Sexually Transmitted Diseases

1. Sexually Transmitted Diseases Chlamydia HPV Genital Herpes HIV/Aids Gonorrhea Syphilis Trichomoniasis Pelvic Lice

2. Chlamydia • Bacterium that is spread by sexual contact and infects the genital organs of males and females. • Approximately 975,000 new cases are reported each year. • Adolescent girls have a particularly high rate of infection.

3. Chlamydia Symptoms: • Men: • Thin, usually clear discharge and mild discomfort on urination, appearing 7 to 14 days after infection. • 50 percent of cases are asymptomatic. • Women: • 75 percent of cases are asymptomatic. • Diagnosis: • Men - urine sample • Women - cell sample from cervix or urine sample.

4. Chlamydia Treatment: • Curable with azithromycin or doxycycline; does not respond to penicillin. • Poorly treated or undiagnosed cases may lead to: • urethral damage • epididymitis (infection of the epididymis) • Reiter’s syndrome • proctitis in men who had anal intercourse • Pelvic Inflammatory Disease (PID) • Problems with pregnancy and risks for newborn infants of infected mothers

5. Chlamydia Risks from Pelvic Inflammatory Disease: Possible infertility, due to scarring of the fallopian tubes Ectopic (tubal) pregnancy Chronic pelvic pain

6. Chlamydia Prevention: Many infected people are asymptomatic and spread the disease unknowingly. Screening programs can identify, treat, and cure asymptomatic carriers. The best method of prevention is the consistent use of a condom.

7. HPV • Human papillomaviruscauses genital warts: • Around the urethral opening of the penis • On the shaft of the penis • On the scrotum • On the vulva • On the walls of the vagina • In the cervix • On the anus

8. HPV The majority of people infected with HPV are asymptomatic. HPV is the single most important risk factor for cervical cancer. Also associated with cancer of the penis and the anus. Individuals infected by oral sex have an increased risk of cancers of the mouth and throat.

9. HPV • Diagnosis is done by inspecting the warts or analyzing DNA of the patient. • Several treatments are available: • Podophyllin acid or bichloroacetic acid - applied directly to the warts • Cryotherapy - warts are frozen off • Laser therapy can also be used to destroy the warts. • Several vaccines are currently being tested.

10. Genital Herpes • A disease of the genital organs caused by a herpes simplex virus (HSV-1or HSV-2). • Symptoms - small, painful bumps or blisters • Usually found on the vaginal lips, penis, or anus.

11. Genital Herpes Treatment: Drug acyclovir prevents or reduces recurring symptoms, but there is no cure. Valacyclovir and famciclovir are new drugs that are even more effective at shortening outbreaks and suppressing recurrences. Scientists are actively working to create an immunization against herpes.

12. Genital Herpes Complications: • Meningitis • Narrowing of the urethra due to scarring • Increased risk of becoming infected with HIV • Transfer of virus from mother to infant in childbirth • Psychological consequences need to be taken as seriously as the medical consequences. • One highly effective treatment program combines information on herpes, relaxation training, stress management training, and imagery technique.

13. HIV Infection and AIDS • AIDS - acquired immune deficiency syndrome • HIV - human immune deficiency virus; the virus that causes AIDS. • Opportunistic diseases make take over once HIV has damaged an individual’s immune system.

14. HIV Infection and AIDS By the end of 2005, more than 1 million persons in the United States had been diagnosed with AIDS; 550,000 had died from it. It is estimated that 40 million are infected with HIV worldwide. In the early years of the U.S. epidemic, gay male sex accounted for the majority of cases. Today, women are the fastest growing group for new HIV infection.

15. HIV

16. HIV Infection and AIDS Watch Gapminder video here!

17. HIV Infection and AIDS Transmission: Exchange of body fluids Contaminated blood and needles From infected woman to baby during pregnancy, childbirth, or breastfeeding

18. HIV Infection and AIDS Transmission: Anal intercourse is the sexual behavior most likely to spread AIDS. Heterosexual, penis-in-vagina intercourse spreads HIV as well. The greater your number of sexual partners, the greater your risk of getting infected with HIV. Condoms are 87 percent effective in protecting against HIV transmission during heterosexual intercourse.

19. HIV • HIV is one of a group of retroviruses • Retroviruses reproduce only in living cells of the host species, in this case humans. • HIV invades a group of white blood cells (lymphocytes) called T-helper or T4 cells. • These cells are critical to the body’s immune response in fighting off infections. • When HIV reproduces, it destroys the infected T cell.

20. HIV • The Centers for Disease Control has established the following categorization of HIV infection: • Early Stage – initial infection • Middle Stage – may have no symptoms • AIDS

21. HIV Diagnosis: • Two major tests for HIV infection: • ELISA (enzyme-linked immunosorbent assay) - blood test that detects the presence of antibodies to HIV • Produces a substantial number of false positives. • Western blot or immunoblot method • Highly accurate though more expensive and difficult to perform.

22. HIV Diagnosis: • ELISA test involves a waiting period of more than a week before results are known. • OraQuick rapid HIV test for blood and OraQuick rapid HIV test for oral fluid both provide test results in 20 to 30 minutes. • Both tests must be done in clinics.

23. HIV Treatment: No cure for AIDS. AZT (azidothymidinezidovudine, ZDV) stops virus from multiplying. DDI (dideoxyinosine or didanosine) slows the progression of the disease. DDC (dideoxycytidine) stops the virus from replicating.

24. HIV Treatment: • Protease inhibitors - attack the viral enzyme protease, which is necessary for HIV to make copies of itself and multiply. • HAART (highly active anti-retroviral therapy) • Patients take a “drug cocktail” of protease inhibitor combined with AZT and another anti-HIV drug. • Helping people survive much longer • Concern about the emergence of resistant strains

25. HIV • HIV/AIDS is now the fifth leading cause of death for U.S. women between the ages of 25 and 44. • Leading cause of death for African American women between the ages of 25 and 34. • Intervention programs should include sexual assertiveness training, in which women are empowered to insist that their sex partners use condoms.

26. HIV • Children become infected: • From an infected mother at birth (89 percent) • Because of hemophilia (4 percent) • From transfusions of contaminated blood (6 percent) • African Americans • 12 percent of population • 50 percent of AIDS cases • Hispanics • 13 percent of the population • 18 percent of AIDS cases • Asian Americans and Native Americans have less than 1 percent of cases.

27. HIV • Many patients experience a reaction that is a typical response to receiving a diagnosis of incurable disease. • Denial of the reality • Anger • Depression • AIDS is a socially stigmatized disease.

28. HIV/AIDS Progress in AIDS Research: • Vaccine • Researchers are working to develop a vaccine, but this is more difficult than was expected. • Research on Nonprogressors • HIV-infected people who go for 10 years or more without symptoms are being studied. • They have high levels of chemokines (HIV-suppressor factors), which can block HIV from entering cells.

29. HIV/AIDS Robust People: Studying people who resist infection may also yield clues to a vaccine or a cure. Some researchers believe that HIV’s property of rapid mutation could be used against it by forcing it to mutate to a harmless form.

30. Gonorrhea • Also called “the clap” or “the drip” • Caused by a bacterium • Oldest of the sexual diseases • Symptoms: • Men: pus-like discharge and painful, burning urination • Women: asymptomatic

31. Gonorrhea Diagnosis: • Men: • Sample of discharge is examined. • A urine test is also available. • Women: • Cervical discharge is taken and cultured. • A pelvic exam should also be performed in women. • Both: • A swab from the throat or rectum should be taken and cultured if necessary.

32. Gonorrhea Treatment: The traditional treatment was a large dose of penicillin or tetracycline. Ceftriaxone is highly effective antibiotic, even against resistant strains.

33. Syphilis Caused by the treponemapalliduma bacterium. Incidence is much less than that of gonorrhea or chlamydia. Can damage the nervous system and even cause death. Syphilis infection makes one more vulnerable to HIV and vice versa.

34. Syphilis • Major early symptom - chancre • A round, ulcerlike lesion with a hard, raised edge, resembling a crater • Syphilis proceeds in stages: • Primary-stage syphilis • Secondary-stage syphilis • Latent syphilis • Late syphilis • Congenital syphilis - passed from mother to infant.

35. Syphilis • Diagnosis: • Physical exam; examination of fluid from chancre • VDRL - fairly accurate blood test; cheap and easy to perform • Treatment - antibiotics • Penicillin, tetracycline, or doxycycline • Total elimination of syphilis seems to be a feasible goal.

36. Viral Hepatitis There are 5 types of viral hepatitis but hepatitis B is of most interest in a discussion of STDs. People with long-term hepatitis B may develop serious liver disease involving cirrhosis or cancer. Treatment - rest, symptom relief, antiviral treatments Prevention - vaccine for hepatitis B.

37. Trichomoniasis • Caused by Trichomonasvaginalis protozoan. • Transmitted mainly through sexual intercourse. • Occasionally transmitted nonsexually -organism can survive on toilet seats and other objects • Can lead to pelvic inflammatory disease and problems with birth.

38. Pelvic Lice (Crabs) Tiny lice that attach to the base of pubic hairs and feed on blood from their human host. Symptom - itching Treatment - Nix and Rid both are available without prescription.

39. Prevention of STI’s Abstain from sexual activity. Limit oneself to monogamous relationship with an uninfected person. Condoms can help. Careful washing and inspecting of genitals. Urinating before and after intercourse helps keep bacteria out of the urethra.

40. Other General Infections • Vaginitis– • Vaginal inflammation or irritation. • Monilia(candida) – • Yeast infection. • Bacterial vaginosis • Cystitis – • Infection of the urinary tract or bladder in women. • Prostatitis – • Inflammation of the prostate gland.