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National Academies of Sciences, Engineering, and Medicine;Health and Medicine Division;Board on Population Health and Public Health Practice;Committee on Prevention and Control of Sexually Transmitted Infections in the United States; Crowley JS, Geller AB, Vermund SH, editors. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington (DC): National Academies Press (US); 2021 Mar 24.

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Sexually Transmitted Infections: Adopting a Sexual Health Paradigm.

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ACharacteristics of Major STIs in the United States

STI (etiologic agent)Routes of TransmissionFrequency of Asymptomatic InfectionsMajor Long-Term Health ConsequencesIncreases Risk for Acquisition or Transmission of HIV Infection?Effective Curative Treatment Available/ Vaccine Available?
Chlamydial infection (Chlamydia trachomatis) (CDC, 2016, 2017a)
  • Vaginal, anal, and oral sex
  • Pregnant person-to-infant transmission with eye inoculation
Very common for men and women
  • Pelvic inflammatory disease
  • Infertility in women and possibly men (Bryan et al., 2019)
  • Ectopic pregnancy
  • Chronic pelvic pain
  • Ophthalmia neonatorum and pneumonia in infants
YesAntibiotics can cure. No vaccine. (Gottlieb and Johnston, 2017)
Gonorrhea (Neisseria gonorrhoeae) (CDC, 2017e, 2019b)
  • Vaginal, anal, and oral sex
  • Pregnant person-to-infant transmission with eye inoculation
  • Possible association with kissing (Chow et al., 2019)
Women: very common Men: commona
  • Pelvic inflammatory disease
  • Infertility in women and men
  • Ectopic pregnancy
  • Chronic pelvic pain
  • Ophthalmia neonatorum
  • Septic arthritis
YesAntibiotics can cure (but antibiotic-resistant strains exist). No vaccine. (CDC, 2020a; Gottlieb and Johnston, 2017)
Syphilis (all stages) (Treponema pallidum) (CDC, 2017f)
  • Vaginal, anal, and oral sex
  • Pregnant person-to-infant transmission
  • Blood-borne
Women: common Men: common or les common (IOM, 1997)
  • Ocular and neurologic morbidity
  • Cardiovascular, bone, skin, and other organ system morbidity
  • Congenital syphilis
YesAntibiotics can cure. No vaccine. (CDC, 2017g; Gottlieb and Johnston, 2017)
Congenital syphilis (Treponema pallidum) (CDC, 2019a; Yeganeh et al., 2015)Pregnant person-to-infant transmissionMay be asymptomatic in the first few weeks after birth
  • Preterm birth
  • Stillbirth
  • Infant death
  • Severe lifelong disabilities, including blindness, deafness, and bone deformity
YesAntibiotics can cure, but possible lifelong sequelae.
Human papillomavirus infection (human papillomavirus) (CDC, 2017d)Vaginal, anal, and oral sexual contactVery common for men and women
  • Genital tract dysplasia and cancer, most commonly the cervix and anus, but also the vagina, vulva, and penis (Arbyn et al., 2012)
  • Oral dysplasia and cancer
Probably yes (Houlihan et al., 2012)Ablation of lesions can treat but not cure. Three vaccines available for prevention. (CDC, 2020d)
Genital herpes (herpes simplex virus types 1 and 2) (CDC, 2017b,c)
  • Vaginal, anal, and oral sex
  • Pregnant person-to-infant transmission
Very common for men and women
  • Genital tract lesions that are often painful and can be debilitating
  • Congenital and neonatal herpes, which can lead to preterm birth, stillbirth, infant death, or severe disabilities (Corey and Wald, 2009)
YesNo cure, but medications can reduce severity and duration of symptoms. No vaccines.
Trichomonas vaginalis infection (Trichomonas vaginalis) (CDC, 2017h; Tompkins et al., 2020)Vaginal, anal, and oral sexVery common for men and women
  • Cervicovaginal or penile discharge
  • Inflammatory changes with vaginitis or urethritis
YesAntibiotics can cure. No vaccine. (Gottlieb and Johnston, 2017)
Hepatitis B virus infection (hepatitis B virus) (CDC, 2020c; NASEM, 2016, 2017)
  • Vaginal or anal sex; not oral sex
  • Pregnant person-to-infant transmission
  • Blood-borne
Early infection may be asymptomatic, with symptoms emerging many years later (A minority of patients with sexually acquired infection may experience chronic infection leading to sequelae.)
  • End-stage liver cirrhosis or hepatocellular carcinoma
  • Perinatal transmission from pregnant person to child, with high risk of eventual liver disease in an untreated infant
NoNo cure, though both active and passive immunization highly efficacious. (Schillie et al., 2018)
Chancroid (Haemophilus ducreyi) (CDC, 2015a; Lewis, 2003)Vaginal, anal, and oral sexWomen: Very common Men: Less Common
  • Genital tract lesions that are often painful and can be debilitating
Probably yesAntibiotics can cure. No vaccine.
Lymphogranuloma venereum (C. trachomatis serovars L1, L2, and L3) (CDC, 2015b; Rönn et al., 2014)Vaginal, anal, and oral sexCommon for men and women
  • Genital tract lesions that are often painful and can be debilitating
UnknownAntibiotics can cure. No vaccine.
Mycoplasma genitalium infectionb (Mycoplasma genitalium) (Horner and Martin, 2017; Wiesenfeld and Manhart, 2017)Vaginal, anal, and oral sexCommon for men and women
  • Cervicovaginal or penile discharge
  • Inflammatory changes with vaginitis or urethritis
Possibly yes (Napierala Mavedzenge and Weiss, 2009)Antibiotics can cure, but recurrence is common. Antibiotic resistance is a concern. No vaccine. (CDC, 2020a)
Human immunodeficiency virus (HIV) infection (HIV) (CDC, 2019c, 2020b)
  • Vaginal and anal sex
  • Less often oral sex
  • Pregnant person-to-infant transmission
  • Blood-borne
Flu-like symptoms noted in some during acute infection, but then may be asymptomatic for years
  • Immunodeficiency with life-threatening risks of opportunistic infections or malignancies
Medications can slow disease progression. No vaccines, but preexposure prophylaxis is available for prevention.
a

Most women with gonorrhea are asymptomatic. Many men with gonorrhea are asymptomatic (CDC, 2019b).

b

Emerging STI; see Chapter 2 for more information.

REFERENCES

Copyright 2021 by the National Academy of Sciences. All rights reserved.
Bookshelf ID: NBK573157

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