Chapter 8: STIs

1. Chapter 8: STIs Leonora Mendiola Erik Humbert Christine Nguyen HSC 425 (Matza) TuTh 2PM

2. Introduction • STI: Sexually Transmitted Infection • STD: Sexually Transmitted Diseases

3. Common Myths Most activities don't spread STDs! You cannot get an STD from everyday, nonsexual activities, such as: • sitting next to an infected person • sitting on toilet seats • sharing eating utensils • touching doorknobs • using swimming pools

4. Transmittance of STI’s “Most people think they would know if they had a sexually transmitted infection (STI) . . . wrong!” (ASHA) • STDs are spread through contact with infected body fluids, such as blood, vaginal secretions, or semen • sharing needles or syringes

5. The symptoms of STDs may include: • sores or blisters on or around the sex organs or mouth • pain or burning during urination • discharge from the penis or vagina that smells or looks unusual • itching, swelling, or pain in or around the sex organs

6. How can you avoid STDs? No Sex • Don't have sex. • Masturbation. • Massage • Kissing. • Fantasy. Having Sex: • Use barrier methods like latex condoms • Limit the number of partners you have. • Have regular physical exams. Ask you physician to test for STDs if you think you've been exposed. Regular tests help find STDs early, when treatment can be most effective.

7. Chlamydia • Infection caused by the Chlamydia trachomatis bacterium • Lives in cells in bodily fluids (ex: vaginal secretions and semen) • One of the most commonly diagnosed and reported STIs in the U.S. • Infection rate in women is 3X that in men • Often produces NO noticeable symptoms (especially in women) • Bacterium is HIGHLY contagious with or without symptoms! • Most common in men/women under the age of 25

8. Symptoms • 75% of women, 50% man do not experience noticeable symptoms • If untreated, symptoms present will usually diminish and disappear within a month (but remains highly transmissible) • Most common symptom: thick, cloudy discharge (greater in quantity and cloudier than normal female discharge)

9. Other Symptoms Symptoms in Women Symptoms in Men discharge from penis burning sensation during urination inflammation at urethral opening in the morning, the urethral opening may be red and sealed together (dried secretions) • pelvic pain • irregular periods • increased menstrual pains • discomfort during urination • irritation of vaginal or anal area

10. Serious Health Problems • If untreated, commonly leads to reduced fertility in men and women • Women: Pelvic inflammatory disease (PID) • inflammation of the uterus, fallopian tubes, and ovaries • permanent infertility, chronic pelvic pain, and tubal pregnancy • Men: • Urethritis: inflammation of the urethra • Epididymitis: painful swelling/inflammation of the epididymis

11. Transmission • Sexual contact: Oral, vaginal, and anal sex • Easily transmitted during one sexual encounter • Chlamydia can infect the throat (oral sex) and eyes (contact) • Can pass from mother to infant: serious health problems for infant

12. Diagnosis • Health care professional: doctor’s office or clinic • Urine sample: microscopic C. trachomatis bacterium • Discrete home tests now available: test urine, vaginal/penile swab • http://home-bio-test.com • http://www.privatediagnostics.com • Yearly screening is recommended for women: under 25, with multiple/new sex partners, or pregnant • Get tested regardlessof the presence of symptoms

13. Hepatitis B Virus (HBV) • Hepatitis: inflammation of the liver • Hepatitis B is the only strain sexually transmitted • 5% of the U.S. population • 45,000 new cases of Hepatitis each year

14. Symptoms • No symptoms until virus is active and affects the liver (1-6 months of exposure) • Jaundice: yellowing of skin and eyes • Loss of appetite • Fatigue • Abdominal pain • Nausea • Vomiting • Darkening of urine • Rash • Joint pain

15. Serious Symptoms • In 90% of cases, the patient fully recovers and no longer carries the virus • In 10% of those infected as adults become chronically infected, lifelong carrier of virus • 10-15% of chronic carriers develop serious liver disease: • Cirrhosis of the liver • Liver cancer • May lead to liver failure • Without transplant: death

16. Transmission • Spread by direct contact with contaminated blood products: semen, vaginal fluid, and saliva (rare) • Infected bodily fluids enter bloodstream of another • Common routes of transmission: sharing needles, sexual contact, tattooing, and body piercing • Pregnant women can infect infant during pregnancy, birth, or breastfeeding • Riskiest behaviors: unprotected vaginal, anal and oral sex, and oral-anal activities

17. Diagnosis and Treatment • Jaundice indicates HBV, confirmed by a blood test • Virus may not be detectable during incubation period:1-4 months after contracting virus, antibodies are not yet present (can still be transmittable) Acute infection treatment: • Treatment options are limited: • Body usually resolves an acute infection • Acute infections: bed rest, increased fluid intake, good nutrition, avoidance of alcohol • Symptoms last 4-12 weeks, virus gone in 6 months

18. Treatment (Continued) Chronic infection treatment: • Antiviral medications (7 approved for HBV) • Meds do not cure • Slow virus multiplication which helps prevent inflammation that can lead to liver damage • Prevention: HBV vaccine available (required in most public schools) • Vaccine: series of 3 injections over 6 months for lifetime immunity

19. Human Immunodeficiency Virus(HIV)

20. Background History • Believed to have been originated in West Africa • First human case noted in 1959 in Kinshasha, Democratic Republic of Congo • Simian Immunodeficiency Virus  Human Immunodeficiency Virus (SIVHIV) • Chimpanzee hunting • Believed to have originated in America in mid to late 70’s • Discovered through observations of rare kinds of cancer, pneumonia, and other illnesses by doctors in Los Angeles and New York. • Treatments being discovered, but no cure

21. West Africa/Congo

22. What is HIV? • Human- Virus can only affect humans • Immunodeficiency- weakens your immune system by destroying certain cells (t-cells) that fight disease and infection • Virus- can only reproduce itself by taking over a cell in the host’s body • *HIV and AIDS are not necessarily the same thing!*

23. What is AIDS? • Acquired- Something you get after birth, cannot be born with AIDs • Immunodeficiency- When your immune system is deficient or not working properly (t-cells) • Syndrome- AIDS is a syndrome, unlike HIV that is a virus. It is a collections of symptoms and diseases that has a wide variety of complications and symptoms • *LAST STAGE of HIV* *Dependent on HIV*

24. Prevalence(Who gets it most?) • People who have unprotected sex more likely. (vaginal and anal) • Sharing drug equipment also a factor • African Americans (Economic) • Gay/Bisexual Men (Anal)

25. Genital Herpes

26. Basic Genital Herpes Info • Very common STD found in people that are sexually active • Genital Herpes is caused by two types of herpes • Herpes Simplex type 1 • Herpes Simple type 2

27. Herpes Simplex 1 • Also known as cold sores • Not just on lips. (Mouth, ears nose) • Rare cases that HSV 1 can cause sores on genitals • Spread through kissing, or sharing drinks/eating utensils • One time is all it takes (Vegas) • No symptoms no problem? Not true

28. YUMMMMMM

29. Herpes Simplex 2 • Genital herpes • Spread through sexual activity from infected partner to non-infected partner • Most symptoms and signs occur on the genitals • Rare cases can cause facial sores • No symptoms no problem? Not true

30. Yummmmmmm

31. Other Herpes Facts • 20% of sexually active adults in America have genital herpes. • Women more likely than men to get genital herpes • No cure, but antivirals can help sores heal faster • People with genital herpes may still have sex.

32. Human Papillomavirus • HPV is a different virus than HIV and HSV (herpes) • There are many different types of HPV. Some types can cause health problems including genital warts and cancers. • You can get HPV by having oral, vaginal, or anal sex with someone who has the virus

33. How is HPV spread? • You can get HPV by having oral, vaginal, or anal sex with someone who has the virus • Anyone who is sexually active can get HPV, even if you have had sex with only one person • HPV can be passed even when an infected person has no signs or symptoms.

34. Health Problems with HPV • Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower • HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils.

35. How can I avoid HPV and the health problems it can cause? • Get vaccinated. HPV vaccines are safe and effective • They can protect males and females against diseases (including cancers) caused by HPV when given in the recommended age group • Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas that are not covered by a condom - so condoms may not give full protection against getting HPV

36. Trichomoniasis • Trichomoniasis (or “trich”) is a very common sexually transmitted disease (STD) that is caused by infection with a protozoan parasite called Trichomonasvaginalis • Trichomoniasis is considered the most common curable STD. In the United States, an estimated 3.7 million people have the infection

37. What are the signs and symptoms of trichomoniasis? • Infection is more common in women than in men, and older women are more likely than younger women to have been infected. • they can range from mild irritation to severe inflammation. Some people with symptoms get them within 5 to 28 days after being infected, but others do not develop symptoms until much later. Symptoms can come and go.

38. What is the treatment for trichomoniasis? • Trichomoniasis can be cured with a single dose of prescription antibiotic medication (either metronidazole or tinidazole), pills which can be taken by mouth • Using latex condoms correctly every time you have sex will help reduce the risk of getting or spreading trichomoniasis. However, condoms don’t cover everything, and it is possible to get or spread this infection even when using a condom. 

39. Gonorrhea Neisseria gonorrhoeae bacterium

40. What is it? • Also known as “The Clap” or “The Drip” • A sexually transmitted disease that is can infect both men and women • Cause infection in the genitals, rectum and throat • Most common reported notifiable disease in U.S. • Most common in ages ranging from 17 to 25 years

41. Transmission • Can be transmitted… • Anally • Orally • Vaginal intercourse • During child birth • Conjunctivitis • Complications of conjunctivitis

42. Environment • Gonorrhea thrives in • Warm and moist environment provided by the mucous membrane lining in the… • Mouth • Throat • Vagina • Cervix • Urethra • rectum

43. Symptoms for Men • Watery discharge • Itching or burning at the urethral opening • Pain when urinating • Could also produce symptoms of… • Yellow or greenish discharge • Increasing discomfort • Painful or swollen testicles

44. Symptoms for Women • Up to 80% of women show no symptoms • If symptoms occur • Thick yellow or white vaginal discharge with a bad odor that may be bloody • Burning sensation during urination • Unusual pain during menstruation • Severe lower abdominal pain • Pelvic Inflammatory Disease (PID) • Pain in lower abdomen • Fever • Pain and/or bleeding during intercourse • Burning sensation during urination • Bleeding between periods • Treatment?

45. Complications of Gonorrhea • May cause • Sterility in both sexes • Ectopic Pregnancy • Prostate Damage • Epididymitis • Scaring of the urethra in men • Testicular pain • Gonorrhea and HIV • Treatment?

46. Pubic Lice Phrhirus pubis

47. What is it? • Also known as crabs • Parasitic insects found primarily in the pubic or genital region of humans • Must feed on blood • Pubic lice size • Different lifecycles

48. Lifecycles of Pubic Lice • Usually grasp adjacent hairs when mating • Females soon lay nits (lice eggs) and attaches them to the hairs • Rate: 3 eggs a day for about 7-10 days • Nits hatch within 6-10 days and then begin reproducing in about 2-3 weeks after nymph stage

49. Transmission • Moves easily from the hair of one person to that of another • Can be transmitted during sexual contact • They could also be transmitted through… • Underwear • (Bed) Sheets • Towels • Wearing an infected person’s clothing • Can survive for up to a day AND lay eggs in these environments!

50. Thriving Environment • Usually found in the genital area on the pubic hair • It can also be found in… • Hair on the legs • Armpits • Mustache • Beard • Anywhere there is coarse hair