A search and evaluation of the medical literature was performed
on January 22, 2008. This search was limited to studies published
in English concerning human trials. An Ovid search was performed,
as was a search of the Centers for Disease Control and Prevention
website and the National Guideline Clearinghouse.
Sexually transmitted diseases (STDs) are a heterogeneous group
of infections with a wide variety of causative agents. The pathogens
associated with STDs run the range from bacterial, viral, and fungal
sources to parasitic organisms. The common link between the infecting
agents and the diseases they cause, is their propensity to be spread
through sexual contact.
Primary care providers are in the unique position to not only
diagnose and treat current STD infections, but they also have the
opportunity to reduce STD transmission through risk reduction counseling.
Screening for STD risk factors should occur at each health care
contact and education on safer sexual practices is appropriate for
all at-risk patients. Counseling measures aimed at preventing transmission
of STDs must be delivered in a nonjudgmental manner and should address each
patient’s particular risk factors. Patients who seek testing
for one STD should also be offered testing for all STDs, including
Risk factors for acquiring STDs include young age, socioeconomic
factors, immune status, sexual orientation and sexual behaviors
among others. Specific behaviors associated with increased risk of
infection with a STD (regardless of other risk factors) include
multiple sexual partners, male with male sex, and sexual contact
with those people known to be infected with STDs.
Short of abstinence, the best protection against contracting
a STD is participation in a mutually monogamous relationship with
an uninfected partner. Consistent and proper usage of latex condoms
offers the next best protection against STDs.
Although STDs occur more commonly in males than females, the
complications associated with STDs tend to be more severe in women.
These complications can include damage to the reproductive system,
increased risk of cervical cancer and disease transmission to the
neonate during pregnancy or childbirth.
This chapter will focus on the most commonly encountered STDs
(Table 45-1). The recommendations contained in this chapter are
derived from the Centers for Disease Control and Prevention (CDC)
Table 45-1. Sexually Transmitted
and Sexually Transmissible Microorganisms |Favorite Table|Download (.pdf)
Table 45-1. Sexually Transmitted
and Sexually Transmissible Microorganisms
|Transmitted in adults predominantly
by sexual intercourse|
|Neisseria gonorrhoeae||HIV (types 1 and 2)||Trichomonas vaginalis|
|Chlamydia trachomatis||Human T-cell lymphotropic virus type I||Phthirus pubis|
|Treponema pallidum||Herpes simplex virus type 2|
|Haemophilus ducreyi||HPV (multiple genotypes)|
|Ureaplasma urealyticum||Molluscum contagiosum virus|
|Sexual transmission repeatedly described but
not well defined or not the predominant
|Mycoplasma hominis||Cytomegalovirus||Candida albicans|
|M. genitalium||Human T-cell lymphotropic virus type II||Sarcoptes scabiei...|
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