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Chapter Eighteen Sexually Transmitted Diseases The Major STD’s • • • • HIV/AIDS Chlamydia Gonorrhea Herpes Simplex • Syphilis • Pelvic Inflammatory Disease • Hepatitis • HPV (genital warts) HIV Infection • It is estimated that more than 60 million people have been infected with HIV • By 2004, it is estimated that 1 million Americans are living with HIV • HIV infection continues to spread, even though death rates have declined among Americans, however, a cure has not been discovered What is HIV? (Human Immuno-Deficiency Virus) • Cause – HIV, virus that attacks the CD4 T cells of the immune system • Spread – direct contact involving the exchange of bodily fluids (blood, semen, vaginal secretions) – through infected blood products – prenatal transmission (mother to fetus) or during breast-feeding HIV Infection (cont.) (Human Immuno-Deficiency Virus • Following several weeks after becoming infected, about half of those develop flu-like symptoms (Primary Infection Phase) • Experts believe that half of all HIV cases are spread during this phase • The next phase is known as the Chronic Asymptomatic Stage which can last 2-20 years • During this time, the virus is progressively infecting and destroying cells of the immune system Populations of Special Concern for HIV Infection • Although the transmission of HIV occurs through specific individual behaviors, high levels of infection within certain groups are tied to social, cultural, and economic factors • Such groups that are affected are: • Women • Gay men • Men who are having sex with other men but do not considered themselves ‘gay’ • Minorities • Poor HIV Symptoms • Most infected people are asymptomatic or can remain symptom-free for years, even though antibodies have been formed within weeks of infection • Eventually the following may appear (HIV with symptoms) – – – – – – tiredness fever loss of appetite/weight diarrhea night sweats swollen glands Diagnosis of HIV Infection • • • • Enzyme Linked Immunosorbent Assay (ELISA) Western BLOT test HIV Replication Capacity (viral fitness) Rapid HIV test, home tests, and non-blood tests are currently available Diagnosing AIDS • AIDS is the more severe form of HIV Infection • A diagnosis of AIDS has been made if a person is: • HIV positive • Developed an infection as an AIDS indicator • Has a severely damaged immune system based upon the number of CD4 T cells Treatment for HIV/AIDS • No cure at this time • Combination drugs reverse transcriptase inhibitors and protease inhibitors; both assist the body by disallowing replication of the virus in various cycles • Fusion inhibitors How Can You Protect Yourself ? • Learn the sexual history and HIV status of your partner • Limit the number of sexual partners • Use lubricated condoms correctly and consistently • Avoid contact with body fluids • Curtail the use of drugs Prevention of HIV Infection, cont’d • Never share hypodermic needles • Refrain from sex with known injectable drug users • Get regular tests for STD’s • Participate in an HIV Education Program Chlamydia • Chlamydia (bacterium) – most prevalent in the U.S. • Symptoms in males include: • Painful urination • Slight watery discharge • Pain in the testes • Symptoms in women include: • Vaginal discharge • Burning urination • Lower abdominal pain • Diagnosis: urine sample • Treatment: antibiotics Gonorrhea • Gonorrhea (bacteria) – estimated 700,000 new cases in the United States annually • Symptoms for men: • Urethritis (yellowish discharge) • Swollen lymph glands of the groin • Symptoms for women: • Most females are asymptomatic but will have some discharge and pain during urination • Diagnosis: culture from urine or discharge sample • Treatment: antibiotics Pelvic Inflammatory Disease • PID occurs when the initial infection of either gonorrhea or chlamydia enters beyond the cervix • Even if the disease is treated successfully, 25% of women will have long-term problems • PID is the leading cause of infertility for young women • Diagnosis usually requires a pelvic exam and lab tests • Treatment is usually with antibiotics Human Papillomavirus (HPV) • HPV (virus) – genital warts which can lead to cervical cancer in women and penile cancer in men • HPV is very contagious and difficult to control since many infected people seem to be asymptomatic • Symptoms include: growths that cause irritation and bleeding • Diagnosis: appearance of the lesions or biopsy • Treatment: cryosurgery or laser surgery Genital Herpes • Caused by HS2 (Herpes Simplex 2 virus) which is sexually transmitted even though the partner may appear asymptomatic • Herpes lesions may contain and transmit HIV • Symptoms include: flu-like symptoms accompanied with painful lesions around the genitals • Diagnosis: sample of fluid from lesions or blood test • Treatment: antiviral medications reduce symptoms even though a cure is not available Hepatitis A, B, C • Virus • Inflammation of the liver • Symptoms – fever, nausea, abdominal pain, jaundice – Type A – associated with fecal contamination of food due to poor food handling – Type B – sexual contact, IV drug use, tattooing, piercing – Type C – similar to type B Hepatitis B • Inflammation of the liver which can cause serious damage and sometimes result in death • Transmitted by blood and bodily secretions • Symptoms: many people do not have physical symptoms (silent symptoms), but may develop flu-like symptoms within several weeks of exposure • Diagnosis: blood tests • Prevention: vaccinations and preventive measures against infected bodily fluids Syphilis • Caused by a spirochete (thin, corkscrew shaped bacterium) • Transmitted by passing the pathogen through breaks in the skin or mucous membranes via kissing, or sexual activity • Symptoms are the presence of ‘chancre’ or sores that are usually painless • Late Syphilis can damage many organs of the body, which eventually can lead to death • Diagnosis: blood test • Treatment: antibiotics Other Prevalent STD’s • Vaginal infections (yeast) – can cause thrush, allowing colored discharges and itching. Protozoan infections are “trichomonisis.” • Bacterial vaginosis – common cause of abnormal vaginal discharge • Chancroid - bacterial infection, creating sores on the genitals • Public lice – ‘crabs’ that are highly contagious and feed on blood in and around the hairs • Scabies – parasites that deposit eggs beneath the skin, creating an intense itch What Can You Do? • • • • • • Education Get Vaccinated Be Alert for possible symptoms Get Tested Inform your partners Get Treatment Chapter Eighteen Sexually Transmitted Diseases