SEXUALLY
TRANSMITTED
INFECTIONS

Edited by Nancy Malla
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Sexually Transmitted Infections
Edited by Nancy Malla


Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia

Copyright © 2012 InTech
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Notice
Statements and opinions expressed in the chapters are these of the individual contributors
and not necessarily those of the editors or publisher. No responsibility is accepted for the
accuracy of information contained in the published chapters. The publisher assumes no
responsibility for any damage or injury to persons or property arising out of the use of any
materials, instructions, methods or ideas contained in the book.

Publishing Process Manager Marina Jozipovic
Technical Editor Teodora Smiljanic
Cover Designer InTech Design Team

First published March, 2012
Printed in Croatia

A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from


Sexually Transmitted Infections, Edited by Nancy Malla
p. cm.
ISBN 978-593-51-0258-8

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Contents
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Preface IX
Part 1 Introduction 1
Chapter 1 Sexually Transmitted Infections: An Overview 3
Nancy Malla and Kapil Goyal
Part 2 Bacterial Infections 29
Chapter 2 Chlamydia trachomatis Infections of the Adults 31
Sabina Mahmutovic Vranic
Chapter 3 Gonorrhea in Men Sex Men and Heterosexual Men 47
Ángela María Rosa Famiglietti and Susana Diana García
Chapter 4 Mucosal Immunity and Evasion
Strategies of Neisseria gonorrhoeae 69
Mónica Imarai, Claudio Acuña, Alejandro Escobar,
Kevin Maisey and Sebastián Reyes-Cerpa
Chapter 5 Syphilis 89
Roberto Saraiva, Augusto Daige, Joao Jazbik,
Claudio Cesar, Marco Mello and Evandro Lopes
Part 3 Protozoal Infection 105
Chapter 6 Human Trichomoniasis due to
Trichomonas vaginalis – Current Perspectives 107
Nancy Malla
Part 4 Human Papilloma Virus Infection 125
Chapter 7 Human Papillomavirus Infection in Croatian Men:
Prevalence and HPV Type Distribution 127

Blaženka Grahovac, Anka Dorić, Željka Hruškar,
Ita Hadžisejdić and Maja Grahovac
VI Contents

Chapter 8 Human Papilloma Virus and Anal Cancer 141
João Batista de Sousa and Leonardo de Castro Durães
Chapter 9 Recurrent Oral Squamous Papilloma
in a HIV Infected Patient: Case Report 155
Helena Lucia Barroso dos Reis, Mauro Romero Leal Passos,
Aluízio Antônio de Santa Helena, Fernanda Sampaio Cavalcante,
Arley Silva Júnior and Dennis de Carvalho Ferreira
Part 5 Epidemiology 163
Chapter 10 Sexually Transmitted Infections Among Army
Personnel in the Military Environment 165
Krzysztof Korzeniewski
Chapter 11 Syphilis and Herpes Simplex Virus Type 2 Sero-Prevalence
Among Female Sex Workers and Men Who Have Sex
with Men in Ecuador and Andhra Pradesh (India) 183
Juan Pablo Gutiérrez and Erika E. Atienzo
Chapter 12 Knowledge, Attitude and Behaviour Related
to Sexually Transmitted Infections in Portuguese
School (Adolescent) and College Students 199
Lúcia Ramiro,

Marta Reis, Margarida Gaspar de Matos
and José Alves Diniz
Chapter 13 Knowledge, Attitude, Behavior, and Practice of the UNIFIL
Peacekeepers on Human Immunodeficiency Virus 219
Abdo R. Jurjus, Inaya Abdallah Hajj Hussein and Alice A. Gerges




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Preface
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Sexually transmitted infections (STIs) are considered as neglected diseases and are on the
list of diseases targeted by WHO for control. Apart from HIV, STIs cause significant
morbidity. Several STIs adversely affect outcome of pregnancy and may lead to neonatal
and genital infections. Genital infection with Human papilloma virus (HPV) may lead to
cervical cancer, the most common cause of cancer-related death in women worldwide.
High risk group persons and women, particularly adolescents are disproportionately
vulnerable to STIs, many of which remain asymptomatic favouring spread of infection.
The risk of acquiring STIs is highest in urban areas, in low socioeconomic groups, in the
young and in association with illicit drug users and prostitution. Prevention is the Hall
mark for control of STIs. Prevention and control of STIs require a global initiative, the
success of which will largely depend on the development of safe and effective vaccines.
Currently, except for hepatitis B infection, no such vaccines exist. Although, there is
plethora of the literature available on STIs and many books are available on the
individual infections covered in this book, yet numerous advances continue to be made
in understanding the different aspects of these infections.
In Tech publisher has planned to publish the book and have invited authors with their
rich expertise on the topics contributed by them. The purpose of the book and
approach used is an attempt made to present the historical as well as advanced
reference material on different aspects of STIs. This book is essentially a collection of

chapters providing novel knowledge on some of the most debated topics. The book is
intended for general reference work for physicians, researchers and students
interested in the subject. The strong and genuine enthusiasm of the authors is clearly
visible in their respective contributions. The book does not cover all the sexually
transmitted infections. In the introductory chapter, an attempt has been made to
provide an overview on the STIs with special reference to syndromic approach for
management as a general practitioner in the field, especially those who may not have
access to specialist literature. I am sure that the information provided in this book, will
stimulate the reader to understand different aspects on the topics contributed and will
be of interest to health care professionals, scientists dedicated to this field as well as
readers, in general.
I wish to put on record my gratitude to many colleagues for reviewing few chapters
and for their time and valuable suggestions. Their ideas shaped the book and guided
X Preface

every step of its creation. In particular, I would like to acknowledge the help of Prof.
Jane Carlton for her suggestions for the chapter on Human trichomoniasis, Prof. D.R.
Arora and Dr. Neelam Taneja for chapter on Syphilis, Dr. Mini P. Singh for chapters
on Human Papilloma Virus and Dr. Kusum Sharma for chapter on Chlamydia. Lastly,
I would like to thank the In Tech publishers for appointing me 'Book Editor' and
providing me an opportunity to review the chapters contributed in this book.
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Nancy Malla
Professor and Head, Department of Parasitology,
Post Graduate Institute of Medical Education and Research
Chandigarh,
India




Part 1
Introduction