SEXUALLY TRANSMITTED
INFECTIONS AT ILLINOIS
STATE UNIVERSITY
© 2013 John B. Pryor, Ph.D.
Department of Psychology
Top 6 STIs at ISU:
1995-2007
1. Genital Warts
2. Genital Herpes
3. Chlamydia
4. Scabies
5. Trichomoniasis
6. Gonorrhea
Sexually Transmitted Infections Treated at the ISU
Student Health Center 1995-2007
6% 2%
9%
13%
50%
20%
Genital Warts
Genital Herpes
Chlamydia
Scabies
Trichomoniasis
Gonorrhea
Human Papilloma Virus (HPV)
•
•
•
•
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Virus that causes genital warts - 60 known types
estimated 16% of Americans infected (21% of
women & 12% of men)
In more than 90 percent of cases, the infections
are harmless and go away without treatment.
Related to the occurrence of pre-cancerous cells on
the cervix. Persistent HPV infection is found in
most cases of cervical cancer.
A new vaccine, Gardasil, protects against four HPV
types, which together cause 70% of cervical cancers
and 90% of genital warts.The CDC reccomends this
vaccine for use in males/females ages 11-26 years.
Symptomatically treated by chemical agents
(podophyllin), cryotherapy, or laser therapy
Figure 53. Genital Warts—Initial Visits to
Physicians’
Offices,Visits
United
States,Offices,
Genital Warts—Initial
to Physicians’
United States, 1966–2011
1966–2011
NOTE: The relative standard errors for genital warts estimates of more than 100,000 range
from 18% to 30%. See Other Surveillance Data Sources in the Appendix and Table 44.
SOURCE: IMS Health, Integrated Promotional Services™. IMS Health Report, 1966–2011.
Human Papilloma Virus
warts
Some carriers are asymptomatic
Human
Papilloma
Virus
transmission
through
physical
contact
wart
Human
Papilloma
Virus
Most common
sites in men:
penis,
urethra,
bladder,
& anus
warts
Human
Papilloma
Virus
Most common
sites in women:
vulva,
vagina,
cervix,
& anus
HPV - can be transmitted via
oral sex
Genital Herpes
Caused by a virus
Two types:
• 1) herpes simplex virus type 1( HSV-1) typically around mouth (cold sores)
• 2) herpes simplex virus type 2 (HSV-2)
- typically found in the genital region.
• However, either can infect either place.
•
Genital Herpes - incidence
•
•
•
HSV-1 antibodies are present in 95%
of Americans.
Nationwide, 16.2%, or about one out of
six, people 14 to 49 years of age have
genital HSV-2 infection.
Most people who are infected never
recognize their symptoms.
Genital Herpes—Initial Visits to Physicians’ Offices,
United States, 1966–2011
Genital Herpes
•
•
•
•
Transmission - through physical contact
with infected area
Transmission is possible even when
someone is asymptomatic
No cure
Symptomatic treatment with acyclovir
Genital Herpes
leision
Genital
Herpes
Genital
Herpes
leisions
Genital
Herpes
scars
Genital
Herpes
Genital Herpes
•
•
•
Some myths about HSV-2:
1) Genital herpes is often
transmitted through casual
contact.
2) Women who have recurrent
HSV-2 should not bear children
because of dangers to the
developing fetus.
Psychosocial Aspects of Herpes
Survey of 3100 People with Herpes
84% -reported episodes of depression
70% -indicated feelings of isolation
40% -diminished work performance as the
result of lowered self-esteem
35% -decreased sexual desire
25% -self-destructive thoughts
18% -the breakup of long term relationships
Chlamydia trachomatis infections are the most
commonly reported notifiable disease in the
United States. In 2010, 1,307,893 chlamydial
infections were reported to CDC.
Chlamydia—Rates by Sex, United States, 1990–2011
Chlamydia—Rates by Age and Sex, United States, 2011
Chlamydia Rates per 100,000 in
Illinois
500
476.4
487.5
480
446.6
460
431.5
440
420
407.1
400
380
360
2005
2006
2007
2008
2009
Chlamydia—Rates by County, United States, 2011
McLean County, Illinois
Chlamydia -caused by a bacteria
Up to 75 percent of women and 50
percent of men with uncomplicated
chlamydia infection have no symptoms
or signs of infection. If symptoms do
occur, they typically appear within one
week to a month after exposure to an
infected person.
Chlamydia Symptoms - Men
* pain or burning during
urination
* frequent urination
* pain and swelling in the
testicles
* low-grade fever
* burning and itching
around the opening of
the penis
* watery or milky
discharge from the
penis
Chlamydia Symptoms - Women
* irregular vaginal bleeding
* burning with urination
* itching and burning in the genital area
* vaginal discharge
* lower abdominal pain often
accompanied by nausea and fever
Chlamydia - possible complications for women
scared/blocked
fallopian tubes
pelvic abscess
adhesions
Treatment of Chlamydia
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
Curable with azithromycin or doxycycline; does
not respond to penicillin.
Poorly treated or undiagnosed cases may lead to:

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urethral damage
epididymitis (infection of the epididymis)
Reiter’s syndrome (inflammation throughout body;
arthritis)
proctitis in men who had anal intercourse
Pelvic Inflammatory Disease (PID)
Problems with pregnancy and risks for newborn
infants of infected mothers
Chlamydia - possible complications for
women



Up to 40% of women with untreated
chlamydia will develop PID. Undiagnosed
PID caused by chlamydia is common.
Of those with PID, 20% will become infertile;
18% will experience debilitating, chronic
pelvic pain; and 9% will have a lifethreatening tubal pregnancy.
Tubal pregnancy is the leading cause of firsttrimester, pregnancy-related deaths in
American women.
Scabies
Scabies is caused
by tiny mites
which are at
most half a
millimeter in
length and are
difficult to see.
Scabies
Scabies
Scabies usually infest areas
between the fingers and
toes, wrists, elbows,
armpits, buttocks, breasts,
genitals, and other areas
of contact.
Scabies
Small red bumps
or tiny lines
(burrows) may
appear.
Scabies
CDC Recommended Regimen • Permethrin cream (5%) applied to all areas of
the body from the neck down and washed off
after 8-14 hours
Transmission • Scabies among adults may be sexually
transmitted, although scabies among children
is usually not sexually transmitted.
Trichomoniasis
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•
•
an estimated 7.4 million new cases yearly
caused by a single-celled protozoan parasite
symptoms in women include a heavy, yellowgreen or gray vaginal discharge,
discomfort during
intercourse, vaginal
odor, and painful
urination
Trichomoniasis and Other Vaginal Infections—Women—
Initial Visits to Physicians’ Offices, United States, 1966–
2011
Prevalence of Trichomoniasis
Trichomoniasis is the most common
curable STI in young, sexually active
women.
 An estimated 7.4 million new cases
occur each year in women and men.

Trichomoniasis
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•
•
symptoms also may include irritation
and itching of the female genital area
symptoms in men include a thin,
whitish discharge from the penis and
painful or difficult urination
most men do not experience any
symptoms, women also may be
asymptomatic
Trichomoniasis
•
•
•
Sexual transmission is possible even
when no symptoms are present.
Metronidazole is the drug used to treat
trichomoniasis.
It is administered in a
single dose.
Trichomoniasis
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Trichomoniasis in pregnant women may
cause premature rupture of the membranes
and pre-term delivery.
The genital inflammation caused by
trichomoniasis also might increase a woman's
risk of acquiring HIV infection if she is
exposed to the virus.
Trichomoniasis in a woman who is also
infected with HIV can increase the chances of
transmitting HIV infection to a sex partner.
Gonorrhea is caused by the gonococcus, a
bacterium that grows and multiplies
quickly in moist, warm areas of the
body such as the cervix, urethra, mouth,
or rectum.
.
GONORRHEA
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Incidence &
treatment
Gonorrhea is the second most commonly
reported infectious disease in the United
States, with 309,341 cases reported in 2010.
Treatment is usually easy with antibiotics
Drug resistance is an increasingly important
concern in the treatment and prevention of
gonorrhea
Gonorrhea—Rates, United States, 1941–2011
Gonorrhea—Rates by Age and Sex, United States,
2011
Gonorrhea—Rates by County, United States,
2011
McLean County, Illinois
Gonorhea Cases per 100,000 in
Ilinois
167.6
168
166.5
166
164
162
162.5
161.2
160.7
160
158
156
2005
2006
2007
2008
2009
Gonorrhea - transmission
genital-to-genital contact
• genital-to-oral contact
• genital-to-anal contact
• spread fromvagina to rectum
•
Gonorrhea - Symptoms
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early symptoms often are mild
most women who are infected have no
symptoms
if symptoms of gonorrhea develop, they
usually appear within 2 to 10 days after
sexual contact with an infected partner
some may be infected for several
months without showing symptoms.
Gonorrhea - Symptoms for Women
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•
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a painful or burning sensation when
urinating
an abnormal vaginal discharge
more advanced symptoms, which
indicate progression to PID, include
abdominal pain, bleeding between
menstrual periods, vomiting, or fever
Gonorrhea - Symptoms for Men
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•
•
a discharge from the penis
a burning sensation during
urination
symptoms of rectal infection
include discharge, anal itching, and
sometimes painful bowel
movements.
Gonorrhea often spreads in social networks where an
aymptomatic female with many sexual partners can be
a core infector
Male
Male
Male
Female
Male
Female
(no
Symptoms)
Male
Male
Male
Female
Male
Gonorrhea
discharge
Gonorrhea Discharge
Both Gonorrhea & Chlamydia can cause future
fertility problems in women
Chlamydia
Gonorrhea
Possible scarring
or blockage of
fallopian tubes