4/3/2012
Sexually Transmitted Diseases
(STDs) Affecting Men
Anthony Merriweather, MSPH
Director, Division of STD
Alabama Department of Public Health
Main Bacterial STD Infections and
Clinical Presentations in Men
Bacterial STDs are easy to test and
treat. They are curable.
•
•
Overview of STDs Affecting Men
•
A sexually transmitted disease is any disease that
can be transmitted through physical intimacy,
including oral, anal, and vaginal sex or any type of
genital contact.
•
There are an estimated 19 million cases of STDs in
the United States every year. Half or more are in
people 25 years and younger.
•
There are many different types of sexually
transmitted infections. STDs can be caused by
bacteria, virus, protozoa, or parasite.
Main Bacterial STD Infections and
Clinical Presentations in Men. Cont.
•
Chancroid: Painful genital ulcers; may be
accompanied by bubo
Chlamydia: Urethral discharge (urethritis) will lead
to epididymitis and infertility if not treated
•
Lymphogranuloma Venereum (LGV): Ulcer,
inguinal swelling (bubo), proctitis
Gonorrhea: Urethral discharge (urethritis) will lead
to epididymitis and infertility if not treated
•
Granuloma Inguinale (Donovanosis): Ulcerative
lesions of the inguinal and anogenital areas
Syphilis: Primary syphilis - ulcer (chancre) with
local adenopathy; secondary syphilis - skin rash,
condylomata; will lead to cardiovascular,
neurological damage, death, and blindness if not
treated
Main Viral STD Infections
Viral STDs are difficult infections
because they are not curable.
•
•
•
•
•
HIV: HIV-related diseases, AIDS
Genital Herpes: Anogenital vesicular lesions and
ulcerations
Genital Warts: Penile and anal warts; carcinoma
of the penis
Viral Hepatitis: Acute hepatitis, liver cirrhosis,
liver cancer
Molluscum Contagiosum: Genital or generalized
umbilicated, firm skin nodules
Main Protozoal STD Infection
Protozoa STDs are easy to treat. It is
curable
Trichomoniasis: Urethral discharge
(nongonococcal urethritis (NGU)); often no
symptoms
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4/3/2012
Main Parasitic STD Infections
Parasitic STDs are easy to treat. They
are curable
Pubic Lice: Itching in the genital area
Visible nits (lice eggs) or crawling lice
Risk Factors
Scabies: Intense itching and a pimple-like skin
rash
STD Challenges
MSMs: Represent 65% of primary and secondary
syphilis and 44 times more chances of HIV
infection than other men
African-Americans: 12% of the U.S population,
represent 70% of gonorrhea cases, almost half of
all chlamydia and syphilis cases
HIV acquisition and transmission: Most STDs
have been associated with increased risk for HIV
Young people: Almost half of STD infections are
among people 15-24 years of age
STD rate and consequences: Chlamydia and
gonorrhea are far more severe among women than
men ( the need to protect the women)
Counseling, Testing and Prevention
Issues Cont.
Homophobia and stigma can prevent MSM from
seeking prevention, testing, and treatment services
Risk of HIV transmission through receptive anal
sex is much greater than the risk of transmission
through other sexual activities
Some gay and bisexual men relying on prevention
strategies that are less effective than consistent
condom use
Multiple Sex Partners
Lack of condom use
Adolescent
Men who have sex with men (MSM)
Drug/Alcohol Use
Sex for Money or Drugs
Counseling, Testing and Prevention
Issues
High prevalence of HIV and syphilis among gay
and bisexual men
Limited access to prevention services
Complacency about HIV risk among gay and
bisexual men
Lack of consistent maintenance of safe behavior
with every sexual encounter
Lack of awareness of syphilis symptoms and how it
can be transmitted
STD Prevention
Asymptomatic STDs: Because many STDs have
no symptoms, those at risk need to get tested and
find out if they are infected.
Abstinence: Only sure way to prevent STDs
Reduction of sex partners: If sexually active, be
in a long-term relationship with an uninfected
person
Condom use: Correct and consistent use of male
condoms reduces the risk of HIV and certain STDs
Screening: Promote treatment, avoid spread and
serious consequences
Immunizations: HPV and Hepatitis B prevention
Symptoms: Immediately see your provider
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4/3/2012
Chlamydia Cases by Race/Ethnicity,
Alabama 2000-2009
Chlamydia Cases, Alabama 2000-2009
539.0
551.3
530.1
483.9
16000
25000
500.0
327.7
400.0
352.6
329.5
316.7
15000
300.0
300.1
10000
200.0
5000
100.0
1200.0
12000
Number of Cases
20000
1400.0
14000
397.2
Rate per 100,000
Number of Cases
600.0
1000.0
10000
800.0
8000
600.0
6000
400.0
4000
200.0
2000
0
0
0.0
0.0
2000
2001
2002
2003
2004
2005
2006
2007
2008
Rate per 100,000
30000
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2009
Year of Diagnosis
Year of Diagnosis
Black
Hispanic
Hispanic Case Rate
White Case Rate
14000
300.0
257.8
19152
20000
250.9
12000
19264
18711
228.3
17634
10000
13447
13060
Number of Cases
14942
Number of Cases
Black Case Rate
Gonorrhea Cases, Alabama 2000-2009
Chlamyida Cases by Gender, Alabama 2000-2009
25000
15000
White
Case Rate
14014
12952
11672
10000
5965
5995
6432
4911
5000
1399
1178
1630
1653
1106
217.4
206.9
224.7
250.0
233.3
207.6
184.5
200.0
159.5
8000
150.0
6000
100.0
4000
2647
50.0
2000
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
0
Year of Diagnosis
0.0
2000
Female
Rate per 100,000
Chlamydia Cases
2001
2002
2003
2004
Male
2005
2006
2007
2008
2009
Year of Diagnosis
Gonorrhea Cases
Gonorrhea Cases by Gender, Alabama 2000-2009
Case Rate
Primary and Secondary Syphilis Cases,
Alabama 2000-2009
500
12.0
450
7000
10.0
5740
5684
9.7
400
6085
5911
5551
5458
4980 5164
Number of Cases
5000
4540
4651
4510
4621
4564
4788
4122
4000
8.8
350
5023
4210
3687
3218
3000
8.1
300
6.0
250
200
2000
4.0
4.0
3.8
150
3.4
3.2
2.8
1000
8.0
7.0
Rate per 100,000
5694
Number of Cases
6000
2.5
100
2.0
0
2000
2001
2002
2003
2004
2005
Year of Diagnosis
Female
Male
2006
2007
2008
2009
50
0
0.0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Year of Diagnosis
P&S Cases
Case Rate
3
4/3/2012
Early Latent Syphilis Cases by Gender,
Alabama 2000-2009
300
243
250
233
Number of Cases
210
194
200
183
186
172
152
150
99
110
100
111
108
113
109
82
65
121
109
75
73
50
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Year of Diagnosis
Female
Male
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