TOPIC 7: MIDTERMS – HEALTHCARE → Both symptomatic & asymptomatic can lead

to serious complications
Sexually Transmitted Diseases
STI EFFECT ON WOMEN HEALTH
Sexually Transmitted Infections (STIs) → Untreated STI can affect
→ + their complications belong to the top five  Reproductive
disease categories for which adults seek health  Maternal
care in developing countries (WHO)  Newborn health
→ Major global cause of
10-40% of Develop PID (pelvic inflammatory
 Acute illness women with disease)
 Infertility untreated - 6-10x more likely to develop
 Long term disability chlamydial ectopic (tubal) pregnancy
 Death infection - 40-50% of ectopic
→ w/ severe medical & psychological pregnancies can be attributed
consequences (men, women, children) to previous PID
→ unlike HIV, many STI can be treated and 30-40% of Attributed to post-infection tubal
cured relatively easily and cheaply (if female damage
diagnosed early enough) infertility

 Human Papillomavirus (HPV)

CURABLE STIs (4)
- Lead to genital cancers
1. Chlamydia
- Cervical cancer  women
2. Gonorrhea
3. Trichomonas
4. Syphilis – causes most concern STI AND PREGNANCY
→ Untreated STIs are associated with:
→ Consistent and correct use of condom – most  Congenital infection
important method to prevent transmission  Perinatal infection
→ 448 million new infections of curable STIs per **In neonates
 In pregnant women with untreated early
year (adults aged 15-49)
SYPHILIS
→ Some STI exist without symptoms
25% of Stillbirth
pregnancy
KEY FACTS
14% of Neonatal death
 STI is the main preventable cause of infertility pregnancy
(esp. in women) Overall perinatal morality of about 40%
 WHO: syndromic approach to diagnosis and
management of STI  In pregnant women with untreated
GONOCOCCAL INFECTION
INFECTION AND TRANSMISSION 35% of Spontaneous abortion
→ Spread primarily through person-to-person pregnancy
sexual contact 10% of Perinatal death
→ More than 30 different sexually transmissible pregnancy
bacteria, viruses, and parasites
In the ABSENCE OF PROPHYLAXIS,
!! HIV AND SYPHILIS: can be transmitted from 30-50% of Born from mothers with
mother to child during pregnancy and childbirth, infants untreated gonorrhea
and through blood products and tissue transfer 30% of infants From mothers with untreated
chlamydial infection
STI WITHOUT SYMPTOMS Will develop ophthalmia neonatorum  serious
→ 70% of women and significant proportion of eye infection which can lead to blindness
men with
1. Gonococcal infection → Worldwide, 1000-4000 newborns become
2. Chlamydial infection blind every year because of this condition
Experience no symptoms at all

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 STIs and HIV  Transmission
→ Presence of untreated STIs = increased risk - Through sexual contact with penis, vagina,
for acquisition & transmission of HIV mouth, or anus of infected partner
- Ejaculation does not have to occur to be
STI Syndromes transmitted
1. Urethral discharge - Can be perinatally from mother to child
2. Genital ulcers during childbirth
3. Inguinal swellings - Recovered with gonorrhea may be reinfected if
4. Scrotal swelling they have sexual contact again with infected
5. Vaginal discharge person
6. Lower abdominal pain
7. Neonatal eye infections (conjunctivitis)  Signs and Symptoms
- Many men with gonorrhea are asymptomatic
PREVENTION - When present (urethral infection)
→ Most effective:  Dysuria  white, yellow, or green urethral
1. Abstain from sexual intercourse discharge that usually appears 1 to 14
2. Have sexual intercourse only within a long- days after infection
term, mutually monogamous relationship  Burning on urination
w/ uninfected partner  Ocular and periocular symptoms
3. Male latex condoms – consistent and
correct use highly effective in reducing - Most women with gonorrhea are
transmission of STIs asymptomatic
- Mild, non-specific  mistaken for
COMMON STDs bladder/vaginal infection
1. Gonorrhea  Dysuria
2. Syphilis  Increased vaginal discharge
3. Chlamydia  Vaginal bleeding between periods
4. Trichomoniasis  Painful urination & intercourse
5. Hepatitis B
6. HIV/AIDS - Symptoms of rectal infection in both men
7. Genital Herpes and women
8. Genital Warts  Discharge
9. HPV  Anal itching
 Soreness
1. GONORRHEA (clap and drip)  Bleeding
- Caused by Neisseria gonorrhoeae bacterium  Painful bowel movements
(gram-negative diplococci)  May be asymptomatic
- Infects mucous membranes of the - Pharyngeal infection may cause sore throat,
reproductive tract but usually is asymptomatic
 Cervix
 Uterus COMPLICATIONS OF GONORRHEA
 Fallopian tubes Women 1. Bartholin’s Abscess
 Urethra – in men and women 2. PID (pelvic inflammatory disease)
Men 1. Epididymitis
- Mucous membranes of
Men & 1. DGI (Disseminated gonococcal
 Mouth
Women infection)
 Throat
 Eyes
!!! Gonorrhea can increase a person’s risk of
 Anus
acquiring/transmitting HIV, which causes AIDS

 Incubation Period: 2-10 DAYS, possibly >3 days

 Pregnant woman and baby:
- Very common infectious disease
- If mother is infected with gonorrhea, she can
- 200 millioin cases annually (global)
transmit to the baby as the baby passes
- CDC: >700,000 people in US
through the birth canal during delivery

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  Blindness - Easy to cure in early stages
 Joint infection - Most common during the years of peak sexual
 Life-threatening blood infection in the activity
baby - Most new cases – men and women aged 15-
40 years
 Who should get tested for gonorrhea? - Men are affected more frequently with
1. Anyone with genital symptoms primary/secondary syphilis
2. Anyone with oral, anal, or vaginal sex partner - Prevalent in North America, Asia, and Europe
who has been recently diagnosed with STD (esp. Eastern Europe)
3. People even with no symptoms or know of a - Highest rates: South and SE Asia, sub-Saharan
sex partner who has gonorrhea Africa
4. Anyone sexually active
5. People with gonorrhea should also be tested  Incubation Period: 10 days – 3 months (ave. 21
for other STDs days)

DIAGNOSIS OF GONORRHEA - Preliminary 2007 data (US RATE OF P & S

Test Specimen SYPHILIS)
NAAT (Nucleic acid  Urine, urethral (men)  Increased 12% between 2006 and 2007
amplification  Endocervical, vaginal  From 3.3 to 3.7 cases per 100,000
testing) (women) population
Gonorrhea culture  Endocervical
 Total: 11,466 cases in USA
 Urethral swab
If a person has had oral/anal sex, pharyngeal/rectal
 Transmission
swab should be collected for culture or for NAAT
- Person-to-person by direct contact with a
syphilitic sore (chancre)
 Treatment for Gonorrhea
 Mainly occurs on the external genitals,
- Can be cured
vagina, anus, or in the rectum
- Medication should not be shared with anyone
 Also in the lips and in mouth (oral
- Medication  stop infection, but cannot
chancre)
repair any permanent damage done by the
- During vaginal, anal, and oral sex
disease
- Pregnant women can transmit to UNBORN
- Antimicrobial resistance in gonorrhea –
child (during pregnancy)
increasing concern
- If symptoms continue for more than a few
 Signs and Symptoms
days after treatment, he/she should return to a
- “The Great Pretender”  can look like many
health care provider for re-evaluation
other diseases
→ Patients infected with N. gonorrhoeae
- Progression of STAGES
frequently are coinfected with C.trachomatis
 Primary - weeks
→ Most gonococci are susceptible to
 Secondary - months
 Doxycycline
 Latent/Late – years
 Azithromycin
- Routine cotreatment  hinder devt of
Primary Stage  Painless sore (chancre)
antimicrobial-resistant N. gonorrhoeae
 Chancre last 3-6 weeks and
heals regardless if treated or
 If diagnosed, should tell all partners within 60
not
days before the onset of symptoms/diagnosis
 Inadequate treatment
 Abstain until treatment complete/no symptoms result to secondary stage
anymore
Secondary  Skin rashes and/or mucous
Stage membrane lesions
2. SYPHILIS  Sores in mouth, vagina,
- Caused by Treponema pallidum (bacterium) or anus
- Can cause long-term complication/death if not  does not cause ITCHING
adequately treated  rough, red, reddish
brown spots in palm &
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 bottom of feet
 large, raised, gray/white Blood test  Nontreponemal test
lesions (condyloma lata) - VDRL and RPR
 develop in moist warm - Produce false-
areas such as mouth, positive result
underarm, or groin area  Treponemal tests
 fever, swollen lymph glands, - Confirmatory
sore throat, patchy hair loss, - Antibodies remain
headaches, weight loss, detectable for life
muscle aches, fatigue
 may go with/without  Treatment
treatment but without - No home remedies/OTC drugs but easy to
treatment infection may cure in early stages
progress to latent stage - A single injection of long-acting Benzathine
penicillin G (2.4 million units administered IM)
Latent and Late  begins when primary and will cure primary, secondary, and EARLY latent
Stages secondary symptoms stage
disappear
 Three doses of this at weekly intervals for
 without treatment, syphilis
LATE latent syphilis or latent syphilis of
persists in body even w/out
unknown duration
symptoms
- Abstain until sores are completely healed
 Early Latent Syphilis - Must notify if diagnosed
- Occurred within the past - Syphilis does not recur
12 months  Having syphilis once does not protect
 Late Latent Syphilis person from being infected again
- Occurred more than 12
months ago
 Prevention
- Correct and consistent use of latex condoms
 Latent Syphilis can last for
years - Syphilis sore outside of the area covered by a
 Difficulty coordinating latex condom can still allow transmission.
muscle movements, - abstain from sexual contact
paralysis, numbness, gradual - Mutually monogamous relationship
blindness, dementia (uninfected)
- Transmission of an STD, including syphilis,
 NEUROSYPHILIS cannot be prevented by washing the
- Syphilis can invade the nervous system at any genitals, urinating, and/or douching after sex
stage of infection - Avoiding alcohol and drug use may also help
- Asymptomatic/symptomatic prevent transmission of syphilis because these
- Headache, altered behavior, movement activities may lead to risky sexual behavior
problems
3. CHLAMYDIA
 Pregnant Woman and Baby: - caused by the bacterium, Chlamydia
- Infect baby during pregnancy trachomatis
- High risk of stillbirth  damages a woman’s reproductive organs
- Untreated babies: - symptoms are usually mild and absent
 Developmentally delayed - Serious complication that can cause
 Seizures irreversible damage:
 Death  Infertility  occurs silently
- Only penicillin therapy for pregnant women - Can cause discharge from the penis of an
to prevent passing to baby (98% success rate) infected man.

DIAGNOSIS OF SYPHILIS  INCUBATION PERIOD:

Darkfield  Rarely performed  2-3 WEEKS for males
Microscope (technologically difficult  Usually NO SYMPTOMS FOR FEMALE
method)
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 3. Potentially fatal ectopic pregnancy
- According to WHO, there were more than 140 4. Increase risk of HIV infection
million cases of Chlamydia trachomatis 5. Epididymitis (swollen/tender testicles)
infection worldwide
- prevalent in persons aged 15-24 years  Pregnant Woman and Baby
- Acquisition rates are comparable for the two → Premature delivery
sexes → Early infant pneumonia and conjunctivitis
(pink eye in newborns)
→ Women are more likely to be asymptomatic
than men (80% vs 50%)  Diagnosis
→ Women are more likely to develop long 1. Urine test
term complications 2. Chlamydia culture
 Infertility
 PID (pelvic inflammatory disease)  Treatment
→ Easily treated and cured with antibiotics
 Transmission Single dose Azithromycin
→ during vaginal, anal, or oral sex Twice daily (for a Doxycycline
→ can also be passed from an infected mother to week)
her baby during vaginal childbirth → abstain from sexual intercourse for 7 days
→ Men who have sex with men - risk for after single dose or until completion of a 7-
chlamydial infection day course of antibiotics
 Prevention
 Signs and symptoms → Similar to other STD prevention
→ known as a "silent" disease because the
majority of infected people have no 4. TRICHOMONIASIS (TRICH)
symptoms → Very common, caused by infection with a
protozoan parasite called Trichomonas
Women – initial Men vaginalis
infection (cervix and → Most women and men who have the parasite
urethra) cannot tell they are infected
 abnormal vaginal  discharge from their
discharge penis  Estimates of the worldwide prevalence of
 burning sensation  a burning sensation trichomoniasis range from 170-180 million cases
when urinating when urinating o annually.
 lower abdominal burning and itching  The World Health Organization estimates the
pain around the opening worldwide incidence of trichomonas infection at
 low back pain, of the penis
over 170 million cases annually
nausea, fever  Pain and swelling in
 Typically found in sexually active
 bleeding between the testicles are
adolescents/adults
menstrual periods uncommon
 infection of the 2.3% Adolescents aged 18-24 y.o
prevalence
cervix can spread to
the fallopian tube 4% Adults >25 y.o
and rectum
 Men or women who have receptive anal → Men more likely to be symptomatic than
intercourse may acquire chlamydial infection in women
the rectum
 Rectal pain  Transmission
 Discharge → Usually passed by direct sexual contact
 Bleeding Women → Lower genital tract is most
 Can also be found in the throat (oral sex) commonly infected
 Vulva
 Complications from untreated chlamydia  Vagina
1. PID (pelvic inflammatory disease)  Urethra
2. Infertility Men → Most commonly infected is inside of

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 penis (urethra)  can be self-limited or chronic

 Incubation Period: 6 weeks to 6 months

 Incubation period: 4-20 days (average 7 days)
→ The HBV carrier rate variation is 1-20%
 Signs and Symptoms worldwide.
→ 70% of infected people do not have any signs → High-prevalence areas (rate of 10-20%)
or symptoms include China, Indonesia, sub-Saharan Africa,
the Pacific Islands, and Southeast Asia
Women Men → More cases of HBV disease occur in males
 itching, burning,  itching or irritation than in females
redness or soreness inside the penis
of the genitals  burning after  Transmission
 discomfort with urination or  Sex with an infected partner
urination ejaculation  Injection drug use that involves sharing
 a thin discharge with  some discharge needles, syringes, or drug-preparation
an unusual smell from the penis equipment
that can be clear,  Birth to an infected mother
white, yellowish, or
 Contact with blood or open sores of an
greenish
infected person
 Without treatment, the infection can last for
 Needle sticks or sharp instrument exposures
months or even years.
 Sharing items such as razors or toothbrushes
with an infected person
 Complications of trichomoniasis
!!! not spread through food or water, sharing eating
→ increase the risk of getting or spreading other
utensils, breastfeeding, hugging, kissing, hand holding,
sexually transmitted infections
coughing, or sneezing.
 Pregnant Woman and Baby
→ preterm delivery  HBV can survive outside the body at least 7 days
→ low birth weight (less than 5.5 pounds) and still be capable of causing infection
 Blood spills (even dried blood)
 Diagnosis → infectious  cleaned using 1:10 dilution
1. Flagellated, motile trichomonads on wet of one part household bleach to 10
mount parts of water for disinfecting the area.
2. Vaginal pH > 4.5 → Gloves should be used
3. Diagnosis confirmed by microscopy
4. Culture Test  Who are at risk for HBV infection?
1. Infants born to infected mothers
 Treatment 2. Sex partners of infected persons
→ Single dose of prescription antibiotic 3. Sexually active persons who are not in a long-
medication (metronidazole or tinidazole) – term, mutually monogamous relationship (e.g.,
taken orally >1 sex partner during the previous 6 months)
→ People who have been treated for 4. Men who have sex with men
trichomoniasis can get it again. 5. Injection drug users
6. Household contacts of persons with chronic
 Prevention HBV infection
→ Similar to syphilis prevention 7. Hemodialysis patients
8. Health care and public safety workers at risk
5. HEPATITIS B for occupational exposure to blood or blood-
→ caused by infection with the Hepatitis B virus contaminated body fluids
(HBV) 9. Residents and staff of facilities for
 found in highest concentrations in blood developmentally disabled persons
and in lower concentrations in other body
fluids (e.g., semen, vaginal secretions, and  Signs and Symptoms
wound exudates) 1. Fever
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 2. Fatigue → There were approximately 34 [31.4–35.9]
3. Loss of appetite million people living with HIV in 2011
4. Nausea → Sub-Saharan Africa is the most affected
5. Vomiting region, with nearly 1 in every 20 adults living
6. Abdominal pain with HIV. 69% of all people living with HIV are
7. Dark urine living in this region.
8. Clay-colored bowel movements
9. Joint pain  There is no cure for HIV infection.
10. Jaundice  However, effective treatment with
antiretroviral drugs can control the virus so
 typically last for several weeks but can persist for that people with HIV can enjoy healthy and
up to 6 months productive lives

<5 y.o and newly Asymptomatic

infected → In 2011, more than 8 million people living with
immunosuppressed
HIV were receiving antiretroviral therapy (ART)
adults
in low- and middle-income countries. Another
30%–50% of persons Have initial signs and
7 million people need to be enrolled in
aged ≥5 years symptoms
treatment to meet the target of providing
ART to 15 million people by 2015
ACUTE HBV INFECTION
→ ranges from asymptomatic or mild disease to
HIV
— rarely — fulminant hepatitis
→ targets the immune system and weakens
→ more severe among adults aged >60 years
people's surveillance and defense systems
→ fatality rate among acute cases reported to
against infections and some types of cancer.
CDC is 0.5%–1%
→ Immune function is typically measured by CD4
→ Chronically infected after childhood die
cell count
prematurely from cirrhosis or liver cancer.
→ Majority remain asymptomatic until onset of
AIDS
cirrhosis or end-stage liver disease → most advanced stage of HIV infection
→ 2 to 15 years to develop depending on the
Acute Infection No medication individual
available, supportive → development of certain cancers, infections,
treatment
or other severe clinical manifestations
Chronic Infection Antiviral drugs
1. Adefovir
 Signs and Symptoms
dipivoxil
First few weeks  No symptoms
2. Interferon alfa-
after initial  Flu-like illness
2b infection  Fever
3. Pegylated
 Headache
interferon alfa-
 Rash
2a
 Sore throat
4. Lamivudine
Warning Signs  rapid weight loss
5. Entecavir
 dry cough
6. telbivudine
 recurring fever or profuse
night sweats
 Prevention
 profound and unexplained
→ Hepa B vaccine
fatigue
 3-4 shots over a 6-month period  swollen lymph glands in
the armpits, groin, or neck
7. HIV/AIDS  diarrhea that lasts for more
→ continues to be a major global public health than a week
issue, having claimed more than 25 million  white spots or unusual
lives over the past three decades blemishes on the tongue,
in the mouth, or in the

7
 throat similar specific assay
 Pneumonia
 red, brown, pink, or  Prevention
purplish blotches on or 1. Male and female condom use
under the skin or inside 2. Testing and counselling for HIV and STIs
the mouth, nose, or eyelids
3. Voluntary medical male circumcision
 memory loss, depression,
 Male circumcision reduces the risk of
and other neurological
female-to-male sexual transmission of HIV
disorders
by around 60%
 Transmission
4. Antiretroviral therapy (ARV) based prevention
→ exchange of a variety of body fluids from
 ART as prevention
infected individuals, such as blood, breast
 Pre-exposure prophylaxis (PrEP) for
milk, semen and vaginal secretions
HIV-negative partner
→ !!!! cannot become infected through ordinary
 Post-exposure prophylaxis for HIV
day-to-day contact such as kissing, hugging,
(PEP)
shaking hands, or sharing personal objects,
→ use of ARV drugs within 72 hours of
food, or water
exposure to HIV in order to prevent
infection
→ administering of a 28-day course of
antiretroviral drugs with follow-up
care
 Harm reduction for injecting drug users
 Elimination of mother-to-child
transmission of HIV (eMTCT)

 Treatment
- can be suppressed by combination
 Risk Factors
antiretroviral therapy (ART) consisting of three
1. having unprotected anal or vaginal sex
or more antiretroviral (ARV) drugs
2. having another sexually transmitted infection
- With ART, people living with HIV can live
such as syphilis, herpes, chlamydia, gonorrhea,
healthy and productive lives.
and bacterial vaginosis
3. sharing contaminated needles, syringes and
6. GENITAL HERPES
other injecting equipment and drug solutions
- most people with genital herpes infection do
when injecting drugs
not know they have it.
4. receiving unsafe injections, blood transfusions,
 You can get genital herpes even if your
medical procedures that involve unsterile
partner shows no signs of the infection
cutting or piercing
 Symptoms (like a sore on your genitals,
5. experiencing accidental needle stick injuries,
especially one that periodically recurs)
including among health workers
laboratory tests can help determine if
you have genital herpes
 Diagnosis
→ HIV test reveals infection status by detecting
- no cure for herpes, but treatment is available
the presence or absence of antibodies to
to reduce symptoms and decrease the risk of
HIV in the blood
transmission
→ Most people have a "window period" of
- caused by the herpes simplex viruses type 1
usually 3 to 6 weeks  antibodies to HIV are
(HSV-1) or type 2 (HSV-2)
still being produced and are not yet
detectable.
 HSV is well distributed worldwide. An increase in
Screening Assays
seroprevalence of antibodies to HSV-2 has been
ELISA (enzyme-linked
immunoabsorbent documented throughout the world (including the
assay) United States) over the last 20 years
Western blot assays or CONFIRMATORY
8
 Globally, the large majority of cases are caused  Recurrences are much less
by HSV-2; infection is common in both the frequent for genital HSV-1
industrialized and developing worlds, and HSV-2 infection than for genital HSV-2
uncommonly causes infection by non-sexual infection.
means.
 HSV-1 is usually acquired in childhood by
contact with oral secretions that contain the virus.  Incubation Period: 4 days (range 2-12)
 Seropositivity to antibodies to HSV-2 is more
common in women (25%) than in men (17%).
 mortality rate associated with herpes simplex  Complications of Herpes
infections is related to 3 situations 1. Blindness
1. perinatal infection 2. Encephalitis
2. encephalitis 3. Aseptic meningitis
3. infection in the immunocompromised host 4. extragenital lesions in the buttocks, groin,
thigh, finger, and eye

2 TYPES OF HSV
 Pregnant Woman and Baby
HSV-2 Causes most genital infections
- Herpes infection can be passed from mother
HSV-1 Causes oral infections (cold sores,
to child.
fever blisters) and some genital
- fatal infection (neonatal herpes)
infections
- If herpes symptoms are present a cesarean
delivery is recommended to prevent HSV
 Transmission transmission to the infant.
- through contact with lesions, mucosal surfaces,
genital secretions, or oral secretions  Diagnosis
- HSV-1 and HSV-2 can also be shed from skin 1. Viral culture – reference standard for herpes
that looks normal diagnosis
2. PCR – direct/virologic test
 Signs and Symptoms 3. Indirect/serologic test – ELIZA
- Most individuals infected with HSV-1 or HSV-2
are asymptomatic, or have very mild  Treatment
symptoms that go unnoticed or are mistaken - No cure for herpes
for another skin condition - Antiviral medications can, however, prevent or
Typical  one or more vesicles on or shorten outbreaks during the period of time
around the genitals, rectum or the person takes the medication
mouth - Antiviral can reduce the likelihood of
 vesicles break and leave transmission
painful ulcers that may take - no commercially available vaccine
two to four weeks to heal. - Correct and consistent use of latex condoms
First Infection  longer duration of herpetic can reduce the risk of genital herpes.
lesions  Outbreaks can occur in areas that are not
 increased viral shedding covered by a condom.
(making HSV transmission
- The surest way to avoid transmission is to
more likely)
abstain from sexual contact.
 fever, body aches, swollen
- Long-term mutually monogamous relationship
lymph nodes, and headache
with a partner who has been tested and is
Prodromal  mild tingling or shooting
symptoms pains in the legs, hips and known to be uninfected
(recurrence) buttocks occurring hours to - Even if a person does not have any symptoms,
days before eruption of herpetic he or she can still infect sex partners.
lesions - Persons with herpes should abstain from
 typically shorter in duration and sexual activity with partners when sores or
less severe other symptoms of herpes are present
 episodes tends to decrease
over time
7. HUMAN PAPILLOMA VIRUS (HPV)
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 - the most common sexually transmitted  In US, 50% of sexually active men and women get
infection (STI) HPV at some point in their lives.
- more than 40 HPV types that can infect the  Vaccines can protect males and females against
genital areas of males and females. some of the most common types of HPV that can
 can also infect the mouth and throat lead to disease and cancer.
 Most people who become infected with  most effective when given at 11 or 12 years
HPV do not even know they have it of age.
- HPV is not the same as herpes or HIV (the virus
that causes AIDS)  Prevention
 These are all viruses that can be passed on 1. Consistent and correct use of condom
during sex, but they cause different 2. Mutually monogamous relationship with an
symptoms and health problems. uninfected partner.
3. Avoid sexual activity
 Signs and Symptoms of HPV
- Most people with HPV do not develop  Diagnosis
symptoms or health problems from it - no general test for men or women to check
- In 90% of cases, the body’s immune system one’s overall "HPV status“
clears HPV naturally within two years. - Regular Pap smear for females
But sometimes, HPV infection are not cleared and
cause:  Treatment
1. Genital warts - no treatment for the virus itself, but there are
2. Rarely, warts in the throat treatments for the diseases that HPV can cause
3. Cervical cancer and other, less common but
serious cancers, cancers of the vulva, vagina,
penis, anus, and oropharynx
- The types of HPV that can cause genital warts
are not the same as the types that can cause
cancers

 Transmission
- passed on through genital contact, most often
during vaginal and anal sex.
 HPV may also be passed on during oral
sex and genital-to-genital contact
- can be passed on between straight and same-
sex partners—even when the infected partner
has no signs or symptoms
- person can have HPV even if years have
passed since he or she had sexual contact with
an infected person

How does HPV cause GENITAL WARTS and

CANCER?
 HPV can cause normal cells on infected skin to
turn abnormal.
 Warts can appear within weeks or months after
getting HPV.
 Cancer often takes years to develop after getting
HPV

 Globally, HPV infection is the most common STD.

Genital warts have affected as many as 30 million
individuals worldwide.

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