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Sexually Transmitted
Diseases / Infections
Health II
STD’s:
• Are infectious diseases
that spread from person
to person through
intimate sexual contact.
• STDs can affect guys
and girls of all ages and
backgrounds who are
having sexual contact
— it doesn't matter if
they're rich or poor.
STD’s:
• Are considered an
EPIDEMIC among
teens and young
adults.
• Epidemic: The occurrence of
more cases of a disease
than expected.
3 types of STD’s / STI’s
• Caused by a
bacteria
• Caused by a virus
• Caused by a
parasite
Bacteria vs Virus
• Bacteria are single-celled microorganisms that thrive
in many different types of environments. Some
varieties live in extremes of cold or heat, while others
make their home in people's intestines, where they
help digest food. Most bacteria cause no harm to
people, but some can cause great harm.
• Viruses are even smaller than bacteria and require
living hosts — such as people, plants or animals — to
multiply. Otherwise, they can't survive. When a virus
enters your body, it invades some of your cells and
takes over the cell machinery, redirecting it to produce
the virus.
Bacteria
• Bacterial STDs, such
as gonorrhea, syphilis,
and chlamydia, are
often cured with
antibiotics
Virus
• Viral STDs, (such
as HIV, HPV,
herpes, and
hepatitis, have no
cure, but their
symptoms can be
alleviated with
treatment.
Parasitic
• STDs can also be caused by protozoa
(trichomoniasis) and other organisms
(crabs/pubic lice and scabies).
• These STDs can be cured with antibiotics or
topical creams/lotions.
STD’s
• COMMON STD’S
Chlamydia
• One of the most commonly reported bacterial
sexually transmitted diseases (STDs).
• Global chlamydia statistics show that an
estimated 92 million new chlamydia infections
occur each year, affecting more women (50
million) than men (42 million).
Figure 3. Chlamydia—Rates by State, United States
and Outlying Areas, 2009
Chlamydia
How can it be transmitted:
•
By having unprotected vaginal,
anal or oral sex with someone
who is infected;
•
From a mother to her baby
during vaginal childbirth;
•
By transferring the infection on
fingers from the genitals to the
eyes, although it is rare for this
to happen.
Diagnosing Chlamydia
• Chlamydia symptoms usually appear between 1 and 3 weeks
after exposure but may not emerge until much later.
• Chlamydia is known as the ‘silent’ disease as in many people it
produces no symptoms.
• It is estimated that 70-75% of women infected with chlamydia
are asymptomatic (have no symptoms) and a significant
proportion of men also have no symptoms.
Chlamydia Symptoms
• Women
• An increase in vaginal discharge caused by an
inflamed cervix
• the need to urinate more frequently, or pain whilst
passing urine
• pain during sexual intercourse or bleeding after sex
• lower abdominal pains
• irregular menstrual bleeding.
Chlamydia Symptoms
• Men
• A white/cloudy and watery discharge from the penis that may
stain underwear
• A burning sensation and/or pain when passing urine
• Pain and swelling in the testicles.
• Men are more likely to notice chlamydia symptoms than women,
though they too may be asymptomatic
“What should I do if I think I
have chlamydia?”
• You can visit your doctor, who may be able to test you for
chlamydia.
• Planned Parenthood
• These health centers provide a wide range of safe, reliable
health care - and more than 90 percent is preventive,
primary care, which helps prevent unintended pregnancies
through contraception, reduce the spread of sexually
transmitted infections through testing and treatment, and
screen for cervical and other cancers
Chlamydia Testing
• For Men:
• Either a urine sample is taken, or a swab is taken from the
opening of the urethra at the tip of the penis.
• Some testing sites now just take a urine sample.
• This is an easier and less painful procedure, but is slightly
less reliable than a swab.
Chlamydia Testing
• A woman:
• Can provide a urine sample, which is sent to a laboratory for
testing.
• Alternatively a swab can be taken from the vagina (either by
a doctor or nurse) that is sent to a laboratory.
• Results for the chlamydia test are usually available within
one week, though this may vary depending on location.
Treatment of Chlamydia
• The treatment of chlamydia is effective once the infection has
been diagnosed.
• It consists of a short course of antibiotic tablets, which if taken
correctly, can be more than 95 percent effective.
• The doctor or health advisor will discuss the chlamydia infection
and answer any questions.
• It is important that the patient returns for a check-up once the
treatment has been completed to make sure they have no
recurring infection. The patient should not have penetrative sex
until they have received a negative test result following the
check-up.
Complications of Chlamydia
• Women
• Pelvic inflammatory disease (PID) - an infection of the uterus,
ovaries and fallopian tubes. PID increases the future risk of ectopic
pregnancy (a pregnancy outside the womb) or premature birth. If
the fallopian tubes are scarred, it can also lead to problems with
fertility.
• Cervicitis - an inflammation of the cervix. Symptoms include a
yellowish vaginal discharge and pain during sex. In long-term
cervicitis the cervix becomes very inflammed and cysts can develop
and become infected. This can lead to deep pelvic pain and
backache.
Complications of Chlamydia
• Women
• If a pregnant woman has untreated chlamydia,
the infection can potentially be passed on to a
baby during pregnancy, giving it an eye or lung
infection.
• Chlamydia can be safely treated during
pregnancy provided the correct antibiotics are
prescribed.
Complications of Chlamydia
• Men
• Epididymitis - painful inflammation of the tube system that is part
of the testicles, which can lead to infertility.
• Urethritis - inflammation of the urine tube (urethra), causing a
yellow or clear pus-like discharge to collect at the tip of the penis.
Left untreated it can lead to a narrowing of the urethra, which can
affect the ability to urinate easily and can potentially cause kidney
problems.
• Reactive arthritis - symptoms include inflammation of the joints,
urethra and eyes.
Chlamydia Prevention
• Abstinence
• Using condoms greatly reduces the risk of chlamydia
being passed on during sex.
• Getting tested for STDs at a sexual health clinic, and
encouraging new partners to get tested before having
sexual intercourse, also helps to prevent
transmission.
Gonorrhea
• Gonorrhea is one of the most common sexually
transmitted diseases (STDs)
• Global gonorrhea statistics show that an estimated
62 million cases of gonorrhea occur each year,
affecting more women than men.
Gonorrhea—Rates by State, United States and Outlying
Areas, 2009
Gonorrhea
How can it be transmitted:
• Gonorrhea is passed on through
penetrative sex, including:
• vaginal sex
• anal sex
• oral sex
Diagnosing Gonorrhea
• Symptoms of gonorrhea infection may appear 1 to 14 days after
exposure, although it is possible to be infected with gonorrhea
and have no symptoms.
• Men are far more likely to notice symptoms as they are more
apparent.
•
It is estimated that nearly half of the women who become
infected with gonorrhea experience no symptoms, or have nonspecific symptoms such as a bladder infection.
Gonorrhea Symptoms
• Women
• A change in vaginal discharge; it may appear in abundance,
change to a yellow or greenish color, and develop a strong
smell.
• A burning sensation or pain while passing urine.
• Irritation and/or discharge from the anus.
Gonorrhea Symptoms
• Men:
• A white or yellow discharge from the penis.
• A burning sensation or pain while urinating.
• Irritation and/or discharge from the anus.
“What should I do if I think I
have gonorrhea?”
• You can visit your doctor, who may be able to test you for
gonorrhea.
• Planned Parenthood
Gonorrhea Testing
•
To test for gonorrhea an examination of the genital area will be carried
out by a doctor or nurse and samples will be taken, using a cotton wool
swab or sponge, from any infected areas - the cervix, urethra, anus or
throat.
•
Women will also be given an internal pelvic examination, similar to a
smear test. A sample of urine may be taken.
•
If a person has had anal sex, it is important they tell the doctor so that a
swab can be taken from the rectum.
•
They should also tell the doctor if they have had oral sex so swabs can
be taken from the throat
Treatment of Gonorrhea
• The patient will be given an antibiotic in tablet, liquid or injection
form.
• Once a course of treatment is started it is important to complete
it, even if symptoms diminish, to ensure the infection is cured.
• The doctor or health advisor will discuss the gonorrhea infection
and answer any questions.
• They will also want to know about any partners the patient has
had sexual contact with as they will also be at risk of having
gonorrhea and should be tested.
• The patient should not have penetrative sex until they have
returned to the clinic and it is confirmed that the infection is
gone.
Complications of Gonorrhea
• Women
• Gonorrhea can cause Pelvic Inflammatory Disease (PID), an
inflammation of the fallopian tubes (the tubes along which an egg
passes to get to the womb), which increases the future risk of
ectopic pregnancy (a pregnancy outside the womb) or premature
birth.
• If a woman is pregnant and has gonorrhea when giving birth, the
infection may be passed on to her child. The baby could be born
with a gonoccocal eye infection, which must be treated with
antibiotics as it can cause blindness. It is better for the woman to
get treatment before giving birth.
Complications of Gonorrhea
• Men
• Gonorrhea can cause painful inflammation of the
testicles and the prostate gland, potentially leading
to epididymitus, which can cause infertility.
• Without treatment, a narrowing of the urethra or
abscesses can develop after time. This causes
considerable pain and problems whilst urinating.
Gonorrhea Prevention
• Abstinence
• Using a condom during sex can reduce the chances
of getting or passing on gonorrhea. Latex condoms
are proven to be over 99% effective when used
consistently and correctly.
Genital Herpes
• Genital herpes is a sexually transmitted disease (STD) caused
by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2).
• HSV-1 is acquired orally, causing cold sores
• HSV-2 is acquired during sexual contact and affects the genital area.
• Most genital herpes is caused by HSV-2
• Results of a nationally representative study show that genital
herpes infection is common in the United States. Nationwide,
16.2%, or about one out of six, people 14 to 49 years of age
have genital HSV-2 infection.
Genital Herpes
How can it be transmitted:
• Herpes is spread by direct skin to skin contact.
• Unlike a flu virus that you can get through the air, herpes
spreads by direct contact, that is, directly from the site of
infection to the site of contact.
• For example, if you have a cold sore and kiss someone, you can
transfer the virus to their mouth. Similarly, if you have active
genital herpes and have vaginal or anal intercourse, you can
give your partner genital herpes.
• Finally, if you have a cold sore and put your mouth on your
partners genitals (oral sex), you can give your partner genital
herpes.
• Herpes is most easily spread when a sore is present, but, it is
also often spread at other times too.
Diagnosing Herpes
• Symptoms of herpes usually develop within 2 to 20 days after
contact with the virus, although it could take longer.
• Many people infected with HSV are not aware of their infection
• These symptoms may last up to several weeks, varying from
one person to the next.
• In many people, the first infection is so mild that it goes
unnoticed.
• It is possible that a person becomes aware of the first episode
years after the infection is acquired.
Herpes Symptoms
• Genital herpes often doesn’t cause any symptoms. If you do
have symptoms, you might notice:
• Painful blisters or sores on or around the genitals or anus.
These sores typically heal within two to four weeks.
• Feeling like you have the flu when the sores are present.
• Sores that come back several times within a year. The presence
of the sores is called an outbreak.
• There are two types of genital herpes virus - HSV1 and HSV2.
Both types can cause sores or blisters on or around the genitals.
HSV1 can also cause sores on the mouth or lips, which are
called fever blisters.
What should I do if I think I
have HERPES?
• See a doctor while symptoms are still present.
• The doctor will look at the area, take a sample from the sore(s)
and test to see if the herpes virus is present.
• The test you should request is a specific virus culture or assay
for herpes virus.
• Remember, the test will not work if the sores have healed.
• A blood test will also show the herpes virus.
Can Herpes Be Treated
• There is no cure for genital herpes, but there are treatments for
its symptoms.
• Some medicines can prevent the blisters or make them go away
faster.
• If you have several outbreaks in a year, a treatment called daily
suppressive therapy can reduce your chance of passing the
infection to your sex partners.
Herpes Prevention
• The surest way to prevent genital herpes is not to have sex.
• Having sex only with someone who is not infected and who has
sex only with you.
• Condoms can reduce your risk of getting genital herpes if used
the right way every single time you have sex. But a condom
protects only the area of the body that it covers. Areas the
condom doesn’t cover can become infected.
• Washing the genitals, urinating, or douching after sex will not
prevent any sexually transmitted disease (STD).
HUMAN PAPILLOMAVIRUS
(HPV)
• Genital human papillomavirus (also called HPV) is the most
common sexually transmitted infection (STI). (according to the
CDC)
• There are more than 40 HPV types that can infect the genital
areas of males and females. These HPV types can also infect
the mouth and throat.
• Most people who become infected with HPV do not even know
they have it.
• HPV is not the same as herpes or HIV (the virus that causes
AIDS). These are all viruses that can be passed on during sex,
but they cause different symptoms and health problems.
HPV Statistics
• HPV (the virus). Approximately 20 million
Americans are currently infected with HPV.
Another 6 million people become newly
infected each year. HPV is so common that at
least 80% of sexually active men and women
get it at some point in their lives.
• Genital warts. About 1% of sexually active
adults in the U.S. have genital warts at any
one time.
HPV Statistics
•
Cervical cancer. Each year, about 12,000 women get cervical cancer in
the U.S.
•
Other cancers that can be caused by HPV are less common than
cervical cancer. Each year in the U.S., there are about:
• 3,700 women who get vulvar cancer
• 1,000 women who get vaginal cancer
• 1,000 men who get penile cancer
• 2,700 women and 1,700 men who get anal cancer
• 2,300 women and 9,000 men who get head and neck cancers.
[Note: although HPV is associated with some of head and neck
cancers, most of these cancers are related to smoking and heavy
drinking.]
Certain populations are at higher risk for some HPV-related health
problems. This includes gay and bisexual men, and people with weak
immune systems (including those who have HIV/AIDS).
•
•
RRP is very rare. It is estimated that less than 2,000 children get RRP
every year in the U.S.
HPV
HOW CAN IT BE SPREAD:
• HPV is passed on through genital contact, most often during
vaginal and anal sex. HPV may also be passed on during oral
sex and genital-to-genital contact.
• HPV can be passed on between straight and same-sex
partners—even when the infected partner has no signs or
symptoms.
• A person can have HPV even if years have passed since he or
she had sexual contact with an infected person. Most infected
persons do not realize they are infected or that they are passing
the virus on to a sex partner.
• A pregnant woman with genital HPV can pass HPV to her baby
during delivery. In these cases, the child can develop RRP.
Diagnosing HPV
• Most people with HPV do not develop symptoms or health
problems from it. In 90% of cases, the body’s immune system
clears HPV naturally within two years.
• But sometimes, certain types of HPV can cause genital warts in
males and females. Rarely, these types can also cause warts in
the throat -- a condition called recurrent respiratory
papillomatosis or RRP.
• Other HPV types can cause cervical cancer. These types can
also cause other, less common but serious cancers, including
cancers of the vulva, vagina, penis, anus, and head and neck
(tongue, tonsils and throat).
• The types of HPV that can cause genital warts are not
the same as the types that can cause cancer. There is
no way to know which people who get HPV will go on to
develop cancer or other health problems.
Symptoms of HPV
• Genital warts
• Usually appear as a small bump or groups of bumps in the
genital area.
• They can be small or large, raised or flat, or shaped like a
cauliflower.
• Health care providers can diagnose warts by looking at the
genital area during an office visit.
• Warts can appear within weeks or months after sexual
contact with an infected partner-even if the infected
partner has no signs of genital warts.
• If left untreated, genital warts might go away, remain
unchanged, or increase in size or number.
• They will not turn into cancer.
Symptoms of HPV
• Cervical cancer usually does not have symptoms until it is quite
advanced. For this reason, it is important for women to get
regular screening for cervical cancer. Screening tests can find
early signs of disease so that problems can be treated early,
before they ever turn into cancer.
• Other HPV-related cancers might not have signs or symptoms
until they are advanced and hard to treat. These include
cancers of the vulva, vagina, penis, anus, and head and neck.
• RRP causes warts to grow in the throat. It can sometimes block
the airway, causing a hoarse voice or troubled breathing.
HPV Testing
• The HPV tests on the market are only used to help
screen for cervical cancer.
• There is no general test for men or women to check
one’s overall “HPV status,” nor is there an HPV test to
find HPV on the genitals or in the mouth or throat.
• HPV usually goes away on its own, without causing
health problems. So an HPV infection that is found
today will most likely not be there a year or two from
now.
Treatment of HPV
There is no treatment for the virus itself, but there are treatments for the
diseases that HPV can cause:
•
Visible genital warts can be removed by the patient him or herself with
medications. They can also be treated by a health care provider. Some
people choose not to treat warts, to see if they disappear on their own.
No one treatment is better than another.
•
Cervical cancer is most treatable when it is diagnosed and treated
early. But women who get routine Pap tests and follow up as needed
can identify problems before cancer develops. Prevention is always
better than treatment.
•
Other HPV-related cancers are also more treatable when diagnosed
and treated early.
•
RRP can be treated with surgery or medicines. It can sometimes take
many treatments or surgeries over a period of years.
HPV Prevention
•
Vaccines can protect males and females against some of the most
common types of HPV. These vaccines are given in three shots. It is
important to get all three doses to get the best protection. The vaccines
are most effective when given before a person's first sexual contact,
when he or she could be exposed to HPV.
• Girls and women:
• Two vaccines (Cervarix and Gardasil) are available to protect females
against the types of HPV that cause most cervical cancers.
• One of these vaccines (Gardasil) also protects against most genital
warts.
• Both vaccines are recommended for 11 and 12 year-old girls, and for
females 13 through 26 years of age, who did not get any or all of the
shots when they were younger.
• These vaccines can also be given to girls as young as 9 years of age.
• It is recommended that females get the same vaccine brand for all
three doses, whenever possible.
HPV Prevention
• Boys and men: One available vaccine (Gardasil)
protects males against most genital warts. This
vaccine is available for boys and men, 9 through 26
years of age.
• Condoms - BUT HPV can effect areas that are not
covered by a condom, so condoms will not fully
protect against HPV.
• ABSTINANCE
HIV
•
Human Immunodeficiency Virus
•
HIV is a virus. Viruses such as HIV cannot grow or reproduce on their
own, they need to infect the cells of a living organism in order to
replicate (make new copies of themselves). The human immune
system usually finds and kills viruses fairly quickly, but HIV attacks the
immune system itself - the very thing that would normally get rid of a
virus.
•
With around 2.6 million people becoming infected with HIV in 2009,
there are now an estimated 33.3 million people around the world who
are living with HIV, including millions who have developed AIDS.
HIV Symptoms
•
Some people experience a flu-like illness, develop a rash, or get
swollen glands for a brief period soon after they become infected with
HIV. However, these are also common symptoms of other less serious
illnesses, and do not necessarily mean that a person has HIV.
•
Often people who are infected with HIV don't have any symptoms at all.
It is important to remember that a person who has HIV can pass on the
virus immediately after becoming infected, even if they feel healthy. It's
not possible to tell just by looking if someone has been infected with
HIV.
•
The only way to know for certain if someone is infected with HIV is for
them to be tested
HIV Testing
• There are various types of HIV test, but the most
commonly used
• - the antibody or ELISA test - detects HIV
antibodies in a person's blood. It is necessary to
wait at least 3 months after the last possible
exposure before having an HIV antibody test, to
be certain of an accurate result.
HIV Transmission
•
•
•
•
•
Unprotected sexual intercourse with an infected person: Sexual
intercourse without a condom carries the risk of HIV infection.
Contact with an infected person's blood: If sufficient blood from
somebody who has HIV enters someone else's body, then HIV can be
passed on in the blood.
Use of infected blood products: Many people in the past have been
infected with HIV by the use of blood transfusions and blood products
which were contaminated with the virus. In much of the world this is no
longer a significant risk, as blood donations are routinely tested for HIV.
Injecting drugs: HIV can be passed on when injecting equipment that
has been used by an infected person is then used by someone else. In
many parts of the world, often because it is illegal to possess them,
injecting equipment or works are shared.
From mother to child: HIV can be transmitted from an infected woman
to her baby during pregnancy, delivery and breastfeeding.
HIV Treatment
• Antiretroviral drugs keep the levels of HIV in the
body at a low level, so that the immune system is
able to recover and work effectively.
• Starting Antiretroviral drugs for HIV infection involves
commitment - drugs have to be taken every day, and
for the rest of a person's life.
• Adhering to HIV treatment is important, particularly
because not doing so increases the risk of drug
resistance.
• Side effects to the HIV drugs can make adherence
difficult, and are sometimes very severe.
HIV Prevention
• Abstinence
• Condoms - consistently and correctly
• Make sure HIV blood does not enter
your body!
AIDS
• Acquired Immune Deficiency Syndrome
• A person is diagnosed with AIDS when their
immune system is too weak to fight off
infections.
• Since AIDS was first identified in the early
1980s, an unprecedented number of people
have been affected by the global AIDS
epidemic. Today, there are an estimated 33.3
million people living with HIV and AIDS
worldwide.
AIDS Symptoms
• A person is diagnosed with AIDS when they have
developed an AIDS related condition or symptom,
called an opportunistic infection, or an AIDS related
cancer. The infections are called ‘opportunistic’
because they take advantage of the opportunity
offered by a weakened immune system.
• It is possible for someone to be diagnosed with AIDS
even if they have not developed an opportunistic
infection. AIDS can be diagnosed when the number
of immune system cells (CD4 cells) in the blood of an
HIV positive person drops below a certain level.
AIDS Testing
• HIV test
AIDS Treatment
• Antiretroviral treatment can prolong the
time between HIV infection and the
onset of AIDS.
Pubic Lice
• Also called crab lice or "crabs," pubic
lice are parasitic insects found primarily
in the pubic or genital area of humans.
• Pubic lice infestation is found worldwide
and occurs in all races, ethnic groups,
and levels of society.
What do pubic lice look like?
Pubic Lice
• Pubic lice have forms:
• the egg (also called a nit)
• the nymph,
• the adult
Nit
• Nit: Nits are lice eggs.
• They can be hard to see and are found
firmly attached to the hair shaft.
• They are oval and usually yellow to
white.
• Pubic lice nits take about 6-10 days to
hatch.
Nymph
• Nymph: The nymph is an immature
louse that hatches from the nit (egg).
• A nymph looks like an adult pubic louse
but it is smaller.
• Pubic lice nymphs take about 2-3 weeks
after hatching to mature into adults
capable of reproducing.
• To live, a nymph must feed on blood.
Adult
• Adult: The adult pubic louse resembles a miniature
crab when viewed through a strong magnifying glass.
• Pubic lice have six legs; their two front legs are very
large and look like the pincher claws of a crab. This is
how they got the nickname "crabs."
• Pubic lice are tan to grayish-white in color.
• Females lay nits and are usually larger than males.
• To live, lice must feed on blood. If the louse falls off a
person, it dies within 1-2 days.
Where are pubic lice found?
• Pubic lice usually are found in the genital
area on pubic hair; but they may occasionally
be found on other coarse body hair, such as
hair on the legs, armpits, mustache, beard,
eyebrows, or eyelashes.
• Lice found on the head generally are head
lice, not pubic lice.
• Animals do not get or spread pubic lice.
Symptoms of Pubic Lice
• Itching in the genital area
• Visible nits (lice eggs) or crawling lice
How is it transmitted?
• Pubic lice usually are spread through sexual contact and are
most common in adults.
• Occasionally, pubic lice may be spread by close personal
contact or contact with articles such as clothing, bed linens, or
towels that have been used by an infested person.
• A common misconception is that pubic lice are spread easily by
sitting on a toilet seat. This would be extremely rare because
lice cannot live long away from a warm human body and they do
not have feet designed to hold onto or walk on smooth surfaces
such as toilet seats.
• Persons infested with pubic lice should be examined for the
presence of other sexually transmitted diseases.
How is it diagnosed?
• A pubic lice infestation is diagnosed by finding a "crab"
louse or egg (nit) on hair in the pubic region or, less
commonly, elsewhere on the body (eyebrows, eyelashes,
beard, mustache, armpit, perianal area, groin, trunk,
scalp).
• Pubic lice may be difficult to find because there may be
only a few.
• Pubic lice often attach themselves to more than one hair
and generally do not crawl as quickly as head and body
lice.
• If crawling lice are not seen, finding nits in the pubic area
strongly suggests that a person is infested and should be
treated.
Treatment
• A lice-killing lotion.
• These products are available over-thecounter without a prescription at a local drug
store or pharmacy.
• These medications are safe and effective
when used exactly according to the
instructions in the package or on the label.
Prevention
• ABSTINENCE
• Correct and consistent use of condoms
• Avoid contact with other people’s
personal items:
• Bed linens
• Towels
• Clothes
Lymphogranuloma Venereum
• LGV
Trichomonaisis
• Trichomoniasis
Syphilis
• Syphilis
Hepatitis B
• http://yourstdhelp.com/hepatitis.html