Download The Major STDs

The Major STDs
A.
Sexually transmitted diseases(STD)--also called sexually transmitted infections
(STI)--are spread from person to person mainly through sexual activity.
1.
These diseases are considered major threats because they are serious in
themselves, can cause serious complications if left untreated, and pose
risks to a fetus.
a.
HIV/AIDS
b.
Hepatitis
c.
Syphilis
d.
Chlamydia
e.
Gonorrhea
f.
Herpes
g.
Human papollomavirus (HPV)
2.
STIs are caused by viruses, bacteria, fungi, and protozoa.
3.
Human immunodeficiency virus (HIV) causes acquired immunodeficiency
syndrome (AIDS).
a.
AIDS originated in Africa during the early twentieth century but was
not recognized until 1981.
b.
It is estimated that 65 million people have been infected, or almost 1
percent of the world’s population. Currently about 33 million people
are infected with HIV/AIDS.
c.
The epidemic appears to be slowing, however, AIDS remains the
leading cause of death in Africa.
d.
In the U.S. about 1.1 milliong people have been infected with HIV and
500,000 have died. About 21 percent of Americans infected with HIV
are unaware of their condition.
4.
In 1998 researchers discovered a similar virus in wild chimpanzees called
simian immunodeficiency virus (SIV).
a.
Genetic evidence shows that SIV infected humans in the 1930’s from
trapping and butchering of chimpanzees was common.
5.
HIV attacks the immune system, which normally would destroy any virus
that enters the body.
a.
HIV takes over CD4 T cells, monocytes, and macrophages, which are
essential elements of the immune system.
b.
HIV enters a human cell and inserts its own genetic material into the
host cell.
c.
The viral DNA forces the CD4 cell to make new copies of HIV. The
CD4 cell becomes incapable of performing its immune functions.
d.
The immune system cannot keep pace with the rapid replication of
the virus.
e.
6.
7.
8.
The destruction of the immune system is signaled by the loss of CD4
T cells; as the number declines, an infected person may experience
symptoms.
f.
A person has full-blown AIDS if a condition defined as a marker for
AIDS is present or if CD4 cell level drops below a certain level.
The infections that prove deadly for those with HIV are seldom serious for
people with a healthy immune system. Opportunistic infections usually are
caused by organisms that are very common in the environment.
During the first weeks after infection with HIV, called the primary infection
phase, about 50 percent of people develop flu-like symptoms. During this
phase people have large amounts of HIV in the bloodstream, making them
much more infectious than they will be several months later when they
enter the chronic stage.
a.
Experts believe that about half of all cases of HIV infection are
acquired from people who are in the primary infection stage.
(1) Most people in this stage have no idea they are infected.
(2) Even if they suspect that they may be infected and get tested,
the most commonly used tests for HIV will be negative in this
stage.
(3) Special tests can detect primary HIV infection. Increasing
awareness of primary infection could help reduce the spread of
the virus.
b.
During the next phase, called the chronic asymptomatic or the
symptom-free stage, most people feel well. This period can last 2 to
20 years. The virus is progressively infecting and destroying the cells
of the immune system.
c.
People with HIV can transmit the infection to others when they are
symptom-free. Even if they receive treatment, they remain infectious
to a varying degree throughout their lives.
HIV is transmitted by blood and blood products, semen, vaginal and
cervical secretions, and breast milk.
a.
The three main routes of transmission are:
(1) From specific kinds of sexual contact
(2) From direct exposure to infected blood
(3) From an HIV-infected mother to her fetus during pregnancy or
childbirth, or to an infant during breastfeeding.
b.
The most likely method of HIV transmission is unprotected anal or
vaginal intercourse. Unprotected anal intercourse is the riskiest of
sexual activities.
(1) The risk of HIV transmission during oral sex increases if a
person has poor hygiene or oral sores, or has brushed or
c.
d.
e.
f.
g.
h.
flossed just before or after oral sex. Some evidence suggests
that recent consumption of alcohol may make the cells that line
the mouth more susceptible to infection with HIV.
(2) HIV can be transmitted through tiny tears, traumatized points,
or irritated areas in lining of the vagina, cervix, penis, anus, and
mouth and through direct infection of cells.
(3) The presence of lesions, blisters, or inflammation from other
STDs makes transmission more likely.
(4) Any irritation of tissues that might result from rough or
unwanted intercourse and the use of enemas before anal
intercourse increase the risk of transmission.
(5) Spermicides also may cause irritation and increase the risk of
transmission.
HIV is more likely to be transmitted through sexual assult because
protection is rarely used and the tissue trauma is generally greated
than with unforced sexual activity.
Direct bloodstream contact can result from the sharing of needles
used for injecting drugs. HIV also can be transmitted through needles
used for acupuncture, tattooing, and piercing parts of the body.
(1) HIV infection was transmitted through the blood supply before
screening became available. The current risk of transfusionrelated HIV transmission is less than 1 in 2 million (per unit of
blood product) in the United States. The WHO estimates that
about 5 percent of all cases of HIV infection worldwide have
resulted from the transfusion of infected blood and blood
products.
(2) Health-care workers can be infected from inadvertent needle
sticks when caring for an HIV-positive patient.
About 25 percent to 30 percent of infants born to untreated HIVpositive mothers are infected.
(1) HIV-infected children rarely appear ill at birth, but they begin to
develop health problems over the first months and years of life.
(2) About 20 percent of infected children become very ill and
progress to AIDS or death by age 4; the remaining 80 percent
develop problems more slowly.
Although trace amounts of HIV have been found in saliva and tears, it
probably cannot be transmitted through those fluids. It may possibly
be transmitted through urine and feces.
HIV is not transmitted by casual contact.
In the United States, the most common means of transmission has
been sexual activity between men, followed by injection drug use and
heterosexual contact.
(1)
9.
The CDC estimated that in 2008 75 percent of HIV-positive
Americans were men and the remaining 25 percent were
female.
i.
Disproportionately high rates of infection in certain groups are tied to
social, cultural, and economic factors. HIV is increasingly affecting
minorities, women, and the poor.
(1) Heterosexual transmission accounts for a growing proportion of
new cases, while the share caused by sex between men and
injection drug use is falling.
(2) Women, especially African American women and Latinas, make
up an increasingly large proportion of all U.S.’ AIDS cases.
(3) African American men and women are vastly overrepresented
among people newly diagnosed with AIDS.
(4) AIDS incidence and deaths have declined since 1996 among all
groups of Americans, but these declines have been smaller
among women and minorities compared with other groups.
(5) Young men who have sex with men are at increased risk for
HIV infection because more young men are engaging in unsafe
sexual practices such as unprotected anal intercourse. This
trend may be caused by younger gay men being less likely than
older gay men to have had the experience of watching friends
die from AIDS and also may be less afraid of acquiring the
disease because of advancing treatment and a false belief that
a cure is near.
(6) There are also a growing number of cases among men who
acquire HIV through sex with older men but who do not identify
themselves as gay. Particularly among minorities, many men
who have sex with men also have sex with women, and they
identify themselves as heterosexual, not gay or bisexual.
(7) Reducing rates of transmission will require dealing with
problems of drug abuse, poverty, and discrimination.
(8) Increased testing is one of the most important aspects of HIV
prevention, but knowledge of HIV status may not be enough to
change behavior. Studies show that about one-third of people
who have been diagnosed with HIV continue to have
unprotected sex.
About half of the people infected with HIV will develop symptoms soon after
exposure. Symptoms may include fever, fatigue, rashes, headaches,
swollen lymph nodes, body aches, night sweats, sore throat, nausea, and
diarrhea.
a.
Pneumocystitis carinii pneumonia is the most common infection seen
in people with HIV.
Kaposi’s sarcoma, a rare form of cancer, is commonly seen among
infected men.
c.
Infected women often have persistent vaginal yeast infections.
Because drugs can slow the progress of HIV infection, early diagnosis is
important.
a.
The most common tests for HIV check for the presence of antibodies
to the virus.
(1) HIV primarily disrupts T-cell immunity, but B cells are still able
to produce antibodies to HIV and will show up in tests.
(2) Unfortunately, these antibodies do not protect against the
spread of the virus. The presence of an antibody indicates an
active case of the disease.
b.
The HIV antibody tests are used for screening because they are
accurate and inexpensive.
(1) Standard testing involves an initial test, called ELISA. If this test
is positive, a second test called a Western Blot, or
immunoflourescence assay, is performed to confirm the results.
(2) However, not everyone with HIV will test positive on antibody
tests. Antibodies may not appear in the blood for weeks or
months after infection, so newly infected people are likely to
have a negative test result.
(3) A more expensive test, the HIV RNA test, directly measures the
presence of the virus.
(4) Rapid (same-day) HIV tests are effective.
(5) Babies born to HIV-infected mothers may carry HIV antibodies
passed from their mother and test positive on an HIV antibody
test without being infected with HIV. Further tests must be
performed to determine whether the infant is infected.
c.
If an individual is HIV-positive, one gauges the status of the immune
system by measuring CD4 T-cell levels.
d.
One monitors the progress of the infection by measuring the amount
of the virus in the body.
A diagnosis of AIDS is made if an HIV-positive person either has an
infection defined as an AIDS indicator or has a severely damaged immune
system as measured by CD4 T-cell counts.
Among those who have never been tested, nearly 75 percent say that they
haven’t been tested because they don’t think they are at risk. About 10
percent say they are afraid to have blood drawn, 6 percent say they are
worried about confidentiality, and another 6 percent say they don’t know
where to go to be tested.
b.
10.
11.
12.
a.
13.
14.
Many people are not aware that rapid HIV tests, home tests, and
tests that do not require a blood sample are now available.
b.
A new diagnostic test, HIV Replication Capacity, shows how fast HIV
from a patient’s blood sample can reproduce itself. It is a measure of
viral “fitness,” and may be helpful when used in conjunction with CD4
and viral load tests in predicting how quickly a given person may
progress to more serious disease.
c.
The CDC recommends that men who have sex with men should be
tested at least once a year, and people who engage in high-risk
behavior should be tested more often.
All cases in the U.S. of diagnosed HIV or AIDS must be reported to public
health authorities.
a.
Tracking has been difficult.
(1) Prior to 2006 California had not been included in the national
data because of its method of collecting data.
(2) A standard positive HIV test only shows the presence of
infection, not nessessarily a new case.
(3) A new blood test makes it possible to estimate the length of
time a person has been infected, allowing a more accurate
picture.
HIV infection has no known cure, but new drugs can alter the course of the
disease and extend life. The drop in the number of U.S. AIDS deaths since
1996 is largely due to treatment with combinations of new drugs.
a.
Research focuses on several types of antiviral drugs and on drugs
that stimulate or regulate the immune system.
(1) Reverse transcriptase inhibitors, including the widely used AZT
(zidovudine), inhibit the integration of HIV genetic material into
human cells.
(2) Protease inhibitors target the enzyme HIV uses to create a
protein coat for each viral copy.
(3) Entry inhibitors block HIV from entering and infecting cells
(4) Treatment with combinations of drugs, called highly active
antiretroviral therapy (HAART), can reduce HIV in the blood to
undetectable levels, although HIV-infected men on HAART may
still transmit HIV to others through body fluids.
(5) Other antiviral drugs are under development.
(6) HIV/AIDS treatment is becoming increasingly complex—not
only because the virus can mutate and behave unpredictably,
but because so many treatment options are available.
b.
There are several potential postexposure (PEP) treatments for HIV.
Antiviral medications are being used in some cases to prevent
15.
16.
17.
18.
infection in people who have been exposed to the virus. PEP involves
28 days of HAART which should begin within 72 hours of exposure.
c.
Antibiotics are used to prevent opportunistic infections.
The risk of transmitting HIV from an infected mother to her baby can be
reduced by 2 percent by treating the mother during her pregnancy and
labor, giving the baby antiretroviral drugs during the fist weeks of life,
avoiding breastfeeding, and delivering the baby by cesarean section if
necessary.
a.
Without treatment, 25 percent-30 percent of infants born to HIVinfected women are themselves infected with the virus.
b.
A cesarean delivery can reduce the risk of infection in women who
have high blood levels of HIV. Women who have undergone antiviral
treatment and have very low levels of HIV usually can deliver
vaginally.
There are major challenges in the treatment of HIV.
a.
The cost of drugs is prohibitive for many, particularly in developing
countries.
b.
A 2006 study estimated the average cost of treatment in the U.S. at
$2,100 per month.
c.
Antiretroviral drugs can have serious side effects, short term include;
nausea, vomiting, diarrhea and fatigue. Long term effects include;
abnormal blood lipids, heart disease, liver problems, bone loss,
kidney disease and cancers.
d.
The regimen for taking drugs is complicated, and failing to follow it
precisely can lessen their effectiveness and may allow the virus to
develop resistance.
e.
Some people cannot tolerate the side effects, and the drugs may not
be as effective for some people as for others.
Development of an effective, safe, affordable vaccine is the best hope for
stopping the spread of HIV. Experts are discouraged by recent vaccine trial
failures stating that a licensed AIDS vaccine is now estimated to be at least
a decade away.
a.
Researchers are making faster progress in developing a microbicide,
a kind of chemical condom that could prevent the spread of AIDS.
b.
Another approach is the use of pre-exposure treatment as prevention.
Although controversial, HIV-negative individuals at high risk for
infection would take an anti-HIV medication before an activity that
might expose them to HIV.
c.
The female condom may someday play a larger role in HIV
prevention.
HIV infection is a preventable disease.
a.
B.
Anyone not involved in a long-term mutually monogamous
relationship should abstain from any sexual activity that involves the
exchange of body fluids.
b.
Use of a lubricated condom reduces the risk of transmitting HIV
during all forms of intercourse.
c.
Limiting the number of partners and communicating openly with
partners helps reduce risk. Recent surveys of HIV-positive people
found that one-third failed to reveal their HIV status to sexual
partners; of these, nearly two-thirds failed to always use a condom.
d.
Most college students do not follow safer sex practices and therefore
are at high risk for contracting HIV.
e.
Injection drug users should not share needles and should obtain help
in breaking their drug habit.
f.
The cornerstone of prevention is education.
Chlamydia trachomatis causes chlamydia, the most common bacterial STD in the
United States, with about 1 million new cases in 2006.
1.
The highest rates of infection are in single people etween the ages of 15
and 24, however, women face the greatest consequences from chlamydia
infection.
a.
In women, chlamydia produces no early symptoms but can lead to
extensive damage, including pelvic inflammatory disease
(inflammation of the fallopian tubes) and ectopic pregnancy.
b.
African-American women have seven times the rate of white women
for chlamydia.
c.
Men with chlamydia risk urinary tract infections and epididymitis
(inflammation of the testicles).
d.
Infants can contract chlamydia during passage through the birth canal
during delivery, leading to eye infections and pneumonia. More than
150,000 babies are born each year with infections as a result of
untreated maternal chlamydia.
2.
Symptoms in men include painful urination and watery discharge from the
penis; women may experience vaginal discharge, painful urination, and
painful inflammation of the oviducts, which is symptomatic of PID. Most
people have few or no symptoms, making inadvertent spread of the
disease more likely.
3.
Chlamydia is diagnosed through laboratory tests. Specimens usually are
obtained by collecting a urine sample or a small amount of fluid from the
urethra or cervix and then by growing the organism in culture.
4.
Treatment for chlamydia includes antibiotics.
5.
Treatment of both partners is important to avoid reinfection.
C.
D.
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae, which flourishes in
mucous membranes. It cannot live long outside the human body, dying within
moments of exposure to light and air.
1.
In 2006, more than 350,000 cases of gonorrhea were reported to the CDC,
a 5.5 percent increase over 2005.
a.
Gonorrhea is underreported because it is often symptomless.
2.
Like chlamydia, if untreated, gonorrhea can cause PID in women and
epididymitis and urethritis in men.
a.
It also can cause arthritis, rashes, and eye infections, and it
occasionally involves internal organs.
b.
Being infected with gonorrhea increases the likelihood that HIV will be
transmitted.
c.
In addition, infants can contract gonococcal conjunctivitis, leading to
blindness, while passing through the birth canal of an infected
mother. Antimicrobial eye drops, given at birth, prevent the infection.
3.
Symptoms of gonorrhea in men include urethritis, which makes urination
painful; thick yellow-white discharge from the penis; inflammation at the
urethral opening; and enlarged lymph nodes. Up to half will have very
minor symptoms or no symptoms at all.
4.
Most women with gonorrhea exhibit no symptoms and do not realize they
are infected. Those who do have symptoms may experience mild vaginal
discharge, painful urination, and severe menstrual cramps.
5.
Gonorrhea bacteria also can infect the throat or rectum, leading to sore
throat or pus on the tonsils, pus in the feces, or rectal irritation, pain, and
itching.
6.
Gonorrhea is diagnosed by evaluating samples of body fluids.
a.
New antibiotics are necessary because gonorrhea has developed
drug resistance.
b.
Additional antibiotics may be needed to treat people who also have
chlamydia.
7.
After treatment, one can become reinfected by having sexual contact with
an infected partner.
Pelvic inflammatory disease (PID) is a major complication in 10 percent to 40
percent of women who have been infected with gonorrhea or chlamydia and
have not received treatment.
1.
PID occurs when the initial untreated infection travels beyond the cervix.
2.
About one-fourth of women who are successfully treated for PID are
susceptible to recurrent infection, ectopic pregnancy, sterility, and chronic
pelvic pain.
3.
PID is the leading cause of infertility in young women.
4.
E.
The more sex partners a woman has, the greater her risk of PID. Other risk
factors include smoking, IUD use, and vaginal douching.
5.
Women with PID often are asymptomatic. Some may experience chills,
fever, nausea, vomiting, abdominal pain, abnormal vaginal bleeding,
prolonged menstruation, or abnormal vaginal discharge.
6.
PID is diagnosed on the basis of symptoms, examination, ultrasound, and
testing; laparoscopy may be used to isolate the suspected organism and
culture it.
7.
Treatment includes immediate antibiotics, possibly with hospitalization for
intravenous administration.
8.
If a woman has PID, it is important for her partners to be treated, even if
asymptomatic.
Human papillomavirus (HPV) infection (genital warts) has increased in recent
years and is the most common STD in the United States.
1.
Human papillomavirus (HPV), the causative agent, causes many types of
warts. There are about 100 different strains of HPV. More than 30 types are
likely to cause genital infections, and five are implicated in cervical cancer.
Other strains are linked to anal, penile, and other genital cancers.
2.
The precancerous condition known as cervical dysplasia often occurs
among women with untreated genital warts.
3.
Genital wart infections are very contagious through contact with lesions.
Condoms do not provide complete protection.
4.
Many people who carry HPV have no visible symptoms; asymptomatic
people can infect others. Even after treatment, HPV can continue to infect
neighboring tissue. In addition, babies can be infected during delivery.
5.
Warts may appear as small bumps or as large warty growths. If untreated,
they can grow into cauliflower-like masses that may obstruct the urethra,
leading to irritation and bleeding, painful urination, and urethral discharge.
HPV-infected tissue often appears normal.
6.
Warts may appear on the vulva, labia, perineum, and cervix—making them
difficult to see.
7.
The incubation period for genital warts ranges from 1 month to 2 years.
8.
Genital warts are diagnosed by the physical appearance of the lesion or by
discovery of HPV infection of the cervix by Pap test. New tests are
available to detect the presence of HPV infection and to distinguish among
the more common strains of HPV, including those that cause most cases of
cervical cancer.
9.
Treatment focuses on reducing the number and size of the warts, although
most warts eventually disappear, even without treatment. Many current
treatments are painful and physically destructive, and none can ensure
eradication of HPV
b.
F.
Warts also can be removed by electrocautery, cryosurgery, or laser
therapy.
c.
Currently available treatments do not eradicate HPV.
10. Because treatment eradicates an individual wart but not the virus in a
person’s system, an infected person still can infect others.
11. Warts may persist and become severe in people with an impaired immune
system.
12. The FDA has approved the vaccine, Gardasil, as a vaccine for HPV. The
vaccine is recommended for females aged 11-12, ideally before their first
sexual activity.
13. Regular screening is suggested for all women.
Genital herpes affects about one in five adults in the United States. It plays a
major factor in the transmission of HIV worldwide. Most people infected with HIV
also are infected with HSV 2, and herpes lesions contain large amounts of HIV,
making it more likely that the virus is transmitted. The presence of herpes lesions
in an HIV-negative person increases the likelihood that he or she will be infected
by an HIV-positive partner.
1.
Two different viruses in the herpes family can cause genital or oral-labial
lesions.
a.
HSV 1 causes cold sores and fever blisters around the mouth. It is
extremely common in the United States.
b.
Genital herpes due to HSV 1 usually is acquired through oral-genital
contact.
c.
HSV 2 (genital herpes) usually causes sores in the genitals and is
almost always sexually transmitted.
2.
The risk of mother-to-child HSV transmission during pregnancy and
delivery is less than 1 percent in women with longstanding herpes infection.
3.
Herpes is incurable. After the initial infection, the victim is subject to
unpredictable outbreaks. Each time the disease recurs, the victim is
contagious again.
4.
Symptoms occur 2 to 20 days after exposure, although up to 90 percent of
infected people have no symptoms.
a.
Symptoms include painful, fluid-filled lesions and flulike sensations.
b.
After the herpes virus has produced an initial outbreak, it lies dormant
and can recur at any time. Outbreaks can be triggered by stress,
exposure to sunshine, acute illness, generally poor health, or other
factors.
5.
Herpes is diagnosed by the presence of lesions and systemic symptoms. A
culture can be performed. Several blood tests can detect the presence of
HSV antibodies. Older tests did not distinguish between HSV 1 and HSV 2,
while newer tests can.
a.
G.
H.
Studies show that adults infected with HSV 2 are 15 times more likely
than those without HSV 2 to be infected with HIV.
6.
Acyclovir or other suppressive treatment significantly reduces the number
of painful outbreaks and reduces viral shedding between outbreaks.
7.
An herpes vaccine is undergoing testing but has not had positive results.
Hepatitis (inflammation of the liver) has many causes. It can be transmitted
sexually as well as through nonsexual contact.
1.
The hepatitis B virus (HBV) is found in all body fluids and is easily
transmitted through any sexual activity that involves the exchange of body
fluids, use of contaminated needles, and blood-to-blood contact.
a.
It also can be transmitted through nonsexual close contact.
b.
Primary risk factors are sexual exposure and injection drug use.
c.
A pregnant woman can transmit the virus to her child, although HBV
screening has greatly reduced the incidence.
2.
Symptoms resemble those of the flu, but they are not always obvious.
a.
The incubation period is about 30 to 180 days.
b.
Nausea, vomiting, dark-colored urine, and jaundice are possible
symptoms.
c.
People with hepatitis B may become chronic carriers.
d.
Acute hepatitis B can result in prolonged illness or even death.
3.
Blood tests that analyze liver enzymes are used for diagnosis.
4.
There is no cure for hepatitis B and no specific treatment for chronic
infections. Antiviral drugs may be used for cases of chronic HBV infection.
Treatment with hepatitis B immunoglobulin can protect people exposed to
HBV.
5.
Preventive measures for hepatitis B are similar to those for prevention of
HIV.
a.
The vaccine for hepatitis B is safe and effective.
b.
The vaccine is recommended for everyone under age 19 and for all
adults at increased risk for hepatitis B, including people with more
than one sex partner is 6 months, men who have sex with other men,
those who inject illegal drugs, and health care workers who are
exposed to blood and body fluids.
The prevalence of syphilis, once widespread, has declined dramatically. About
7,000-10,000 new cases of early syphilis are diagnosed each year.
1.
The open sores associated with syphilis dramatically increase the risk of
contracting HIV or transmitting it to someone else.
2.
Syphilis can be effectively treated with antibiotics.
3.
Syphilis is caused by the spirochete Treponema pallidum.
a.
4.
5.
6.
VI.
A.
It is transmitted through sexual contact or to a fetus through the
placenta of an infected mother.
b.
The organism passes through any break or opening in the skin;
therefore it can be transmitted by kissing, vaginal or anal intercourse,
or oral-genital contact.
Syphilis has three stages.
a.
Primary syphilis is manifested by a single chancre, or sore, smaller
than a dime, that appears at the site where the organism entered the
body within 10 to 90 days after contact.
(1) Chancres contain large numbers of bacteria, making the
disease highly contagious when they are present.
(2) Chancres also can occur in the mouth and on the breasts or
fingers.
b.
Secondary syphilis is characterized by flulike symptoms and a skin
rash that appears about 3 to 6 weeks after the chancre developed.
(1) The rash may cover the entire body or a few areas, but the
palms of the hands and soles of the feet usually are affected.
(2) If the disease remains untreated, relapses can occur.
c.
Third stage (latent) syphilis exists by definition in those with evidence
of having had syphilis.
(1) The organism invades the internal organs, possibly causing
dementia, cardiovascular damage, blindness, and death.
(2) Infected pregnant women can transmit the organism across the
placenta, leading to stillbirth, prematurity, or congenital
deformity.
Diagnosis is made from a specimen of infected tissue and through blood
tests.
Antibiotics are used for treatment of all stages, but damage from late
syphilis can be permanent.
Other STDs
Trichamoniasis, or trich, is caused by a single celled organism, Trichomonas
vaginalis, which thrives in warm, moist conditions, making women particulatly
susceptible.
1.
Symptoms include greenish, foul-smelling vaginal discharge and severe
pain and itching in the vagina.
2.
Early treatment is important because studies suggest trich may increase
the risk of HIV transmission and premature delivery.
3.
Treatment is with metronidazole (Flagyl), and both partners must be treated
simultaneously.
B.
C.
Bacterial vaginosis (BV) involves a shift in the makeup of bacteria that normally
inhabit the vagina and is associated with sexual activity.
1.
Symptoms of BV include a vaginal discharge with a fish-like odor and
vaginal irritation.
2.
Some studies show an association between BV and increased risk of PID,
HIV transmission, infection after childbirth or gynecological surgery, and
premature delivery in pregnant women.
3.
BV is treated with topical and oral antibiotics but often reoccurs.
Pubic lice (crabs) are not technically a disease but are an infestation that is
highly contagious, both sexually and nonsexually.
1.
Treatment is generally easy using over-the-counter or prescription
shampoo and lotion, which is applied to the body, and all clothes and linens
must be washed.
VIII. What You Can Do
A.
Education is a cornerstone of STD prevention, greatly fueled of late because of
the HIV epidemic.
1.
Education programs have led to an increase in condom use, but lapses in
safer sex practices, especially among younger gay men, are common.
2.
Among certain groups, such as injection drug users, infection rates are still
increasing.
3.
Everyone is individually responsible for learning about and preventing
STDs.
B.
Early diagnosis and treatment can help prevent further infection and spread.
1.
Every young, sexually active person should be vaccinated for hepatitis B.
a.
Men who have sex with men should be vaccinated for hepatitis A.
b.
Girls and women aged 9-26 should be vaccinated for HPV.
c.
The CDC recommends that everyone between the ages of 13 and 64
be tested for HIV at least once during routine medical care.
2.
Self-examination is an important part of diagnosis.
3.
Almost all STDs can be asymptomatic, making periodic screening
essential.
4.
If you have had a risky sexual encounter, see a physician as soon as
possible.
5.
Testing can be performed at private physicians’ offices, public health
clinics, community health agencies, and some student health services.
6.
After diagnosis, treatment should begin immediately, and partners should
be informed so they also can start treatment. No sexual activity should take
place during treatment until further tests indicate a cure.
7.
C.
Ethical behavior requires informing all sex partners about the infection,
even though it is difficult.
8.
Treatment and cure of an STD does not guarantee a person will not get it
again; once treated, people need to know how to avoid being infected
again.
Prevention is the best method of dealing with STDs.
1.
Practicing abstinence is the only sure way to avoid exposure to STDs.
Assuming responsibility for safer sex practices will greatly reduce or
eliminate the risk of contracting an STD.
2.
Communication between partners is an essential part of prevention.
3.
Using alcohol and drugs leaves you vulnerable to sexual assault and
increases the risk of acquiring a serious STD.
4.
Practicing responsible sexual behavior means protecting yourself and
others from STDs.