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Sexually Transmitted
Diseases
Chapter 14
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Estimated STD Incidence
and Prevalence
Estimated Annual
Incidence
Trichomoniasis
HPV infection
Chlamydia
Genital herpes
7,400,000
6,200,000
2,800,000
1,600,000
Estimated
Prevalence
n/a
20,000,000
1,900,000
45,000,000
Because viral STDs are incurable, the number of
currently infected people capable of transmitting the
infection (prevalence) greatly exceeds the annual
number of new cases (incidence).
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Estimated STD Incidence
and Prevalence
Estimated Annual
Incidence
Gonorrhea
718,000
Hepatitis B
81,000
Syphilis (all stages) 61,000
HIV Infection
40,000
Estimated
Prevalence
n/a
1,250,000
n/a
900,000
Because viral STDs are incurable, the number of
currently infected people capable of transmitting the
infection (prevalence) greatly exceeds the annual
number of new cases (incidence).
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
The Major STDs








HIV / AIDS
Chlamydia
Gonorrhea
Pelvic inflammatory disease
Genital warts (HPV infection)
Genital herpes
Hepatitis B
Syphilis
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Acquired Immunodeficiency
Syndrome (AIDS)


Leading cause of death worldwide
for people ages 15 - 59 years
Worldwide, more than 40 million
people are infected with human
immunodeficiency virus (HIV);
more than one million Americans
are infected
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Acquired Immunodeficiency
Syndrome (AIDS)

HIV Infection


AIDS



A chronic, progressive disease that
damages the immune system
A generally fatal, incurable, sexually
transmitted disease
Severe stage of HIV infection
HIV is the virus that causes
HIV Infection and AIDS
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS

Over time, HIV damages the
immune system, signaled by the
loss of CD4 - T cells
(a type of white blood cell that
helps coordinate the activity of
the immune system)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS


A person with HIV infection is
diagnosed with AIDS when he or
she develops a marker condition
or when the CD4 count drops
below 200 / µl
The asymptomatic period in an
untreated adult averages 11 years
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Transmitting the Virus

Sexual contact



Unprotected anal or vaginal
intercourse is riskiest
Presence of lesions, blisters,
or trauma
Male - to - female more likely than
female - to - male
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Transmitting the Virus

Direct exposure to infected blood


Injection drug use or sharing of
other needles or blades
Blood and blood products
(prior to testing)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Transmitting the Virus

Vertical or perinatal transmission


An HIV - infected woman to her fetus
during pregnancy or childbirth or to
her infant during breastfeeding
Risk is greatly reduced
with treatment
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Symptoms

Flulike symptoms of acute HIV
infection may occur within a few
days or weeks of infection
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Symptoms

Opportunistic infections occur
later, as the immune system
weakens




Pneumocystis carinii pneumonia
Kaposi’s sarcoma
Frequent and difficult - to - treat
vaginal yeast infections
Tuberculosis
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Diagnosis

HIV antibody test detects the
presence of antibodies to HIV,
indicating infection




ELISA = first stage of test
Western blot = confirmatory test
Blood, urine, or oral fluid;
rapid tests are available
May take up to six months following
infection for antibodies to appear
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Diagnosis

HIV RNA assay measures the
amount of the HIV virus in the
blood; used to detect HIV
infection in the earliest stages and
to track the status of the infection
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Treatment

Antiviral drugs





Reverse transcriptase inhibitors
Protease inhibitors
Fusion inhibitors
Drugs to prevent and treat
opportunistic infections
Cost, access, side effects,
effectiveness
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Prevention


Abstinence is the only truly safe
option unless you are in a
long - term monogamous
relationship with an uninfected
partner
Don’t drink or use drugs in sexual
situations
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Prevention


Limit the number of partners,
especially those who have
engaged in risky behavior;
remember that many people are
not truthful about their
sexual history
Use latex condoms correctly
during every act of intercourse
and oral sex
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
HIV Infection and AIDS:
Prevention



Avoid sexual contact that could
cause cuts or tears
Don’t share needles, syringes, or
anything that could have
blood on it
Get screened, get tested, get
vaccinated for hepatitis B
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Chlamydia





Caused by the bacterium
Chlamydia trachomatis
Can cause PID, infertility,
epididymitis, urethritis
Often asymptomatic
Diagnosed with urine or lab tests
Treated with antibiotics
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Gonorrhea


Caused by the bacterium
Neisseria gonorrhoeae, which
affects mucous membranes
Can cause PID, infertility,
epididymitis, urethritis, rashes,
arthritis; in infants, it can cause
the serious eye infection
gonococcal conjunctivitis
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Gonorrhea



Often asymptomatic in women;
in men, it causes urinary
discomfort and penile discharge
Diagnosed with urine or lab tests
Treated with antibiotics; many
strains are resistant
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Pelvic Inflammatory Disease
(PID)


PID is an infection that progresses
from the vagina and cervix to the
uterus, oviducts, and pelvic cavity
Common following untreated
cases of gonorrhea or chlamydia
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Pelvic Inflammatory Disease
(PID)



Leading cause of infertility in
young women; also increases risk
of ectopic pregnancy and chronic
pelvic pain
Symptoms highly variable
Treated with antibiotics; may
require hospitalization
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Genital Warts

Viral infection characterized by
growths on the genitals; also
called condyloma or genital HPV
infection; caused by infection with
human papillomavirus (HPV)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Genital Warts


Most of the more than 20 million
infected Americans have no
symptoms but can still transmit
the virus
Infected tissue may appear
normal or may have obvious
bumps or large warty growths
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Genital Warts


Treatment does not eliminate
the infection
HPV infection is the key cause of
cervical cancer
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Genital Herpes

Persistant viral infection affecting
about 45 million American adults;
infants can be infected during
birth


HSV - 1 usually causes cold sores
HSV - 2 usually causes
genital herpes
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Genital Herpes

Symptoms


Recurrent outbreaks of painful
genital lesions; often asymptomatic
Diagnosed from symptoms or
blood test
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Genital Herpes


Treatment with antivirals can
reduce the frequency and severity
of outbreaks
The virus remains in the body and
can be transmitted even if no
lesions are present
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Hepatitis B

Inflammation of the liver that can
cause permanent damage to the
liver and death


Some people recover, some become
chronic carriers, some develop
chronic liver disease or liver cancer
Hepatitis B virus can be
transmitted sexually and through
close nonsexual contact
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Hepatitis B

Symptoms may include flulike
illness

Jaundice



Increased bile pigment levels, causing
yellowing of the skin and whites
of the eyes
Diagnosed with blood tests
No cure, but a vaccine is available
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Syphilis


Caused by the spirochete
Treponema pallidum
Potentially fatal if not treated
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Syphilis

Symptoms at different stages
of infection



Primary Syphilis = an ulcer called
a chancre
Secondary Syphilis = flulike
symptoms and a skin rash
Late, or tertiary, Syphilis =
asymptomatic or symptoms of
severe organ damage
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Syphilis



Diagnosed with blood tests
Treated with antibiotics
Infants can also be infected
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Other STDs



Trichomoniasis (Trich)
Bacterial vaginosis (BV)
Pubic lice (crabs)
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
What You Can Do



Education
Diagnosis and treatment
Prevention



Abstain
Mutually monogamous relationship
with one uninfected partner
Plan ahead for and practice
safer sex
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14
©2007 McGraw-Hill Higher Education. All rights reserved.