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Sections
1. The History of Sexually
Transmitted Disease
2. Viral and Parasitic
Infections
3. Bacterial and Fungal
Infections
4. HIV and AIDS
5. Preventing STDs
6. STDs and Pregnancy
What is and “STD?”
• Sexually transmitted Diseases
(STDs), also often referred to as
sexually transmitted infections
(STIs) or venereal diseases (VD),
are identified as infectious
conditions that have a high
probability of transmission
between humans through sexual
contact, primarily including vaginal
sex, oral sex, and/or anal
intercourse.
STD’s: A Brief History
• Prior to the 1900’s and the invention
of modern medicine, STD’s were
considered incurable and treatment
was symptomatic.
• STDs have been known since
antiquity. symptoms have been
described by Greek and Roman
medical writers as well as the ancient
Egyptians (in particular he symptoms
of gonorrhea and syphilis)
STD’s: A Brief History (cont.)
• The prevalence and spread of these
diseases was exacerbated by war,
poor hygiene, prostitution, and the
rise of city dwelling, (an increase of
people living in close proximity to
one another). By the Middle Ages
both gonorrhea and syphilis were
widespread.
• It is widely th0ought that syphilis was
brought to Europe by Christopher
Columbus' sailors on their return
from the New World.
“My
Bad!”
Viral Infections: Hepatitis B
• Hepatitis B is characterized by irritation and
swelling (inflammation) of the liver due to
infection with the hepatitis B virus (HBV).
• Transmission: contact with the blood, semen,
vaginal fluids, and other body fluids of an
infected individual.
• Symptoms include: appetite loss, fatigue
fever, muscle and joint aches, nausea and
vomiting, yellow skin and dark urine due to
jaundice
• Damage from the hepatitis B virus is due to
the immunological response and is
characterized by liver inflammation. Chronic
flare-ups can lead to liver failure.
Viral Infections:
Herpes Simplex
Transmission: direct contact with
a lesion or the body fluid of an
infected individual. Transmission
may also occur through skin-toskin contact during periods of
asymptomatic shedding.
• Herpes simplex is caused by virus
types HSV-1 and HSV-2 categorized
into one of 2 distinct disorders based
on the site of infection. Oral herpes,
(cold sores), are localized on the face
or mouth and are the most common
form of infection. Genital herpes,
known simply as herpes, is the second
most common form of herpes.
• Symptoms: viruses cycle between
active periods (presenting as blisters
containing infectious virus particles)
lasting 2 weeks on average, followed
by a remission period. Genital herpes
is often asymptomatic, though viral
shedding may still occur. Viruses
reside in sensory nerve cell bodies,
where they become latent and reside
life-long.
Viral infections: HPV
Genital warts, result from human papilloma
virus (HPV). More than 70 different types of HPV
exist. Certain types of HPV can lead to
precancerous growths in the cervix and/or anal
cancer.
Symptoms: HPV infection around the genitals is
common. However, most people have no
symptoms. In women, HPV can spread to areas
inside the walls of the vagina and cervix. Warts
may look like extremely small flesh-colored spots
that are raised or flat they often look like the top
of a cauliflower.
Transmission: passed through genital contact. 1
in 3 adult females lives with HPV and 1 in 5
males, making it the most common STD.
Parasitic STDs
• "crabs" or "pubic lice" (Pthirus pubis)
and Scabies (Sarcoptes scabiei) are
small obligate ectoparasites which
live in/on pubic hair and associated
follicles.
• Transmission: Any close contact with
an affected individual (sexual or nonsexual) can result in parasite transfer.
• Symptoms: Infection results in
intense itching and folliculitis. Scabies
burrow under the skin and are
considered more virulent for this
reason.
Parasitic STDs
(Cont.)
Trichomoniasis (“trich”) is a somewhat common
STD caused by infection by a parasitic protozoan
called Trichomonas vaginalis. Although
symptoms can vary, most people (both mane and
women) are asymptomatic (only about 30%
develop any symptoms.)
Transmission: The parasite is passed from one
person to their partner during sex. In females,
the lowest portion of the genital tract becomes
infected (vulva, vagina, or urethra). In men the
most commonly infected body part is the inside
of the penis (urethra).
Symptoms: When symptoms occur (5-28 days
after exposure), they range from mild irritation
to severe inflammation. Men may feel
itching/irritation inside the penis, burning after
urination/ejaculation. Women may notice
itching, burning, soreness of the genitals,
discomfort with urination. A yellow/greenish
discharge with an unusual smell often occurs.
Did You Know?
Donovanosis is a very rare
sexually transmitted disease
characterized by small, painless
nodules which after 10-40 days
after exposure and, if left
untreated, can completely
destroy penile tissue.
Bacterial Infections:
Gonorrhea
Symptoms: In men, an abnormal
discharge from the penis (clear or yellow
and often blood-tinged) coupled with
painful/frequent urination or urethritis. In
women, the infection is typically
asymptomatic, although sometimes
symptoms comparable to a urinary tract
infection are experienced.
Gonorrhea is caused by the coffeebean shaped cocci bacteria Neisseria
gonorrhea. The bacteria grow in
warm, moist areas of the body,
including the urethra. In women, the
bacteria may be found in the
reproductive tract (which includes the
fallopian tubes, uterus, and cervix).
The bacteria can even grow in the
eyes and throat.
Transmission: Anyone who has any
type of sex become infected with
gonorrhea (contact with the mouth,
vagina, penis, or anus)
Bacterial Infections: Chlamydia
Chlamydia is caused by the bacteria Chlamydia
trachomatis. It is the 2nd most commonly
acquired STD in the United States. It is known
as a "silent" disease because the majority of
infected people have no symptoms. If
symptoms do occur, they usually appear within
1 to 3 weeks after exposure.
Symptoms occur in about 25% of males and
30% of females and are very much similar to
Gonorrhea infection. Left untreated, chlamydia
can cause permanent damage to the cervix and
fallopian tubes.
Transmission: sexual intercourse
Bacterial Infections:
Syphilis
• Syphilis is a sexually transmitted disease (STD)
caused by the spiral-shaped bacterium
Treponema pallidum. It has often been called
"the great imitator" because so many of the
signs and symptoms are indistinguishable from
those of other diseases.
• Transmission: Syphilis is passed from person
to person through direct contact with a syphilis
sore. Sores occur mainly on the external
genitals, anus, lips, or mouth. Some people
infected with syphilis are asymptomatic for
years. Although sores often go unrecognized,
transmission may easily occur from persons
who are unaware of their infection.
Primary Stage Syphilis
• The primary stage of syphilis is marked by
the appearance of a one or more sores
called chancres. The time between
infection with syphilis and appearance of
a symptoms can range from 10 to 90
days. The chancre is usually firm, round,
small, and painless and appears on or
near the genitals (where the bacteria
entered the body). Chancres last 3 to 6
weeks, and it heal without treatment.
However, if adequate treatment is not
administered, the infection progresses to
the secondary stage.
Secondary Stage Syphilis
• Skin rash and mucous
membrane lesions
characterize the secondary
stage. The rash usually does
not cause itching. It appears
as rough, reddish-brown
spots typically on the palms
of the hands and the
bottoms of the feet.
However, rashes with a
different appearance may
occur on other parts of the
body, sometimes
resembling rashes caused
by other diseases.
Latent Stage Syphilis
• In the late stages of syphilis (10-20 years after exposure),
the disease may damage the internal organs, including the
brain, nerves, eyes, heart, blood vessels, liver, bones, and
joints. Signs and symptoms of the late stage of syphilis
include difficulty coordinating muscle movements,
paralysis, numbness, gradual blindness, severe dementia,
and death.
Did You Know?
Many believe that Benjamin Franklin
died from complications associated
with latent stage Syphilis, acquired
during one of his ‘diplomatic’
excursions to Europe. Franklin was
not only a man of innovation, letter,
and science, but also a ladies man
with an apparent penchant for ‘low
women.’
Fungal STDs
There are 2 types of fungi associated with
sexual transmission, although they are more
likely contracted by other means.
Tinea Cruris, commonly known as Jock Itch
causes a burning or itching feeling in the skin
of groin and is characterized by a red rash.
Candidiasis Yeast infections are usually caused
by yeast known as Candida albicans.
Symptoms include burning, swelling, soreness
and irritation of the genitals.
fungal STDs can be alleviated or treated with a
full course of antifungal topical solutions and
creams.
HIV and AIDS
• Human immunodeficiency virus is the
retrovirus that causes acquired
immunodeficiency syndrome (AIDS); a
condition in which progressive failure of
the immune system allows lifethreatening opportunistic infections and
cancers to thrive. Infection with HIV
occurs by the transfer of blood, semen,
vaginal fluid, pre-ejaculate, or breast milk.
• The virus itself attacks and reproduces
within T-lymphocytes, crippling the
overall function of the adaptive immune
system.
• Treatment with a number
antiretroviral drugs reduces
both the mortality and the
morbidity of HIV infection and
can prolong the lives of
infected individuals for many
years.
• Kaposi's sarcoma is a unique
cancer very closely associated
with AIDS. Opportunistic
diseases eventually overcome
the depressed immune
system.
Did You Know?
• Although on the decline in the U.S., AIDS
killed more than 25 million people since
its discovery in 1981.
• HIV infects about 0.6% of the world's
population.[5]
• AIDS reached its global peak mortality
of 2.1 million in 2004
• Approximately 260,000 children died of
AIDS in 2011.
• A disproportionate number of AIDS
deaths occur in Sub-Saharan Africa,
where approx. 1 in 5 people are infected.
Preventing STDs
• Although sexual contact of any kind places on
at risk for STDs, proper condom use
(throughout the entire act) can dramatically
reduce the likelihood of transmission.
• Condoms are not likely to prevent transmission
when one or both partners have genital sores,
a rash, or discharge consistent with bacterial,
fungal, or viral infections.
• The only time unprotected sex is safe, is if both
individuals have sex only with each other, and
if it's been a minimum of 6 months since both
have tested negative for STDs.
Did You Know?
The first condoms were made
in the 16th century. They were
designed from animal intestine
and intended to be used
multiple times.
STDs and Pregnancy
• Some STDs can potentially harm, or
cause permanent damage to the
developing fetus. Others are only
potentially harmful during delivery, as
lesions on the vagina/cervix are highly
contagious and can infect the infant as
he or she is being born.
• Luckily, modern medicine can usually
ensure the safe development and
delivery of babies with infected
mothers.
Did You Know?
Women under the age of 25 are
four times more likely to
contract an STD than they are to
become pregnant.
4 Key Misconceptions about STDs
1. Pre-ejaculate can still transmit infection.
Withdrawing before ejaculation also does
not prevent STDs.
2. Douching before and after sex does not
protect against STDs and, in fact, may
promote an infection after exposure.
3. Mutual masturbation is not a guarantee
against contracting an STD. Pubic lice,
scabies, herpes simplex, and HPV can all
easily be contracted via this type of contact.
4. Appearances can be deceiving, even if a
person is 100% asymptomatic, they can still
transmit virtually all STDs if infected.
QUIZ!
1. Prior to the 1900’s and the invention of modern medicine, STD’s were considered
incurable and treatment was _______________.
2. Some historians believe that ____________ was brought to Europe by
Christopher Columbus' sailors on their return from the New World.
3. Damage from the _________________ virus is due to the immunological response
and is characterized by liver inflammation.
4. Certain types of ________________ can lead to precancerous growths in the
cervix and/or anal cancer.
5. ____________ are best described as small obligate ectoparasites.
6. _______________ is characterized by an abnormal yellowish discharge from the
penis coupled with urethritis and painful urination.
7. ______________ is known as a "silent" disease because the majority of infected
people have no symptoms
8. The primary stage of syphilis is marked by the appearance of a one or more sores
called _____________.
9. _________________ is a unique cancer very closely associated with AIDS.
10. HIV can be effectively treated with a number of _______________ drugs.