Chapter 13 : From Boudoir to Bordello: Sexually Transmitted Diseases and Travel

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This chapter reviews the clinical syndromes and epidemiology of the most commonly encountered sexually transmitted infections (STIs), as well as the clinical and behavioral aspects of travel and sexually transmitted disease (STD) epidemiology. Long-term travelers such as expatriates are at increased risk for human immunodeficiency virus (HIV) and STIs. Sexual intercourse with commercial sex workers (CSWs) is very common among travelers, expatriates, and military personnel and is one of the major risk factors for HIV and other STDs. A study of Hong Kong residents found that condom use was higher when they used CSWs in Hong Kong (91%) than when they used CSWs from mainland China (66%) and that self-reported STD rates were four times higher in those who had traveled to the mainland, 33% of travelers to the mainland had used services of CSWs, and 11% had used these services on the most recent trip. Several review papers have addressed special problems facing HIV-infected travelers. A major concern for all HIV-infected travelers is the risk for opportunistic infections. Persons who are sexually active with multiple partners should have periodic screening for STDs, especially gonorrhea, chlamydia, syphilis, and HIV, at least on an annual basis.

Citation: Zenilman J. 2009. From Boudoir to Bordello: Sexually Transmitted Diseases and Travel, p 311-330. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch13
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Image of FIGURE 1

Vaginal discharge syndrome. organisms on a wet mount are shown. BV. Clue cells with a ground-glass appearance are shown.

Citation: Zenilman J. 2009. From Boudoir to Bordello: Sexually Transmitted Diseases and Travel, p 311-330. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch13
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Image of FIGURE 2

Classical and nonclassical examples of genital ulcers. These lesions could not be differentiated solely on the basis of physical examination. Primary syphilis chancre. Note that the edges are ragged and the lesion is hemorrhagic, in contrast to the classical description. Chancroid. This multicentric ulcer was painful and had an undermined border. Primary herpes. These lesions were extremely painful and presented after the vesicle phase. There was large associated lymphadenopathy.

Citation: Zenilman J. 2009. From Boudoir to Bordello: Sexually Transmitted Diseases and Travel, p 311-330. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch13
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Major STDs

Citation: Zenilman J. 2009. From Boudoir to Bordello: Sexually Transmitted Diseases and Travel, p 311-330. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch13
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Recent papers on travel STDs

Citation: Zenilman J. 2009. From Boudoir to Bordello: Sexually Transmitted Diseases and Travel, p 311-330. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch13
Generic image for table

STD prevention strategy

Citation: Zenilman J. 2009. From Boudoir to Bordello: Sexually Transmitted Diseases and Travel, p 311-330. In Schlossberg D (ed), Infections of Leisure, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815950.ch13

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