STI Public Health Lecture 2019

Christian Ezekiel R.
Derla, MD
Department of Family and Community Medicine

September 24, 2019
Objectives:
• To be able to identify some of the
common STIs
• To be able to know their differences
• To be able to know how to detect an STI
• To be able to know how to prevent

getting an STI
References
• World Health Organization
• Centers for Disease Control and Prevention
• https://www.cdc.gov/std/prevention/default.htm
• https://www.cdc.gov/std/chlamydia/stdfact-
chlamydia.htm
• https://www.webmd.com/sexual-
conditions/guide/chlamydia#1
• https://www.webmd.com/sexual-conditions/syphilis#1
• https://www.cdc.gov/std/herpes/
What are STIs (or STDs)?
Diseases that are transmitted and

contracted through having
unsafe SEX
Why learn?
• > 1M STIs are acquired EVERYDAY
worldwide
• est. 376 M new infections EVERY YEAR

(chlamydia, gonorrhea, syphilis, and trichomoniasis)
• > 290 M women have HPV infections
• Serious consequences such as INFERTILITY

and Mother-to-child transmission
WHO. (2019). Sexually transmitted infections (STIs). Available:https://www.who.int/
news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
How is it
spread? 3 ways
Exchange of Mother – to - Needles/Sharin
bodily fluids child g of needles
with an infected transmission with an infected
person person
STDs are NOT transmitted
through…
Are you at risk?
UNPROTECTED SEX
• Increases the
chance to get STD
• Exchange of bodily
fluids
Being < 25 years old
• Young women are

more biologically
susceptible than
older women.
Illicit drug use
• Drug influence
makes easier to
engage in risky
behavior
• IV drug-use
increases risk of
blood-borne
diseases
Serial monogamy
• More likely to be
tempted to STOP
USING safer sex
precautions.
Multiple partners
• The more partners

you have, that
more you will be
exposed to an STD.
Alcohol Use
• Less discriminating
about whom they
choose to have sex
with
• Loss of inhibition
Sex for money or drugs
• People who trade

sex for money or
drugs may not be
sufficiently
empowered to
negotiate for a
safer sex.
Previously had STD
• Having STD
frequently makes
you susceptible to
other STD infection
• EX.
If you have
Gonorrhea, you
might also have
Hepatitis B
• Community with
high prevalence of
STD
• Having a high-risk
STD partner (such as
CSW)
• Thinks that taking

“pills” is enough
Common STI’s
• Gonorrhea • Chlamydia
• Trichomoniasis • Hepatitis B
• Syphilis • HIV
• Herpes
Symptoms
• Sores or bumps: genitals, oral area, anal area
Mayo Clinic. (2019). Sexually transmitted diseases. Available: https://www.mayoclinic.org/diseases-

conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240
Symptoms
• Painful or burning urination
• Unusual or odd-smelling genital discharges
• Pain during sex

Genital discharges
Symptoms
• Sore, swollen lymph nodes particularly in the groin
• Lower abdominal pain

Symptoms
• Fever
• Rashes: trunk, hands, or feet

Gonorrhea
• “TULO”
• Symptoms start:
2 – 30 days after
having sex with an infected
person
Gonorrhea in Men
Gonorrhea in Women
Rectal infections
Discharge
Anal itching
Soreness
Bleeding
Painful bowel
movements
What happens if I don’t get
treated?
• Formation of
scar tissue
the blocks
fallopian
tubes
treated?
treated?
• Infertility
• Long - term pelvic/abdominal pain

Trichomoniasis
• “TRICH”
• Symptoms start:
5-28 days after
person
• But varies
• Mostly women
How do you know if you have Trichomoniasis?
Men Women
Itching or irritation inside the Itching, burning, redness or

penis soreness
Burning after urination or

Discomfort with urination
ejaculation
Vaginal discharge that is clear,

Discharge from penis white, yellowish or greenish
with unusual fishy smell
Strawberry Cervix
Syphilis
• Symptoms start:
10 - 90 days after
person
• has 3 stages
• Primary stage
 Painless sore
(chancre)
 Sores around the
mouth or genitals
 Highly infectious
• Secondary
stage
 rash, fever,
lymphadenopath
y
Secondary Syphilis
• Skin rashes “copper penny”
• palms of the hands
• Soles of the feet
• Warts in the groin
• White patches on the inside of

mouth
• Lymphadenopathy
• Fever
• Tertiary Stage
 Heart,brain and
nerve that will lead to
paralysis, blindness,
and dementia
Neurosyphilis and Ocular
Syphilis
• Severe headache
• Difficulty coordinating muscle movements
• Paralysis
• Numbness
• Dementia
Herpes simplex
• Symptoms start:
2 – 14 days after having sex with an
infected person
• has 2 types: HSV1 (Oral)
HSV2 (Genital)
HSV 1: Oral Herpes
• Cold sores
• Blisters
• Oral herpes can

spread from the
mouth to the
genitals through
oral sex
HSV 2: Genital Herpes
• More than 1 of
every 6 people
aged 14 - 49
years have
genital herpes
Chlamydia
• Symptoms start:
14 - 21 days after
having sex with an
infected person
• 75% of infections in
women and 50% in men
are without symptoms
• Can cause PERMANENT DAMAGE to
women’s reproductive system.
• Discharges from penis
• Burning sensation when
urinating
• Painful testicular swelling
• Burning and itching
around the opening of
the penis
• Abnormal vaginal
discharges
• Burning sensation when
urinating
• Painful menses and sex
• Burning and itching in and
around the vagina
• Bleeding between periods
Rectal Infection
Rectal pain
Discharges
Bleeding
Hepatitis B
• Symptoms start:
28 – 42 days after
getting infected
• Flu-like
• Yellowing of the skin and eyes
• Abdominal pain
• Hepatitis B can NOT be transmitted
through…
• DOLE Dept.
Advisory 05 – 2010
• Right to work for

patients infected
with Hepatitis B
• Can lead to liver cirrhosis and/or liver
cancer
HIV-AIDS
• Symptoms start:
can be asymptomatic for years
Stage 4:
Acquired Immuno-
deficiency Syndrome
(AIDS)
PREVENTION
PREVENTION
1. Abstinence
2. Mutual monogamy
3. Condom use
4. Reduce number of sex partners
5. Vaccination
Abstinence
• The
most
reliable
way to
avoid
infection
Mutual Monogamy
• Be sexually active with
only one person
• It is important
to have an open
and honest conversation
with your partner
Condoms
• Correct and consistent
use of latex condom =
highly effective
• Use a condom every

time you have anal,
vaginal and oral sex
The Right Way To Use A Male Condom
Do’s Dont’s
DON’T store condoms in your
DO use a condom every time you
wallet as heat and friction can
have sex
damage them
DON’T use a nonoyxnol-9
DO put on a condom before
(spermicide) as this can cause
having sex
irritation
DON’T use oil-based products like
DO read the package and check
baby oil, lotion, petroleum jelly, or
the expiration date
cooking oil
DO make sure there are no tears DON’T use more than one condom
or defects at a time
DO store condoms in a cool, dry
place
DO use latex or polyurethane
condoms
The Right Way To Use A Male
Condom
Reduce Number of Sex
Partners
• decreases your
risk for STIs
• you and your partner

get tested
• share your test
results with one
another
Vaccination
• safe, effective, and
recommended
to prevent hepatitis B and
HPV
• Recommend for all

teen
girls and women
through age 26
• Recommended for all
teen boys and men
through age 21
Questions?

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Christian Ezekiel R.

Department of Family and Community Medicine

• To be able to know their differences

• To be able to know how to detect an STI

• To be able to know how to prevent

• Centers for Disease Control and Prevention

Diseases that are transmitted and

• est. 376 M new infections EVERY YEAR

• > 290 M women have HPV infections

• Serious consequences such as INFERTILITY

• Young women are

• The more partners

• People who trade

• Thinks that taking

Mayo Clinic. (2019). Sexually transmitted diseases. Available: https://www.mayoclinic.org/diseases-

Mayo Clinic. (2019). Sexually transmitted diseases. Available: https://www.mayoclinic.org/diseases-

Mayo Clinic. (2019). Sexually transmitted diseases. Available: https://www.mayoclinic.org/diseases-

Mayo Clinic. (2019). Sexually transmitted diseases. Available: https://www.mayoclinic.org/diseases-

• Long - term pelvic/abdominal pain

Itching or irritation inside the Itching, burning, redness or

Burning after urination or

Vaginal discharge that is clear,

• palms of the hands

• Soles of the feet

• Warts in the groin

• White patches on the inside of

• Difficulty coordinating muscle movements

• has 2 types: HSV1 (Oral)

• Oral herpes can

• Yellowing of the skin and eyes

• Right to work for

• Use a condom every

• you and your partner

• Recommend for all

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