Download Sexually Transmitted Diseases - McGraw Hill Higher Education

Chapter 15
Preventing Sexually
Transmitted Disease
A Wellness Way of Life
Ninth Edition
Robbins/Powers/Burgess
© 2011 McGraw-Hill Higher Education. All rights reserved.
Chapter 15 Objectives
After reading this chapter, you will be able to:
1.
2.
3.
4.
5.
6.
7.
Describe symptoms of AIDS and the most common
sexually transmitted diseases.
Identify the three curable and four incurable sexually
transmitted diseases.
Describe at least four ways HIV is transmitted.
Recognize the latency period for AIDS.
Identify three high-risk and three low-risk sexual
activities.
Discuss the five ways to deter unwanted sexual
behavior.
List three actions you can take to decrease the risk of
acquiring a sexually transmitted disease.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Sexually Transmitted Disease
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One in two sexually active people will acquire an
STD by age 24.
There are over 25 known STDs, some of which are
incurable.
More sexual partners increases risk.
Alcohol and drug use increases risk.
Risk is determined by your behavior, not your age
or sexual orientation.
Risk can be reduced or
eliminated through longterm monogamy or
abstinence.
If you are sexually active
you should get a
yearly screening.
© Thinkstock
© 2011 McGraw-Hill Higher Education. All rights reserved.
Curable and Incurable STDs
Bacterial (curable)
 Chlamydia
 Gonorrhea
 Syphilis
Viral (incurable)
 Genital herpes
 Genital warts
 Hepatitis B
 AIDS
© 2011 McGraw-Hill Higher Education. All rights reserved.
What are HIV and AIDS?
 AIDS is a syndrome or group of symptoms caused
by the Human Immunodeficiency Virus (HIV).
Symptoms include chronic fatigue, swollen lymph
glands, unexplained weight loss, fevers, and night
sweats.
 HIV attacks lymphocytes (white blood cells) called Tcells.
 The virus penetrates T-cells and forces them to
make copies of HIV which causes the T-cell to die.
 Fewer T-cells result in a weakened immune system
and risk for opportunistic diseases.
 HIV infection and certain opportunistic diseases or
HIV infection and a low T-cell count (200 or less) will
result in an AIDS diagnosis.
© 2011 McGraw-Hill Higher Education. All rights reserved.
How Is HIV Transmitted
 Through blood, semen, vaginal secretions
and breast milk.
 Through sexual intercourse with an HIV
carrier.
 Through sharing of hypodermic needles.
 By pregnant women to their fetus or mother to
their baby (breast milk).
 Rarely through a transfusion of blood.
© 2011 McGraw-Hill Higher Education. All rights reserved.
HIV: What is Safe?
Safe
 Casual contact.
 Hugging.
 Eating together.
 Massage.
 Masturbation.
 Insects (they do not
spread HIV).
Unsafe
 Vaginal sex.
 Anal sex.
 Oral sex.
 Deep kissing.
 Multiple partners.
 Sharing needles.
© 2011 McGraw-Hill Higher Education. All rights reserved.
AIDS Cases by Transmission Category and Gender
Figure 15-4
© 2011 McGraw-Hill Higher Education. All rights reserved.
Students and STDs
• Over 50% report having sexual intercourse
with more than one partner and sporadic or
no use of condoms – why??
• They feel invincible.
• They lack social skills and have low self-esteem.
• They engage in unwanted sexual behavior.
• They are victims of sexual assault.
• Society sends mixed messages.
• They share needles (mostly steroids).
© 2011 McGraw-Hill Higher Education. All rights reserved.
Should I Be
Tested?
You should be tested if:
 You have had any
STD.
 Shared drug needles.
 Had sex with a prostitute.
 Had sex with a man who had sex with another man.
 Had unprotected sex with three or more partners.
Remember that the test looks for HIV antibodies. It
could take 3 to 6 months before antibodies appear in
the blood. A person should have 6 months with no
risk behavior before a test can be accurate.
For more information contact your local health
department.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Chlamydia: bacteria Chlamydia
trachomatis
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Transmission
• Passed during direct sexual contact and hand to eye. 3 million cases
annually. (10% of college women infected).
Incubation
• Poorly defined, probably 7-14 days or longer.
Typical Symptoms
• Up to 80% of women and 50% of men have no symptoms. When
symptoms do occur, they are often mild. Symptoms include
discharge, itching and burning, painful urination, and flu-like
symptoms.
Diagnosis
• Culture tests of discharge collected from around the cervix and in the
urethra. Reliable and affordable.
Treatment
• Curable with certain antibiotics (not penicillin).
Danger
• If untreated, can cause Pelvic Inflammatory Disease.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Genital Herpes: Herpes Simplex
Virus (HSV)
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Transmission
• Direct contact with infectious blisters or sores usually on genitals,
anus, or mouth. May also be passed through asymptomatic viral
shedding.
Incubation
• 2-30 days
Typical Symptoms
• Painful blisters or sores form, break, crust over, and heal in 1 to 3
weeks. Sores may reappear throughout life, but heal faster, are less
painful and occur less frequently. Factors like stress, fatigue, and
other illness may bring on reoccurrences.
Diagnosis
• Visual examination and tissue culture.
Treatment
• No cure at present time. Medications (acyclovir) used to relieve pain,
shorten outbreak, or prevent infection in open sore.
Danger
• Can be fatal to infants who acquire the disease.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Genital Warts: Human Papilloma Virus
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Transmission
• Direct contact with warts in genital area. May be transmitted without
visible warts.
Incubation
• Range from 1-8 months. Some never become visible.
Typical Symptoms
• Flat or round bumps with cauliflower-like appearance occurring on
moist areas of genitals and anus. Many have no symptoms.
Diagnosis
• Visual examination, tissue cultures. Pap smears can detect warts
not visible. Common cause of cervical cancer.
Treatment
• Freezing, laser, chemical prep, and surgery. May not “cure” the
infection.
Danger
• HPV causes cervical cancer. Pap smears are important. There is
now a vaccine available.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Gonorrhea: bacteria
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Transmission
• Direct contact between mucous membranes, i.e., genitals, anus, and
mouth. Contaminated fingers can pass organism to the eye. People
can not get gonorrhea from objects.
Incubation
• Usually 2-14 days.
Typical Symptoms
• Genitals, anus, throat, and eyes can be infected. Symptoms include
discharge, burning and itching, painful urination, or a mild sore throat.
Up to 80% of women and 20% of men have no symptoms.
Diagnosis
• Microscopic observation of discharge. Culture from site.
Treatment
• Curable with antibiotics. Some strains may become resistant.
Danger
• Can cause PID and sterility in men and women.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Hepatitis B: virus
 Transmission
 Vaginal, anal and oral sex, sharing needles, and mother to
baby.
 Incubation
 1 – 9 months but people can carry the virus with no active
infection (and spread to others)
 Typical Symptoms
 Most have none or mild flu-like feelings, itching, and joint pain.
Eventually leads to liver enlargement and failure.
 Diagnosis
 Through a blood test.
 Treatment
 A vaccine is available.
 Dangers
 Progressive destruction of liver cells, cirrhosis, or liver cancer.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Syphilis: Bacteria Treponema Pallidum
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Transmission
• Direct contact with infectious sore or lesionous rashes.
Incubation
• 1 to 12 weeks before primary stage.
Typical Symptoms
• Primary: painless chancre sore at site of entry of germ and lasts 1–5
weeks. If not treated, leads to secondary syphilis.
• Secondary: 2 weeks to 6 months after chancre. Rash, flu-like
symptoms, patchy hair loss. Secondary will go away without
treatment, but will lead to latent syphilis.
• Latent: no longer infectious to carry bacteria and lead to tertiary.
• Tertiary Stage: 3 to 40 years later, damage to body organs such as
the brain and heart, paralysis and death.
Diagnosis
• Physical examination, microscopic test from sore, blood tests.
Treatment
• Cured with antibiotics. Tissue damage cannot be treated.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Other STIs
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Trichomonas – treatable parasite
Vaginosis – imbalance in bacteria
Chancroid – curable genital sore
Pubic lice – treatable parasite
Scabies – treatable parasite
Vaginosis, Pubic lice and Scabies can
occur without sexual contact.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Prevention of STDs
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Abstinence
• Avoid sexual intercourse. Infected persons should avoid intimate contact
with others when symptoms are present.
Stay Faithful
• Maintain a long-term trusted relationship with one uninfected partner who
is having sex only with you (monogamy). Use good communication.
Choose Lower Risk Behaviors
• No fluid exchange
Take Precautions
• Limit the number of sex partners and use a latex condom during the
entire sex act (vaginal, anal, and oral) before any direct contact.
Avoid Drug Use
• Mind-altering drugs, including alcohol, reduce our ability to reason, which
can lead to risky behavior and risky sex.
If you are sexually active
• Observe your partners for sores, discharge or needle tracts, and get an
STD exam every 6 months.
© 2011 McGraw-Hill Higher Education. All rights reserved.
How to Avoid an STD
• The only 100% guaranteed way to avoid getting an
STD:
**DON’T HAVE SEXUAL CONTACT**
• If you make a well thought-out decision to have
sexual contact:
• Stay with one sexual partner
• Choose your sex partner carefully
• Use condoms
• Wash genital area after having sex
• Urinate after sex
• If you think you might have an STD, see a doctor
• Get screened every 6 months if you have a new
partner
© 2011 McGraw-Hill Higher Education. All rights reserved.
How to Use a Condom
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•
•
Step 1
• Open the package only when you are ready to use it. Air, heat, and
light can spoil latex condoms. When you are opening the package, be
careful not to tear the condom. Put the condom on before penetration.
Step 2
• Squeeze the tip of the condom so there is no air trapped in the end.
This is important so there is room for the semen during ejaculation.
Unroll the condom onto the penis as soon as the penis becomes erect
and before the penis is used in any foreplay.
Step 3
• If you want to use a lubricant, make sure to use one that is water
based. Do not use oil-based lubricants such as Vaseline , baby oil,
vegetable oil, or cold cream. Oil-based lubricants break down the
latex in a condom, making it more likely to break.
Step 4
• After ejaculation, hold on to the condom at the rim and pull out while
your penis is still hard. If you wait until the penis is soft, the condom
may slip off and semen may spill out. Throw the condom away. Use it
only once.
• Female condoms are also available if the male is unwilling.
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How to Use a Condom
© 2011 McGraw-Hill Higher Education. All rights reserved.
Coping with Unwanted Sexual
Pressure and Avoiding Assault
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Attend parties with friends you can trust.
Be selective.
Avoid isolation.
Communicate your limits clearly.
Listen closely to what a person is saying. Ask for
clarification.
Make sure your actions agree with what you are saying.
Be aware of what is happening.
Speak up if you believe someone is at risk.
Stay sober!
No means No.
Don’t make assumptions about a person’s behavior.
Don’t assume that silence is consent for sex.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Coping with Unwanted Sexual
Pressure and Avoiding Assault
 What can a person do to prevent unwanted
sexual behavior?
 Build skills in assertiveness, self-esteem, decision
making, running a relationship, and dealing with
intimacy.
 If you are sexually assaulted, follow these steps:
 Once out of immediate danger, call the police.
 Do not do anything that might destroy evidence.
 Go with a trusted friend to the ER for a rape exam.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Rx for Action
• If you are sexually active and have not been screened for STDs
in the last year, call to schedule a checkup with you physician or
health clinic.
• Plan how you will deal with unwanted sexual pressure, and what
you can do to avoid an unsafe situation.
• Think about how you will bring up the subject of safer sex or
abstinence to a potential partner.
• Consider ways to express affection physically without sexual
intercourse.
• If you have questions about STDs, write them down and phone
an appropriate STD hotline listed at the end of this chapter.
• Download a fact sheet on STDs at www.cdc.gov/std/
© 2011 McGraw-Hill Higher Education. All rights reserved.
What Do You Think?
 Are you surprised that 50% of sexually active
people will get an STD before they are 24?
 What is your risk for contracting an STD?
 Have you ever thought about getting tested for
HIV?
 What are low-risk sexual behaviors?
 What actions can you take to decrease the risk
of acquiring an STD?
 Do you know how to reduce the risk of
unwanted sexual pressures or sexual assault?
© 2011 McGraw-Hill Higher Education. All rights reserved.
Questions?
© 2011 McGraw-Hill Higher Education. All rights reserved.