Sexually Transmitted Infection

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Most Common STI

  • HPV (Human Papillomavirus) is the most common STI, with nearly 100% lifetime prevalence.
  • The most common non-viral STI in the U.S. is Trichomoniasis.

STI Reporting & Partner Treatment

  • Reportable STIs (in all states): Syphilis, Gonorrhea, Chlamydia, Chancroid, HIV/AIDS.

  • Expedited Partner Therapy (EPT): A way to treat a partner without a doctor’s visit by giving medications or a prescription to the patient for their partner.

    • EPT Treatment: Cefixime 800 mg + Doxycycline 100 mg twice daily for 7 days.

  • Partners should also get tested and treated ASAP.

Chlamydia: The Silent Infection

  • Annual screening is recommended for all women under 25 and those at risk.
  • Testing: Urine test or vaginal swab (NAATs are most accurate).
  • Treatment:
    • Azithromycin 1g PO once or Doxycycline 100 mg PO twice daily for 7 days
    • No sex for 7 days after treatment.
    • Pregnant? Use Azithromycin or Amoxicillin instead of Doxycycline.

Gonorrhea: Often Hiding with Chlamydia

  • Often asymptomatic and frequently co-infected with Chlamydia.

  • Screening: Annual testing for women under 25 and those at risk.

  • Treatment:

    • Ceftriaxone 500 mg IM once (1000 mg if over 150 kg)

    • Add Doxycycline for 7 days if Chlamydia is not ruled out.

Trichomoniasis: The "Trich" Dance

  • Symptoms: Yellow-green, foul-smelling discharge with vaginal irritation.
  • Testing: NAAT (best test) or wet prep (shows “wiggling” trichomonads).
  • Treatment:
    • Metronidazole 500 mg PO twice daily for 7 days.
    • Sex partners must be treated (avoid sex until both complete treatment).
    • Retest in 3 months due to high recurrence.

Genital Herpes: Painful Sores That Come & Go

  • Caused by HSV-1 or HSV-2 (lifelong infection).
  • Symptoms: Painful blisters or sores on the genitals.
  • Testing: PCR swab or viral culture.
  • Treatment: Antiviral medications help control outbreaks but do not cure herpes.

Syphilis: The Great Pretender

  • Stages:
      • Primary → Painless sore (chancre).
      • Secondary → Rash on palms/soles, fever, swollen lymph nodes.
      • Latent → No symptoms but still infectious.
      • Tertiary → Can damage the brain, heart, and nerves.
    • Testing: Blood tests (RPR, VDRL) and confirmatory treponemal test.
    • Treatment: Penicillin injection.

HPV & Genital Warts: The Virus That Sticks Around

  • HPV is the most common STI, and some strains cause warts while others increase cancer risk.
  • Prevention: HPV Vaccine (Gardasil) protects against high-risk and wart-causing strains.
  • Treatment for Warts:
    • Imiquimod cream
    • Cryotherapy (freezing)
    • Surgical removal (if needed)
  • HPV testing is NOT needed for genital warts.

HIV: Know Your Status

  • Screening:

    • Everyone 13-64 years old should be tested at least once.

    • Annual testing for those at risk.

    • Pregnant women should be tested in every pregnancy.

  • Prevention:

    • PrEP (Pre-Exposure Prophylaxis) for those at high risk.

    • PEP (Post-Exposure Prophylaxis) within 72 hours of high-risk exposure.

  • Treatment: Antiretroviral therapy (ART) can help people with HIV live normal lives.

Takeaway Tips for STI Prevention

  • Get tested regularly (especially if under 25 or have new/multiple partners). Use condoms to reduce risk.
  • Get vaccinated for HPV and Hepatitis B.
  • Limit alcohol and drugs (reduces risky behaviors).
  • Talk to your partner about STI testing and protection.

Your sexual health is important—get tested, stay informed, and protect yourself!

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