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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.

A

Characteristics of Major STIs in the United States

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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: common^a	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)

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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)

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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.

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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 infection^b (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.

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REFERENCES

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