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STDs An Introduction to Sexually Transmitted Diseases Sexually Transmitted Diseases In the United States more than 65 million people are currently living with an incurable sexually transmitted disease. STDs Statistics • STDs are the most common infectious diseases in the United States. • More than 20 STDs have now been identified • They affect more than 13 million men and women in this country each year. The annual Comprehensive Cost of STDs in the United States. In excess of $8,000,000,000. (8 billion dollars) Who STDs Affect? • Men and women of all backgrounds and economic levels. • Most prevalent among teenagers and young adults. • Two thirds of all STDs occur in people younger than 25 years old Serious Problems Caused by STDs • Pelvic Inflammatory Disease (PID), which can cause infertility and ectopic pregnancy. (The later can be fatal.) • Cervical Cancer • STDs passed from mother to baby before and during birth. • Some of the infections of the newborn can be cured easily, but others may cause a baby to be permanently disabled or even die. Well Known STDs • • • • HPV (genital warts) Trichomoniasis Chlamydia Herpes (HSV-2) • Gonorrhea • Hepatitis B • Syphilis CDC’s STD Incidence & Prevalence Report July,20 2002 STD Incidence (per year) Prevalence HPV 5.5 million 20 million 5 million 3 million 1 million 650,000 120,000 70,000 N/A 2 million 45 million N/A 417,000 N/A (genital warts) Trichomoniasis Chlamydia Herpes(HSV-2) Gonorrhea Hepatitis B Syphilis Attention! You are about to be exposed to the truth. STDs are not pretty, so be prepared for grotesque pictures. Human Papilloma Virus (HPV) Genital Warts HPV (genital warts) • An estimated 75 percent of the reproductiveage population have been infected with sexually transmitted HPV. • When a person is infected with HPV it may take one to three months for warts to appear. • Some people who are infected never get warts. Where Can the Warts Grow? • • • • • • • • Women In the vagina Around the vagina On the Cervix Around the anus Men On tip of penis Shaft of penis On the scrotum Around the anus • Genital warts can also develop in the mouth or throat of a person who has had oral sex with an infected person. What Does HPV Look Like? • Small pink or red growths in or around the sex organs. • Similar looking to cauliflower. • Found in groups of three or four. • Very tiny, difficult to see HPV Treatments • There is no cure for the HPV virus. • Laser therapy will remove warts. • Surgery may be needed for larger growths. Tests Used to Detect HPV • Biopsy of cervical tissue • Examinations of physical growths • Examination of rectum • • • • Fluid sample Blood sample Pelvic exam Pap smear If it Goes Untreated • Increased risk of cervical cancer • Increased risk of cancer of the penis Trichomoniasis Most common STD in sexually active young women. Trichomoniasis • The most common curable STD. • Caused by a small organism called Trichomoniasis vaginalis. • Women more than men are affected by the disease. Signs and Symptoms Male • Irritation inside the penis • Mild discharge • Slight burning after urination or ejaculation • • • • • Female Greenish-yellow, frothy vaginal discharge Strong odor Painful urination Discomfort during intercourse. Lower abdominal pain (rare) Tests and Treatment Tests • Pelvic Examination • Laboratory tests Treatments • Oral Antibiotic If it Goes Untreated • Increased risk of acquiring HIV if exposed. • I pregnant women,Premature rupture of membranes that protect the baby, and preterm delivery. Chlamydia In the sexually active 18-30s crowd, 50% are infected. Chlamydia • Most common sexually transmitted disease in the USA. • The infection is easily spread because it often causes no symptoms. • 75 percent of women and 50 percent of men have no symptoms. Signs and Symptoms • • • • • • • Women Vaginal discharge Strong foul odor Painful periods Abdominal pain with fever Pain when having sex Itching or burning in or around vagina Pain when urinating Men • Small amounts of clear or cloudy discharge • Painful urination • Pain and swelling around testicles Tests and Treatments Tests • Cervical swab Treatments • Oral antibiotics If it Goes Untreated • • • • • • Pelvic Inflammatory disease Infertility Risk of ectopic pregnancy Damage of fallopian tubes Premature births Infection passed from mother to child, causing an eye infection of pneumonia in the newborn. Herpes (HSV-2) Genital Herpes is most common in young white teens. Herpes (HSV-2) • A highly contagious infection • Spread during intercourse, oral, or anal sex through open sores • Also can be spread to a newborn at birth if the mother has an active infection. How Common is Herpes? • More than one in five Americans- 50 million people- are infected with genital herpes. • Yet, At least 80 percent of those with herpes are unaware they have it. What Causes Herpes? • The infection is caused by the herpes simplex virus-2 • Herpes simplex virus-1 is responsible for cold sores. Signs and Symptoms • Inflamed genitalia • Skin may burn, itch or be painful • Blister like sores appear on genitalia • Sores open, scab over than heal This may also be accompanied by: • • • • Swollen glands Fever Headache Burning when passing urine • Muscle aches What Triggers an Outbreak? • • • • • • Stress Illness Surgery Vigorous sex Diet Monthly period Treatment • There is no cure. • Antivirus medication can help heal sores faster. • Antiviral medication can help suppress outbreaks. How to Protect Yourself. • Do not have sex with someone who has an open sore. • Always use latex condoms during sex. • Use a spermicide that contains nonoxynol-9. • Limit your number of sex partners. Gonorrhea The highest rates of infections are found in 15-19 year-old women and 20-24 year-old men. Gonorrhea • Also called “The Clap” or “The Drip”. • Caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in mucus membranes. Where Does Gonorrhea Grow? • • • • • • • • Cervix Uterus Fallopian tubes Urethra Mouth Throat Anus Eyes Symptoms in Women • Greenish yellow or whitish discharge from vagina • Lower abdominal or pelvic pain • Burning when urinating • Conjunctivitis • Bleeding between periods • Spotting after intercourse • Swelling of the vulva(vulvitis) • Burning in the throat (due to oral sex) • Swollen glands(due to oral sex) Symptoms in Men • Greenish yellow or whitish discharge from the penis • Burning when urinating • Burning in the throat (due to oral sex) • Swollen glands (due to oral sex Tests and Treatment • • • • Tests Fluid sample from the urethra (in men) Fluid sample form cervix (in women) Throat cultures Anal cultures Treatment • There is a cure for Gonorrhea. • Oral or injected antibiotic What Happens When it Goes Untreated? • • • • In Women Damage fallopian tubes Can cause Pelvic Inflammatory Disease Infertility Increased risk of ectopic pregnancy In Men • Epididymitis, which can cause infertility • Prostate damage • Scaring of the urethra Hepatitis B (Hep B) Cost associated with sexually transmitted hepatitis B in the United States totaled $200 million in 2000. Hepatitis B • Hepatitis B is a virus caused by the Hepatitis B virus (HBV). • Hepatitis B is 100 times more infectious than HIV. • 40% of those infected do not know how they acquired the infection. Affects of the Hepatitis B Virus • • • • Scarring of the liver Liver failure Liver cancer Death How Hepatitis B is Spread • • • • • • Infected blood Semen Vaginal secretions Saliva Open sores Breast milk Hep B, Limited Infection • In most cases Hep B causes limited infection. (90% - 95%) • Most people fight off the infection successfully within a few months, developing an immunity that lasts a lifetime. • Blood tests will show evidence of this immunity, but no signs of active infection. Hep B Carriers • If you are infected with Hep B for more than 6 months, you are considered a carrier. Even if you have no symptoms. • In a small percentage of carriers the infection eventually goes away for unknown reasons. Chronic Hep B • Some carriers go on to develop chronic Hep B. • Chronic Hep B is an ongoing infection of the liver that can lead to cirrhosis. • Cirrhosis, or hardening of the liver, causes liver tissue to scar and stop working. • 5%- 10% of people with the Hepatitis B infection go on to develop chronic infection. Signs and Symptoms • Jaundice (yellowing of the skin or whites of the eyes and/or a brownish or orange tint to the urine. • Unusually light colored stool • Unexplained fatigue that persists for weeks or moths • Flu-like symptoms such as fever, loss of appetite, nausea, and vomiting. • Abdominal pain Tests • Complete physical exam • Blood tests If The Disease Becomes Chronic • Liver biopsies (to detect the severity of the disease. Treatment • Within two weeks of exposure immediate immunization with Hep B vaccination and a shot to boost the immune system. • Bed rest (to speed recovery) • Some doctors recommend a highcalorie, high-fat diet. • It is important to stay away form alcohol and acetaminophen, as they can harm the liver. Treatment for Chronic Hep B • Immune system boosting medicine (interferon alpha is injected for at least 6 months. • Lamivudine (Epivir) in combination with interferon alpha Risk of Pregnancy • A pregnant woman can spread the hepatitis B virus to her baby at the time of birth. • Many babies infected with hepatitis B develop long-term liver problems. How to Protect Yourself • Get vaccinated • Use condoms every time you have sex • Wear gloves when touching or cleaning up body secretions. • Do not share razors, toothbrushes, manicuring tools, or pierced earrings with anyone. • Do not share chewing gum or prechew food for a baby. • Make certain that any needles for drugs, ear piercing, or tattooing are properly sterilized. • Cover all open cuts and wounds. Is There a Cure? Currently, there is not cure for hepatitis B. Luckily, the disease is limited in most acute cases and occasionally disappears in those with chronic disease. Syphilis This disease can not be spread by toilet seats, door knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils. Syphilis • A highly contagious disease caused by the bacteria Treponema pallidum. • A treatable infection that can spread throughout the body and affect the heart, brain,and nerves. • Also known as “syph”. Syphilis • Since 1990 the rate of new cases of syphilis per year has dropped 84%. • Today Syphilis is one of the least common STDs. Three Distinct Phases of Syphilis Primary, Secondary, and Tertiary Primary • Infection referred to as “great imitator” • Signs are visible within 10-90 days. • Infection can be mistaken for many other conditions. • Development of one or more chancre sores is common. • The sores look like large round bug bites and are often hard and painless • The sores occur on the genitalia or in or around the mouth. • The sores will heal and scar within 6 weeks. Secondary • May last 1-3 months • Begins within 6 weeks to 6 months after exposure • A rosy “copper penny” rash typically on the palms of the hands and bottoms of feet appears. • Moist warts may also appear on the groin. • White patches inside the mouth, swollen lymph glands, fever, and weight loss are also symptoms Latent Syphilis • This is when the infection lies dormant (inactive) without symptoms. Tertiary • Severe problems with the heart, brain, and nerves • Can result in blindness, dementia, impotency, and even death if it goes untreated. Tests • Blood test • Chancre swab Treatment • If caught before 1 year a single dose of penicillin is usually enough to destroy the infection. • If it is in a later stage more doses of penicillin will be used to treat the infection. Effects of Syphilis on Pregnancy • Depending on how long the mother has been infected she has a good chance of having a stillbirth. • There is also a great risk that the baby will die shortly after birth. • If not treated immediately the baby may become developmentally delayed, have seizures, or die. Outlook • There is a cure for Syphilis. • Prompt diagnosis and treatment will help prevent any serious problems. • If treated too late, there may be permanent damage to the heart and brain. Protection • Using condoms during intercourse, oral and anal sex is the only way to protect yourself from STDs. • Even those barrier methods are not always safe. • Every time you have sexual relations with another individual you are at risk. Is it worth it? At Least One In Four Americans Will Contract An STD At Some Point In Their Life Less than half adults age 18 to 44 have ever been tested for an STD other than HIV/AIDS Bibliography • Aol Health with WebMD http://aolsvc.health.webmd.aol.com/ • Center for Disease Control (CDC) http://www.cdc.gov/ • Sexuality Information and Education Council of the United States(SIECUS) http://www.siecus.org/ • The Journal of the American Medical Association (JAMA) http://www.ama-assn.org/ Bibliography cont. • Health Awareness Connection (HAC) http://www.healthac.org/ • American Social Health Association (ASHA) http://www.ashastd.org/ • Pictures: http://www.thebody.com/ http://www-nehc.med.navy.mil/