Skip to Main Content




He who immerses himself in sexual intercourse will be assailed by premature ageing, his strength will wane, his eyes will weaken, and a bad odour will emit from his mouth and his armpits, his teeth will fall out and many other maladies will afflict him.

Moses ben Maimon (1135–1204), Mishneh Torah


Sexually transmitted infections (STIs) are a group of communicable infections, usually transmitted by sexual contact. Their incidence has been of widespread significance during the past 30 years and they are a major public health problem in all countries.


The STIs have developed a high profile in modern society with the advent of HIV infection, hepatitis B, Chlamydia trachomatis as a major cause of PID, the emergence of penicillin-resistant gonorrhoea and the increasing frequency of the human papilloma (wart) virus infection with its association with cervical cancer. STIs are summarised in Table 119.1.

Table Graphic Jump Location
Table 119.1

Sexually transmitted or acquired infections: causative organisms and treatment2,4


Key facts and guidelines

  • In Western society most patients with STIs are in the 15–30 years age group.

  • Gonorrhoea and syphilis are no longer the commonest STIs.

  • Chlamydial infection, hepatitis B, human papillomavirus and genital herpes are now common infections.

  • Not all STIs are manifest on the genitals.

  • Not all genital lesions are STIs.

  • The 5% rule:1

    • 5% of urethritis (STI) in males is lower UTI

    • 5% of lower UTI in females is urethritis (STI)

  • Chlamydia trachomatis is now the commonest cause of urethritis.

  • Chlamydia typically causes dysuria in men but may be asymptomatic. It usually causes no symptoms in women.

  • Gonorrhoea may cause no symptoms, especially in ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

Murtagh Collection Full Site: One-Year Subscription

Connect to a suite of general practice resources from one of the most influential authors in the field. Learn the breadth of general practice, including up-to-date information on diagnosis and treatment, as well as key clinical skills like communication.

$145 USD
Buy Now

Pay Per View: Timed Access to all of Murtagh Collection

48 Hour Subscription $34.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.