (for example, when starting a long term mutually monogamous sexual relationship, in [[Bareback (sex)#Fluid bonding|fluid bonding]], or for procreation).
  +
* as a check prior to or during pregnancy, to prevent harm to the baby
  +
* as a check after birth, to check that the baby has not caught an STI from the mother
  +
* to prevent the use of infected [[blood donation|donated blood]] or [[organ donation|organ]]s
  +
* as part of the process of [[contact tracing]] from a known infected individual
  +
* as part of mass [[epidemiological]] surveillance
   
==Types and their pathogenic causes==
+
Not all STIs are [[symptom]]atic, and symptoms may not appear immediately after infection. In some instances a disease can be carried with no symptoms, which leaves a greater risk of passing the disease on to others. Depending on the disease, some untreated STIs can lead to [[infertility]], [[chronic pain]] or even death.<ref name="STI video">{{cite web|url=http://sexperienceuk.channel4.com/education/about/male-sti-check-up|title=Male STI check-up video|accessdate=2009-01-22|publisher=Channel 4|year=2008}}</ref> Early identification and treatment results in less chance to spread disease, and for some conditions may improve the outcomes of treatment.
   
Most of the diseases on this list are most commonly transmitted sexually. Some are commonly transmitted in other ways as well; for example, [[HIV/AIDS]] is also commonly transmitted through the sharing of infected needles by drug users, while [[SARS]], which can be spread through casual contact such as coughing and sneezing, is very often not associated with sexual activity.
+
There is often a [[window period]] after initial infection during which an STI test will be negative. During this period the infection may be transmissible. The duration of this period varies depending on the infection and the test.
   
=== Bacterial ===
+
Diagnosis may also be delayed by reluctance of the infected person to seek a medical professional. One report indicated that afflicted people turn to the Internet rather than to a medical professional for information on STIs to a higher degree than for other sexual problems.<ref name=Quilliam2011>{{cite journal | author = Quilliam Susan | year = 2011 | title = 'The Cringe Report' | url = http://www.medscape.com/viewarticle/743689_3 | journal = J Fam Plann Reprod Health Care. | volume = 37 | issue = 2| pages = 110–112 }}</ref>
*[[Chancroid]] (''[[Haemophilus ducreyi]]'')
 
*[[Chlamydia|Chlamydia infection]] (''[[Chlamydia trachomatis]]'')
 
*[[Donovanosis]] (''[[Granuloma inguinale]]'' or ''[[Calymmatobacterium granulomatis]]'')
 
*[[Gonorrhea]] (''[[Neisseria gonorrhoeae]]'')
 
*[[Lymphogranuloma venereum]] (LGV) (''[[Chlamydia trachomatis]]'' serotypes L<sub>1</sub>, L<sub>2</sub>, L<sub>3</sub>. See [[Chlamydia]])
 
*[[Non-gonococcal urethritis]] (NGU) (''[[Ureaplasma urealyticum]]'' or ''[[Mycoplasma hominis]]'')
 
*[[Syphilis]] (''[[Treponema pallidum]]'')
 
=== Fungal ===
 
*[[Crotchrot]]
 
*[[Yeast Infection]]
 
   
=== Viral ===
+
== Management ==
*[[Hepatitis B]]. <br />(Note: [[Hepatitis A]] and [[Hepatitis E]] are transmitted via the [[fæcal-oral route]], not sexually; [[Hepatitis C]] is rarely sexually transmittable,<!--
+
High-risk exposure such as that which occurs in rape cases may be treated prophylactically using antibiotic combinations such as [[azithromycin]], [[cefixime]], and [[metronidazole]].
--><ref name=Workowski>{{cite journal | author = Workowski K, Berman S | title = [http://www.cdc.gov/mmwr/PDF/rr/rr5511.pdf Sexually transmitted diseases treatment guidelines], 2006. | journal = MMWR Recomm Rep | volume = 55 | issue = RR-11 | pages = 1-94 | year = 2006 | id = PMID 16888612}}</ref><!--
 
-->and the route of transmission of [[Hepatitis D]] is uncertain, but may include sexual transmission.<ref>{{cite journal | author = Wu J, Chen C, Sheen I, Lee S, Tzeng H, Choo K | title = Evidence of transmission of hepatitis D virus to spouses from sequence analysis of the viral genome. | journal = Hepatology | volume = 22 | issue = 6 | pages = 1656-60 | year = 1995 | id = PMID 7489970}}</ref> <ref>{{cite journal | author = Farci P | title = Delta hepatitis: an update. | journal = J Hepatol | volume = 39 Suppl 1 | issue = | pages = S212-9 | year = | id = PMID 14708706}}</ref> <ref>{{cite journal | author = Shukla N, Poles M | title = Hepatitis B virus infection: co-infection with hepatitis C virus, hepatitis D virus, and human immunodeficiency virus. | journal = Clin Liver Dis | volume = 8 | issue = 2 | pages = 445-60, viii | year = 2004 | id = PMID 15481349}}</ref>)
 
   
*[[Herpes simplex]]
+
An option for treating partners of patients ([[index case]]s) diagnosed with [[Chlamydia infection|chlamydia]] or [[gonorrhea]] is [[patient-delivered partner therapy]], which is the clinical practice of treating the sex partners of index cases by providing prescriptions or medications to the patient to take to his/her partner without the health care provider first examining the partner.<ref name=EPTFinalReport2006>[http://www.cdc.gov/std/treatment/EPTFinalReport2006.pdf Expedited Partner Therapy in the Management of Sexually Transmitted Diseases (2 February 2006)] U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE. Centers for Disease Control and Prevention National Center for HIV, STD, and TB Prevention</ref>
**[[Herpes simplex virus]] (HSV)
 
*[[Human Immunodeficiency Virus]] ([[HIV]]/[[AIDS]])
 
*[[Human papillomavirus]] (HPV)
 
**Certain strains of HPV cause [[genital warts]]
 
**Certain strains of HPV cause cervical dysplasias which can lead to [[cervical cancer]]/[[anal cancer]]
 
*[[Molluscum contagiosum|Molluscum]] (MC)
 
*[[Mononucleosis]]
 
*[[Kaposi's sarcoma-associated herpesvirus]] ([[KSHV]]/HHV8)
 
**The cause of [[Kaposi's sarcoma]]
 
   
=== Parasites ===
+
== Epidemiology ==
*[[Pubic lice]], colloquially known as "crabs" (''[[Phthirius pubis]]'')
+
[[File:STDs excluding HIV world map - DALY - WHO2004.svg|thumb|Age-standardized, [[disability-adjusted life years]] for STDs (''excluding HIV'') per 100,000 inhabitants in 2004.<ref>{{cite web |url=http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html |title=WHO Disease and injury country estimates |year=2004 |work=World Health Organization |accessdate=Nov. 11, 2009}}</ref>
*[[Scabies]] (''[[Sarcoptes scabiei]]'')
+
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{{Multicol-end}}]]
  +
STD incidence rates remain high in most of the world, despite diagnostic and therapeutic advances that can rapidly render patients with many STDs noninfectious and cure most. In many cultures, changing sexual morals and oral contraceptive use have eliminated traditional sexual restraints, especially for women, and both physicians and patients have difficulty dealing openly and candidly with sexual issues. Additionally, development and spread of [[drug resistance|drug-resistant bacteria]] (e.g., penicillin-resistant gonococci) makes some STDs harder to cure. The effect of travel is most dramatically illustrated by the rapid spread of the [[AIDS]] virus ([[HIV-1]]) from Africa to Europe and the Americas in the late 1970s.<ref name=AMN>{{cite journal | author = Mary-Ann Shafer, Anna-Barbara Moscicki | title = Sexually Transmitted Infections, 2006 | url = http://www.health.am/sex/more/sexually_transmitted_infections/ | journal = | volume = | issue = | pages = 1–8 | year = 2006}}</ref>
   
=== Protozoal ===
+
In 1996, the [[World Health Organization]] estimated that more than 1 million people were being infected daily. About 60% of these infections occur in young people <25 years of age, and of these 30% are <20 years. Between the ages of 14 and 19, STIs occur more frequently in girls than boys by a ratio of nearly 2:1; this equalizes by age 20. An estimated 340 million new cases of syphilis, gonorrhea, chlamydia and trichomoniasis occurred throughout the world in 1999.<ref>{{cite web|url=http://www.avert.org/stdstatisticsworldwide.htm |title=STD Statistics Worldwide |publisher=Avert.org |date= |accessdate=2011-01-09}}</ref>
*[[Trichomoniasis]] (''[[Trichomonas vaginalis]]'')
 
   
===Sexually transmitted enteric Infections ===
+
Commonly reported prevalences of STIs among sexually active adolescent girls both with and without lower genital tract symptoms include [[Chlamydia infection|chlamydia]] (10–25%), [[gonorrhea]] (3–18%), [[syphilis]] (0–3%), [[Trichomonas vaginalis]] (8–16%), and [[herpes]] simplex virus (2–12%).{{Citation needed|date=February 2007}} Among adolescent boys with no symptoms of urethritis, isolation rates include chlamydia (9–11%) and gonorrhea (2–3%).{{Citation needed|date=February 2007}} At least one in four U.S. teenage girls has a sexually transmitted disease,<ref>"[http://www.sciencedaily.com/releases/2008/03/080312084645.htm One In Four Teenage Girls In U.S. Has Sexually Transmitted Disease, CDC Study Shows]". ''[[Science Daily]]''. March 12, 2008.</ref> a [[Centers for Disease Control and Prevention|CDC]] study found.<ref>"[http://www.nytimes.com/2008/03/12/science/12std.html?_r=1 Sex Infections Found in Quarter of Teenage Girls]". [[The New York Times]]. March 12, 2008.</ref> Among girls who admitted ever having sex, the rate was 40%.<ref>"[http://newsok.com/article/3214748/1205233095 CDC study says at least 1 in 4 teen girls has a sexually transmitted disease; HPV most common]". [[The Oklahoman]]. March 11, 2008.</ref>
Various bacterial ([[Shigella]], Campylobacter, or [[Salmonella]]), viral (hepatitis A), or parasitic (Giardia or ameba) pathogens are transmitted by sexual practices that promote anal-oral contamination. Although the bacterial pathogens may coexist with or cause proctitis, they usually produce symptoms (diarrhoea, fever, bloating, nausea, and abdominal pain) suggesting disease more proximal in the GI tract.
+
  +
[[AIDS]] is the single largest cause of mortality in present-day [[Sub-Saharan Africa]].<ref>{{cite web
  +
| author =[[Joint United Nations Programme on HIV/AIDS|UNAIDS]], [[World Health Organization|WHO]]
  +
| month = December | year = 2007
  +
| title = 2007 AIDS epidemic update
  +
| url= http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf
  +
| accessdate = 2008-03-12
  +
| format= PDF
  +
}}</ref> The majority of [[HIV]] infections are acquired through unprotected sexual relations between partners, one of whom has HIV. Approximately 1.1 million persons are living with HIV/AIDS in the [[United States]],<ref>"[http://blogs.abcnews.com/politicalpunch/2009/10/obama-ends-travel-ban-on-foreigners-with-hivaids.html Obama Ends U.S. Travel Ban On Visitors, Immigrants With HIV-AIDS]". [[ABC News]]. October 30, 2009.</ref> and AIDS remains the leading cause of death among [[African American]] women between ages 25 and 34.<ref>"[http://www.cnn.com/2008/HEALTH/conditions/07/29/black.aids.report/index.html Report: Black U.S. AIDS rates rival some African nations]". [[CNN.com]]. July 29, 2008.</ref> [[Hepatitis B]] is also classed as a sexually transmitted disease because it can be passed on sexually.<ref>"[http://www.health.state.mn.us/divs/idepc/diseases/hepb/hepbstd.html Hepatitis: Type B (caused by hepatitis B virus)]". Minnesota Department of Health.</ref> The disease is found globally, with the highest rates in Asia and Africa and lower rates in the Americas and Europe.<ref>"[http://www.fda.gov/ohrms/dockets/ac/02/slides/3885S2_02_Hoofnagle/tsld002.htm Hepatitis B]". U.S. Food and Drug Administration.</ref> Worldwide, an estimated two billion people have been infected with the hepatitis B virus.<ref>{{cite web|title=FAQ about Hepatitis B|url=http://liver.stanford.edu/Education/faq.html|publisher=Stanford School of Medicine|date=2008-07-10|accessdate=2009-09-19}}</ref>
  +
  +
== History ==
  +
[[File:Syphilis false shame and fear may destroy your future.png|thumb|1930s [[Works Progress Administration]] poster]]
  +
  +
The first well-recorded European outbreak of what is now known as [[syphilis]] occurred in 1494 when it broke out among French troops besieging [[Naples]].<ref name=Scars_of_Venus>{{cite book | author=Oriel, J.D. | title=The Scars of Venus: A History of Venereology | location=London | publisher= Springer-Verlag | year=1994 | isbn=3-540-19844-X }}</ref> From this centre, the disease swept across [[Europe]], killing more than five million people.<ref>{{cite news
  +
|url = http://www.cbc.ca/health/story/2008/01/14/syphilis-columbus.html
  +
|title = Study traces origins of syphilis in Europe to New World
  +
|accessdate = 2008-01-15
  +
|last = CBC News Staff
  +
|authorlink =
  +
|year = 2008
  +
|month = January}}</ref> As [[Jared Diamond]] describes it, "[W]hen syphilis was first definitely recorded in Europe in 1495, its [[pustule]]s often covered the body from the head to the knees, caused flesh to fall from people's faces, and led to death within a few months," rendering it far more [[case fatality rate|fatal]] than it is today. Diamond concludes,"[B]y 1546, the disease had evolved into the disease with the symptoms so well known to us today."<ref name=Diamond1>{{cite book | author=Diamond, Jared | year=1997 | title=Guns, Germs and Steel | location=New York | publisher=W.W. Norton | page=210 | isbn=84-8306-667-X}}</ref>
  +
  +
Prior to the invention of modern medicines, sexually transmitted diseases were generally incurable, and treatment was limited to treating the symptoms of the disease. The first voluntary hospital for venereal diseases was founded in 1746 at [[London Lock Hospital]].<ref name="AIM-Albert">Archives in London and the M25 area ([http://www.aim25.ac.uk/index.stm AIM25]) [http://www.aim25.ac.uk/cgi-bin/search2?coll_id=859&inst_id=9 London Lock Hospital records]</ref> Treatment was not always voluntary: in the second half of the 19th century, the [[Contagious Diseases Act]] was used to arrest suspected prostitutes.
  +
  +
The first effective treatment for a sexually transmitted disease was [[Arsphenamine|salvarsan]], a treatment for syphilis. With the discovery of [[antibiotic]]s, a large number of sexually transmitted diseases became easily curable, and this, combined with effective public health campaigns against STDs, led to a public perception during the 1960s and 1970s that they have ceased to be a serious medical threat.
  +
  +
During this period, the importance of [[contact tracing]] in treating STIs was recognized. By tracing the sexual partners of infected individuals, testing them for infection, treating the infected and tracing their contacts in turn, STI clinics could be very effective at suppressing infections in the general population.
  +
  +
In the 1980s, first [[genital herpes]] and then [[AIDS]] emerged into the public consciousness as sexually transmitted diseases that could not be cured by modern medicine. AIDS in particular has a long asymptomatic period—during which time [[HIV]] (the human immunodeficiency virus, which causes AIDS) can replicate and the disease can be transmitted to others—followed by a symptomatic period, which leads rapidly to death unless treated. HIV/AIDS entered the United States in about 1969 likely through a single infected immigrant from Haiti.<ref>{{cite journal
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|author=Gilbert MT, Rambaut A, Wlasiuk G, Spira TJ, Pitchenik AE, Worobey M
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|title=The emergence of HIV/AIDS in the Americas and beyond
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|journal=Proc. Natl. Acad. Sci. U.S.A.
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|volume=104 |issue=47 |pages=18566–70
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|year=2007 |month=November
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|pmid=17978186 |pmc=2141817 |doi=10.1073/pnas.0705329104
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|url=http://www.pnas.org/cgi/pmidlookup?view=long&pmid=17978186
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|accessdate=March 20, 2010
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}}</ref> Recognition that AIDS threatened a global [[pandemic]] led to public information campaigns and the development of treatments that allow AIDS to be managed by suppressing the replication of HIV for as long as possible. Contact tracing continues to be an important measure, even when diseases are incurable, as it helps to contain infection.
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{{-}}
   
 
==See also==
 
==See also==
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==References==
 
==References==
 
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<references/>
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==Further reading==
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{{refbegin}}
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* {{Cite book |last = Aral |first =Sevgi O |coauthor= |year =2008 |title = Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases|url=http://books.google.ca/books?id=F1RIOW0x5gAC&lpg=PR1&dq=Sexually%20transmitted%20disease&pg=PR1#v=onepage&q&f=true |publisher= : Springer Singapore Pte. Limited|isbn=978-0-387-85768-8 |accessdate = |postscript = <!-- Bot inserted parameter. Either remove it; or change its value to "." for the cite to end in a ".", as necessary. -->{{inconsistent citations}} }}
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* {{Cite book |last = Faro |first = Sebastian|coauthor= |year = 2003|title =Sexually transmitted diseases in women
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|url =http://books.google.ca/books?id=l0xZNxirdx0C&lpg=PP1&dq=Sexually%20transmitted%20disease&pg=PP1#v=onepage&q&f=true|publisher=Lippincott Williams & Wilkins |isbn= 0-397-51303-8|accessdate = |postscript = <!-- Bot inserted parameter. Either remove it; or change its value to "." for the cite to end in a ".", as necessary. -->{{inconsistent citations}} }}
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* {{Cite book |last = Ford |first =Carol A |coauthor= Elizabeth Shimer Bowers |year =2009 |title = Living with Sexually Transmitted Diseases|url = http://books.google.ca/books?id=kSVqn-w8kSUC&lpg=PA17&dq=Sexually%20transmitted%20disease&pg=PP1#v=onepage&q&f=true|publisher=Facts On File |isbn=978-0-8160-7672-7 |accessdate = |postscript = <!-- Bot inserted parameter. Either remove it; or change its value to "." for the cite to end in a ".", as necessary. -->{{inconsistent citations}} }}
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* {{Cite book |last =Sehgal |first =Virendra N |edition=4th |coauthor= |year =2003 |title = Sexually Transmitted Diseases
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|url = http://books.google.ca/books?id=VORwYIzp__wC&lpg=PP1&dq=Sexually%20transmitted%20disease&pg=PP1#v=onepage&q&f=true|publisher=Jaypee Bros. Medical Publishers |isbn= 81-8061-105-1 |accessdate = |postscript =<!-- Bot inserted parameter. Either remove it; or change its value to "." for the cite to end in a ".", as necessary. -->{{inconsistent citations}} }}
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* {{Cite book |last =Shoquist |first = Jennifer |coauthor= Diane Stafford|year = 2003|title =The encyclopedia of sexually transmitted diseases|url =http://books.google.ca/books?id=LFMvJNyVoUgC&lpg=PA177&dq=Sexually%20transmitted%20disease&pg=PP1#v=onepage&q&f=true |publisher= Facts On File|isbn=0-8160-4881-9 |accessdate = |postscript =<!-- Bot inserted parameter. Either remove it; or change its value to "." for the cite to end in a ".", as necessary. -->{{inconsistent citations}} }}
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{{refend}}
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==External links==
 
==External links==

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Sexually transmitted infection
Classification and external resources
SheMayLookCleanBut.jpg
U.S. propaganda poster targeted at World War II soldiers and sailors appealed to their patriotism in urging them to protect themselves. The text at the bottom of the poster reads, "You can't beat the Axis if you get VD." Images of women were used to catch the eye on many VD posters.
ICD-10 A64
ICD-9 099.9
DiseasesDB 27130
MeSH D012749

Sexually transmitted diseases (STD), also referred to as sexually transmitted infections (STI) and venereal diseases (VD), are illnesses that have a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex. While in the past, these illnesses have mostly been referred to as STDs or VD, in recent years the term sexually transmitted infections (STIs) has been preferred, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without having a disease. Some STIs can also be transmitted via the use of IV drug needles after its use by an infected person, as well as through childbirth or breastfeeding. Sexually transmitted infections have been well known for hundreds of years, and venereology is the branch of medicine that studies these diseases.

Classification

File:"VD CAN BE CURED BUT THERE'S NO MEDICINE FOR REGRET" - NARA - 515957.jpg

Until the 1990s, STIs were commonly known as venereal diseases, the word venereal being derived from the Latin word venereus, and meaning relating to sexual intercourse or desire, ultimately derived from Venus, the Roman goddess of love.[1] Social disease was a phrase used as a euphemism.

Sexually transmitted infection is a broader term than sexually transmitted disease.[2] An infection is a colonization by a parasitic species, which may not cause any adverse effects. In a disease, the infection leads to impaired or abnormal function. In either case, the condition may not exhibit signs or symptoms. Increased understanding of infections like HPV, which infects most sexually active individuals but cause disease in only a few has led to increased use of the term STI. Public health officials originally introduced the term sexually transmitted infection, which clinicians are increasingly using alongside the term sexually transmitted disease in order to distinguish it from the former.[3]

STD may refer only to infections that are causing diseases, or it may be used more loosely as a synonym for STI. Most of the time, people do not know that they are infected with an STI until they are tested or start showing symptoms of disease.

Moreover, the term sexually transmissible disease is sometimes used since it is less restrictive in consideration of other factors or means of transmission. For instance, meningitis is transmissible by means of sexual contact but is not labeled as an STI because sexual contact is not the primary vector for the pathogens that cause meningitis. This discrepancy is addressed by the probability of infection by means other than sexual contact. In general, an STI is an infection that has a negligible probability of transmission by means other than sexual contact, but has a realistic means of transmission by sexual contact (more sophisticated means—blood transfusion, sharing of hypodermic needles—are not taken into account). Thus, one may presume that, if a person is infected with an STI, e.g., chlamydia, gonorrhea, genital herpes, it was transmitted to him/her by means of sexual contact.

The diseases on this list are most commonly transmitted solely by sexual activity. Many infectious diseases, including the common cold, influenza, pneumonia, and most others that are transmitted person-to-person can also be transmitted during sexual contact, if one person is infected, due to the close contact involved. However, even though these diseases may be transmitted during sex, they are not considered STIs.

Cause

Bacterial

Fungal

Viral

File:Herpes simplex virus pap test.jpg

Parasites

Protozoal

Transmission probabilities

The risks and transmission probabilities of sexually transmitted diseases are summarized by act in the table below.[8][9][10][11][12][13][14] [15] [16] [17] [18]

Odds of transmission per unprotected sexual act with an infected person
Known risks Possible or unknown risks
Performing oral sex on a man

With anal to oral practices:

Performing oral sex on a woman
Receiving oral sex—man
Receiving oral sex—woman
Vaginal sex—man
Vaginal sex—woman
Anal sex—insertive
Anal sex—receptive
Anilingus

Pathophysiology

Many STIs are (more easily) transmitted through the mucous membranes of the penis, vulva, rectum, urinary tract and (less often—depending on type of infection) the mouth, throat, respiratory tract and eyes.[19] The visible membrane covering the head of the penis is a mucous membrane, though it produces no mucus (similar to the lips of the mouth). Mucous membranes differ from skin in that they allow certain pathogens into the body.[20] The amount of contact with infective sources which causes infection varies with each pathogen but in all cases a disease may result from even light contact from fluid carriers like venereal fluids onto a mucous membrane.

This is one reason that the probability of transmitting many infections is far higher from sex than by more casual means of transmission, such as non-sexual contact—touching, hugging, shaking hands—but it is not the only reason. Although mucous membranes exist in the mouth as in the genitals, many STIs seem to be easier to transmit through oral sex than through deep kissing. According to a safe sex chart, many infections that are easily transmitted from the mouth to the genitals or from the genitals to the mouth are much harder to transmit from one mouth to another.[21] With HIV, genital fluids happen to contain much more of the pathogen than saliva. Some infections labeled as STIs can be transmitted by direct skin contact. Herpes simplex and HPV are both examples. KSHV, on the other hand, may be transmitted by deep-kissing but also when saliva is used as a sexual lubricant.

Depending on the STI, a person may still be able to spread the infection if no signs of disease are present. For example, a person is much more likely to spread herpes infection when blisters are present than when they are absent. However, a person can spread HIV infection at any time, even if he/she has not developed symptoms of AIDS.

All sexual behaviors that involve contact with the bodily fluids of another person should be considered to contain some risk of transmission of sexually transmitted diseases. Most attention has focused on controlling HIV, which causes AIDS, but each STI presents a different situation.

As may be noted from the name, sexually transmitted diseases are transmitted from one person to another by certain sexual activities rather than being actually caused by those sexual activities. Bacteria, fungi, protozoa or viruses are still the causative agents. It is not possible to catch any sexually transmitted disease from a sexual activity with a person who is not carrying a disease; conversely, a person who has an STI got it from contact (sexual or otherwise) with someone who had it, or his/her bodily fluids. Some STIs such as HIV can be transmitted from mother to child either during pregnancy or breastfeeding.

Although the likelihood of transmitting various diseases by various sexual activities varies a great deal, in general, all sexual activities between two (or more) people should be considered as being a two-way route for the transmission of STIs, i.e., "giving" or "receiving" are both risky although receiving carries a higher risk.

Healthcare professionals suggest safer sex, such as the use of condoms, as the most reliable way of decreasing the risk of contracting sexually transmitted diseases during sexual activity, but safer sex should by no means be considered an absolute safeguard. The transfer of and exposure to bodily fluids, such as blood transfusions and other blood products, sharing injection needles, needle-stick injuries (when medical staff are inadvertently jabbed or pricked with needles during medical procedures), sharing tattoo needles, and childbirth are other avenues of transmission. These different means put certain groups, such as medical workers, and haemophiliacs and drug users, particularly at risk.

Recent epidemiological studies have investigated the networks that are defined by sexual relationships between individuals, and discovered that the properties of sexual networks are crucial to the spread of sexually transmitted diseases. In particular, assortative mixing between people with large numbers of sexual partners seems to be an important factor.

It is possible to be an asymptomatic carrier of sexually transmitted diseases. In particular, sexually transmitted diseases in women often cause the serious condition of pelvic inflammatory disease.

Prevention

File:Sanfranciscocityclinicnight.jpeg
Main article: Safe sex

Prevention is key in addressing incurable STIs, such as HIV and herpes. Sexual health clinics promote the use of condoms and provide outreach for at-risk communities.

The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which can lead to transfer with an infected partner. Not all sexual activities involve contact: cybersex, phonesex or masturbation from a distance are methods of avoiding contact. Proper use of condoms reduces contact and risk. Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom.[22]

Ideally, both partners should get tested for STIs before initiating sexual contact, or before resuming contact if a partner engaged in contact with someone else. Many infections are not detectable immediately after exposure, so enough time must be allowed between possible exposures and testing for the tests to be accurate. Certain STIs, particularly certain persistent viruses like HPV, may be impossible to detect with current medical procedures.

Many diseases that establish permanent infections can so occupy the immune system that other diseases become more easily transmitted. The innate immune system led by defensins against HIV can prevent transmission of HIV when viral counts are very low, but if busy with other viruses or overwhelmed, HIV can establish itself. Certain viral STI's also greatly increase the risk of death for HIV infected patients.

Vaccines

Vaccines are available that protect against some viral STIs, such as Hepatitis A, Hepatitis B, and some types of HPV. Vaccination before initiation of sexual contact is advised to assure maximal protection.

Condoms

Condoms and female condoms only provide protection when used properly as a barrier, and only to and from the area that it covers. Uncovered areas are still susceptible to many STDs. In the case of HIV, sexual transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin, thus properly shielding the insertive penis with a properly worn condom from the vagina or anus effectively stops HIV transmission. An infected fluid to broken skin borne direct transmission of HIV would not be considered "sexually transmitted", but can still theoretically occur during sexual contact, this can be avoided simply by not engaging in sexual contact when having open bleeding wounds. Other STIs, even viral infections, can be prevented with the use of latex, polyurethane or polyisoprene condoms as a barrier. Some microorganisms and viruses are small enough to pass through the pores in natural skin condoms, but are still too large to pass through latex or synthetic condoms.

Proper usage entails:

  • Not putting the condom on too tight at the end, and leaving 1.5 cm (3/4 inch) room at the tip for ejaculation. Putting the condom on snug can and often does lead to failure.
  • Wearing a condom too loose can defeat the barrier.
  • Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not.
  • Avoiding condoms made of substances other than latex, polyisoprene or polyurethane that do not protect against HIV.
  • Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms, as oil can eat holes into them.
  • Using flavored condoms for oral sex only, as the sugar in the flavoring can lead to yeast infections if used to penetrate.

Not following the first five guidelines above perpetuates the common misconception that condoms are not tested or designed properly.[citation needed]

In order to best protect oneself and the partner from STIs, the old condom and its contents should be assumed to be infectious. Therefore the old condom must be properly disposed of. A new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the effectiveness as a barrier.

Nonoxynol-9

Researchers had hoped that nonoxynol-9, a vaginal microbicide would help decrease STI risk. Trials, however, have found it ineffective[23] and it may put women at a higher risk of HIV infection.[24]

Diagnosis

STI tests may test for a single infection, or consist of a number of individual tests for any of a wide range of STIs, including tests for syphilis, trichomonas, gonorrhea, chlamydia, herpes, hepatitis and HIV tests. No procedure tests for all infectious agents.

STI tests may be used for a number of reasons:

  • as a diagnostic test to determine the cause of symptoms or illness
  • as a screening test to detect asymptomatic or presymptomatic infections
  • as a check that prospective sexual partners are free of disease before they engage in sex without safer sex precautions (for example, when starting a long term mutually monogamous sexual relationship, in fluid bonding, or for procreation).
  • as a check prior to or during pregnancy, to prevent harm to the baby
  • as a check after birth, to check that the baby has not caught an STI from the mother
  • to prevent the use of infected donated blood or organs
  • as part of the process of contact tracing from a known infected individual
  • as part of mass epidemiological surveillance

Not all STIs are symptomatic, and symptoms may not appear immediately after infection. In some instances a disease can be carried with no symptoms, which leaves a greater risk of passing the disease on to others. Depending on the disease, some untreated STIs can lead to infertility, chronic pain or even death.[25] Early identification and treatment results in less chance to spread disease, and for some conditions may improve the outcomes of treatment.

There is often a window period after initial infection during which an STI test will be negative. During this period the infection may be transmissible. The duration of this period varies depending on the infection and the test.

Diagnosis may also be delayed by reluctance of the infected person to seek a medical professional. One report indicated that afflicted people turn to the Internet rather than to a medical professional for information on STIs to a higher degree than for other sexual problems.[26]

Management

High-risk exposure such as that which occurs in rape cases may be treated prophylactically using antibiotic combinations such as azithromycin, cefixime, and metronidazole.

An option for treating partners of patients (index cases) diagnosed with chlamydia or gonorrhea is patient-delivered partner therapy, which is the clinical practice of treating the sex partners of index cases by providing prescriptions or medications to the patient to take to his/her partner without the health care provider first examining the partner.[27]

Epidemiology

File:STDs excluding HIV world map - DALY - WHO2004.svg

STD incidence rates remain high in most of the world, despite diagnostic and therapeutic advances that can rapidly render patients with many STDs noninfectious and cure most. In many cultures, changing sexual morals and oral contraceptive use have eliminated traditional sexual restraints, especially for women, and both physicians and patients have difficulty dealing openly and candidly with sexual issues. Additionally, development and spread of drug-resistant bacteria (e.g., penicillin-resistant gonococci) makes some STDs harder to cure. The effect of travel is most dramatically illustrated by the rapid spread of the AIDS virus (HIV-1) from Africa to Europe and the Americas in the late 1970s.[29]

In 1996, the World Health Organization estimated that more than 1 million people were being infected daily. About 60% of these infections occur in young people <25 years of age, and of these 30% are <20 years. Between the ages of 14 and 19, STIs occur more frequently in girls than boys by a ratio of nearly 2:1; this equalizes by age 20. An estimated 340 million new cases of syphilis, gonorrhea, chlamydia and trichomoniasis occurred throughout the world in 1999.[30]

Commonly reported prevalences of STIs among sexually active adolescent girls both with and without lower genital tract symptoms include chlamydia (10–25%), gonorrhea (3–18%), syphilis (0–3%), Trichomonas vaginalis (8–16%), and herpes simplex virus (2–12%).[citation needed] Among adolescent boys with no symptoms of urethritis, isolation rates include chlamydia (9–11%) and gonorrhea (2–3%).[citation needed] At least one in four U.S. teenage girls has a sexually transmitted disease,[31] a CDC study found.[32] Among girls who admitted ever having sex, the rate was 40%.[33]

AIDS is the single largest cause of mortality in present-day Sub-Saharan Africa.[34] The majority of HIV infections are acquired through unprotected sexual relations between partners, one of whom has HIV. Approximately 1.1 million persons are living with HIV/AIDS in the United States,[35] and AIDS remains the leading cause of death among African American women between ages 25 and 34.[36] Hepatitis B is also classed as a sexually transmitted disease because it can be passed on sexually.[37] The disease is found globally, with the highest rates in Asia and Africa and lower rates in the Americas and Europe.[38] Worldwide, an estimated two billion people have been infected with the hepatitis B virus.[39]

History

File:Syphilis false shame and fear may destroy your future.png

The first well-recorded European outbreak of what is now known as syphilis occurred in 1494 when it broke out among French troops besieging Naples.[40] From this centre, the disease swept across Europe, killing more than five million people.[41] As Jared Diamond describes it, "[W]hen syphilis was first definitely recorded in Europe in 1495, its pustules often covered the body from the head to the knees, caused flesh to fall from people's faces, and led to death within a few months," rendering it far more fatal than it is today. Diamond concludes,"[B]y 1546, the disease had evolved into the disease with the symptoms so well known to us today."[42]

Prior to the invention of modern medicines, sexually transmitted diseases were generally incurable, and treatment was limited to treating the symptoms of the disease. The first voluntary hospital for venereal diseases was founded in 1746 at London Lock Hospital.[43] Treatment was not always voluntary: in the second half of the 19th century, the Contagious Diseases Act was used to arrest suspected prostitutes.

The first effective treatment for a sexually transmitted disease was salvarsan, a treatment for syphilis. With the discovery of antibiotics, a large number of sexually transmitted diseases became easily curable, and this, combined with effective public health campaigns against STDs, led to a public perception during the 1960s and 1970s that they have ceased to be a serious medical threat.

During this period, the importance of contact tracing in treating STIs was recognized. By tracing the sexual partners of infected individuals, testing them for infection, treating the infected and tracing their contacts in turn, STI clinics could be very effective at suppressing infections in the general population.

In the 1980s, first genital herpes and then AIDS emerged into the public consciousness as sexually transmitted diseases that could not be cured by modern medicine. AIDS in particular has a long asymptomatic period—during which time HIV (the human immunodeficiency virus, which causes AIDS) can replicate and the disease can be transmitted to others—followed by a symptomatic period, which leads rapidly to death unless treated. HIV/AIDS entered the United States in about 1969 likely through a single infected immigrant from Haiti.[44] Recognition that AIDS threatened a global pandemic led to public information campaigns and the development of treatments that allow AIDS to be managed by suppressing the replication of HIV for as long as possible. Contact tracing continues to be an important measure, even when diseases are incurable, as it helps to contain infection.

See also

References

  1. Venereal. dictionary.reference.com. URL accessed on June 18, 2013.
  2. Sexually transmitted diseases (STDs)?. PLWHA/National AIDS Resource Center. URL accessed on March 25, 2013.
  3. K. Madhav Naidu. "Epidemiology and Management" Community Health Nursing, Gyan Publishing House (2010).
  4. Workowski K, Berman S (2006). Sexually transmitted diseases treatment guidelines, 2006.. MMWR Recomm Rep 55 (RR–11): 1–94.
  5. Wu J, Chen C, Sheen I, Lee S, Tzeng H, Choo K (1995). Evidence of transmission of hepatitis D virus to spouses from sequence analysis of the viral genome. Hepatology 22 (6): 1656–60.
  6. Farci P (2003). Delta hepatitis: an update. J Hepatol 39 (Suppl 1): S212–9.
  7. Shukla N, Poles M (2004). Hepatitis B virus infection: co-infection with hepatitis C virus, hepatitis D virus, and human immunodeficiency virus. Clin Liver Dis 8 (2): 445–60, viii.
  8. Department of Public Health, City & County of San Francisco (2011). STD Risks Chart
  9. 9.0 9.1 9.2 9.3 Varghese B, Maher JE, Peterman TA, Branson BM,Steketee RW (2002). Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sex. Transm. Dis. 29 (1): 38–43.
  10. 10.0 10.1 10.2 Jin F et al. (March 2010). Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS 24 (6): 907–913.
  11. 11.0 11.1 11.2 11.3 11.4 Hoare A (2010). models of HIV epidemics in Australia and Southeast Asia
  12. 12.0 12.1 12.2 Burchell A et al. (March 2006). Modeling the Sexual Transmissibility of Human Papillomavirus Infection using Stochastic Computer Simulation and Empirical Data from a Cohort Study of Young Women in Montreal, Canada. American Journal of Epidemology 169 (3): 534–543.
  13. 13.0 13.1 13.2 13.3 13.4 Australasian contact tracing manual. Specific infections where contact tracing is generally recommended
  14. Bryan C (2011)INFECTIOUS DISEASE CHAPTER EIGHT SEXUALLY TRANSMITTED DISEASES
  15. 15.0 15.1 15.2 Mahiane, Séverin-Guy et al. (January 2009). Transmission probabilities of HIV and herpes simplex virus type 2, effect of male circumcision and interaction: a longitudinal study in a township of South Africa 23 (3): 377–383.
  16. 16.0 16.1 Holmes, King et al. (1970). An estimate of the risk of men acquiring gonorrhea by sexual contact with infected females 91 (2): 170–174.
  17. 17.0 17.1 Platt, Richard et al. (1983). Risk of Acquiring Gonorrhea and Prevalence of Abnormal Adnexal Findings Among Women Recently Exposed to Gonorrhea. JAMA 250 (23): 3205–3209.
  18. 18.00 18.01 18.02 18.03 18.04 18.05 18.06 18.07 18.08 18.09 18.10 Sarah Edwards, Chris Carn (1998). Oral sex and the transmission of non-viral STIs. Sex Transm In 74 (1): 95–100.
  19. K. Madhav Naidu. Community Health Nursing, Gen Next Publications, 2009, p.248
  20. Virus Pathogenesis, Microbiology Bytes
  21. Safe Sex Chart, violet blue: open source sex
  22. Villhauer, Tanya Condoms Preventing HPV?. University of Iowa Student Health Service/Health Iowa. URL accessed on 2009-07-26.
  23. Wilkinson D, Ramjee G, Tholandi M, Rutherford G (2002). Nonoxynol-9 for preventing vaginal acquisition of sexually transmitted infections by women from men. Cochrane Database Syst Rev (4): CD003939.
  24. Williams, M. Healthy Choices for Fertility Control. CreateSpace, Scotts Valley, CA, 2009. ISBN 1-4486-6472-1
  25. (2008). Male STI check-up video. Channel 4. URL accessed on 2009-01-22.
  26. Quilliam Susan (2011). 'The Cringe Report'. J Fam Plann Reprod Health Care. 37 (2): 110–112.
  27. Expedited Partner Therapy in the Management of Sexually Transmitted Diseases (2 February 2006) U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE. Centers for Disease Control and Prevention National Center for HIV, STD, and TB Prevention
  28. (2004). WHO Disease and injury country estimates. World Health Organization. URL accessed on Nov. 11, 2009.
  29. Mary-Ann Shafer, Anna-Barbara Moscicki (2006). Sexually Transmitted Infections, 2006: 1–8.
  30. STD Statistics Worldwide. Avert.org. URL accessed on 2011-01-09.
  31. "One In Four Teenage Girls In U.S. Has Sexually Transmitted Disease, CDC Study Shows". Science Daily. March 12, 2008.
  32. "Sex Infections Found in Quarter of Teenage Girls". The New York Times. March 12, 2008.
  33. "CDC study says at least 1 in 4 teen girls has a sexually transmitted disease; HPV most common". The Oklahoman. March 11, 2008.
  34. UNAIDS, WHO (2007). 2007 AIDS epidemic update. (PDF) URL accessed on 2008-03-12.
  35. "Obama Ends U.S. Travel Ban On Visitors, Immigrants With HIV-AIDS". ABC News. October 30, 2009.
  36. "Report: Black U.S. AIDS rates rival some African nations". CNN.com. July 29, 2008.
  37. "Hepatitis: Type B (caused by hepatitis B virus)". Minnesota Department of Health.
  38. "Hepatitis B". U.S. Food and Drug Administration.
  39. FAQ about Hepatitis B. Stanford School of Medicine. URL accessed on 2009-09-19.
  40. Oriel, J.D. (1994). The Scars of Venus: A History of Venereology, London: Springer-Verlag.
  41. includeonly>CBC News Staff. "Study traces origins of syphilis in Europe to New World". Retrieved on 2008-01-15.
  42. Diamond, Jared (1997). Guns, Germs and Steel, New York: W.W. Norton.
  43. Archives in London and the M25 area (AIM25) London Lock Hospital records
  44. Gilbert MT, Rambaut A, Wlasiuk G, Spira TJ, Pitchenik AE, Worobey M (November 2007). The emergence of HIV/AIDS in the Americas and beyond. Proc. Natl. Acad. Sci. U.S.A. 104 (47): 18566–70.

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