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Sexually Transmitted Diseases Project Red Talon Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Stephanie Craig Rushing, MPH ([email protected]) www.npaihb.org STDs: Sexually Transmitted Diseases There are over 30 kinds of sexually transmitted diseases!! Northwest Portland Area Indian Health Board STDs: Sexually Transmitted Diseases How many can you name? Northwest Portland Area Indian Health Board STDs: Sexually Transmitted Diseases • We will focus on the major ones that impact our communities: • • • • Northwest Portland Area Indian Health Board Chlamydia Crabs Genital Herpes Genital Warts - Gonorrhea - Syphilis - PID - HIV/AIDS Bacteria or Virus? • • • • Northwest Portland Area Indian Health Board Chlamydia Gonorrhea Syphilis PID (pelvic inflammatory disease) • Genital Herpes • Genital Warts • HIV/AIDS • • • • Northwest Portland Area Indian Health Board Bacteria Virus Chlamydia Gonorrhea Syphilis PID (pelvic inflammatory disease) • Genital Herpes • Genital Warts • HIV/AIDS Bacteria / Virus • What is the difference between a bacterial infection and a viral infection? Chlamydia trachomatis Northwest Portland Area Indian Health Board Bacteria No Cure: Just Treatment / Virus Cure: Antibiotics Chlamydia trachomatis Northwest Portland Area Indian Health Board How STDs Spread… Sexually Transmitted Diseases (STDs) are caused by viruses or bacteria that enter the body through tiny cuts or tears. Northwest Portland Area Indian Health Board You can get infected without having sex… STDs can be passed by: 1. skin-to-skin contact 2. through sexual fluids 3. ingesting fecal material Northwest Portland Area Indian Health Board You can get infected without having sex… 1. skin-to-skin contact (oral, vaginal, or anal sex) 2. through sexual fluids (blood, semen, infected discharge, vaginal fluids) Northwest Portland Area Indian Health Board 3. ingesting fecal material (even microscopic amounts!) Fact: 1 out of 4 teens having sex has an STD Northwest Portland Area Indian Health Board Most people don’t know they’re infected Many STDs do not produce noticeable signs or symptoms, and mild signs often go unrecognized. Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Chlamydia Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Chlamydia • No symptoms 80% of the time! • Symptoms for Women: bleeding after sex, lower abdominal pain, discharge from vagina • Symptoms for Men: painful urination, discharge from penis, lower abdominal pain Northwest Portland Area Indian Health Board • Bacterial infection (can be cured!!!) Total and AI Chlamydia Rates by Age Group 2003 United States Cases per 100,000 population Total U.S. AI U.S. 3,000 2,500 2,000 1,500 1,000 500 0 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-54 55-64 65+ Report Year Chlamydia is most common among 15-24 year olds, and is more Northwest Portland Area Indian common Health Board among Native youth than among other populations. Fact: 1 in 10 sexually active teens has chlamydia. Northwest Portland Area Indian Health Board This woman’s cervix has manifested signs of a erosion and erythema due to chlamydial infection. (1985) Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Copyright © 2001-2004 Campaign for Our Children Gonorrhea Northwest Portland Area Indian Health Board Gonorrhea • Bacterial infection (can be cured!!!) • Symptoms for Women: irritation of the cervix, pee often, can cause PID and infertility • Symptoms for Men: painful urination, inflammation, discharge from penis only 50% of the time Northwest Portland Area Indian Health Board Fact: Chlamydia and gonorrhea rates are highest among 15 to 24 year olds. Northwest Portland Area Indian Health Board This patient presented with a case of gonorrhea with symptoms including cervicitis and vaginal discharge. Northwest Portland Area Indian Health Board This patient presented with a case of gonorrhea with symptoms including penile discharge. Northwest Portland Area Indian Health Board This patient presented with a lesion of the right hand due to a disseminated Neisseria gonorrhoeae bacteremia. (1979) Though a sexually transmitted disease, if a Gonorrhea infection is allowed to go untreated, the Neisseria gonorrhea bacteria responsible for the infection can become disseminated Northwest Portland Area throughout the body, forming lesions in extra-genital locations. Indian Health Board Northwest Portland Area Indian Health Board Syphilis Northwest Portland Area Indian Health Board Syphilis • Bacterial infection (can be cured) • 3 distinct phases: Northwest Portland Area Indian Health Board – Primary (sores develop then go away) – Secondary (4 – 10 weeks after chancres go away) – Latent (dormant phase, no signs… all but gone, causes irreversible brain, nerve, and tissue damage) Total and AI/AN P/S Syphilis Rates, by Age Group - 2003 United States AI/AN AI U.S.U.S. Total U.S. Cases per 100,000 population 10 9 8 7 6 5 4 3 2 1 0 10-14 15-19 Northwest Portland Area Indian Health Board 20-24 25-29 30-34 35-39 Age 40-44 45-54 55-64 65+ These images show chancres on the penile shaft due to a primary syphilitic infection caused by Treponema pallidum bacteria. The primary stage of syphilis is usually marked by the appearance of a single sore called a chancre. The chancre is usually firm, round, small, and painless. It appears at the spot where T. pallidum bacteria entered the body, and lasts 3-6 Northwest Portland Area weeks, healing Indian Health Board on its own. This syphilis patient presented with symptoms indicative of the secondary stage of the disease, which included multiple lesions located on the penis and scrotum. Secondary syphilis is the most contagious of all the stages, and is characterized by a systemic spread of the Treponema pallidum bacterium. The secondary maculopapular rash usually causes no itching, and can appear as the chancre, or chancres found during the primary stage of syphilis Northwest Portland Area are healing, several weeks after the chancres have healed. Indian Healthor Board Northwest Portland Area Indian Health Board HIV/AIDS Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Copyright © 2001-2004 Campaign for Our Children HIV/AIDS • No cure! • Can be treated • HIV: Human Immunodeficiency virus • AIDS: Acquired Immune Deficiency Syndrome Northwest Portland Area Indian Health Board Fact: Two U.S. teens are infected with HIV every hour of every day. Northwest Portland Area Indian Health Board Race/ethnicity of persons living with AIDS, 2003 Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Other STDs… Northwest Portland Area Indian Health Board Pelvic Inflammatory Disease • Also called PID • Bacterial infection (can be cured) • Can be caused by untreated chlamydia or gonorrhea • Infects reproductive organs • 1 million women have it!!! Northwest Portland Area Indian Health Board Pubic Lice “Crabs” • Caused by a parasite • Not the same thing as head or body lice • Women and men: itching and burning Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Copyright © 2001-2004 Campaign for Our Children This is an illustration comparing the Head Louse, Pediculus humanus, with the Pubic Louse, Phthirus pubis. Northwest Portland Area Indian Health Board Genital Herpes Northwest Portland Area Indian Health Board • Can’t be cured…Can be treated! • Causes blisters/ulcers on or around genitals • Very contagious • As many as 80 to 90% of those infected fail to recognize symptoms! • 50 million Americans have it! This patient presented with what was diagnosed as a herpes genitalis outbreak on the penile shaft due to HSV-2. (1978) Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board HPV: Genital Warts Northwest Portland Area Indian Health Board • No cure! New Vaccine. • It can be treated • Caused by the HPV (human papilloma virus) • Can cause cervical cancer in women • Most common STD transmitted by a virus!!! Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Hepatitis A • Inflammation of the liver • Hepatitis A heals completely • Can’t get it again, lifelong immunity • Oral-fecal transmission • Vaccine preventable Northwest Portland Area Indian Health Board Hepatitis B • Inflammation of the liver • Transmission: blood, semen, vaginal secretions, saliva • Acute and chronic carriers • Over 1 millions Americans have chronic Hepatitis B • Vaccine preventable Northwest Portland Area Indian Health Board Hepatitis C Northwest Portland Area Indian Health Board • Inflammation of the liver • Transmitted mainly through blood (IV drug use especially) • Like Hepatitis A and B, there is no cure for Hepatitis C • Can cause liver failure and cancer. • No vaccine available. Know the Facts. Know for Sure. If left untreated, STDs can cause infertility, long-term pain, or cancer. Northwest Portland Area Indian Health Board Prevention Northwest Portland Area Indian Health Board Preventing STDs… As with many other diseases, prevention is key. It's much easier to prevent STDs than to treat them. The only way to completely prevent STDs is to abstain from all types of sexual contact. Northwest Portland Area Indian Health Board Preventing STDs… Northwest Portland Area Indian Health Board If you decide to have sex, it means you must also take responsibility to protect yourself and your partner from unplanned pregnancy and STDs. Latex condoms are the only form of birth control that lessen your risk of contracting an STD. Fact: 1 of every 5 sexually active teen females will get pregnant this year. Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board Copyright © 2001-2004 Campaign for Our Children Northwest Portland Area Indian Health Board Preventing STDs… What Works: Northwest Portland Area Indian Health Board ABSTINENCE. Latex condoms. Sticking to one partner, who has been tested and is uninfected. Good communication about sexual history & STDs. Avoiding alcohol and drugs. Know the Facts. Know for Sure. If you have had unprotected sex, you may have an STD and not know it. Northwest Portland Area Indian Health Board Know the Facts. Know for Sure. If your partner has had unprotected sex, your partner may have an STD and not know it. Northwest Portland Area Indian Health Board Know the Facts. If you think youfor have an STD, there Know Sure. is something you can do about it… The only way to know for sure is to be tested. Visit your clinic or call the CDC National STD and AIDS Hotline for more information at (800) 227-8922, 24 hours a day, 7 days a week. Northwest Portland Area Indian Health Board Northwest Portland Area Indian Health Board In many States (including Oregon, Washington, and Idaho), teens age 14 years and above may consent to STD and HIV testing and treatment without parental consent… If you are concerned about this, call the clinic before you go. Ask if you need to bring your parent along for permission and what information the clinic will share with them. This way you know what to expect ahead of time. Northwest Portland Area Indian Health Board Know your Score, Take the Quiz! 1. Have you talked to your partner about Sexual Health? 2. Do you have sex with a condom or barrier on every occasion? 3. Are you sure your current partner is free of Sexually Transmitted Diseases (STDs)? 4. Do you know for sure if any of your past partners have had an STD? 5. Has your partner shown you STD test results? If you answered “No” or “Not Sure” to any of these questions, visit your clinic to receive confidential testing. Northwest Portland Area Indian Health Board Questions? Northwest Portland Area Indian Health Board