Jocelyn Domingo-Santiago,MD

Occupational Health Physician/

Internal Medicine

At the end of the session, attendees should:

Have

basic knowledge on the different STDs;

Know how STDs can be acquired and thereby
prevent transmission;

STDs are diseases that are infectious in origin

and acquired during sexual contact with an
infected person.
There are more than 20 known sexually
transmitted diseases.
Infectious causes can ve viruses, bacteria,
parasites, fungi.
Usually affects the genital area but other parts
of the body can be involved.
Also known as Sexually Transmitted Infections;
Venereal Diseases.
Usually asymptomatic early on, and when
symptoms appear, it is usually difficult to treat.

 Chlamydia
Trichomoniasis
Gonorrheal

Infections
Genital Herpes
Genital Warts
Syphilis
Hepatitis
HIV-AIDS
Others Scabies, Crabs(pubic lice),
molluscum contagiosum

 Chlamydia

trachomatis is the bacteria that

causes chlamydial infections
Signs and symptoms may include:

Painful urination
Lower abdominal pain
Vaginal discharge in women
Discharge from the penis in men
Pain during sexual intercourse in women
Testicular pain in men

LGV

or Lymphogranuloma Venereum is one

STD caused by chlamydia.

 Caused

by the protozoa- Trichomonas

vaginalis
Affects both male and female but usually
asymptomatic among males.
Causes Vaginitis in women.
Signs and Symptoms:

Greenish yellow, possibly frothy vaginal discharge

Strong vaginal odor
Vaginal itching or irritation
Pain during sexual intercourse
Painful urination
Light vaginal bleeding

 Gonorrhea

is a bacterial infection.
Infection may occur for months without any
manifestation.
Signs and symptoms, which may occur 2-10
after exposure include:

Thick, cloudy or bloody discharge from the penis

or vagina
Pain or burning sensation when urinating
Frequent urination
Pain during sexual intercourse

 Caused

by Herpes simplex 2 virus.

Most infections are asymptomatic.
When sypmtoms occur, usually worst.
When present, genital herpes signs and
symptoms may include:

Small, red bumps, blisters (vesicles) or open

sores (ulcers) in the genital, anal and nearby
areas
Pain or itching around the genital area, buttocks
and inner thighs

 Symptoms

begin as severe itching or tingling

sensation, and when they rupture, the sores
are weeping or may even bleed.

 One

of the most common STD.

Caused by Human Papilloma Virus
Signs and symptoms include:

Small, flesh-colored or gray swellings in your

genital area
Several warts close together that take on a
cauliflower shape
Itching or discomfort in your genital area
Bleeding with intercourse

The

warts can occur on the mouth in persons

who had oral sex with an infected/carrier
partner.

 Genital

warts can lead to the development of

Cervical Cancer among the female
population.

 HAV,

HBV, and HCV are some of the causes of

infectious hepatitis.
Causes inflammation of the liver.
Hepatitis A is not strictly sexually acquired,
but oral-anal contact is the usual cause.
Some may have the virus in the body without
showing the signs and symptoms of the
disease(Carrier).

 Manifestations:

Fatigue
Nausea and vomiting
Abdominal pain or discomfort, especially in the
area of your liver on your right side beneath your
lower ribs
Loss of appetite
Fever
Dark urine
Muscle or joint pain
Itching
Yellowing of your skin and the whites of your
eyes (jaundice)

 Caused

by the bacterium Treponema

pallidum.
Usually infects the genitals, skin and mucous
membranes, but a more progressive disease
affects the brain, the spinal cord and the
heart.
Has 4 stages that may show different
symptomatology.

 These

signs may occur from 10 days to three

months after exposure:

A small, painless sore (chancre) on the part of

your body where the infection was transmitted,
usually your genitals, rectum, tongue or lips. A
single chancre is typical, but there may be
multiple sores.
Enlarged lymph nodes.
Signs and symptoms of primary syphilis typically
disappear without treatment, but the underlying
disease remains and may reappear in the second
(secondary) or third (tertiary) stage.

 Signs

and symptoms of secondary syphilis

may begin two to 10 weeks after the chancre
appears, and may include:

Rash marked by red or reddish-brown, pennysized sores over any area of your body, including
your palms and soles
Fever
Fatigue and a vague feeling of discomfort
Soreness and aching

 In

some people, a period called latent

syphilis in which no symptoms are present
may follow the secondary stage. Signs and
symptoms may never return, or the disease
may progress to the tertiary stage.

Without treatment, syphilis bacteria may spread,

leading to serious internal organ damage and
death years after the original infection.
Some of the signs and symptoms of tertiary
syphilis include:

Neurological problems. These may include stroke and

infection and inflammation of the membranes and
fluid surrounding the brain and spinal cord
(meningitis). Other problems may include poor muscle
coordination, numbness, paralysis, deafness or visual
problems. Personality changes and dementia also are
possible.
Cardiovascular problems. These may include bulging
(aneurysm) and inflammation of the aorta your
body's major artery and of other blood vessels.
Syphilis may also cause valvular heart disease, such as
aortic valve problems.

 The

Department of Health AIDS Registry

showed that 53 percent of the victims are
men, 38 percent are women and 9 percent
are children.
Among persons diagnosed as being infected
with AIDS, 55 percent are drug addicts, 40
percent were infected by heterosexual
activities (mainly with prostitutes), and 5
percent by homosexual activity.

. WHO and MSF estimate the Philippines will

have 30,112 cases by the end of 1999, and about
39,780 cases by the year 2000.
That is a 70-percent increase in the incidence of
AIDS in just two years in a population of 79
million people.
Acquired immune deficiency syndrome (AIDS)
was first described in the U.S.A. in 1978. In
1988, an anecdotal report indicates that one
infected Filipina prostitute from New York City
came home to die in the Philippines.
Twenty years after AIDS was diagnosed in
California, the first twenty cases of AIDS were
diagnosed in the Philippines (1990).

The current epidemiological explanation of the

origins of HIV traces it to a mutant strain of SIV
(simian immunovirus) found in green monkeys
of the sub-Saharan regions of Africa. Two
thousand years ago, the ancient Filipinos
supplemented their rice and vegetarian diet with
meat from a variety of game animals, including
native Philippine monkeys. These simian
creatures are the main prey of another worldfamous carnivore, the Philippine monkey-eating
eagle. In spite of their carnivorous appetite, the
Filipino aborigines did not contract the HIV virus.
Even today, there are Filipinos who still savor
exotic menus of Philippine monkeys.
Nevertheless, the HIV virus has reached the
Philippines by other routes.

 Statistics

for the end of 2008 indicate that

around 33 million people are living with HIV,
the virus that causes AIDS.
Each year around 2.7 million more people
become infected with HIV and 2 million die
of AIDS.
The epidemic is spreading most rapidly in
Eastern Europe and Central Asia, where the
number of people living with HIV increased
67% between 2001 and 2008.

There are various ways a person can become

infected with HIV:
Unprotected sexual intercourse with an
infected person: Sexual intercoursewithout
a condom carries the risk of HIV infection.
Contact with an infected person's blood: If
sufficient blood from somebody who has HIV
enters someone else's body, then HIV can be
passed on in the blood.
Use of infected blood products: Many people in
the past have been infected with HIV by the use
of blood transfusions and blood products which
were contaminated with the virus. In much of
the world this is no longer a significant risk, as
blood donations are routinely tested for HIV.

 Injecting

drugs: HIV can be passed on when

injecting equipment that has been used by
an infected person is then used by someone
else. In many parts of the world, often
because it is illegal to possess them,
injecting equipment or works are shared.
From mother to child: HIV can be
transmitted from an infected woman to her
baby during pregnancy, delivery
and breastfeeding.

 Signs

and symptoms:

Some people experience a flu-like illness,

develop a rash, or get swollen glands for a brief
period soon after they become infected with HIV.

However,

although these are HIV

symptoms, they are also common symptoms
of other less serious illnesses, and do not
necessarily mean that a person has HIV.

 The

antibody or ELISA test - detects HIV

antibodies in a persons blood.
It is necessary to wait at least 3 months after
the last possible exposure before having an
HIV antibody test, to be certain of an
accurate result.

Scabies, Crabs, Molluscum contagiosum

Not strictly sexually transmitted, because
transmission can occur in close skin contact.
Scabies is an intensely itchy, contagious skin
infestation of parasitic mites. A rash of inflamed
pimple-like lumps appears as an allergic reaction
to the mites, their eggs and faeces.
Crabs, or pubic lice, are small parasites that
burrow into the skin to feed on blood. They live
on coarse body hair such as pubic hair, but can
also be found in armpit hair, facial hair and even
on eyelashes.

 Molluscum

contagiosum, or MCV, also known

as water warts, causes pearl-shaped papules
(bumps or lesions) on the skin. The papules
are filled with a white fluid that is very
contagious. MCV often occurs in children,
especially those prone to skin conditions such
as eczema.