Download STD - Illinois State University Department of Psychology

SEXUALLY TRANSMITTED
INFECTIONS AT ILLINOIS
STATE UNIVERSITY
© 2008 John B. Pryor, Ph.D.
Department of Psychology
Top 6 STIs at ISU:
1995-2007
1. Genital Warts
2. Genital Herpes
3. Chlamydia
4. Scabies
5. Trichomoniasis
6. Gonorrhea
Sexually Transmitted Infections Treated at the ISU
Student Health Center 1995-2007
6% 2%
9%
13%
50%
20%
Genital Warts
Genital Herpes
Chlamydia
Scabies
Trichomoniasis
Gonorrhea
Human Papilloma Virus (HPV)
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Virus that causes genital warts - 60 known types
estimated 20 million Americans infected
In more than 90 percent of cases, the infections
are harmless and go away without treatment.
Related to the occurrence of pre-cancerous cells on
the cervix. Persistent HPV infection is found in
most cases of cervical cancer.
A new vaccine, Gardasil, protects against four HPV
types, which together cause 70% of cervical cancers
and 90% of genital warts.The FDA recently licensed
this vaccine for use in girls/women, ages 9-26 years.
Symptomatically treated by chemical agents
(podophyllin), cryotherapy, or laser therapy
Genital warts - Initial Visits to Physicians’
Offices in the U.S. 1965-2005
Source: CDC
Human Papilloma Virus
warts
Some carriers are asymptomatic
Human
Papilloma
Virus
transmission
through
physical
contact
wart
Human
Papilloma
Virus
Most common
sites in men:
penis,
urethra,
bladder,
& anus
warts
Human
Papilloma
Virus
Most common
sites in women:
vulva,
vagina,
cervix,
& anus
HPV - can be transmitted via
oral sex
Genital Herpes
Caused by a virus
Two types:
• 1) herpes simplex virus type 1( HSV-1) typically around mouth (cold sores)
• 2) herpes simplex virus type 2 (HSV-2)
- typically found in the genital region.
• However, either can infect either place.
•
Genital Herpes - incidence
•
•
•
HSV-1 antibodies are present in 95%
of Americans.
31 million Americans have a genital
herpes infection (about 1 in 6 people).
Most people who are infected never
recognize their symptoms.
Genital Herpes
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•
•
•
Transmission - through physical contact
with infected area
Transmission is possible even when
someone is asymptomatic
No cure
Symptomatic treatment with acyclovir
Genital Herpes - Initial visit to
physicians’ offices - 1966-2005
Source: CDC
Genital Herpes
leision
Genital
Herpes
Genital
Herpes
leisions
Genital
Herpes
scars
Genital
Herpes
Genital Herpes
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•
•
Some myths about HSV-2:
1) Genital herpes is often
transmitted through casual
contact.
2) Women who have recurrent
HSV-2 should not bear children
because of dangers to the
developing fetus.
Psychosocial Aspects of Herpes
Survey of 3100 People with Herpes
84% -reported episodes of depression
70% -indicated feelings of isolation
40% -diminished work performance as the
result of lowered self-esteem
35% -decreased sexual desire
25% -self-destructive thoughts
18% -the breakup of long term relationships
Chlamydia is the most frequently reported
infectious disease in the United States. An
estimated 800,000 new cases occur annually.
Chlamydia Rates per 100,000 in Illinois
2002-2006
440
431.5
430
420
407.1
410
400
390
387.3
388.9
379.9
380
370
360
350
2002
2003
2004
Year
2004
2006
Chlamydia rates for men and women in the U.S. in
2005 (Source: CDC, 2007)
Chlamydia -caused by a bacteria
Up to 75 percent of women and 50
percent of men with uncomplicated
chlamydia infection have no symptoms
or signs of infection. If symptoms do
occur, they typically appear within one
week to a month after exposure to an
infected person.
Chlamydia Symptoms - Men
* pain or burning during urination
* frequent urination
* pain and swelling in the testicles
* low-grade fever
* burning and itching around the opening of
the penis
* watery or milky discharge from the penis
Chlamydia Symptoms - Women
* irregular vaginal bleeding
* burning with urination
* itching and burning in the genital area
* vaginal discharge
* lower abdominal pain often
accompanied by nausea and fever
Chlamydia - possible complications for women
scared/blocked
fallopian tubes
pelvic abscess
adhesions
Treatment of Chlamydia
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Curable with azithromycin or doxycycline; does not
respond to penicillin.
Poorly treated or undiagnosed cases may lead to:
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urethral damage
epididymitis (infection of the epididymis)
Reiter’s syndrome (inflammation throughout body;
arthritis)
proctitis in men who had anal intercourse
Pelvic Inflammatory Disease (PID)
Problems with pregnancy and risks for newborn infants of
infected mothers
Chlamydia - possible complications for
women

Up to 40% of women with untreated chlamydia will
develop PID. Undiagnosed PID caused by chlamydia
is common. Of those with PID, 20% will become
infertile; 18% will experience debilitating, chronic
pelvic pain; and 9% will have a life-threatening tubal
pregnancy. Tubal pregnancy is the leading cause of
first-trimester, pregnancy-related deaths in American
women.
Scabies
Scabies is caused
by tiny mites
which are at
most half a
millimeter in
length and are
difficult to see.
Scabies
Scabies
Scabies usually infest areas
between the fingers and
toes, wrists, elbows,
armpits, buttocks, breasts,
genitals, and other areas
of contact.
Scabies
Small red bumps
or tiny lines
(burrows) may
appear.
Scabies
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CDC Recommended Regimen • Permethrin cream (5%) applied to all areas of
the body from the neck down and washed off
after 8-14 hours
Transmission • Scabies among adults may be sexually
transmitted, although scabies among children
is usually not sexually transmitted.
Trichomoniasis
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affects 5 million Americans yearly
caused by a single-celled protozoan parasite
symptoms in women include a heavy, yellowgreen or gray vaginal discharge,
discomfort during
intercourse, vaginal
odor, and painful
urination
Trichomoniasis
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•
symptoms also may include irritation
and itching of the female genital area
symptoms in men include a thin,
whitish discharge from the penis and
painful or difficult urination
most men do not experience any
symptoms, women also may be
asymptomatic
Trichomoniasis
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•
Sexual transmission is possible even
when no symptoms are present.
Metronidazole is the drug used to treat
trichomoniasis.
It is administered in a
single dose.
Trichomoniasis
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Trichomoniasis in pregnant women may
cause premature rupture of the membranes
and pre-term delivery.
The genital inflammation caused by
trichomoniasis also might increase a woman's
risk of acquiring HIV infection if she is
exposed to the virus.
Trichomoniasis in a woman who is also
infected with HIV can increase the chances of
transmitting HIV infection to a sex partner.
Gonorrhea is caused by the gonococcus, a
bacterium that grows and multiplies
quickly in moist, warm areas of the
body such as the cervix, urethra, mouth,
or rectum.
.
GONORRHEA
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Incidence &
treatment
Gonorrhea is the second most commonly
reported infectious disease in the United
States, with 339,593 cases reported in 2005.
Treatment is usually easy with antibiotics
Drug resistance is an increasingly important
concern in the treatment and prevention of
gonorrhea
Gonorrhea Rates in the U.S.,
1941-2005 (CDC, 2007)
Gonorrhea Rates per 100,000 in Illinois 20022006
250
200
193.5
175.7
165.8
161.2
162.5
2004
2004
2006
150
100
50
0
2002
2003
Year
Cases of Gonorrhea in Illinois in 1st 8 Months
of 2005
unknown
11
50+
169
45 to 49
171
Age Groups
40 to 44
385
35 to 39
557
980
30 to 34
25 to 29
1908
20 to 24
3930
15 to 19
3437
10 to 14
153
5 to 9
3
0 to 4
9
0
500
1000
1500
2000
2500
3000
Cases Reported to IDPH
3500
4000
4500
Gonorrhea - transmission
genital-to-genital contact
• genital-to-oral contact
• genital-to-anal contact
• spread fromvagina to rectum
•
Gonorrhea - Symptoms
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early symptoms often are mild
most women who are infected have no
symptoms
if symptoms of gonorrhea develop, they
usually appear within 2 to 10 days after
sexual contact with an infected partner
some may be infected for several
months without showing symptoms.
Gonorrhea - Symptoms for Women
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a painful or burning sensation when
urinating
an abnormal vaginal discharge
more advanced symptoms, which
indicate progression to PID, include
abdominal pain, bleeding between
menstrual periods, vomiting, or fever
Gonorrhea - Symptoms for Men
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a discharge from the penis
a burning sensation during
urination
symptoms of rectal infection
include discharge, anal itching, and
sometimes painful bowel
movements.
Gonorrhea
discharge
Gonorrhea Discharge
Both Gonorrhea & Chlamydia can cause future
fertility problems in women
Chlamydia
Gonorrhea
Possible scarring
or blockage of
fallopian tubes