My Clinical Approach
For STDs, I apply complete screening panel (chlamydia, gonorrhea, syphilis, HIV, hepatitis) for every patient with symptoms or risk exposure, even if suspicion is for a single pathogen.
I emphasize confidentiality and psychological support. The topic involves very sensitive personal lives and the trust relationship is critical.
I educate about the need for partner treatment (Expedited Partner Therapy) to break the transmission chain and prevent re-infection.
What are STDs?
STDs are infections caused by bacteria, viruses, or parasites and transmitted primarily through vaginal, oral, or anal sexual contact. Some can also transmit from mother to child during pregnancy, delivery, or breastfeeding, and via blood.
- Globally >1 million new infections/day (WHO 2024)
- 376 million new cases/year (4 most common: chlamydia, gonorrhea, syphilis, trichomoniasis)
- In the US: 2.5 million chlamydia/gonorrhea/syphilis cases (CDC 2023)
- Most common ages 15–24
- Many asymptomatic (up to 70% of chlamydia)
Most Common STDs
Chlamydia (Chlamydia trachomatis)
Most common bacterial STD. 70% of women & 50% of men asymptomatic. Complications: PID, infertility, ectopic pregnancy. Treatment: doxycycline or azithromycin.
Gonorrhea (Neisseria gonorrhoeae)
Purulent discharge, dysuria. Increasing antibiotic resistance. Treatment: ceftriaxone IM (CDC 2021 update).
Syphilis (Treponema pallidum)
Primary chancre, secondary rash, latent, tertiary (neurosyphilis). Treatment: benzathine penicillin G IM.
HPV (Human Papillomavirus)
>200 types. High-risk (16, 18) → cervical, penile, anal, oropharyngeal cancer. Prevention: HPV vaccine (Gardasil 9).
Genital Herpes (HSV-2)
Painful vesicles/ulcers, recurring. Not curable but controlled with acyclovir/valacyclovir.
HIV
With modern antiretroviral therapy (ART) → normal life expectancy. Undetectable viral load = untransmittable (U=U). PrEP for prevention.
Symptoms
- Discharge from urethra/vagina/rectum
- Burning or pain on urination
- Pain or bleeding during intercourse
- Vesicles, ulcers, itching, rash
- Testicular swelling or pain
- Inguinal lymph node enlargement
- Fever, fatigue, malaise
- Many STDs are asymptomatic - this is why regular screening is critical
For any symptoms or risk exposure, seek medical evaluation within 1–2 weeks. Delay increases complications and transmission risk.
Diagnosis
- NAAT (Nucleic Acid Amplification Test) - sensitivity >95% for chlamydia/gonorrhea
- Discharge culture
- Serologic tests for syphilis (RPR, VDRL, TPHA)
- HIV: 4th generation antigen/antibody, viral load
- Hepatitis B/C: HBsAg, anti-HCV
- PCR for HSV (from vesicle)
- HPV DNA test (PAP smear in women)
- Sample from urethra, vagina, rectum, pharynx based on exposure
Treatment (CDC STI Treatment Guidelines 2021)
Bacterial (Complete cure)
- • Chlamydia: doxycycline 100mg ×2/day ×7 days
- • Gonorrhea: ceftriaxone 500mg IM single dose
- • Syphilis: benzathine penicillin G 2.4 MU IM
- • Trichomoniasis: metronidazole 2g PO single dose
Viral (Control, not cure)
- • HSV: acyclovir/valacyclovir (suppression of recurrences)
- • HIV: lifelong antiretroviral therapy (ART)
- • Hepatitis B: interferon/tenofovir
- • Hepatitis C: direct-acting antivirals (DAAs) → 95% cure
- • HPV: monitoring, condyloma cauterization
Adjunct Measures
- • Sexual abstinence 7 days post-treatment
- • Test of cure at 3-4 weeks
- • Re-screening at 3 months (re-infection)
- • Treatment of all recent partners (60 days)
Prevention
- Correct condom use (latex/polyurethane) - reduces risk >85%
- HPV vaccination (recommended ages 9–14, catch-up to age 26)
- Hepatitis B vaccination
- PrEP (Pre-Exposure Prophylaxis) for HIV - tenofovir/emtricitabine
- PEP (Post-Exposure Prophylaxis) within 72 hours of exposure
- Mutual monogamy with screened partner
- Regular screening (every 3–6 months for high-risk)
- Avoiding alcohol/drugs that impair judgment
Partner Notification
Notification of recent sexual partners (60 days for chlamydia/gonorrhea, 90 days for syphilis) is an ethical and medical obligation. It allows timely treatment and prevents transmission chains and re-infection.
- Direct discussion with partners
- Anonymous partner notification (via health authorities or online platforms)
- Expedited Partner Therapy (prescription for partner without examination - where allowed)
- Patient confidentiality respected
Frequently Asked Questions (FAQ)
What are the most common STDs?
According to CDC 2024 data: chlamydia (Chlamydia trachomatis), gonorrhea (Neisseria gonorrhoeae), genital herpes (HSV-2), HPV, syphilis, and HIV. Chlamydia is the most common bacterial STD with 1.6 million annual cases in the US.
When should I get tested for STDs?
After every new sexual partner, after unprotected sex, when symptoms appear (discharge, burning, rash), and as annual routine screening for sexually active people under 25. CDC recommends screening every 3–6 months for high-risk individuals.
Are STDs curable?
Bacterial STDs (chlamydia, gonorrhea, syphilis) are completely curable with antibiotics. Viral STDs (HSV, HPV, HIV, Hepatitis B) cannot be cured but are controlled with antivirals. Hepatitis C is curable with direct-acting antivirals (95% cure rate).
How long do symptoms take to appear?
Variable: chlamydia 7–21 days, gonorrhea 2–7 days, syphilis 10–90 days, herpes 2–12 days, HIV 2–4 weeks (acute infection). Up to 70% of women and 50% of men with chlamydia are asymptomatic.
How do I protect myself from STDs?
Correct condom use (reduces risk >85%), HPV and Hepatitis B vaccination, regular screening, fewer partners, avoiding alcohol/drugs that impair judgment, and PrEP for people at high risk for HIV.
Book Your Appointment in Rhodes
STD screening and treatment with complete confidentiality. Comprehensive testing panel, psychological support, and prevention education.
References
- CDC. Sexually Transmitted Infections Treatment Guidelines, 2021 — cdc.gov/std
- WHO. Sexually Transmitted Infections (STIs) Fact Sheet, 2024 — who.int
- EAU Guidelines on Urological Infections, 2024 update — uroweb.org
Medical review
Dr. Marinos Vasilas, Urologist – Andrologist
Dr. Marinos Vasilas runs a private urological practice in Rhodes specializing in STD management with complete confidentiality and comprehensive screening.
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