Sexually Transmitted Diseases

  • Charles B. Whitlow
  • Lester Gottesman
  • Mitchell A. Bernstein


There are over 25 diseases primarily spread by sexual means with an annual incidence of approximately 15 million cases in the USA.1 In 1994, the overall cost related to major sexually transmitted diseases (STDs) was estimated to be 17 billion dollars. In the UK, the incidence of STDs has substantially increased over the past 6 years and has led to a new government strategy to counteract these increases.2,3


  1. 1.
    Centers for Disease Control and Prevention. Tracking the hidden epidemics. Trends in STDs in the USA. Atlanta: Centers for Disease Control and Prevention; 2001. p. 1–26.Google Scholar
  2. 2.
    British Medical Association. Sexually transmitted infections. February 2002;1–25.Google Scholar
  3. 3.
    Kinghorn G. A sexual health and HIV strategy for England. Br Med J. 2001;323:243–4.CrossRefGoogle Scholar
  4. 4.
    Halperin DT. Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part 1. AIDS Patient Care STDs. 1999;13:717–30.CrossRefGoogle Scholar
  5. 5.
    Kozlowski PA, Neutra MR. The role of mucosal immunity in ­prevention of HIV transmissions. Curr Mol Med. 2003;3:217–28.CrossRefGoogle Scholar
  6. 6.
    Sobhani I, Walker F, Aparicio T, et al. Effect of anal epidermoid cancer-related viruses on the dendritic (Langerhans’) cells of the human anal mucosa. Clin Cancer Res. 2002;8:2862–9.PubMedGoogle Scholar
  7. 7.
    Middleton K, Peh W, Southern S, et al. Organization of human papillomavirus productive cycle during neoplastic progression provide a basis for selection of diagnostic markers. J Virol. 2003;77:10186–201.CrossRefGoogle Scholar
  8. 8.
    Kampmeier RH. Identification of the gonococcus by Albert Neisser. Sex Transm Dis. 1978;5:71.CrossRefGoogle Scholar
  9. 9.
    Hansen L, Wong T, Perrin M. Gonorrhoea resurgence in ­Canada. Int J STD AIDS. 2003;14:727–31.CrossRefGoogle Scholar
  10. 10.
    Hook III EW, Handsfield HH. Gonococcal infection in the adult. In: Holmes KK, Sparling PR, Mardh PA, et al., editors. Sexually transmitted diseases. New York: McGraw-Hill; 1999. p. 451–66.Google Scholar
  11. 11.
    McMillan A, Young H, Moyes A. Rectal gonorrhoea in homosexual men: source of infection. Int J STD AIDS. 2000;11:284–7.CrossRefGoogle Scholar
  12. 12.
    Ison C, Martin D. Gonorrhea. In: Morse SA, Ballard RC, Holmes KK, Moreland AA, editors. Atlas of sexually transmitted diseases and AIDS. Edinburgh: Mosby; 2003. p. 109–25.Google Scholar
  13. 13.
    Young H, Manavi K, McMillan A. Evaluation of ligase chain reaction for the non-cultural detection of rectal and pharyngeal gonrrhea in men who have sex with men. Sex Transm Infect. 2003;79:484–6.CrossRefGoogle Scholar
  14. 14.
    Centers for Disease Control and Prevention. Sexually ­transmitted diseases treatment guidelines 2002. MMWR. 2002;51(RR-6):1–77.Google Scholar
  15. 15.
    Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2002 supplement. Gonococcal isolate surveillance project annual report. Atlanta: US Department of Health and Human Services; 2003.Google Scholar
  16. 16.
    Fenton KA, Ison C, Johnson AP, et al. Ciprofloxacin resistance in Neisseria gonorrhoeae in England and Wales in 2002. Lancet. 2003;361:1867–8.CrossRefGoogle Scholar
  17. 17.
    Cates W. Estimates of the incidence and prevalence of sexually transmitted diseases in the United States. Sex Transm Dis. 1999;26(Suppl):S2–7.CrossRefGoogle Scholar
  18. 18.
    Rampalo AM. Diagnosis and treatment of sexually acquired proctitis and proctocolitis: an update. Clin Infect Dis. 1999;28 Suppl 1:S84–90.CrossRefGoogle Scholar
  19. 19.
    Gregory A, Gottesman L. Sexually transmitted and infectious diseases. In: Beck DE, Wexner SD, editors. Fundamentals of anorectal surgery. London: WB Saunders; 1998. p. 414–31.Google Scholar
  20. 20.
    Stamm W. Chlamydia trachomatis infections of the adult. In: Holmes KK, Sparling PR, Mardh PA, et al., editors. Sexually transmitted diseases. New York: McGraw-Hill; 1999. p. 407–22.Google Scholar
  21. 21.
    Schacter J, Stephens R. Infections caused by Chlamydia ­trachomatis. In: Morse SA, Ballard RC, Holmes KK, Moreland AA, editors. Atlas of sexually transmitted diseases and AIDS. Edinburgh: Mosby; 2003. p. 73–96.Google Scholar
  22. 22.
    Golden MR, Astet SG, Galvan R, et al. Pilot study of COBAS PCR and ligase chain reaction for detection of rectal infections due to Chlamydia trachomatis. J Clin Microbiol. 2003;41:2174–5.CrossRefGoogle Scholar
  23. 23.
    Centers for Disease Control and Prevention. Primary and secondary syphilis – United States 2002. MMWR. 2003; 52:1117–20.Google Scholar
  24. 24.
    Centers for Disease Control and Prevention. The national plan to eliminate syphilis from the United States. Atlanta: US Department of Health and Human Services; 1999. p. 1–84.
  25. 25.
    Cox D, Liu H, Moreland A, Levine W. Syphilis. In: Morse SA, Ballard RC, Holmes KK, Moreland AA, editors. Atlas of sexually transmitted diseases and AIDS. Edinburgh: Mosby; 2003. p. 23–51.Google Scholar
  26. 26.
    Kohl KS, Farley T, Ewell J, Scioneaux J. Usefulness of partner notification for syphilis control. Sex Transm Dis. 1999; 26:201–7.CrossRefGoogle Scholar
  27. 27.
    Spinola SM, Bauer ME, Munson RS. Immunopathogenesis of Haemophilus ducrei infection (Chancroid). Infect Immun. 2002;70:1667–76.CrossRefGoogle Scholar
  28. 28.
    DiCarlo RP, Martin DH. The clinical diagnosis of genital ulcer disease in men. Clin Infect Dis. 1997;25:292–8.CrossRefGoogle Scholar
  29. 29.
    Ballard R, Morse S. Chancroid. In: Morse SA, Ballard RC, Holmes KK, Moreland AA, editors. Atlas of sexually transmitted diseases and AIDS. Edinburgh: Mosby; 2003. p. 53–71.Google Scholar
  30. 30.
    Orle KA, Gates CA, Martin DH, et al. Simultaneous PCR detection of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus types 1 and 2 from genital ulcers. J Clin Microbiol. 1996;34:49–54.PubMedPubMedCentralGoogle Scholar
  31. 31.
    O’Farrell N. Donovanosis. Sex Transm Dis. 2002;78:452–7.CrossRefGoogle Scholar
  32. 32.
    Fleming DT, McQuillan GM, Johnson RE, et al. Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med. 1997;337:1105–11.CrossRefGoogle Scholar
  33. 33.
    Roberts CM, Pfister JR, Spear SJ. Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sex Transm Dis. 2003;30:797–800.CrossRefGoogle Scholar
  34. 34.
    Lafferty WE. The changing epidemiology of HSV-1 and HSV-2 and implications for serological testing. Herpes. 2002;9:51–5.PubMedGoogle Scholar
  35. 35.
    Goodell SE, Quinn TC, Mkrtichian E, et al. Herpes simplex virus proctitis in homosexual men. Clinical, sigmoidoscopic, and histopathological features. N Engl J Med. 1983;308:868–71.CrossRefGoogle Scholar
  36. 36.
    Pertel PR, Spear PG. Biology of herpesviruses. In: Holmes KK, Sparling PR, Mardh PA, et al., editors. Sexually transmitted diseases. New York: McGraw-Hill; 1999. p. 269–83.Google Scholar
  37. 37.
    Wald A, Ashley-Morrow R. Serological testing for herpes simplex virus (HSV)-1 and HSV-2 infection. Clin Infect Dis. 2002;35 Suppl 2:S173–82.CrossRefGoogle Scholar
  38. 38.
    Slomka MJ. Current diagnostic techniques in genital herpes: their role in controlling the epidemic. Clin Lab. 2000;46: 591–607.PubMedGoogle Scholar
  39. 39.
    Ashley RL. Performance and use of HSV type-specific serology test kits. Herpes. 2002;9:38–45.PubMedGoogle Scholar
  40. 40.
    Rompalo AM, Mertz GJ, Davis LG, et al. A double-blind study of oral acyclovir for the treatment of first episode herpes simplex virus proctitis in homosexual men. JAMA. 1988;259:2879–81.CrossRefGoogle Scholar
  41. 41.
    Wald A. New therapies and prevention strategies for genital herpes. Clin Infect Dis. 1999;28(Suppl):S4–13.CrossRefGoogle Scholar
  42. 42.
    Patel R. Progress in meeting today’s demands in genital herpes: an overview of current management. J Infect Dis. 2002;186 Suppl 1:S47–56.CrossRefGoogle Scholar
  43. 43.
    Corey L, Wald A, Patel R, et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med. 2004;350:11–20.CrossRefGoogle Scholar
  44. 44.
    Wiley DJ, Douglas J, Beutner K, et al. External genital warts: diagnosis, treatment, and prevention. Clin Infect Dis. 2002;35 Suppl 2:S210–24.CrossRefGoogle Scholar
  45. 45.
    von Krogh G, Longstaff E. Podophyllin office therapy against condyloma should be abandoned. Sex Transm Infect. 2001;77:409–12.CrossRefGoogle Scholar
  46. 46.
    von Krogh G, Lacey CJN, Gross G, et al. European course on HPV associated pathology: guidelines for primary care physicians for the diagnosis and management of anogenital warts. Sex Transm Infect. 2000;76:162–8.CrossRefGoogle Scholar
  47. 47.
    Greenberg MD, Rutledge LH, Reid R, et al. A double-blind, randomized trial of 0.5% podofilox and placebo for the treatment of genital warts in women. Obstet Gynecol. 1991;77:735–9.PubMedGoogle Scholar
  48. 48.
    Edwards L, Ferenczy A, Eron L, et al. Self-administered topical 5% imiquimod cream for external anogenital warts. Arch Dermatol. 1998;134:25–30.CrossRefGoogle Scholar
  49. 49.
    Tyring S, Edwards L, Cherry LK, et al. Safety and efficacy of 0.5% podofilox gel in the treatment of anogenital warts. Arch Dermatol. 1998;134:33–8.CrossRefGoogle Scholar
  50. 50.
    Maitland JE, Maw R. An audit of patients who have received imiquimod cream 5% for the treatment of anogenital warts. Int J STD AIDS. 2000;11:268–70.CrossRefGoogle Scholar
  51. 51.
    Beutner K, Tyring SK, Trofatter Jr KF, et al. Imiquimod, a patient-applied immune-response modifier for treatment of external genital warts. Antimicrob Agents Chemother. 1998;42:789–94.CrossRefGoogle Scholar
  52. 52.
    Fife KH, Ferenczy A, Douglas JM, et al. Treatment of external warts in men using 5% imiquimod cream applied three times a week, once daily, twice daily, or three times a day. Sex Transm Dis. 2001;28:226–31.CrossRefGoogle Scholar
  53. 53.
    Kaspari M, Gutzmer R, Kaspari T, et al. Application of imiquimod by suppositories (anal tampons) efficiently prevents recurrences after ablation of anal canal condyloma. Br J Dermatol. 2002;147:757–9.CrossRefGoogle Scholar
  54. 54.
    Buschke A, Lowenstein L. Uber carcinomahnliche condylomata acuminata. Klin Wochenschr. 1925;4:1726.CrossRefGoogle Scholar
  55. 55.
    Trombetta LJ, Place RJ. Giant condyloma acuminatum of the anorectum: trends in epidemiology and management. Report of a case and review of the literature. Dis Colon Rectum. 2001;44:1878–86.CrossRefGoogle Scholar
  56. 56.
    Butler TW, Gefter J, Kleto D, et al. Squamous-cell carcinoma of the anus in condyloma acuminatum: successful treatment with pre-operative chemotherapy and radiation. Dis Colon Rectum. 1987;30:293–5.CrossRefGoogle Scholar
  57. 57.
    Frisch M, Biggar RJ, Goedert JJ. Human papillomavirus-associated cancers in patients with immunodeficiency virus infection and acquired immunodeficiency syndrome. J Natl Cancer Inst. 2000;92:1500–10.CrossRefGoogle Scholar
  58. 58.
    Goedert JJ, Cote TR, Virgo P, et al. Spectrum of AIDS-associated cancers in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome. Lancet. 1998;351:1833–9.CrossRefGoogle Scholar
  59. 59.
    Chin-Hong PV, Palefsky JM. Natural history and clinical management of anal human papillomavirus disease in men and women infected with human immunodeficiency virus. Clin Infect Dis. 2002;35:1127–34.CrossRefGoogle Scholar
  60. 60.
    Palefsky JM. Anal human papillomavirus infection and anal cancer in HIV-positive individuals: an emerging problem. AIDS. 1994;8:293–5.CrossRefGoogle Scholar
  61. 61.
    Cleary RK, Shaldebrand JD, Fowler JJ, et al. Perianal Bowen’s disease and anal intraepithelial neoplasia. Dis Colon Rectum. 1999;42:945–51.CrossRefGoogle Scholar
  62. 62.
    Caruso ML, Valentini AM. Different human papillomavirus genotypes in anogenital lesions. Anticancer Res. 1999;19:3049–53.PubMedGoogle Scholar
  63. 63.
    Colquhoun P, Nogeras JJ, Dipasquale B, et al. Interobserver and intraobserver bias exists in the interpretation of anal dysplasia. Dis Colon Rectum. 2003;46:1338.CrossRefGoogle Scholar
  64. 64.
    Piketty C, Darragh TM, Heard I, et al. High prevalence of anal squamous intraepithelial lesions in HIV-positive men despite the use of highly active antiretroviral therapy. Sex Transm Dis. 2004;31:96–9.CrossRefGoogle Scholar
  65. 65.
    Piketty C, Darragh TM, Da Costa M, et al. High prevalence of anal human papillomavirus infection and anal cancer precursors among HIV-infected persons in the absence of anal intercourse. Ann Intern Med. 2003;183:453–9.CrossRefGoogle Scholar
  66. 66.
    Douglas Jr JM. Molluscum contagiosum. In: Holmes KK, Sparling PR, Mardh PA, et al., editors. Sexually transmitted diseases. New York: McGraw-Hill; 1999. p. 385–9.Google Scholar
  67. 67.
    Skinner RB. Treatment of mollscum contagiosum with imiquimod 5% cream. J Am Acad Dermatol. 2002;47:S221–4.CrossRefGoogle Scholar
  68. 68.
    Syed TA, Lundin S, Ahmad M. Topical 0.3% and 0.5% ­podophyllotoxin cream for self-treatment of molluscum contagiosum in males. A placebo-controlled, double-blind study. Dermatology. 1994;189:65–8.CrossRefGoogle Scholar
  69. 69.
    Barre-Sinoussi F, Chermann JC, Rey F, et al. Isolation of a ­T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science. 1983;220:868–71.CrossRefGoogle Scholar
  70. 70.
    Centers for Disease Control and Prevention. HIV/AIDS ­surveillance report 2005 (modified June, 2007);17:12.Google Scholar
  71. 71.
    Centers for Disease Control and Prevention. MMWR 1992; 41(RR-17)Google Scholar
  72. 72.
    Barrett WL, Callahan TD, Orkin BA. Perianal manifestations of human immunodeficiency virus infection. Experience with 260 patients. Dis Colon Rectum. 1998;41:606–12.CrossRefGoogle Scholar
  73. 73.
    Morandi E, Merlini D, Salvaggio A, et al. Prospective study of healing time after hemorroidectomy. Influence of HIV infection, acquired immunodeficiency syndrome, and anal wound infection. Dis Colon Rectum. 1999;42:1140–4.CrossRefGoogle Scholar
  74. 74.
    Nadal SR, Manzione CR, Galvao VM, et al. Healing after fistulotomy. Comparative study between HIV+ and HIV− patients. Dis Colon Rectum. 1998;41:177–9.CrossRefGoogle Scholar
  75. 75.
    Lord RVN. Anorectal surgery in patients infected with human immunodeficiency virus. Factors associated with delayed wound healing. Ann Surg. 1997;226:92–9.CrossRefGoogle Scholar
  76. 76.
    Brar HS, Gottesman L, Surawicz C. Anorectal pathology in AIDS. Gastrointest Endosc Clin N Am. 1998;8:913–31.CrossRefGoogle Scholar
  77. 77.
    Bernstein M. Anal fissure and the human immunodeficiency virus. Semin Colon Rectal Surg. 1997;8:40–5.Google Scholar
  78. 78.
    Modesto VL, Gottesman L. Surgical debridement and ­intralesional steroid injection in the treatment of idiopathic AIDS-related anal ulcerations. Am J Surg. 1997;174:439–41.CrossRefGoogle Scholar
  79. 79.
    Hewitt WR, Sokol TP, Fleshner RP. Should HIV status alter indications for hemorrhoidectomy? Dis Colon Rectum. 1996;39:615–8.CrossRefGoogle Scholar

Copyright information

© ASCRS (American Society of Colon and Rectal Surgeons) 2011

Authors and Affiliations

  • Charles B. Whitlow
    • 1
  • Lester Gottesman
    • 2
  • Mitchell A. Bernstein
    • 3
    • 4
  1. 1.Department of Colon and Rectal SurgeryOchsner Medical CenterNew OrleansUSA
  2. 2.Department of Colorectal SurgeryColumbia School of Physicians and Surgeons, St. Luke’s RooseveltNew YorkUSA
  3. 3.Senior Attending Department of Surgery, Program Director, Colon and Rectal Surgery FellowshipColumbia University College of Physicians and SurgeonsNew YorkUSA
  4. 4.St. Luke’s Roosevelt Hospital CenterNew YorkUSA

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