Gonorrhea is a sexually transmitted disease (STD) caused by infection with the Neisseria gonorrhoeae bacterium. N. gonorrhoeae infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in women and men. N. gonorrhoeae can also infect the mucous membranes of the mouth, throat, eyes, and rectum.
Gonorrhea is a very common infectious disease. CDC estimates that approximately 1.6 million new gonococcal infections occurred in the United States in 2018, and more than half occur among young people aged 15-24. Gonorrhea is the second most commonly reported bacterial sexually transmitted infection. However, many infections are asymptomatic, so reported cases only capture a fraction of the true burden.
Gonorrhea is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread perinatally from mother to baby during childbirth.
People who have had gonorrhea and received treatment may be reinfected if they have sexual contact with a person infected with gonorrhea.
If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. This can cause blindness, joint infection, or a life-threatening blood infection in the baby 17. Treatment of gonorrhea as soon as it is detected in pregnant women will reduce the risk of these complications. Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary.
Many men with gonorrhea are asymptomatic. When present, signs and symptoms of urethral infection in men include dysuria or a white, yellow, or green urethral discharge that usually appears one to fourteen days after infection. In cases where urethral infection is complicated by epididymitis, men with gonorrhea may also complain of testicular or scrotal pain.
Most women with gonorrhea are asymptomatic. Even when a woman has symptoms, they are often so mild and nonspecific that they are mistaken for a bladder or vaginal infection. The initial symptoms and signs in women include dysuria, increased vaginal discharge, or vaginal bleeding between periods. Women with gonorrhea are at risk of developing serious complications from the infection, regardless of the presence or severity of symptoms.
Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements. Rectal infection also may be asymptomatic. Pharyngeal infection may cause a sore throat, but usually is asymptomatic.
Untreated gonorrhea can cause serious and permanent health problems in both women and men.
In women, gonorrhea can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses and chronic pelvic pain. PID can also damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy.
In men, gonorrhea may be complicated by epididymitis. In rare cases, this may lead to infertility.
If left untreated, gonorrhea can also spread to the blood and cause disseminated gonococcal infection (DGI). DGI is usually characterized by arthritis, tenosynovitis, and/or dermatitis. This condition can be life threatening.
Who ? Any sexually active person can be infected with gonorrhea. Anyone with genital symptoms such as discharge, burning during urination, unusual sores, or rash should stop having sex and see a health care provider immediately. Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with an STD should see a health care provider for evaluation.
Some people should be tested (screened) for gonorrhea even if they do not have symptoms or know of a sex partner who has gonorrhea. Anyone who is sexually active should discuss his or her risk factors with a health care provider and ask whether he or she should be tested for gonorrhea or other STDs. CDC recommends yearly gonorrhea screening for all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection. People who have gonorrhea should also be tested for other STDs.
How ? Urogenital gonorrhea can be diagnosed by testing urine, urethral (for men), or endocervical or vaginal (for women) specimens using nucleic acid amplification testing (NAAT). It can also be diagnosed using gonorrhea culture, which requires endocervical or urethral swab specimens. Rectal and oral diagnostic tests for gonorrhea (as well as chlamydia) have been validated for clinical use.
Gonorrhea can be cured with the right treatment. CDC now recommends a single 500 mg intramuscular dose of ceftriaxone for the treatment of gonorrhea. Alternative regimens are available when ceftriaxone cannot be used to treat urogenital or rectal gonorrhea. Although medication will stop the infection, it will not repair any permanent damage done by the disease.
Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult. A test-of-cure – follow-up testing to be sure the infection was treated successfully – is not needed for genital and rectal infections; however, if a person's symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated. A test-of-cure is needed 7-14 days after treatment for people who are treated for pharyngeal (infection of the throat) gonorrhea.
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea.
Chlamydia is a common STD that can cause infection among both men and women. It can cause permanent damage to a woman's reproductive system. This can make it difficult or impossible to get pregnant later. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb).
You can get chlamydia by having vaginal, anal, or oral sex with someone who has chlamydia. Also, you can still get chlamydia even if your sex partner does not ejaculate (cum). A pregnant person with chlamydia can give the infection to their baby during childbirth.
Chlamydia often has no symptoms, but it can cause serious health problems, even without symptoms. If symptoms occur, they may not appear until several weeks after having sex with a partner who has chlamydia.
Even when chlamydia has no symptoms, it can damage a woman's reproductive system.
Women with symptoms may notice
Symptoms in men can include
Men and women can also get chlamydia in their rectum. This happens either by having receptive anal sex, or by spread from another infected site (such as the vagina). While these infections often cause no symptoms, they can cause
See a healthcare provider if you notice any of these symptoms. You should also see a provider if your partner has an STD or symptoms of one. Symptoms can include
The initial damage that chlamydia causes often goes unnoticed. However, chlamydia can lead to serious health problems. In women, untreated chlamydia can cause pelvic inflammatory disease (PID). Some of the complications of PID are:
Men rarely have health problems from chlamydia. The infection can cause a fever and pain in the tubes attached to the testicles. This can, in rare cases, lead to infertility. Untreated chlamydia may also increase your chances of getting or giving HIV.
Laboratory tests can diagnose chlamydia. Your healthcare provider may ask you to provide a urine sample for testing, or they might use (or ask you to use) a cotton swab to get a vaginal sample.
Repeat infection with chlamydia is common. You should receive testing again about three months after your treatment, even if your sex partner(s) receives treatment.
It is important that you take all of the medicine your healthcare provider gives you to cure your infection. Do not share medicine for chlamydia with anyone. When taken properly it will stop the infection and could decrease your chances of having problems later. Although medicine will stop the infection, it will not undo any permanent damage caused by the disease.
You should not have sex again until you and your sex partner(s) complete treatment. If given a single dose of medicine, you should wait seven days after taking the medicine before having sex. If given medicine to take for seven days, wait until you finish all the doses before having sex. If you've had chlamydia and took medicine in the past, you can still get it again. This can happen if you have sex without a condom with a person who has chlamydia.
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of Chlamidia.
Syphilis is a sexually transmitted infection (STI) that can cause serious health problems without treatment. Infection develops in stages (primary, secondary, latent, and tertiary). Each stage can have different signs and symptoms.
You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex.
Syphilis can spread from a mother with syphilis to her unborn baby.
You cannot get syphilis through casual contact with objects, such as:
There are four stages of syphilis (primary, secondary, latent, and tertiary). Each stage has different signs and symptoms.
During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is the location where syphilis entered your body. These sores usually occur in, on, or around the
Sores are usually (but not always) firm, round, and painless. Because the sore is painless, you may not notice it. The sore usually lasts 3 to 6 weeks and heals regardless of whether you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.
During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet and look
The rash usually won't itch, and it is sometimes so faint that you won't notice it. Other symptoms may include:
The symptoms from this stage will go away whether you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.
The latent stage of syphilis is a period when there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years.
Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen, it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death. A healthcare provider can usually diagnose tertiary syphilis with the help of multiple tests.
Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can happen during any of the stages described above.
Signs and symptoms of neurosyphilis can include:
Signs and symptoms of ocular syphilis can include:
Signs and symptoms of otosyphilis may include:
Most of the time, healthcare providers will use a blood test to test for syphilis. Some will diagnose syphilis by testing fluid from a syphilis sore.
Syphilis is curable with the right antibiotics from your healthcare provider. However, treatment might not undo any damage the infection can cause. Even after successful treatment, you can get syphilis again. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your healthcare provider is necessary to make sure your treatment was successful.
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of Syphilis.
Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.
Genital herpes is an STD caused by two types of viruses – herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
HSV-1 often causes oral herpes, which can result in cold sores or fever blisters on or around the mouth. However, most people with oral herpes do not have any symptoms. Most people with oral herpes get it during childhood or young adulthood from non-sexual contact with saliva.
You can get genital herpes by having vaginal, anal, or oral sex with someone who has the infection. You can get herpes if you have contact with:
If you touch your sores or fluids from the sores, you may transfer herpes to another body part like your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, quickly wash your hands thoroughly to help avoid spreading the infection.
You also can get genital herpes from a sex partner who does not have a visible sore or is unaware of their infection. It is also possible to get genital herpes if you receive oral sex from a partner with oral herpes.
You will not get herpes from toilet seats, bedding, or swimming pools. You also will not get it from touching objects, such as silverware, soap, or towels.
Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.
Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an “outbreak”. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms (e.g., fever, body aches, or swollen glands) also may occur during the first outbreak.
People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.
Ask a healthcare provider to examine you if:
STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods (if you have a menstrual cycle).
Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.
Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore(s) and test it. If sores are not present, a blood test may be used to look for HSV antibodies.
Have an honest and open talk with your healthcare provider about herpes testing and other STDs.
Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.
There is no cure for genital herpes. However, there are medicines that can prevent or shorten outbreaks. A daily anti-herpes medicine can make it less likely to pass the infection on to your sex partner(s).
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of Chlamidia.
Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus (shed) from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes. If your sex partner(s) has/have genital herpes, you can lower your risk of getting it if: Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider. You avoid having vaginal, anal, or oral sex when your partner has herpes symptoms (i.e., during an "outbreak").
HPV is the most common STI. There were about 43 million HPV infections in 2018 in the US, many among people in their late teens and early 20s. There are many different types of HPV. Some types can cause health problems, including genital warts and cancers. But there are vaccines that can stop these health problems from happening. HPV is a different virus than HIV and HSV (herpes).
You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex. A person with HPV can pass the infection to someone even when they have no signs or symptoms.
If you are sexually active, you can get HPV, even if you have had sex with only one person. You also can develop symptoms years after having sex with someone who has the infection. This makes it hard to know when you first got it.
Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.
HPV can cause cervical and other cancers, including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat (called oropharyngeal cancer). This can include the base of the tongue and tonsils.
Cancer often takes years, even decades, to develop after a person gets HPV. Genital warts and cancers result from different types of HPV.
There is no way to know who will develop cancer or other health problems from HPV. People with weak immune systems (including those with HIV) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.
There is no test to find out a person’s “HPV status.” Also, there is no approved HPV test to find HPV in the mouth or throat.
There are HPV tests that can screen for cervical cancer. Healthcare providers only use these tests for screening women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years.
Most people with HPV do not know they have the infection. They never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.
In most cases (9 out of 10), HPV goes away on its own within two years without health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.
There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of Chlamidia.
You can do several things to lower your chances of getting HPV.
Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. (See “Who should get vaccinated?” below.)
Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.
HPV vaccination recommandation for:
Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination.
Hepatitis B can range from a mild illness, lasting a few weeks, to a serious, life-long (chronic) condition. More than 90% of unimmunized infants who get infected develop a chronic infection, but 6%–10% of older children and adults who get infected develop chronic hepatitis B.
Many people with hepatitis do not have symptoms and do not know they are infected. If symptoms occur with an acute infection, they can appear anytime from 2 weeks to 6 months after exposure. Symptoms of chronic viral hepatitis can take decades to develop. Symptoms of hepatitis can include: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice.
The symptoms are not systematic or may go unnoticed even though you have been infected. It is therefore important to get tested, to protect yourself and your partner after taking a risk.
15%–25% of chronically infected people develop chronic liver disease, including cirrhosis, liver failure, or liver cancer
Blood test
About 90% of infected people will clear it naturally (without treatment) before the chronic disease stage. In the case of chronic hepatitis, there are appropriate treatments to inactivate the virus, but complete cure is rare. There is a vaccine for lifelong protection.
Latex condoms, when used consistently and correctly, can reduce the risk of transmission.
Vaccine (combined with hepatitis A) in 3 or 4 injections, free for children and adolescents.
Do not share toiletries (toothbrushes, razors, nail clippers). This is important because the hepatitis virus, unlike HIV, is highly resistant to airborne infection for up to several weeks.
Hepatitis C can range from a mild illness, lasting a few weeks, to a serious, life-long (chronic) infection. Most people who get infected with the hepatitis C virus develop chronic hepatitis C.
Many people with hepatitis do not have symptoms and do not know they are infected. If symptoms occur with an acute infection, they can appear anytime from 2 weeks to 6 months after exposure. Symptoms of chronic viral hepatitis can take decades to develop. Symptoms of hepatitis can include: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice.
The symptoms are not systematic or may go unnoticed even though you have been infected. It is therefore important to get tested, to protect yourself and your partner after taking a risk.
Acute: There is not a recommended treatment for acute hepatitis C. People should be considered for treatment if their infection becomes chronic. Chronic: There are several medications available to treat chronic hepatitis C. Current treatments usually involve 8-12 weeks of oral therapy (pills) and cure over 90% of people with few side effects
Latex condoms, when used consistently and correctly, can reduce the risk of transmission.
Do not share toiletries (toothbrushes, razors, nail clippers). This is important because the hepatitis virus, unlike HIV, is highly resistant to airborne infection for up to several weeks.
HIV (human immunodeficiency virus) is a virus that attacks the body's immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome). There is currently no effective cure. Once people get HIV, they have it for life. But with proper medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners.
Most people who get HIV get it through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment.
You can get HIV if you have anal sex with someone who has HIV without using protection (like condoms or medicine to treat or prevent HIV).
You can get HIV if you have vaginal sex with someone who has HIV without using protection (like condoms or medicine to treat or prevent HIV).
HIV can be transmitted from a mother to her baby during pregnancy, birth, or breastfeeding. However, it is less common because of advances in HIV prevention and treatment.
There is little to no risk of getting HIV from the activities below. For transmission to occur, something very unusual would have to happen.
Stage 1 : flu-like symptoms
Most people have flu-like symptoms within 2 to 4 weeks after infection. Symptoms may last for a few days or several weeks. Having these symptoms alone doesn't mean you have HIV. Other illnesses can cause similar symptoms. Some people have no symptoms at all. The only way to know if you have HIV is to get tested
When people with HIV don't get treatment, they typically progress through 2 more stages. But HIV treatment can slow or prevent progression of the disease. With advances in HIV treatment, progression to Stage 3 (AIDS) is less common today than in the early years of HIV.
Stage 2 : asymptomatic HIV infection or clinical latency
Stage 3 : Acquired Immunodeficiency Syndrome (AIDS)
The only way to know if you have HIV is to get tested. Knowing your HIV status helps you make healthy decisions to prevent getting or transmitting HIV. HIV tests are typically performed on blood or oral fluid. They may also be performed on urine.
There are three types of HIV tests: antibody tests, antigen/antibody tests, and nucleic acid tests (NAT). Antibodies are produced by your immune system when you're exposed to viruses like HIV. Antigens are foreign substances that cause your immune system to activate. If you have HIV, an antigen called p24 is produced even before antibodies develop.
Talk to your health care provider about what type of HIV test is right for you.
It depends on the type of HIV test and where you get tested.
HIV test can detect HIV immediately after infection. That's because of the window period—the time between HIV exposure and when a test can detect HIV in your body. The window period depends on the type of HIV test. A nucleic acid test can usually detect HIV the soonest (about 10 to 33 days after exposure).
There are two types of HIV treatment: pills and shots. Pills are recommended for people who are just starting HIV treatment. There are many FDA-approved single pill and combination medicines available. People who have had an undetectable viral load (or have been virally suppressed) for at least three months may consider shots.
HIV treatment can cause side effects in some people. However, not everyone experiences side effects. The most common side effects are
Latex condoms, when used consistently and correctly, can reduce the risk of transmission.
PrEP is another preventive strategy but it is not for everyone. This preventive treatment, an active HIV drug, is offered to HIV-negative people at high risk of HIV infection. PrEP (Pre-Exposure Prophylaxis) should not be confused with PEP (Post Exposure Treatment). Both are antiretrovirals (anti-HIV drugs) prescribed to an HIV-negative person, but PrEP is started before any risk of exposure to HIV, whereas PEP is an emergency treatment started just after a risk is taken.
If you think you've been exposed to HIV in the last 72 hours, talk to a health care provider, an emergency room doctor, or an urgent care provider about post-exposure prophylaxis (PEP) right away.
Note that one does not exclude the other: it is possible to have recourse to PEP after forgetting to take PrEP as well as to be referred to PrEP at the end of a PEP treatment.
However, you should know that it is always the specialist doctor who decides whether or not to prescribe PrEP after having analysed the risk of acquiring HIV with you.
Content last reviewed: July 28, 2020
Content source: Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention
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