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Human Sexuality December 5, 2012
Chapter 15: Sexually Transmitted Infections
ACQUIRED IMMUNODEFICIENCY
SYNDROME (AIDS)
What is AIDS?
• AIDS results from infection with the human
immunodeficiency virus (HIV)
• Appears to have been introduced to humans from
chimpanzees in Africa, possibly by people eating
infected animals
• Probably arose sometime around 1930, but did not
spread worldwide until the 1970s when Africa became
less isolated
• HIV specifically attacks a type of immune cell called Thelper cells, destroying them
• Without T-helper cells, we are susceptible to many
other illnesses that would not be problematic for a
healthy person
AIDS incidence
• More than 1 million people
in the U.S. have been
diagnosed with AIDS since
1981 and more than
570,000 have died
• However, that is a small
number compared to rates
of AIDS in Africa
• The HIV/AIDS pandemic may
be losing some of its
momentum finally
• Worldwide, most AIDS
transmission is from
heterosexual contact
AIDS in the U.S.
• Most common among men
who have sex with men
(MSM), and among ethnic
and racial minority groups
• Higher rates among
minorities may be due to:
– Reduced access to health care
in these groups
– Cultural or language barriers
that limit access to AIDS
prevention information
– Differences in HIV risk
behavior, especially injection
drug use
Transmission of HIV
• Saliva, semen, blood, vaginal secretions, urine, and
breast milk can contain HIV virus, though in varying
amounts
• It is easier to transmit HIV from a man to a woman than
from a woman to a man
• Anal intercourse spreads the virus more easily than
vaginal intercourse
• Can be transmitted from mother to child during birth or
from breastfeeding
• Can be transmitted by oral-genital contact
• “Viral load” is often highest right after infection
• Circumcision has been shown to reduce transmission of
HIV
Transmission of AIDS through blood
transfusions
• In the early 1980s, there
was no test for HIV, and
approximately 25,000
people contracted HIV from
blood transfusions
• Since 1985, all blood has
been screened for HIV
antibodies, although tests
are not 100% accurate
• MSM, IV drug users, and
other high-risk individuals
are not allowed to donate
blood
Symptoms and complications of HIV
• Flulike symptoms often appear within the first few
weeks of infection
• Virus then often becomes dormant for several years
• Common later symptoms include fevers, night
sweats, weight loss, fatigue, diarrhea, headaches,
chronic cough and oral candidiasis (also known as
“thrush”
• The fact that many people are asymptomatic for a
long time leads to delays in detecting infection,
during which time many more people may be
infected
AIDS symptoms
• AIDS is defined as having one
or more severe, debilitating
diseases associated with
extreme impairment of the
immune system after HIV
infection
• Common complications of
AIDS include Kaposi’s
sarcoma (at right),
Pneumocystis carinii
pneumonia, tuberculosis,
meningitis, and
toxoplasmosis
AIDS treatment
• Death rates from HIV have been decreasing in the
U.S. since 1996
• This is primarily due to treatment with highly active
antiretroviral therapy (HART)
• These are drugs that target the HIV family of
viruses, and because multiple drugs are given at
once, they prevent the virus from mutating to be
resistant to any one drug
• Drawback: these drugs can have serious side
effects, including anemia, insomnia, mouth sores,
diarrhea, inflammation of the pancreas, GI
problems, liver damage, and others
An AIDS vaccine?
• Viral illnesses are harder to
treat than bacterial illnesses,
so it is desirable to prevent
infection through vaccination
• In 1984 Health & Human
Services Secretary Margaret
Heckler predicted that there
would be an AIDS vaccine
within 2 years!
• Hard to test, and to develop,
but efforts are still underway
AVOIDING TRANSMISSION OF STI’S
Know your risk status &
your partners’ risk status
• Have you been tested for STIs?
– Many STIs have few or no symptoms
• Effective communication about risk factors is
key; be honest with yourself and with your
partners and choose partners who will do the
same for you!
• One review of HIV disclosure found that 12–
33% of people did not disclose to their
partners that they were HIV positive
Use latex condoms
• With proper use, condoms drastically reduce rates
of transmission of most STIs
• Major exception: ectoparasitic infections such as
crabs and scabies
• Syphilis, HSV, and HPV can also be spread without
direct genital contact in some cases
• “Natural skin” or “natural membrane” condoms
made from sheepskin do not protect against viruses
• Spermicide can increase STD risk
• Both male and female condoms decrease risk
Store condoms correctly!
• Store in a cool, dry, place out of direct sunlight
• Check the expiration date! Throw out any
condoms that are in damaged packages, brittle,
discolored, or show other signs of aging, even if
the expiration date has not passed.
• Handle condoms so they are not punctured
• Make sure you have them when you need them
Prepare to use condoms correctly!
• Put on a condom BEFORE genital contact for STD
prevention
• Make sure the condom is adequately lubricated
with a water-based lubricant ONLY
• Do not fill a condom with water or blow it up like a
balloon to check it for leaks!
Use condoms correctly!
• For an uncircumcised penis, pull back foreskin
before using a condom
• Unroll the condom directly onto the penis
while pinching the reservoir tip at the end to
leave room for ejaculate
• If a condom breaks, replace it immediately
• Remove the condom while the penis is still
erect
• Never re-use condoms
Other ways to reduce STI risk
• Have fewer partners
• Inspect your partner’s genitals
• Washing genitals before and after sex MAY
reduce transmission
• Get tested for STIs regularly if you are sexually
active, preferably every 3 months
• Inform your partner if you have an STI
Low-Cost reproductive health care
options in the East Bay
• Planned Parenthood 510-300-3800 (Oakland)
• Asian Health Services 510-986-6830 (Oakland)
• Native American Health Center 510-535-4400
(Oakland)
• La Clinica de la Raza 510-535-4000 (Oakland)
• Berkeley Free Clinic 510-548-2570 (Berkeley)
• STD community hotline 1-800-227-8922