7 признаков ЗППП, или Как вовремя обнаружить венерическое заболевание? | Здоровая жизнь | Здоровье

Наш эксперт – врач-гинеколог Марина Веделеева.

Опасная тридцатка

Тема очень прозаична – заболевания, передаваемые половым путем (ЗППП). Практически каждый из нас хоть раз в жизни встречался с ними лично. Между прочим, их более 30: от смертоносной ВИЧ-инфекции до банального хламидиоза, который, кстати, тоже пустячным не назовешь. Тем более по распространенности в России он на втором месте после гриппа.

Конечно, большинство ЗППП излечимы, но не все. Например, с генитальным герпесом расстаться никогда не удастся – лечение только смягчает течение болезни и уменьшает частоту и тяжесть рецидивов. Навсегда избавиться от вируса папилломы человека (ВПЧ) есть шансы только у тех, кто моложе 25. Позже уничтожить вирус не удастся, смысл лечения – в ликвидации изменений тканей, на которые воздействует вирус. Кстати, считается, что вирус папилломы человека может спровоцировать рак шейки матки, влагалища, вульвы и полового члена. Вирус полового герпеса влияет и на сперму, а также, если им заразилась женщина во время беременности, это может вызвать тяжелые врожденные заболевания плода.

Успешным лечение будет лишь в том случае, если начать его без опоздания и довести до конца. Как же заметить самые первые сигналы опасности?

Объявлена тревога!

Есть семь основных признаков, обнаружив которые, не стоит тянуть с визитом к врачу.

Зуд и жжение в интимной зоне.

Покраснение в области половых органов и заднего прохода, иногда – язвочки, пузырьки, прыщики.

Выделения из половых органов, запах.

Частое, болезненное мочеиспускание.

Увеличение лимфатических узлов, особенно в паховой области.

У женщин – боль внизу живота, во влагалище.

Дискомфорт во время полового акта.

Однако, например, сифилис или хламидиоз могут проявиться спустя несколько недель после заражения, а иногда ЗППП вообще долгое время могут протекать скрыто, переходя в хроническую форму.

 

Познакомимся поближе

Хламидиоз

Симптомы. Через 1–4 недели после заражения им у больных появляются гнойные выделения, болезненное мочеиспускание, а также боли внизу живота, в пояснице, кровотечения между менструациями у женщин, у мужчин – боли в области мошонки, промежности.

Чем опасен? У женщин может привести к воспалению маточных труб, шейки матки, патологиям беременности и родов, заболеваниям печени, селезенки; у мужчин – к воспалениям придатков яичек, предстательной железы, мочевого пузыря, нарушению потенции. У новорожденных детей может развиться конъюнктивит, поражение носоглотки, воспаление легких.

Трихомониаз

Симптомы. Они могут проявиться на 4–21‑й день после инфицирования, иногда позже. У женщин возникают обильные пенистые выделения белого или желтовато-зеленого цвета с резким запахом, вызывающие сильный зуд и раздражение половых органов, а также боли, жжение при мочеиспускании, болезненность при половом акте. У мужчин возникает жжение при мочеиспускании, слизисто-гнойные выделения из уретры. Однако нередко это заболевание протекает бессимптомно.

Чем опасен? У женщин поражаются шейка и внутренний слой матки, маточные трубы, яичники, мочевые пути. Инфекция может вызвать даже перитонит! У мужчин страдают предстательная железа, яички и их придатки, мочевые пути.

Микоплазмоз (у мужчин – уреаплазмоз)

Симптомы. Может обнаружить себя через 3 дня после заражения, а может и через месяц, проявляясь зудом и дискомфортом в области гениталий, скудными прозрачными выделениями, болезненным мочеиспусканием.

Чем опасен? Частое осложнение трихомониаза у женщин – воспаления половых органов, у мужчин – нарушение сперматогенеза.

Гонорея

Симптомы. Через 3–7 дней после заражения у женщин появляются желтовато-зеленоватые выделения из влагалища, учащенное, болезненное, мочеиспускание, боль внизу живота, иногда кровянистые выделения. Однако у большинства представительниц слабого пола заболевание долгое время протекает незаметно. У мужчин появляются боли и жжение при мочеиспускании, желтовато-зеленоватые гнойные выделения из мочеиспускательного канала.

Чем опасна? У женщин поражаются мочеиспускательный канал, влагалище, задний проход, матка, яичники, фаллопиевы трубы. У мужчин – внутренние половые органы, развивается хроническое воспаление придатков яичек, семенных пузырьков, простаты, что грозит импотенцией, бесплодием.

Сифилис

Симптомы. Инкубационный период болезни от 3 до 6 недель. Первый признак – язвочка округлой формы (твердый шанкр). У женщин она обитает на половых губах или слизистой влагалища (иногда – в области заднего прохода, во рту, на губах), у мужчин – на половом члене или мошонке. Сама по себе она безболезненна, но через неделю-другую после ее появления увеличиваются ближайшие лимфатические узлы. Именно в это время необходимо начать лечение! Это первая стадия болезни, когда все еще обратимо. Через 2–4 месяца после заражения развивается вторая стадия – по всему телу «разливается» сыпь, появляются высокая температура, головная боль, увеличиваются почти все лимфатические узлы. У некоторых больных выпадают волосы на голове, разрастаются широкие кандиломы на половых органах и в области заднего прохода.

Чем опасен? Эту болезнь называют медленной смертью: если вовремя недолечиться до конца, возникают серьезные проблемы с опорно-двигательным аппаратом, происходят необратимые изменения во внутренних органах, нервной системе – начинается третья стадия болезни, при которой примерно четверть больных погибает.

Забудьте об Интернете!

Заметили, что что-то не так? Лучше перестраховаться и поторопиться к врачу, а не искать в Интернете симптомы и способы лечения.

Как диагностируют ЗППП? Сначала – осмотр врачом, дальше – анализы и исследования. Самый современный метод ДНК-диагностики: ПЦР (полимеразная цепная реакция). Для исследования берут соскоб из мочеиспускательного канала, влагалища и шейки матки.

Врачи используют также метод ИФА (берется кровь из вены или делается соскоб и определяется наличие антител к ЗППП), бактериоскопию (чаще всего выявляет гонококки и трихомонады) и многие другие способы диагностики.

Лечат ЗППП антибактериальными препаратами, а также местными процедурами (промывания мочеиспускательного канала у мужчин, санация влагалища у женщин и другие процедуры). По окончании курса лечения обязательно нужно пройти контрольное обследование – сдать нескольких анализов, чтобы убедиться в отсутствии инфекции в организме.

Как защититься?

Классика самообороны от ЗППП – это презерватив. Качественный и правильно подобранный по размеру.

Используется и экстренная медикаментозная профилактика – одноразовый прием или инъекция антибактериальных препаратов, которые может назначить только врач-дерматовенеролог. Процедура позволяет предотвратить гонорею, хламидиоз, уреаплазмоз, микоплазмоз, сифилис и трихомониаз. Но к такому методу нельзя прибегать часто.

А вот что касается спринцеваний после полового акта специальными гелями или хлорсодержащими антисептиками, то большинство специалистов считают: это не снижает риск заражения.

90000 Sexually transmitted disease | pathology 90001 90002 90003 Sexually transmitted disease (STD) 90004, also called 90003 sexually transmitted infection 90004, any disease (such as syphilis, gonorrhea, AIDS, or a genital form of herpes simplex) that is usually or often transmitted from person to person by direct sexual contact. It may also be transmitted from a mother to her child before or at birth or, less frequently, may be passed from person to person in nonsexual contact (such as in kissing, in tainted blood transfusions, or in the use of unsanitized hypodermic syringes) .Sexually transmitted diseases usually affect initially the genitals, the reproductive tract, the urinary tract, the oral cavity, the anus, or the rectum but may mature in the body to attack various organs and systems. Tertiary syphilis, or paresis, for example, may affect skin, bones, the central nervous system, the heart, the liver, or other organs. Persons infected by human immunodeficiency virus (HIV), the cause of AIDS, may remain outwardly healthy for years before the disease takes hold within the immune system.90007 90002 Britannica Quiz 90007 90002 Diseases, Disorders, and More: A Medical Quiz 90007 90002 Which fever is also called «three-day fever»? 90007 90002 The term 90015 venereal disease 90016 (VD), denoting any disease transmitted by sexual intercourse, lost favour in the late 20th century and was largely supplanted by the more-comprehensive terms 90015 sexually transmitted disease 90016 and 90015 sexually transmitted infection 90016.90007 90002 Sexually transmitted diseases have a long history. The best known of these diseases, syphilis, is caused by the bacterium 90015 Treponema pallidum 90016. Syphilis was first widely reported by European writers in the 16th century, and some medical historians assume that it was imported into Europe by explorers returning from the New World. Other authorities believe that syphilis is of ancient origin and may at one time have been mistakenly identified as leprosy. At any rate, syphilis first became widely recognized and reported in the late 1490s, when a virtual epidemic swept through Europe.90007 Scanning electron micrograph of the spirochete 90015 Treponema pallidum 90016 attached to testicular cell membranes. 90028 ASM / Science Source / Photo Researchers 90029 90002 Urethritis is the infection and inflammation of the urethra (the passage that transmits urine from the bladder to the exterior of the body). Most cases of urethritis are in fact sexually transmitted. Urethritis that is caused by the gonococcus bacterium (90015 Neisseria gonorrhoeae 90016) is called gonorrhea. Gonorrhea was named by the Greek physician Galen and is thought to have been known to the ancient Chinese and Egyptians.90007 Get exclusive access to content from our тисяча сімсот шістьдесят вісім First Edition with your subscription. Subscribe today 90002 Syphilis and gonorrhea were long thought to be one disease. Real progress in characterizing them did not occur until the early 20th century, when their different causative microorganisms were identified and reliable diagnostic tests were developed. Effective treatment in the form of sulfa drugs and penicillin was introduced in the 1930s and ’40s, and the eradication of such diseases seemed imminent.By the end of the 1950s, however, the frequency index had begun to rise again. Among the many reasons cited were the tapering off of active «anti-VD» campaigns, the causative microorganisms ‘growing immunity to the antibiotics used in treatment, and a variety of sociological factors influencing sexual behaviour. Despite campaigns to encourage the use of condoms and a return to «safe sex» in the 1990s, syphilis and gonorrhea remained major global health issues in the early 21st century. 90007 90002 A disease that became especially widespread beginning in the 1960s and ’70s was genital herpes (90015 see 90016 herpes simplex).Herpes infections are significant not only in terms of the discomfort they cause but also for the potentially serious illness that might occur in infants born to mothers with genital herpes infections. A variety of treatments have been used for genital herpes, but none have been entirely satisfactory. 90007 90002 The sexually transmitted disease that caused perhaps the greatest alarm in the late 20th century was acquired immune deficiency syndrome, or AIDS. From the time of its first clear identification in 1981, HIV, the cause of AIDS, spread rapidly, with reported cases of infection rising at a high rate, especially among homosexuals and intravenous drug users in the United States and western Europe and among heterosexuals in tropical Africa.The high mortality rate from AIDS and the absence of a cure or vaccine against the disease had a sobering effect on sexually permissive societies. Promiscuity tended to be more widely discouraged, and the adoption of practices presumed to constitute «safe sex» (or, rather, safer sex) -such as the use of condoms or avoiding anal intercourse-tended to be encouraged. 90007 90002 Nearly a score of other sexually transmitted diseases are known. All have reasonably effective drug cures. About half of all cases of urethritis that are not gonorrhea are chlamydia, which is caused by an infection with 90015 Chlamydia trachomatis 90016.The latter bacterium is also the infecting agent in pelvic inflammatory disease and in still another sexually transmitted disease, lymphogranuloma venereum. The cause for the remaining 50 percent of nongonococcal urethral infections is not known; no organism has been definitely related. 90007 90003 chlamydia; sexually transmitted disease 90004 A Pap smear specimen showing the bacterium 90015 Chlamydia trachomatis 90016, the cause of the sexually transmitted disease chlamydia. 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Influence of site of infection and viral type. 90011 New England Journal of Medicine 90012 1987; 316: 1444-1449. 90003 90002 Lafferty WE, Downey L, Celum C, Wald A. Herpes simplex virus type 1 as a cause of genital herpes: impact on surveillance and prevention. 90011 Journal of Infectious Diseases 90012 2000; 181: 1454-1457.90003 90002 Lowhagen GB, Tunback P, Andersson K, Bergstrom T, Johannisson G. First episodes of genital herpes in a Swedish STD population: a study of epidemiology and transmission by the use of herpes simplex virus (HSV) typing and specific serology. 90011 Sexually Transmitted Infections 90012 2000; 76: 179-182. 90003 90002 Corey L, Wald A. Genital Herpes. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 399-437.90003 90002 Whitley RJ. Herpes Simplex Virus. In: Wallace RB, ed. 90011 Public Health and Preventive Medicine 90012. The McGraw-Hill Companies, Inc .; 2008. 90003 90002 Coyle PV, O’Neill HJ, Wyatt DE, McCaughey C, Quah S, McBride MO. Emergence of herpes simplex type 1 as the main cause of recurrent genital ulcerative disease in women in Northern Ireland. 90011 Journal of Clinical Virology 90012 2003; 27: 22-29. 90003 90002 Lowhagen GB, Tunback P, Bergstrom T. Proportion of herpes simplex virus (HSV) type 1 and type 2 among genital and extragenital HSV isolates.90011 Acta Dermato-Venereologica 90012 2002; 82: 118-120. 90003 90002 Bradford RD, Whitley RL, Stagno S. Herpesvirus Infections in Neonates and Children: Cytomegalovirus and Herpes Simplex Virus. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 1629-1658. 90003 90002 Smith EM, Ritchie JM, Summersgill KF et al. Age, sexual behavior and human papillomavirus infection in oral cavity and oropharyngeal cancers. 90011 International Journal of Cancer 90012 2004; 108: 766-772.90003 90002 Kashima HK, Shah F, Lyles A et al. A comparison of risk factors in juvenile-onset and adult-onset recurrent respiratory papillomatosis. 90011 Laryngoscope 90012 1992; 102: 9-13. 90003 90002 D’Souza G, Kreimer AR, Viscidi R et al. Case-control study of human papillomavirus and oropharyngeal cancer. 90011 New England Journal of Medicine 90012 2007; 356: 1944-1956. 90003 90002 Coutlee F, Trottier AM, Ghattas G et al. Risk factors for oral human papillomavirus in adults infected and not infected with human immunodeficiency virus.90011 Sexually Transmitted Diseases 90012 1997; 24: 23-31. 90003 90002 Dahlstrom KR, Li G, Tortolero-Luna G, Wei Q, Sturgis EM. Differences in history of sexual behavior between patients with oropharyngeal squamous cell carcinoma and patients with squamous cell carcinoma at other head and neck sites. 90011 Head & Neck 90012 2010 року; 33: 847-855. 90003 90002 D’Souza G, Agrawal Y, Halpern J, Bodison S, Gillison ML. Oral sexual behaviors associated with prevalent oral human papillomavirus infection.90011 Journal of Infectious Diseases 90012 2009 року; 199: 1263-1269. 90003 90002 Kreimer AR, Alberg AJ, Daniel R et al. Oral human papillomavirus infection in adults is associated with sexual behavior and HIV serostatus. 90011 Journal of Infectious Diseases 90012 2004; 189: 686-698. 90003 90002 Kreimer AR, Alberg AJ, Viscidi R, Gillison ML. Gender differences in sexual biomarkers and behaviors associated with human papillomavirus-16, -18, and -33 seroprevalence. 90011 Sexually Transmitted Diseases 90012 2004; 31: 247-256.90003 90002 Rintala M, Grenman S, Puranen M, Syrjanen S. Natural history of oral papillomavirus infections in spouses: a prospective Finnish HPV Family Study. 90011 Journal of Clinical Virology 90012 2006; 35: 89-94. 90003 90002 Clarke J, Terry RM, Lacey CJ. A study to estimate the prevalence of upper respiratory tract papillomatosis in patients with genital warts. 90011 International Journal of STD & AIDS 90012 1991; 2: 114-115. 90003 90002 Aaltonen LM, Cajanus S, Back L, Nieminen P, Paavonen J, Ranki A.Extralaryngeal HPV infections in male patients with adult-onset laryngeal papillomatosis. 90011 European Archives of Oto-Rhino-Laryngology 90012 2005; 262: 708-712. 90003 90002 Gillison ML, Broutian T, Pickard RKL et al. Prevalence of oral HPV infection in the United States, 2009-2010. 90011 JAMA 90012 2012; 307: E1-E11. 90003 90002 Winer RL, Koutsky LA. Genital Human Papillomavirus Infection. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed.New York: McGraw-Hill; 2008; 489-508. 90003 90002 Castro TP, Bussoloti F, I. Prevalence of human papillomavirus (HPV) in oral cavity and oropharynx. [Review] [82 refs]. 90011 Revista Brasileira de Otorrinolaringologia 90012 2006; 72: 272-282. 90003 90002 Miller CS, White DK. Human papillomavirus expression in oral mucosa, premalignant conditions, and squamous cell carcinoma: a retrospective review of the literature. [Review] [99 refs]. 90011 Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics 90012 1996; 82: 57-68.90003 90002 Terai M, Hashimoto K, Yoda K, Sata T. High prevalence of human papillomaviruses in the normal oral cavity of adults. 90011 Oral Microbiology & Immunology 90012 1999; 14: 201-205. 90003 90002 Derkay CS, Darrow DH. Recurrent respiratory papillomatosis. [Review] [63 refs]. 90011 Annals of Otology, Rhinology & Laryngology 90012 2006; 115: 1-11. 90003 90002 Derkay CS. Recurrent respiratory papillomatosis. [Review] [39 refs]. 90011 Laryngoscope 90012 2001; 111: 57-69. 90003 90002 Hawes SE, Kiviat NB.Screening for Cervical Cancer. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 1075-1104. 90003 90002 Balasubramanian A, Palefsky JM, Koutsky LA. Cervical Neoplasia and Other STD-Related Genital Tract Neoplasias. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 1051-1074. 90003 90002 Datta DS, Dunne E, Saraiya M, Unger E, Markowitz L.Human Papillomavirus. In: Roush SW, McIntyre L, Baldy LM, eds. 90011 Manual for the Surveillance of Vaccine-Preventable Diseases 90012. Fourth ed. Atlanta, GA: Centers of Disease Control and Prevention; 2008; 1-10. 90003 90002 Markowitz LE, Dunne EF, Saraiya M, et al. Use of 9-valent human papillomavirus (HPV) vaccination: updated HPV vaccination recommendations of the Advisory Committee on Immunization Practices (ACIP). 90011 MMWR — Morbidity & Mortality Weekly Report. Recommendations and Reports.90012 2014; 63 (RR05): 1-30. 90003 90002 Petrosky E, Bocchini Jr JA, Hariri S, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices. 90011 MMWR — Morbidity & Mortality Weekly Report. 90012 2015; 64 (11): 300-304 90003 90002 Derkay CS, Wiatrak B. Recurrent respiratory papillomatosis: a review. [Review] [106 refs]. 90011 Laryngoscope 90012 2008; 118: 1236-1247. 90003 90002 Ragin CC, Modugno F, Gollin SM. The epidemiology and risk factors of head and neck cancer: a focus on human papillomavirus.[Review] [152 refs]. 90011 Journal of Dental Research 90012 2007; 86: 104-114. 90003 90002 Kreimer AR, Clifford GM, Boyle P, Franceschi S. Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. [Review] [31 refs]. 90011 Cancer Epidemiology, Biomarkers & Prevention 90012 2005; 14: 467-475. 90003 90002 Gillison ML. Human papillomavirus-related diseases: oropharynx cancers and potential implications for adolescent HPV vaccination. [Review] [99 refs].90011 Journal of Adolescent Health 90012 2008; 43: Suppl-60. 90003 90002 Centers for Disease Control and Prevention. Making Sense of Your Pap and HIV Test Results. 90011 Centers for Disease Control and Prevention 90012 [serial online] 2008; Available from: Centers for Disease Control and Prevention. Accessed February 25, 2010. 90003 90002 National Cancer Institute. Pap Test Fact Sheet. 90011 National Cancer Institute 90012 [serial online] 2009 року; Available from: National Cancer Institute. Accessed February 25, 2010 року.90003 90002 Keet IP, brecht van LN, Sandfort TG, Coutinho RA, van Griensven GJ. Orogenital sex and the transmission of HIV among homosexual men. 90011 AIDS 90012 1992; 6: 223-226. 90003 90002 del Romero J., Marincovich B, Castilla J et al. Evaluating the risk of HIV transmission through unprotected orogenital sex. 90011 AIDS 90012 2002; 16: 1296-1297. 90003 90002 de Vincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. European Study Group on Heterosexual Transmission of HIV.90011 New England Journal of Medicine 90012 1994; 331: 341-346. 90003 90002 Page-Shafer K, Shiboski CH, Osmond DH et al. Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men. 90011 AIDS 90012 2002; 16: 2350-2352. 90003 90002 Samuel MC, Hessol N, Shiboski S, Engel RR, Speed ​​TP, Winkelstein W, Jr. Factors associated with human immunodeficiency virus seroconversion in homosexual men in three San Francisco cohort studies, 1984-1989.90011 Journal of Acquired Immune Deficiency Syndromes 90012 1993; 6: 303-312. 90003 90002 Vittinghoff E, Douglas J, Judson F, McKirnan D, MacQueen K, Buchbinder SP. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. 90011 American Journal of Epidemiology 90012 1999; 150: 306-311. 90003 90002 Lavoie E, Alary M, Remis RS et al. Determinants of HIV seroconversion among men who have sex with men living in a low HIV incidence population in the era of highly active antiretroviral therapies.90011 Sexually Transmitted Diseases 90012 2008; 35: 25-29. 90003 90002 Schacker T. The role of HSV in the transmission and progression of HIV. [Review] [45 refs]. 90011 Herpes 90012 2001; 8: 46-49. 90003 90002 van Griensven GJ, Tielman RA, Goudsmit J et al. Risk factors and prevalence of HIV antibodies in homosexual men in the Netherlands. 90011 American Journal of Epidemiology 90012 1987; 125: 1048-1057. 90003 90002 Raiteri R, Fora R, Sinicco A. No HIV-1 transmission through lesbian sex. 90011 Lancet 90012 1994; 344: 270.90003 90002 Darrow WW, Echenberg DF, Jaffe HW et al. Risk factors for human immunodeficiency virus (HIV) infections in homosexual men. 90011 American Journal of Public Health 90012 1987; 77: 479-483. 90003 90002 Moir S, Chun T-W, Fauci AS. Immunology and Pathogenesis of Human Immunodeficiency Virus Infection. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 341-358. 90003 90002 Coombs RW. Clinical Laboratory Diagnosis of HIV-1 and Use of Viral RNA to Monitor Infection.In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 1329-1347. 90003 90002 Eron JJ, Hirsch MS. Antiviral Therapy of Human Immunodeficiency Virus Infection. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 1393-1421. 90003 90002 Kaplan JE, Masur H. Preventing Opportunistic Infections Among HIV-Infected Persons. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 1423-1440. 90003 90002 Decker CF, Masur H. Clinical Management of HIV Infection: Management of Opportunistic Infections. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 1441-1467. 90003 90002 Cornett PA, Volberding P. AIDS-Related Malignancies. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012.Fourth ed. New York: McGraw-Hill; 2008; 1470-1421. 90003 90002 Press N, Chavez VM, Ticona E et al. Screening for sexually transmitted diseases in human immunodeficiency virus-positive patients in Peru reveals an absence of Chlamydia trachomatis and identifies Trichomonas vaginalis in pharyngeal specimens. 90011 Clinical Infectious Diseases 90012 2001; 32: 808-814. 90003 90002 Hobbs MM, Sena AC, Swygard H, Schwebke JR. Trichomas vaginalis and Trichomoniasis. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 771-793. 90003 90002 Lemon SM, Lok A, Alter MJ. Viral Hepatitis. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 509-543. 90003 90002 Centers for Disease Control and Prevention. 90011 Shigella sonnei 90012 Outbreak Among Men Who Have Sex with Men — San Francisco, California, 2000-2001. 90011 MMWR — Morbidity & Mortality Weekly Report 90012 2001; 50: 922-926.90003 90002 Aragon TJ, Vugia DJ, Shallow S et al. Case-control study of shigellosis in San Francisco: the role of sexual transmission and HIV infection. 90011 Clin Infect Dis 90012 2007; 44: 327-334. 90003 90002 Rompalo AM, Quinn TC. Sexually Transmitted Intestinal Syndromes. In: Holmes KK, Sparling PF, Stamm WE et al., Eds. 90011 Sexually Transmitted Diseases 90012. Fourth ed. New York: McGraw-Hill; 2008; 1277-1308. 90003 90002 Salit IE, Khairnar K, Gough K, Pillai DR. A possible cluster of sexually transmitted Entamoeba histolytica: genetic analysis of a highly virulent strain.90011 Clin Infect Dis 90012 2009 року; 49: 346-353. 90003 90002 Stark D, van Hal SJ, Matthews G, Harkness J, Marriott D. Invasive amebiasis in men who have sex with men, Australia. 90011 Emerging Infectious Diseases 90012 2008; 14: 1141-1143. 90003 90002 Baggaley RF, White RG, Boily MC. Systematic review of orogenital HIV-1 transmission probabilities. [Review] [29 refs]. 90011 International Journal of Epidemiology 90012 2008; 37: 1255-1265. 90003 90002 Bratt GA, Berglund T, Glantzberg BL, Albert J, Sandstrom E.Two cases of oral-to-genital HIV-1 transmission. 90011 International Journal of STD & AIDS 90012 1997; 8: 522-525. 90003 90002 Edwards S, Carne C. Oral sex and the transmission of viral STIs. [Review] [99 refs]. 90011 Sexually Transmitted Infections 90012 1998; 74: 6-10. 90003 90002 Edwards SK, White C. HIV seroconversion illness after orogenital contact with successful contact tracing. 90011 International Journal of STD & AIDS 90012 1995; 6: 50-51. 90003 90002 Lifson AR, O’Malley PM, Hessol NA, Buchbinder SP, Cannon L, Rutherford GW.HIV seroconversion in two homosexual men after receptive oral intercourse with ejaculation: implications for counseling concerning safe sexual practices. 90011 American Journal of Public Health 90012 1990; 80: 1509-1511. 90003 90002 Varghese B, Maher JE, Peterman TA, Branson BM, Steketee RW. 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. 90011 Sexually Transmitted Diseases 90012 2002; 29: 38-43. 90003 90002 Weinstock H, Workowski KA.Pharyngeal gonorrhea: an important reservoir of infection? 90011 Clinical Infectious Diseases 90012 2009 року; 49: 1798-1800. 90003 90002 Robinson EK, Evans BG. Oral sex and HIV transmission. [Review] [16 refs]. 90011 AIDS 90012 1999; 13: 737-738. 90003 90002 Rothenberg RB, Scarlett M, del RC, Reznik D, O’Daniels C. Oral transmission of HIV. [Review] [126 refs]. 90011 AIDS 90012 1998; 12: 2095-2105. 90003 90002 Hawkins DA. Oral sex and HIV transmission. 90011 Sexually Transmitted Infections 90012 2001; 77: 307-308.90003 .90000 Sexually Transmitted Diseases | Pocket Dentistry 90001 90002 Syphilis 90003 90004 Syphilis is an STD caused by 90005 Treponema pallidum. 90006 As with gonorrhea, humans are the only known natural hosts for syphilis. Broadly, there are early infectious stages (known as primary and secondary syphilis), and if untreated, there is a latent stage followed by a noninfectious late stage (tertiary syphilis). Late stage manifestations are diverse and have led to the historical designation of syphilis as the «great imitator» disease, which includes the imitation of malignancy.The primary site of syphilitic infection is the genitalia, although primary lesions also occur extragenitally, including the oral cavity. Congenital syphilis is also possible. Syphilis remains an important infection in contemporary medicine because of the morbidity it can cause. 90007 90002 Epidemiology 90003 90004 Of the three nationally reported notifiable STDs, syphilis is the least common with an incidence of 19,999 new primary and secondary syphilis cases reported in the United States to the CDC in 2014 (i.e., 6.3 cases per 100,000 persons), a rate that has almost doubled over the past decade. The estimated number of new and existing infections (i.e., including all stages of syphilis prevalence) in 2014 was 63,450. More than 10 men are infected for every woman, with the highest incidence in black men, although the greatest increases have been reported in men who have sex with men (MSM), which is concerning because of the increased risk for the transmission of HIV infection . 90007 90004 Congenital syphilis occurs when a fetus is infected in utero by an infected mother.In 2014 року, a rate of 11.6 per 100,000 live births was reported, demonstrating an increasing trend since 2012. 90007 90002 Etiopathogenesis 90003 90004 90005 Treponema pallidum 90006 is a slender, fragile microaerophilic spirochete. It is transmitted predominantly sexually, by genital-genital, oral-genital, or rectal-genital contact with contaminated sores. However, transmission also may occur through kissing or as a bloodborne infection and may be transmitted to fetuses, leading to congenital syphilis.90005 T. pallidum 90006 is easily killed by heating, drying, disinfecting, and using soap and water; as such, transmission by fomites is unlikely. It is believed that 90005 T. pallidum 90006 does not invade completely intact skin; however, it can invade intact mucosal epithelium and gain entry via minute abrasions or hair follicles. Within a few hours after invasion, spread to the lymphatics and the bloodstream occurs, resulting in early widespread dissemination of the disease. The risk of transmission occurs during the primary, secondary, and early latent stages of disease but not in late syphilis.90007 90002 Clinical Presentation 90003 90004 The clinical manifestations of syphilis are classically divided according to stages of disease, with each stage having its own unique signs and symptoms. These stages are primary, secondary, latent, tertiary, and congenital. Patients are most infectious during the first 2 years of the disease. It is important to note that many infected persons do not develop symptoms for years, yet they remain at risk for late complications if not treated. 90007 90002 Primary Syphilis 90003 90004 This stage is characterized by the chancre, a solitary (although multiple chancres are possible) round, often painless, somewhat firm lesion that develops at the site of contact with the infectious organism.The chancre usually occurs within 2 to 3 weeks (range, 10-90 days) after exposure (Figs. 13.4 and 13.5), and patients are infectious before it appears. The lesion begins as a small papule and enlarges to form a surface erosion or ulceration that commonly is covered by a yellowish hemorrhagic crust that is teeming with 90005 T. pallidum. 90006 Enlarged, painless, and firm regional lymphadenopathy is typically present. The chancre usually subsides in 3 to 6 weeks without treatment, leaving variable scarring in the form of a healed papule.More than 80% of chancres occur on the genitalia, and the most common extragenital site is the oral cavity or oropharynx (others include the fingers, nipples, perineum, anus, and rectum). If adequate treatment is not provided, the infection progresses to secondary syphilis. 90007 90034 FIG 13.4 90004 Primary syphilis: chancre of the penis. 90007 90004 (From Habif TP, Campbell JI Jr, Chapman MS, et al: 90005 Skin disease: diagnosis and treatment, 90006 ed 2, St. Louis, Mosby, 2005.) 90007 90034 FIG 13.5 90004 Chancre on the tongue seen in primary syphilis. 90007 90004 (From Ibsen DAC, Phelan JA: 90005 Oral pathology for the hygienist, 90006 ed 4, St. Louis, Saunders, 2003.) 90007 90002 Secondary Syphilis 90003 90004 The manifestations of secondary syphilis appear 6 to 8 weeks after initial exposure and are associated with the hematogenous spread and associated systemic immunologic response to 90005 T. pallidum. 90006 The chancre may or may not have completely resolved by this time.There is a wide spectrum of systemic signs and symptoms, including fever, malaise, headache, arthralgias, generalized lymphadenopathy, and patchy hair loss and a generalized eruption of the skin and mucous membranes, including the oral cavity (see Oral Manifestations section). In some cases, secondary syphilis can be asymptomatic. The skin rash is maculopapular (Fig. 13.6, 90005 A 90006) with well-demarcated and reddish brown areas involving the trunk and with a predilection for the palms and soles; they are typically not itchy.Warty lesions, known as condyloma lata, may involve the genitalia, the oral cavity, or both. Lues maligna is a rare and severe manifestation of secondary syphilis in immunocompromised patients, such as those with HIV infection. The lesions of skin and mucous membranes are highly infectious. Without treatment, secondary syphilis ultimately resolves; however, infection progresses to latent or late stages. 90007 90034 FIG 13.6 90004 Lesions of secondary syphilis. 90058 A, 90059 Profuse papular rash.90058 B, 90059 Multiple oral lesions, including mucous patches, and nonwipeable white plaques. 90007 90004 (A, From Habif TP, Campbell JI Jr, Chapman MS, et al: 90005 Skin disease: diagnosis and treatment, 90006 ed 2, St. Louis, Mosby, 2005. B, From Dr. Stefania Leuci, Federico II University of Naples, Italy.) 90007 90002 Latent Syphilis 90003 90004 Latent syphilis is defined as the third stage of the untreated infection. Patients are seroreactive but are asymptomatic and do not show clinical evidence of disease.Latent syphilis is divided into early latent syphilis (i.e., disease acquired within the preceding year) and late latent syphilis (> 1 year). During the first 4 years of latent syphilis, patients may have mucocutaneous relapses and are considered infectious. After 4 years, relapses typically do not occur, and patients are considered noninfectious. The latent stage may last for many years or even for the remainder of the person’s life. In some untreated patients, however, progression to tertiary syphilis occurs.90007 90002 Tertiary Syphilis 90003 90004 The tertiary (late) stage occurs in 10% to 40% of untreated persons, generally several years after disease onset. It is the destructive stage of the disease, although patients are considered noninfectious. Any organ of the body may become involved, and some have classified tertiary disease into three subtypes: neurosyphilis, cardiovascular, and gummatous disease. Neurosyphilis can result in a meningitis-like syndrome, Argyll Robertson pupils (which react to accommodation but not to light), altered tendon reflexes, general paresis, tabes dorsalis (degeneration of dorsal columns of the spinal cord and sensory nerve trunks), difficulty in coordinating muscle movements, or insanity.Cardiovascular syphilis is essentially vascular in nature and the end product of an obliterative endarteritis. This can lead to carotid and aortic stenosis and may ultimately manifest as an aneurysm of the ascending aorta. The gumma, which is the classic localized lesion of tertiary syphilis, may involve the skin, mucous membranes (including the oral cavity), bone, or within any organ. It is believed to be the end result of a hypersensitivity reaction and is basically a noninfectious inflammatory granulomatous lesion with a central zone of necrosis.90007 90002 Congenital Syphilis 90003 90004 Syphilis may occur congenitally if the mother is infected while pregnant (i.e., secondary to treponemal bacteremia), and transplacental infection can occur as early as 9 to 10 weeks in utero. Approximately 25% of pregnancies result in stillbirth, and 12% result in neonatal death. The majority of newborns (> 80%) are asymptomatic. The disease persists worldwide because a substantial number of women do not receive antenatal syphilis testing. There are early and late clinical manifestations.Early signs, manifesting at birth or up to 2 years after birth, may include hepatomegaly and associated liver dysfunction, hematologic abnormalities, mucocutaneous findings (ie, maculopapular rash, a rhinitis secondary to nasal inflammation, perioral and perineural condylomata lata), and bone changes (osteochondritis and periostitis causing pseudoparalysis) and, less commonly, neurologic manifestations. Late stage congenital syphilis is rare, and there is a classic triad of congenital syphilis known as Hutchinson’s triad that includes interstitial keratitis of the cornea, eighth nerve deafness, and dental abnormalities (see Oral Manifestations).In addition, rhinitis can lead to a saddle nose caused by cartilage destruction, rhagades, neurologic sequelae (including mental retardation), and bony abnormalities such as frontal bossing. 90007 90002 Laboratory and Diagnostic Findings 90003 90004 90005 T. pallidum 90006 has never been cultured successfully on any type of medium and is difficult to stain for microscopic examination. Historically, the definitive diagnosis of syphilis has been made from microscopic examination of fresh lesion exudates during the primary and early secondary stages using positive dark-field microscopic examination.Other direct testing includes direct fluorescence antibody (DFA) tests or polymerase chain reaction (PCR). However, such testing is no longer widely available, not indicated to detect all stages of syphilis, and can not be used to monitor the disease after treatment. With the advent of serologic tests, the traditional diagnosis of syphilis is based on clinical findings in conjunction with a two-step testing algorithm using a nontreponemal «screening» test followed by a confirmatory specific treponemal test.90007 90002 Nontreponemal Testing 90003 90004 The nontreponemal tests include the Venereal Disease Research Laboratory (VDRL) slide test and the rapid plasma reagin (RPR) test. These tests, both equally valid but noncomparable, detect an antibody-like substance called reagin, which is a surrogate for the immunologic response to a syphilis infection. They are less specific but can better assess current disease activity. The initial test is qualitative, and if positive, a quantitative step is performed that generates «titers» values ​​reported as serologic dilutions (e.g., 1: 2, 1: 4, 1: 8). They are consistently positive and yield the highest titers between 3 and 8 weeks after the appearance of the primary chancre. A fourfold change in titers (e.g., 1: 4 to 1: 16 or 1: 32 to 1: 8) is the threshold signifying a clinically meaningful change in serial test results. In primary syphilis, nontreponemal test results usually revert to negative within 12 months after successful treatment. In secondary syphilis, up to 24 months may be required for the patient to become seronegative.Occasionally, a patient will remain seropositive for the rest of his or her life or will test positive with an associated infection or condition (false positive). With tertiary syphilis, many patients remain seropositive for life. 90007 90002 Treponemal Testing 90003 90004 These include the fluorescent treponemal antibody absorption test (FTA-ABS), 90005 T. pallidum 90006 particle agglutination assay (TPPA), 90005 T. pallidum 90006 hemagglutination assay (TPHA), and various immunoassays (i.e., enzyme immunoassays [EIAs], chemiluminescent immunoassays [CIAs], and microbead immunoassays [MIAs]). These are highly specific, but a positive test result can not differentiate between current and past infection because antibodies remain positive in most patients. 90007 90004 A newer three-step «reverse» algorithm has been adopted with the intent to better capture those with a past history of infection and early stage disease. A treponemal immunoassay is performed first and if reactive is followed by a qualitative nontreponemal test.If this second test result is negative, a final quantitative nontreponemal test is performed. Recently, the FDA has approved a rapid point-of-care treponemal screening test known as the Syphilis Health Check. These point-of-care tests have similar performance to the laboratory treponemal tests and may facilitate screening in resource limited settings. 90007 90002 Medical Management 90003 90004 Testing for concomitant HIV infection and the diagnosis and management of infection in the patient’s sexual partners are recommended.Parenteral injection of long-acting benzathine penicillin G, 2.4 million IU IM in a single dose, remains the recommended and predictable treatment for primary, secondary, or early latent syphilis in adults; 50,000 IU / kg of penicillin G should be used for children or infants. As with gonorrhea, infectiousness is reversed rapidly, probably within a matter of hours after injection. A more intensive regimen is indicated for those with late latent or tertiary syphilis: injections of 2.4 million IU IM once a week for 3 weeks (i.e., total of 7.2 million IU). Neurosyphilis or ocular syphilis is managed more effectively with either 18 to 24 million IU of aqueous crystalline penicillin G delivered intravenously (IV) or 2.4 million IU procaine penicillin G given IM daily plus probenecid 500 mg four times a day, with both regimens given over a 10 to 14-day period. Neonates with possible congenital syphilis should be assessed by means of clinical, radiographic, and laboratory tests of blood and cerebrospinal fluid (CSF) for VDRL.If results prove presence of the disease or suggest that syphilis is highly probable, then the infant should be treated with IV penicillin G for at least 10 days. The first-line drug for patients allergic to penicillin (except for pregnant patients) is oral doxycycline (100 mg orally twice a day for 2 weeks) or tetracycline 500 mg four times a day for 2 weeks. Desensitization to penicillin is recommended for pregnant patients allergic to penicillin. Patients with primary or secondary syphilis who are otherwise immunocompetent should be retested at 6 and 12 months to monitor for seroconversion.HIV-infected patients and those with late latent or tertiary syphilis require more intensive or longer surveillance, respectively. The Jarisch-Herxheimer reaction is an acute febrile reaction that is frequently accompanied by chills, myalgias, and headache that occur within 24 hours after initiation of antibiotic therapy for syphilis. It occurs most often (i.e., in 50% patients) after treatment for early syphilis. 90007 90002 Dental Considerations 90003 90004 Lesions of untreated primary and secondary syphilis are infectious, as are the patient’s blood and saliva.Even after treatment has begun, its absolute effectiveness can not be determined except through conversion of the positive serologic test to negative; however, early reversal of infectiousness is to be expected after antibiotic treatment has been initiated. The time required for this conversion varies from a few months to longer than 1 year. Therefore, patients who are currently under treatment or who remain seropositive for syphilis after receiving treatment should be viewed as potentially infectious.Still, any necessary dental care may be provided with adherence to standard precautions unless oral lesions are present. Dental treatment can commence after oral lesions have been successfully treated. 90007 90002 Oral Manifestations 90003 90004 Oral syphilitic chancres and mucous patches are usually painless unless they become secondarily infected. Both lesions are highly infectious. Oral chancres (see Fig. 13.4) are typically solitary lesions that may involve the lips, tongue, oropharynx, or other oral sites and may be associated with lymphadenopathy.They begin as a round papule that erodes into a painless ulcer with a smooth surface. Size can vary from a few millimeters to more than 2 cm. Sometimes chancres may demonstrate induration. The oral manifestations of secondary syphilis (present in> 30% of patients) (Fig. 13.6, 90005 B 90006) are highly variable and include single or multiple lesions such as mucous patches, maculopapular lesions (ie, the likely counterpart to the skin rash ), erosions, ulcerations including a peculiar «snail-track» variety, white plaques resembling leukoplakia, and papulonodular lesions.The intraoral mucous patch is often asymptomatic and appears as a slightly raised grayish plaque and may involve multiple oral sites. The oral gumma of tertiary syphilis is rare. It typically presents as a solitary lesion that most commonly involves the tongue and palate, which may be exophytic, indurated, and with surface ulceration. Palatal gummas may erode bone and perforate into the nasal cavity or maxillary sinus, creating an oronasal or oral-antral fistula. An atrophic or interstitial glossitis has also been reported in tertiary syphilis.Oral manifestations of congenital syphilis include peg-shaped permanent central incisors with notching of the incisal edge (Hutchinson’s incisors) (Fig. 13.7), defective molars with multiple supernumerary cusps (mulberry molars), a high narrow palate, and perioral rhagades (skin fissures ). 90007 90034 Only gold members can continue reading. Log In or Register to continue 90004 90115 90116 Related 90117 90118 90007 .90000 Sexually transmitted disease — Simple English Wikipedia, the free encyclopedia 90001 90002 A 90003 sexually transmitted disease 90004 (90003 STD 90004) is a disease which spreads by having sex. STDs can spread through oral sex or anal sex, or when two people’s genitals touch. Today, STDs are usually called 90003 sexually transmitted infections 90004 (90003 STIs 90004). In the past, they were called 90003 venereal diseases 90004 (90003 VD 90004). 90015 90002 STDs can be caused by viruses, bacteria, or parasites.Examples of the most common STDs are listed on this page. 90015 90018 Numbers Sexually Transmitted Diseases in the US 90019 90020 STDs caused by viruses [change | change source] 90021 90022 Human Immunodeficiency Virus (HIV) [change | change source] 90023 90002 HIV causes the immune system — the system in the body that is supposed to fight off infection — to not work as well as it should. This makes people with HIV more likely to get infections and some other diseases, like some cancers.HIV is the virus that causes AIDS. 90015 90022 Human papillomavirus (HPV) [change | change source] 90023 90002 There are about 40 different kinds of HPV that can be spread through sex and affect the anus and genitals. 90029 [1] 90030 Examples of diseases that HPV can cause include: 90015 90022 Hepatitis viruses [change | change source] 90023 90002 Hepatitis is an infection of the liver. There are three common types of hepatitis: hepatitis A, hepatitis B, and hepatitis C. 90015 90002 Hepatitis A causes a short-term liver infection.It can be spread by having sex, though this is not the most common way to get hepatitis A. 90029 [4] 90030 90015 90002 Hepatitis B and hepatitis C cause much more serious, long-lasting liver problems. Both can cause very bad liver disease, like cirrhosis, and death. They are more likely than hepatitis A to be spread by having sex. 90029 [4] 90030 90015 90022 Herpex simplex virus [change | change source] 90023 90002 The herpes simplex virus (HSV) causes genital herpes. Genital herpes can cause painful blisters on the genitals and anus.Herpes can also cause sores on the mouth. 90029 [5] 90030 90015 90002 There is no cure for herpes. 90029 [5] 90030 90015 90020 STDs caused by bacteria [change | change source] 90021 90022 Chlamydia [change | change source] 90023 90002 Chlamydia is one of the common STDs in the world. In humans, it is the most common STD caused by bacteria. 90029 [6] 90030 In the United States alone, about 2.8 million more people get chlamydia infection every year. 90029 [7] 90030 90015 90002 If chlamydia is not treated, it can cause serious problems, like diseases of the genitals and eyes.It can even cause blindness. 90029 [8] 90030 Chlamydia can also cause permanent damage to a woman’s reproductive system if it is not treated. 90029 [4] 90030 90015 90022 Gonorrhea [change | change source] 90023 90002 Gonorrhea can infect the genitals, rectum, mouth, throat, and eyes. 90029 [9] 90030 In bad cases, it can spread through the blood to infect the body’s joints. In the worst cases, it can spread through the blood and infect the heart (causing endocarditis, an infection of the heart’s valves) or the spinal cord (causing meningitis).90029 [9] 90030 90015 90022 Syphilis [change | change source] 90023 90002 Syphilis can cause many serious problems if it is not treated. It makes a person much more likely to get HIV, because it causes sores on the genitals that make it easier for HIV (and other STDs) to get spread. 90029 [10] 90030 After a few years, if people with syphilis do not get treated, they can have serious problems with the organs in their body. Eventually — without treatment — syphilis infects the brain and causes death.90015 90020 STDs caused by parasites [change | change source] 90021 90022 Trichomoniasis [change | change source] 90023 90002 Trichomoniasis is the most common STD in the world that is not caused by a virus. 90029 [11] 90030 It can cause inflammation swelling of the vagina (vaginitis, urethra (urethritis), or penis. It can also cause more serious problems. If it is not treated, it can cause permanent damage to a woman’s reproductive system. It can also cause prostate cancer, 90029 [12] 90030 and makes a woman more likely to give birth to a premature baby.90029 [13] 90030 90015 90002 The only way for a person to be sure they will not get an STI is for that person not to have sex. This includes sex of any kind. 90029 [14] 90030 90015 90002 There are some things that a person can do to make it less likely to get an STI: 90029 [14] 90030 90015 90104 90105 Practice safer sex. Use condoms and other forms of birth control 90106 90105 Stay with one sexual partner who has tested negative for STDs 90106 90105 Do not have sex with anyone until you are both tested for STDs 90106 90105 Get the vaccines for HPV, hepatitis A, and hepatitis B 90106 90113 90114 90105 ↑ Division of STD Prevention (1999).Prevention of genital HPV infection and sequelae: report of an external consultants ‘meeting. Atlanta, GA: Centers for Disease Control and Prevention 90106 90105 ↑ 90029 2.0 90030 90029 2.1 90030 90122 Stanley, Margaret A; Winder, David M; Sterling, Jane C; Goon, Peter KC (2012). «HPV infection, anal intra-epithelial neoplasia (AIN) and anal cancer: current issues». 90123 BMC Cancer 90124. 90003 12 90004 (1): 398. doi: 10.1186 / 1471-2407-12-398. ISSN 1471-2407. 90127 90106 90105 ↑ 90122 «Summary of the WHO Position Paper on Vaccines against Human Papillomavirus (HPV)» (PDF).World Health Organization. 17 October 2014. Retrieved 23 January 2015. 90127 90106 90105 ↑ 90029 4.0 90030 90029 4.1 90030 90029 4.2 90030 90122 «Sexually Transmitted Diseases (STDs)». 90123 nichd.nih.gov 90124. National Institutes of Health — National Institute of Child Health and Human Development. May 28, 2013. 90127 90106 90105 ↑ 90029 5.0 90030 90029 5.1 90030 90122 Balasubramaniam, R; Kuperstein, AS; Stoopler, ET (April 2014 року). «Update on oral herpes virus infections».90123 Dental clinics of North America 90124. 90003 58 90004 (2): 265-80. doi: 10.1016 / j.cden.2013.12.001. PMID 24655522. 90127 90106 90105 ↑ 90122 Gerbase AC, Rowley JT, Mertens TE (1998). «Global epidemiology of sexually transmitted diseases». 90123 Lancet 90124. 351 Suppl 3: 2-4. PMID 9652711. 90127 CS1 maint: multiple names: authors list (link) 90106 90105 ↑ Chlamydia fact sheet from the Centers for Disease Control and Prevention 90106 90105 ↑ 90122 Belland R, Ojcius D, Byrne G (2004).»Chlamydia». 90123 Nat Rev Microbiol 90124. 90003 2 90004 (7): 530-1. doi: 10.1038 / nrmicro931. PMID 15248311. 90127 CS1 maint: multiple names: authors list (link) 90106 90105 ↑ 90029 9.0 90030 90029 9.1 90030 90122 Marr, Lisa (2007) [1998]. 90123 Sexually Transmitted Diseases: A Physician Tells You What You Need to Know 90124 (Second ed.). Baltimore, Maryland: Johns Hopkins University. ISBN 90181 978-0-8018-8658-4 90182. 90127 90106 90105 ↑ 90122 Committee on Infectious Diseases (2006).Larry K. Pickering (ed.). 90123 Red book 2006 Report of the Committee on Infectious Diseases 90124 (27th ed.). Elk Grove Village, IL: American Academy of Pediatrics. pp. 631-44. ISBN 90181 9781581102079 90182. 90127 90106 90105 ↑ World Health Organization. Prevalence and Incidence of Selected Sexually Transmitted Infections, Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and Trichomonas vaginalis: Methods and Results Used by WHO to Generate 2005 Estimates. 2011. Available at: http: // whqlibdoc.who.int/publications/2011/9789241502450_eng.pdf. 90106 90105 ↑ 90122 Caini, Saverio; Gandini, Sara; Dudas, Maria; Bremer, Viviane; Severi, Ettore; Gherasim, Alin (2014 року). «Sexually transmitted infections and prostate cancer risk: A systematic review and meta-analysis». 90123 Cancer Epidemiology 90124. 90003 38 90004 (4): 329-338. doi: 10.1016 / j.canep.2014.06.002. ISSN 1877-7821. PMID 24986642. 90127 90106 90105 ↑ 90122 Secor W, Meites E, Starr M, Workowski K (2014 року). «Neglected parasitic infections in the United States: trichomoniasis».90123 Am J Trop Med Hyg 90124. 90003 90 90004 (5): 800-804. doi: 10.4269 / ajtmh.13-0723. 90127 CS1 maint: multiple names: authors list (link) 90106 90105 ↑ 90029 14.0 90030 90029 14.1 90030 90122 «Sexually Transmitted Diseases (STDs)». 90123 mayoclinic.org 90124. The Mayo Clinic. August 19, 2014. Retrieved January 2, 2015. 90127 90106 90221 .