Download Sexually Transmitted Diseases/Infections (STDs/STIs)

Sexually Transmitted
Diseases/Infections
(STDs/STIs)
Infectious diseases spread from
person to person through sexual
contact
What is a Sexually
Transmitted Disease?

Diseases you can get by having sex –
vaginal, oral, or anal – with someone who
is already infected.
STDs in the United States
An estimated 65 million people in the
United States are living with an incurable
STD
 Every 8 seconds, a teenager gets a STD
 1 in 10 teenagers is infected with a STD
 Each year, more than 15 million Americans
become infected with a STD.

– ¼ of these are teens
– 2/3 are under the age of 25
A Silent Epidemic
Epidemics – occurrences of diseases in
which many people in the same place at the
same time are affected
 Why are they spreading so quickly?

– Many STDs are asymptomatic – showing no
signs/symptoms
 Don’t get treatment because they don’t know they’re
infected
– Don’t like to talk about it
– People are scared or embarrassed to get tested
STDs are a growing problem

Rates of STD’s have steadily increased
– 1960’s = 2 STD’s of major concern – syphilis
and gonorrhea (both can be cured)
– Today = more than 25 STD’s

1 in 4 sexually active adolescents will
become infected before graduating high
school
High-Risk Behaviors and STDs
Being sexually active with more than one
person
 Engaging in unprotected sex
 Selecting high-risk partners
 Using alcohol and other drugs

Teen are at a higher risk

Teenager’s bodies may not fight infections
as well as the bodies of healthy adults
– Their immune systems are still developing
How are STDs spread?

ALL SEXUAL ACTIVITY
– Any type of sexual activity that brings an uninfected
person in contact with body fluids from an infected
person
– Any sexual activity that results in contact between one
person’s genitals and another person’s skin or mucous
membranes, in which one of the persons is already
infected with an STD
– Direct contact with open sores

A mother to her baby before birth, during birth, or
during breast-feeding
Consequences of STDs
Some STDs are incurable
 Can cause cancer
 Can cause complications that affect the
ability to reproduce
 Some STDs can be passed from an
infected female to her child before,
during, or after birth

Importance of Abstinence
Only 100% way to prevent STDs!!!
 A majority of teens (54.4%) in high school
choose abstinence

Set your boundaries early!!!
PHYSICAL INTIMACY
Eye to body
Eye to eye
3. Voice to voice
4. Hand to hand
5. Hand to shoulder
6. Hand to waist
7. Face to face
8. Hand to face
9. Hand to body (over clothes)
10. Touching above waist (under clothes)
11. Touching below waist (under clothes)
12. Intercourse – vaginal, oral, anal
1.
2.
9-12 = Sexual Activity
STDs caused by Bacteria
Chlamydia, Gonorrhea
Syphilis
Chlamydia

Most common Bacterial STD
– 2 million people currently infected
– 3 million more will acquire it this year

Transmitted
– Through sexual activity
– During childbirth
Symptoms of Chlamydia
85% of women and 40% of men have no
symptoms
 Vaginal or urethral discharge
 Burning with urination
 Pelvic Pain (women)
 Swelling and tenderness of the scrotum
(men)
 Genital ulcers

Long-term effects of Chlamydia

Pelvic Inflammatory Disease (PID)
– Can damage the fallopian tubes and result in tubal
scarring and infertility
 Causes 25% of the infertility in women pursuing in vitro
fertilization in the US
– Symptoms





Pelvic and abdominal pain
Fever
Abnormal vaginal bleeding
Ectopic (tubal) pregnancy
Infants
– Illness
– Blindness
Diagnosis and Treatment
Diagnosis – lab test (genital fluids or
urine)
 Treated easily IF caught early
 Treatment

– Oral antibiotics
– Newborn infants routinely receive antibiotic
eye drops/ointment to prevent eye infection
Gonorrhea – Skin Lesion
Gonorrhea – skin lesion on heel
Gonorrhea – in eye
Symptoms of Gonorrhea
Discharge from vagina or urethra
 Pain during urination
 Abnormal vaginal bleeding (“spotting”) –
women
 Pain and swelling around the testicles –
men
 25-80% of women and a smaller
percentage of men have no symptoms

Long-term effects of Gonorrhea
Pelvic Inflammatory Disease
 Pregnant women

– Spontaneous abortion
– Premature rupture of membranes
– Preterm birth
– May infect amniotic fluid
 Blindness
 Joint infection
 Life-threatening blood infections
Diagnosis and Treatment
Diagnosis – Body fluids will be examined
and tested
 Treatment

– Oral or injectable antibiotics
– After treatment, infected individuals should be
re-examined and tested again
Syphilis

Number of cases is again on the rise
– Between 1940’s and 2000 – number of cases fell from
approximately 100,000 to less than 6,000
– Today, beginning to rise again (36,000)

Called “The Great Imitator”
– Many of the signs/symptoms resemble other diseases

Transmitted
– Sexual activity
– Contact with syphilitic sores
– Passed to infants during childbirth
Symptoms of Syphilis

Primary Stage (10-90 days after infection)
– Single sore (chancre)
 Firm, round and painless
 Occurs at spot where Syphilis entered body
 Heals in 3-6 weeks if left untreated

Secondary Stage (2-8 weeks after
infection)
– Itch-less rash
– Flu-like symptoms
 Fever, swollen lymph glands, sore throat, patchy
hair loss, headaches, weight loss, muscle aches
and fatigue
Secondary syphilis- rash on palms
of hands
Symptoms (cont)

Latent stage (2 or more years after)
– Signs disappear and think cured
– Attacks heart, blood vessels, and CNS

Late stage (10 to 30 years after)
– Heart, skin, brain, spinal cord affected
– Cannot be cured at this stage
Diagnosis and Treatment
Diagnosis – blood test
 Treatment

– Can be cured if caught early
– Antibiotic
 Will not repair or reverse the damage already
caused by the disease
 A single intramuscular injection of penicillin, an
antibiotic, will cure a person who has had syphilis
for less than a year.
STD’s caused by Viruses
HPV, Genital herpes, Hepatitis, HIV
CANNOT BE CURED!!!
Human Papilloma Virus (HPV)

More than 100 strains of HPV
– 40 cause genital infections


6.2 million Americans are infected with genital HPV each
year
50% of sexually active Americans are or have been
infected
– 20 million currently have the virus
– Another 80 million have been infected some time in the past
In 90% of cases, the body’s immune system clears the
HPV infection naturally within two years
 By the age of 50, 80% of women will have acquired
genital HPV
 Transmission

– Skin-to-skin contact
– Contact with infected body fluids
Symptoms of HPV
Most patients have no symptoms
 Genital and Anal Warts

– 7% of infected people
Long-term effects of HPV
Cervical Cancer – Women
 Genital Cancers – Men

Diagnosis and Treatment

Diagnosis
– abnormalities detected on a Pap Smear – women
– Most asymptomatic men do not know they are
infected

Treatment
– Topical medications applied to the wart
 Decrease in size and disappear
– Surgical removal (burning with a laser)
– Freezing

Even with treatment, warts will often return
Genital Herpes

Most common sexually transmitted viral infection
in US
– 45 million people infected
– 1 in 5 American age 12 or over have genital herpes

2 types of herpes
– HSV-1 and HSV-2
– Most cases of genital herpes are HSV-2
 HSV-1 can be transmitted to genitals via oral sex

Greatest risk factor is the total number sexual
partners a person has had in their life
Transmission of Herpes

Skin to skin contact
– Kissing with a sore
– Touching a sore
– Sexual activity
Exposure to infected body fluids
 During childbirth

Symptoms of Herpes

Initial infection
– Fever, headache and muscle aches
– Lesions appear in area of exposure
 Blisters which break and become ulcers
 About 8 days after exposure
 Painful and often burn or itch

Other symptoms
– Burning with urination, vaginal or urethral discharge,
tender swollen lymph nodes

Recurrent outbreaks
– Skin lesions
Long-term effects of Herpes
NO CURE!!!
 Can transmit to others even at time when
not experiencing symptoms
 90% will experience at least one
recurrence within 12 months of initial
episode
 Recurrences can occur for the remainder
of the person’s life
 Risk of spontaneous abortion and
premature birth

Diagnosis and Treatment
Diagnosis – Viral cultures
 As many as 90% do not know they are
infected
 Treatment

– Anti-viral medications
 Reduces the duration and intensity of symptoms
Trichomoniasis
Caused by a Parasite
 Most common curable STD in young,
sexually active women 7.4 million new
infections occur each year in the US
 Increases the risk of contracting HIV
 Transmission

– Sexual contact
Symptoms of Trichomoniasis
50-80% of women and some men don’t know
they are infected
 Women

– Vaginitis and/or Cervicitis







Men
Vaginal discharge
Abnormal vaginal bleeding
Cervical irritation
Swelling and irritation of the genitals
Itching of the vulva
Abdominal pain
– Urethritis
 Discharge from penis
 Burning during urination
Long-term effects
Premature rupture of membranes
 Preterm labor

Treatment

Oral medication (metronidazole)
Being Responsible About STDs
Seek medical help right away
 Complete the full course of medications
 Have follow up testing done
 Avoid all sexual activity while being
treated
 Notify ALL sexual partners

Contraceptives Don’t
Stop STDs
Safe Sex?
Safer… but not Safe Sex
Condoms
Thin sheath that is placed on an erect
penis to catch semen when a male
ejaculates.
 Most effective kind of condom is a latex
condom with a spermicide containing
nonoxynol-9
 Prevents pregnancy and HIV
 Does not prevent ALL STDs! (HPV or
Herpes)

With 100% Correct Condom Use
STD’s
Approx. risk reduction
Gonorrhea
50%
Chlamydia
50%
Syphilis
30-50%
Trichomoniasis
No evidence
HPV
No evidence
HIV
85%
Think about it. A condom covers one specific part of the body, right? Many
sexually transmitted diseases are spread through skin-to-skin contact.
Spermicide
Chemical that kills sperm
 Sold as jelly, foam, cream, film, or sponge
 Spermicides are most effective when used
along with other forms of contraception,
such as a condom
 Spermicides alone DO NOT protect
against HIV or STDs.

Birth Control Pills
Female hormones that are taken orally
every day to prevent ovulation or affect
the lining of the uterus so that it cannot
support and nourish a fertilized egg.
 Does NOT protect from STDs or HIV.

Think about it…

Approximately 1 in every 5 people using
condoms for pregnancy protection will get
pregnant during the first year
ABSTINENCE
100% WAY TO
AVOID GETTING
ONE OF THOSE!!
HIV and AIDS

AIDS – Acquired Immune Deficiency
Syndrome – a disease in which the immunes
system of the patient is weakened
– 1982 – 1600 cases were reported…700 deaths
resulted
– 2000 – AIDS was the 5th leading cause of death
among adults from 25-44 years

HIV – Human Immunodeficiency Virus – a
virus that attacks the immune system
– Causes AIDS
Teens at Risk

Teen have one of the fastest growing
rates of HIV
How HIV Attacks Cells
Invades certain cells of the immune system
– including T cells
 HIV attaches to cell surface
 Virus core enters cell and goes to
nucleus
 Virus makes a copy of its genetic
material
 New virus assembles at cell surface
 New virus breaks away from host cell
HIV and the Human
Body
As the number of viruses increase…the
number of T cells decrease…the immune
system is weakened
 Opportunistic infections – infections that
occur in individuals who do not have healthy
immune systems
 HIV is progressive

– It destroys the cells of the immune system over
many months or years

AIDS is the advanced stage of HIV
Transmission of HIV
HIV lives inside
cells and body
fluids
 Transmitted
though…

–
–
–
–
Blood
Semen
Vaginal secretions
Breast milk

NOT transmitted by
–
–
–
–
–
Toilet seats
Telephones
Food
Being in the same area
Casual physical
contact – shaking
hands and hugging
– Insect bites
– Sweat
– Sneezing
Transmission of HIV

Sexual intercourse (any form of sex)
– Secretions containing HIV can enter a partner’s blood
through tiny cuts in the body
– Increases with number of sexual partners
– Increases by having another STD that causes sores
 Chlamydia, herpes, gonorrhea, syphilis
Sharing needles
 Mother to baby

– Through the umbilical cord
– During delivery
– While nursing
Stages of HIV
A person in considered infectious immediately after
contracting the virus
 ½ of infected people develop symptoms 3-6 weeks
after becoming infected

– Fever, rash, headache, body aches, and swollen glands
– Symptoms tend to disappear within a week to a month –
mistaken for another viral infection (flu)

Asymptomatic stage – a period of time during which
a person infected with HIV has no symptoms
–
–
–
–
May last 6 months to 10+ years
Virus continues to grow
Can still be passed on to others
Immune system can keep up with the infection –
produces billions of new cells
Stages of HIV
Eventually, the immune system can’t keep up
 Symptomatic stage – the stage in which a
person infected with HIV has symptoms as a
result of a severe drop in immune cells

– Symptoms
 Swollen glands, weight loss, and yeast infections

AIDS
– Later stage where more serious symptoms appear
 Presence of HIV infection
 Severely damaged immune system
– Measured by number of helper T cells – less than 200 per
milliliter of blood
 Appearance of one or more opportunistic infections
Detecting HIV
EIA test – a test that screens for the presence
of HIV antibodies in the blood
 May be inaccurate

– Developing antibodies takes time
 False negative – the test is negative, but the person is
positive
 Most people will test positive in the first 3-4 weeks…but
some take up to 6 months
– Certain health condition
 Hemophilia, hepatitis, and pregnancy can lead to a false
positive – the test is positive, but the person does not
have the infection
Detecting HIV
If the EIA test is positive…person is tested
again
 If the repeat test is positive, another test
is performed
 Western Blot Test – WB – the most
common confirmation test for HIV in the
US

– Tests for viral load in blood
– If done properly, it has 100% accuracy
 HIV
positive = 2 EIA positive tests
and positive Western Blot Test
Availability of Health Services
No cure for HIV/AIDS
Drugs treat HIV and treat and prevent the
complications of opportunistic infections
 Drugs and vaccines are being researched


– To improve the quality of life
– Hard to find a cure
 HIV infects the cells that regulate the immune system
 New strains of the virus have emerged

Treatment downfalls
– Side effect so severe, many people can’t stand to take
medicine
– Expensive - $1000+ per month
– Worldwide people don’t have access to treatment
History of HIV/AIDS
1981: Clusters of previously rare
diseases noticed in both LA and NYC
 1982: Collection of symptoms is named
AIDS – 14 nations report cases of AIDS
 1984: 7,000 Americans have AIDS
 1986: AIDS-causing virus is named HIV;
first drug treatment for AIDS developed
 1988: December 1 is declared annual
World AIDS day

History of HIV/AIDS
1989: Several new drugs available to treat
opportunistic diseases; FDA approves first drug
treatments for more than trial use
 1990: Estimated number of AIDS cases
worldwide = 1 million
 1991: Red ribbon announced as international
symbol of AIDS; scientists report that drugs
have limited use because HIV develops
resistance to them; 1 million cases of AIDS and
133,000 death from the disease reported
worldwide since 1882
 1992: First combination drug therapy approved

History of HIV/AIDS
1994: Studies show that drug treatment greatly
reduces risk of HIV transmission from an
infected mother to her baby
 1998: First trial of an AIDS vaccine begun using
5,000 US volunteers; estimates are that 70% of
all new infections and 80% of all AIDS deaths
are occurring in sub-Saharan Africa
 2002: The disease is the 4th leading cause of
death in the world; an estimated 40 million
people around the world are living with
HIV/AIDS

A continuing problem

Number of reported AIDS cases in
industrial world is decreasing
– Availability of drug cocktails –
combination of drugs – slow the
progression of HIV
False security – research has
identified new, drug-resistant
strains
 Pandemic – a global outbreak of
infectious disease – 40 million
people infected worldwide (2002)

Staying safe
Knowledge is the best defense!
 Abstinence from sexual activity or using
drugs

– Avoid pressure situations
– Practice refusal skills
– Choose relationships carefully