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Sexually Transmitted Infections: Adopting a Sexual Health Paradigm (2021)

Chapter: Appendix A: Characteristics of Major STIs in the United States

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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
STI (etiologic agent) Routes of Transmission Frequency of Asymptomatic Infections Major Long-Term Health Consequences Increases Risk for Acquisition or Transmission of HIV Infection? Effective Curative Treatment Available/Vaccine Available?
Chlamydial infection (Chlamydia trachomatis) (CDC, 2016, 2017a)
  • Vaginal, anal, and oral sex
  • Pregnant person-to-infant transmission with eye inoculation
Very common for men and women
  • Pelvic inflammatory disease
  • Infertility in women and possibly men (Bryan et al., 2019)
  • Ectopic pregnancy
  • Chronic pelvic pain
  • Ophthalmia neonatorum and pneumonia in infants
Yes Antibiotics can cure. No vaccine. (Gottlieb and Johnston, 2017)
Gonorrhea (Neisseria gonorrhoeae) (CDC, 2017e, 2019b)
  • Vaginal, anal, and oral sex
  • Pregnant person-to-infant transmission with eye inoculation
  • Possible association with kissing (Chow et al., 2019)
Women: very common Men: commona
  • Pelvic inflammatory disease
  • Infertility in women and men
  • Ectopic pregnancy
  • Chronic pelvic pain
  • Ophthalmia neonatorum
  • Septic arthritis
Yes Antibiotics can cure (but antibiotic-resistant strains exist). No vaccine. (CDC, 2020a; Gottlieb and Johnston, 2017)
Syphilis (all stages) (Treponema pallidum) (CDC, 2017f)
  • Vaginal, anal, and oral sex
  • Pregnant person-to-infant transmission
  • Blood-borne
Women: common Men: common or les common (IOM, 1997)
  • Ocular and neurologic morbidity
  • Cardiovascular, bone, skin, and other organ system morbidity
  • Congenital syphilis
Yes Antibiotics can cure. No vaccine. (CDC, 2017g; Gottlieb and Johnston, 2017)
Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
Congenital syphilis (Treponema pallidum) (CDC, 2019a; Yeganeh et al., 2015) Pregnant person-to-infant transmission May be asymptomatic in the first few weeks after birth
  • Preterm birth
  • Stillbirth
  • Infant death
  • Severe lifelong disabilities, including blindness, deafness, and bone deformity
Yes Antibiotics can cure, but possible lifelong sequelae.
Human papillomavirus infection (human papillomavirus) (CDC, 2017d) Vaginal, anal, and oral sexual contact Very common for men and women
  • Genital tract dysplasia and cancer, most commonly the cervix and anus, but also the vagina, vulva, and penis (Arbyn et al., 2012)
  • Oral dysplasia and cancer
Probably yes (Houlihan et al., 2012) Ablation of lesions can treat but not cure. Three vaccines available for prevention. (CDC, 2020d)
Genital herpes (herpes simplex virus types 1 and 2) (CDC, 2017b,c)
  • Vaginal, anal, and oral sex
  • Pregnant person-to-infant transmission
Very common for men and women
  • Genital tract lesions that are often painful and can be debilitating
  • Congenital and neonatal herpes, which can lead to preterm birth, stillbirth, infant death, or severe disabilities (Corey and Wald, 2009)
Yes No cure, but medications can reduce severity and duration of symptoms. No vaccines.
Trichomonas vaginalis infection (Trichomonas vaginalis) (CDC, 2017h; Tompkins et al., 2020) Vaginal, anal, and oral sex Very common for men and women
  • Cervicovaginal or penile discharge
  • Inflammatory changes with vaginitis or urethritis
Yes Antibiotics can cure. No vaccine. (Gottlieb and Johnston, 2017)
Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
STI (etiologic agent) Routes of Transmission Frequency of Asymptomatic Infections Major Long-Term Health Consequences Increases Risk for Acquisition or Transmission of HIV Infection? Effective Curative Treatment Available/Vaccine Available?
Hepatitis B virus infection (hepatitis B virus) (CDC, 2020c; NASEM, 2016, 2017)
  • Vaginal or anal sex; not oral sex
  • Pregnant person-to-infant transmission
  • Blood-borne
Early infection may be asymptomatic, with symptoms emerging many years later (A minority of patients with sexually acquired infection may experience chronic infection leading to sequelae.)
  • End-stage liver cirrhosis or hepatocellular carcinoma
  • Perinatal transmission from pregnant person to child, with high risk of eventual liver disease in an untreated infant
No No cure, though both active and passive immunization highly efficacious. (Schillie et al., 2018)
Chancroid (Haemophilus ducreyi) (CDC, 2015a; Lewis, 2003) Vaginal, anal, and oral sex Women: Very common Men: Less Common
  • Genital tract lesions that are often painful and can be debilitating
Probably yes Antibiotics can cure. No vaccine.
Lymphogranuloma venereum (C. trachomatis serovars L1, L2, and L3) (CDC, 2015b; Rönn et al., 2014) Vaginal, anal, and oral sex Common for men and women
  • Genital tract lesions that are often painful and can be debilitating
Unknown Antibiotics can cure. No vaccine.
Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
STI (etiologic agent) Routes of Transmission Frequency of Asymptomatic Infections Major Long-Term Health Consequences Increases Risk for Acquisition or Transmission of HIV Infection? Effective Curative Treatment Available/Vaccine Available?
Mycoplasma genitalium infectionb (Mycoplasma genitalium) (Horner and Martin, 2017; Wiesenfeld and Manhart, 2017) Vaginal, anal, and oral sex Common for men and women
  • Cervicovaginal or penile discharge
  • Inflammatory changes with vaginitis or urethritis
Possibly yes (Napierala Mavedzenge and Weiss, 2009) Antibiotics can cure, but recurrence is common. Antibiotic resistance is a concern. No vaccine. (CDC, 2020a)
Human immunodeficiency virus (HIV) infection (HIV) (CDC, 2019c, 2020b)
  • Vaginal and anal sex
  • Less often oral sex
  • Pregnant person-to-infant transmission
  • Blood-borne
Flu-like symptoms noted in some during acute infection, but then may be asymptomatic for years
  • Immunodeficiency with life-threatening risks of opportunistic infections or malignancies
Medications can slow disease progression. No vaccines, but preexposure prophylaxis is available for prevention.

a Most women with gonorrhea are asymptomatic. Many men with gonorrhea are asymptomatic (CDC, 2019b).

b Emerging STI; see Chapter 2 for more information.

Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×

REFERENCES

Arbyn, M., S. de Sanjosé, M. Saraiya, M. Sideri, J. Palefsky, C. Lacey, M. Gillison, L. Bruni, G. Ronco, N. Wentzensen, J. Brotherton, Y. L. Qiao, L. Denny, J. Bornstein, L. Abramowitz, A. Giuliano, M. Tommasino, and J. Monsonego. 2012. Eurogin 2011 roadmap on prevention and treatment of HPV-related disease. International Journal of Cancer 131(9):1969-1982.

Bryan, E. R., R. I. McLachlan, L. Rombauts, D. J. Katz, A. Yazdani, K. Bogoevski, C. Chang, M. L. Giles, A. J. Carey, C. W. Armitage, L. K. Trim, E. A. McLaughlin, and K. W. Beagley. 2019. Detection of chlamydia infection within human testicular biopsies. Human Reproduction 34(10):1891-1898.

CDC (Centers for Disease Control and Prevention). 2015a. 2015 sexually transmitted diseases treatment guidelines—chancroid. https://www.cdc.gov/std/tg2015/chancroid.htm (accessed November 10, 2020).

CDC. 2015b. 2015 sexually transmitted diseases treatment guidelines—lymphogranuloma venereum (LGV). https://www.cdc.gov/std/tg2015/lgv.htm (accessed November 10, 2020).

CDC. 2016. Chlamydia—CDC fact sheet (detailed). https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm (accessed September 15, 2020).

CDC. 2017a. Chlamydia—CDC fact sheet. https://www.cdc.gov/std/chlamydia/Chlamydia-FS.pdf (accessed September 15, 2020).

CDC. 2017b. Genital herpes—CDC fact sheet (detailed). https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm (accessed November 9, 2020).

CDC. 2017c. Genital herpes—CDC fact sheet. https://www.cdc.gov/std/herpes/Genital-herpes-FS.pdf (accessed November 9, 2020).

CDC. 2017d. Genital HPV infection—CDC fact sheet. https://www.cdc.gov/std/hpv/HPV-FS-print.pdf (accessed November 9, 2020).

CDC. 2017e. Gonorrhea—CDC fact sheet. https://www.cdc.gov/std/gonorrhea/Gonorrhea-FS.pdf (accessed September 15, 2020).

CDC. 2017f. Syphilis—CDC fact sheet (detailed). https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm (accessed October 21, 2020).

CDC. 2017g. Syphilis—CDC fact sheet. https://www.cdc.gov/std/syphilis/syphilis-fact-sheet.pdf (accessed October 21, 2020).

CDC. 2017h. Trichomoniasis—CDC fact sheet. https://www.cdc.gov/std/trichomonas/trichomoniasis-factsheet.pdf (accessed October 21, 2020).

CDC. 2019a. Congenital syphilis—CDC fact sheet. https://www.cdc.gov/std/syphilis/congsyph-oct-2019.pdf (October 20, 2020).

CDC. 2019b. Gonorrhea—CDC fact sheet (detailed version). https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm (accessed October 20, 2020).

CDC. 2019c. HIV transmission. https://www.cdc.gov/hiv/basics/transmission.html (accessed October 20, 2020).

CDC. 2020a. 2019 AR threats report. https://www.cdc.gov/drugresistance/biggest-threats.html (accessed October 21, 2020).

CDC. 2020b. About HIV. https://www.cdc.gov/hiv/basics/whatishiv.html (accessed November 10, 2020).

CDC. 2020c. Hepatitis B. https://www.cdc.gov/hepatitis/hbv/index.htm (accessed October 26, 2020).

CDC. 2020d. Human papillomavirus (HPV) vaccination: What everyone should know. https://www.cdc.gov/vaccines/vpd/hpv/public/index.html (accessed October 21, 2020).

Chow, E. P. F., V. J. Cornelisse, D. A. Williamson, D. Priest, J. S. Hocking, C. S. Bradshaw, T. R. H. Read, M. Y. Chen, B. P. Howden, and C. K. Fairley. 2019. Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea: A cross-sectional study in men who have sex with men. Sexually Transmitted Infections 95(7):516-521.

Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×

Corey, L., and A. Wald. 2009. Maternal and neonatal herpes simplex virus infections. New England Journal of Medicine 361(14):1376-1385.

Gottlieb, S. L., and C. Johnston. 2017. Future prospects for new vaccines against sexually transmitted infections. Current Opinion in Infectious Diseases 30(1):77-86.

Horner, P. J., and D. H. Martin. 2017. Mycoplasma genitalium infection in men. The Journal of Infectious Diseases 216(Suppl 2):S396-S405.

Houlihan, C. F., N. L. Larke, D. Watson-Jones, K. K. Smith-McCune, S. Shiboski, P. E. Gravitt, J. S. Smith, L. Kuhn, C. Wang, and R. Hayes. 2012. Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis. AIDS 26(17):2211-2222.

IOM (Institute of Medicine). 1997. Appendix B: Characteristics of major STDs in the United States. In The hidden epidemic: Confronting sexually transmitted diseases. Washington, DC: National Academy Press. P. 448.

Lewis, D. A. 2003. Chancroid: Clinical manifestations, diagnosis, and management. Sexually Transmitted Infections 79(1):68-71.

Napierala Mavedzenge, S., and H. A. Weiss. 2009. Association of Mycoplasma genitalium and HIV infection: A systematic review and meta-analysis. AIDS 23(5):611-620.

NASEM (National Academies of Sciences, Engineering, and Medicine). 2016. Eliminating the public health problem of hepatitis B and C in the United States: Phase one report. Washington, DC: The National Academies Press.

NASEM. 2017. A national strategy for the elimination of hepatitis B and C: Phase two report. Washington, DC: The National Academies Press.

Rönn, M., G. Hughes, P. White, I. Simms, C. Ison, and H. Ward. 2014. Characteristics of LGV repeaters: Analysis of LGV surveillance data. Sexually Transmitted Infections 90(4):275-278.

Schillie, S., C. Vellozzi, A. Reingold, A. Harris, P. Haber, J. W. Ward, and N. P. Nelson. 2018. Prevention of Hepatitis B virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report 67(1):1-31.

Tompkins, E. L., T. A. Beltran, E. J. Gelner, and A. R. Farmer. 2020. Prevalence and risk factors for Trichomonas vaginalis infection among adults in the U.S., 2013-2014. PLoS One 15(6):e0234704.

Wiesenfeld, H. C., and L. E. Manhart. 2017. Mycoplasma genitalium in women: Current knowledge and research priorities for this recently emerged pathogen. Journal of Infectious Diseases 216(Suppl 2):S389-S395.

Yeganeh, N., H. D. Watts, M. Camarca, G. Soares, E. Joao, J. H. Pilotto, G. Gray, G. Theron, B. Santos, R. Fonseca, R. Kreitchmann, J. Pinto, M. Mussi-Pinhata, M. Ceriotto, D. M. Machado, B. Grinzstejn, V. G. Veloso, M. G. Morgado, Y. Bryson, L. M. Mofenson, K. Nielsen-Saines, and NICHD HPTN 040P1043 Study Team. 2015. Syphilis in HIV-infected mothers and infants: Results from the NICHD/HPTN 040 study. Pediatric Infectious Disease Journal 34(3):e52-e57.

Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×

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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
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Suggested Citation:"Appendix A: Characteristics of Major STIs in the United States." National Academies of Sciences, Engineering, and Medicine. 2021. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington, DC: The National Academies Press. doi: 10.17226/25955.
×
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Next: Appendix B: STI Screening and Treatment Guidelines Issued by Health Professional Societies »
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One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action.

In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.

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