Faculty
Sexually Transmitted
Diseases Affecting Men
Anthony Merriweather, MSPH
Director
Division of STD
Alabama Department of Public Health
Satellite Conference and Live Webcast
Wednesday, April 21, 2010
2:00 - 4:00 p.m. Central Time
Produced by the Alabama Department of Public Health
Video Communications and Distance Learning Division
Overview of STDs Affecting Men
• A sexually transmitted disease is
any disease that can be transmitted
through physical intimacy, including
kissing, oral sex, anal sex, and any
type of genital contact
Overview of STDs Affecting Men
• 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
• STDs can be caused by bacteria,
virus, protozoa, or parasite
Bacterial STD Infections and
Clinical Presentations in Men
• Chlamydia
Bacterial STD Infections and
Clinical Presentations in Men
• Syphilis
– Urethral discharge (urethritis) will
– Primary ulcer (chancre) with local
lead to epididymitis, orchitis, and
adenopathy; secondary skin rash,
infertility if not treated
condylomata; bone,
• Gonorrhea
cardiovascular, and neurological
damage
– Urethral discharge (urethritis),
epididymitis, orchitis, infertility
1
Bacterial STD Infections and
Clinical Presentations in Men
• Chancroid
– Painful genital ulcers; may be
accompanied by bubo
Bacterial STD Infections and
Clinical Presentations in Men
• Granuloma Inguinale (Donovanosis)
– Ulcerative lesions of the inguinal
and anogenital areas
• Lymphogranuloma Venereum (LGV)
– Ulcer, inguinal swelling (bubo),
proctitis
Viral STD Infections
• HIV
– HIV-related diseases, AIDS
• Genital Herpes
Viral STD Infections
• Viral Hepatitis
– Acute hepatitis, liver cirrhosis,
liver cancer
– Anogenital vesicular lesions and
ulcerations
• Genital Warts
– Penile and anal warts; carcinoma
of the penis
Protozoal STD Infection
• Trichomoniasis
– Urethral discharge (nongonococcal
urethritis (NGU))
– Often no symptoms
Parasitic STD Infections
• Pubic Lice
– Itching in the genital area
– Visible nits (lice eggs) or crawling
lice
• Scabies
– Intense itching and a pimple-like
skin rash
2
Risk Factors
STD Prevention
• Abstinence
• Multiple sex partners
– Only sure way to prevent STDs
• Lack of condom use
• Reduction of sex partners
• Adolescent
– If sexually active, be in a long-term
relationship with an uninfected
person
• Men who have sex with men (MSM)
• Drug/alcohol use
• Condom use
• Sex for money or drugs
– Correct and consistent use of male
condoms reduces the risk of HIV
and certain STDs
STD Prevention
Chlamydia Cases, Alabama 2000 -2009
• Screening
30000
551.3
539.0
600.0
530.1
483.9
Number of Cases
– Promote treatment, avoid spread
and serious consequences
• Immunizations
500.0
397.2
20000
327.7
400.0
352.6
329.5
316.7
15000
300.0
300.1
10000
200.0
5000
100.0
Rates per 100,000
25000
– HPV and Hepatitis B prevention
• Symptoms
0
0.0
2000
– Immediately see your provider
2001
2002
2003
2004
2005
Chlamydia Cases
Chlamydia Cases by Race/Ethnicity,
Alabama 2000-2009
1400.0
14000
1200.0
1000.0
10000
800.0
8000
600.0
6000
Number of Cases
12000
15000
17634
13060
13447
14014
4000
0.0
2003
2004
2005
2006
2007
2008
2009
4911
1399
Hispanic
White
Black Case Rate
1178
1630
1653
1106
5965
5995
6432
2647
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Year of Diagnosis
Year of Diagnosis
Black
19264
10000
200.0
0
18711
11672
5000
2000
19152
14942
12952
400.0
2002
2009
Case Rate
20000
2001
2008
Chlamyida Cases by Gender , Alabama 2000-2009
16000
2000
2007
25000
Rates per 100,000
Number of Cases
2006
Year of Diagnosis
Hispanic Case Rate
White Case Rate
Female
Male
3
Gonorrhea Cases, Alabama 2000 -2009
14000
14000
300.0
300.0
250.9
250.9
Number of Cases
228.3
228.3
10000
10000
250.0
250.0
233.3
233.3
224.7
224.7
217.4
217.4
206.9
206.9
207.6
207.6
200.0
200.0
184.5
184.5
159.5
159.5
8000
8000
150.0
150.0
6000
6000
Rates per 100,000
257.8
257.8
12000
12000
100.0
100.0
4000
4000
50.0
50.0
2000
2000
00
0.0
0.0
2000
2000
2001
2001
2002
2002
2003
2003
2004
2004
2005
2005
2006
2006
2007
2007
2008
2008
2009
2009
Year
Year of
of Diagnosis
Diagnosis
Gonorrhea
Gonorrhea Cases
Cases
Case
Case Rate
Rate
Gonorrhea Cases by Gender, Alabama 2000 -2009
7000
7000
6000
6000
5740
5740
5694
5694
5684
5684
6085
6085
5911
5911
5551
5551
5458
5458
5164
4980
4980 5164
5000
5000
5023
5023
4651
4540
4540 4651
4510
4510
4788
4788
4564
4564
4621
4621
4210
4210
4122
4122
4000
4000
3687
3687
3218
3218
3000
3000
2000
2000
1000
1000
00
2000
2000
2001
2001
2002
2002
2003
2003
2004
2004
2005
2005
2006
2006
2007
2007
2008
2008
2009
2009
Year
Year of
of Diagnosis
Diagnosis
Female
Female Male
Male
Primary and Secondary Syphilis Cases,
Alabama 2000 -2009
500
500
12.0
12.0
450
450
10.0
10.0
Number of Cases
8.8
8.8
350
350
8.1
8.1
300
300
8.0
8.0
7.0
7.0
250
250
6.0
6.0
200
200
3.2
3.2
100
100
4.0
4.0
4.0
4.0
3.8
3.8
150
150
Rates per 100,000
9.7
9.7
400
400
3.4
3.4
2.8
2.8
2.5
2.5
2.0
2.0
50
50
00
0.0
0.0
2000
2000
2001
2001
2002
2002
2003
2003
2004
2004
2005
2005
2006
2006
2007
2007
2008
2008
2009
2009
Year
Year of
of Diagnosis
Diagnosis
P&S
P&S Cases
Cases
Case
Case Rate
Rate
4
Early Latent Syphilis Cases by Gender,
Alabama 2000 -2009
300
243
Number of Cases
250
233
210
194
200
186
183
172
152
150
110
100
111
108
99
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
5