Im going to start by saying. This is supposed to be a light hearted College Fantasy Sex game. And some of that is in the game already. But it only affects the player. There is make up your can buy from the compartment store. You can buy whips and paddles from the porn shop. You can form Sub n Dom relationships.
With people who have a Submissive, or Dominant nature. There are costumes that you character can buy and wear to cosplay in. You can get catcalled by walking near the industrial area in town. And finally there are perks you can get for wearing dirty/stained clothes and not upkeeping your hygiene. How that affects NPC's I don't know. As I shower to fuck strangers. Because my character has the always Horny trait, so I always get the prompt to join someone in the shower.
As for everything else, that might be added in the big NPC update. I don't know much about it. But from what I've seen in the comments. It's a update that will focus on updating and revamping NPC actions, reactions, and interactions. With the School, Town, and Player. So I can see most of the stuff your asking for being in that update. As for the aftercare and things like that. It will probably be in the Pregnancy Update. Where the dangers of creampies become real.
But with that said why do you want STDs in the game? I don't like nor want any part of that. It adds a whole level of horror that I don't even want to think about dealing with. In This LIGHT hearted College sex fantasy. Especially when there's a whole event based around the Friday Night Party Milkshakes. Besides that, and being attacked by homeless people on the street. I liked everything else you mentioned. But again I want to remind you that this is supposed to be a Light Hearted College Sex Fantasy.
Edit: You can get Tattoos and Piercings at the Tattoo shop next to the porn shop. There already is a weather system that, will soak your clothes in sweat on a hot day. If you're over dressed. And Technically we already have a stalker/obsessed fan. If you post pictures on Elkbook, you'll occasionally get a creepily hot email. As of now there's no real further interaction with them. But I believe that story will also be expanded on in the NPC update.