Sexually Transmitted Infections

1. Sexually Transmitted Infections Mr. Prall

2. Introduction • STI = Sexually Transmitted Infections • Can still be called STD (Sexually transmitted diseases) • Both were once called VD (Venereal Disease) • People of all ages and backgrounds can be affected. • Why use the term STI instead of STD? • When referring to the term “Disease” there are usually signs and symptoms. However, in the case of most STIs there are no signs and symptoms. • *Most STIs are asymptomatic, meaning they have no signs or symptoms.

3. Introduction cont. (Statistics) • Nineteen million new STIs occur each year, almost half of them among young people ages 15 to 24. • 10,000 teens are infected by STIs per day, one every eight seconds! • One out of every four sexually active teens has an STI, and one in two sexually active youth will contract an STI by age 25! • An estimated one in five Americans have genital herpes infection, and up to 90% of them don't know it. • Teens are also more likely to develop precancerous growths as a result of HPV infection, and these growths more likely to develop into invasive cancer. • *Most people with STIs don’t even know they have one!

4. STI types • Bacterial: • Gonorrhea • Chlamydia • Syphilis • Chancroid • Viral • Herpes • Hepatitis • HPV (Human papilloma virus) • HIV (Human immunodeficiency virus)

5. STI types cont. • Parasites: • Pubic Lice • Scabies • Trichomoniasis

6. Bacertial STIs • Gonorrhea • Chlamydia • Syphilis • Chancroid • Bacterial STIs are curable, however, if they are left untreated they can cause death!

7. Gonorrhea • Gonorrhea is caused by Neisseriagonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and in the urethra in women and men. The bacterium can also grow in the mouth, throat, eyes, and anus. • It can affect the penis, vagina, anus, urethra or throat. • It is sometimes called “the clap” or “the drip”. • It can be a serious health risk if not treated. 700,000 thousand men and women are affected every year.

8. Gonorrhea cont. • How do people get it? • Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread from mother to baby during delivery. • Who is at risk? • Any sexually active person can be infected with gonorrhea. In the United States, the highest reported rates of infection are among sexually active teenagers, young adults, and African Americans

9. Gonorrhea cont. • Signs and symptoms are… • May be asymptomatic in both males and females. • Men: Usually appear 1-14 days after infection. Symptoms may be a burning sensation while urinating, or a white, yellow, or green, discharge from the penis. Sometimes painful or swollen testicles appear. • Women: Painful or burning sensation while urinating, increased vaginal discharge, or vaginal bleeding between periods. • Can lead to PID in women (Pelvic Inflammatory Disease).

10. Gonorrhea cont. • Is it treatable? • Yes! It is easy to treat. You will need an antibiotic, and some are resistant to gonorrhea so you may need to take more than one dose. Both you and your partner should be treated again, this way you can avoid becoming infected again.

11. Chlamydia • Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis. • *Chlamydia is currently the common sexually transmitted infection in the United States. • About 3 million American women and men become infected with Chlamydia every year! • Chlamydia is 5 times as common as gonorrhea. • Chlamydia is more than 30 times as common as syphilis.

12. Chlamydia cont. • How do people get it? • Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth. Because the cervix (opening to the uterus) of teenage girls and young women is not fully matured and is probably more susceptible to infection, they are at particularly high risk for infection if sexually active. Since Chlamydia can be transmitted by oral or anal sex, men who have sex with men are also at risk for Chlamydia infection. • Who is at risk? • Any sexually active person can be infected with Chlamydia.

13. Chlamydia cont. • Signs and symptoms are… • Chlamydia is known as a "silent" disease because the majority of infected people have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure. • Men: Pain or burning during urination, burning or itching around the opening of the penis, or swollen or tender testicles. • Women: Abdominal vaginal discharge or pain while urinating, painful intercourse, bleeding between periods, or a yellowish discharge from the cervix that may have a strong smell.

14. Chlamydia cont. • Is it treatable? • Yes! You will need an antibiotic. One treatment can be taken in one dose, while another can be taken in 7 days. Both you and your partner must be treated for Chlamydia before you have sex again. This will help reduce re-occurance, which can happen.

15. Syphilis • Syphilis is a sexually transmitted disease (STD) caused by a microscopic bacteria called spirochete, the scientific name is Treponemapallidum. It has often been called "the great imitator" because so many of the signs and symptoms are indistinguishable from those of other diseases. • About 36,000 American men and women become infected with syphilis every year. • Most cases occurred in persons 20 to 39 years of age. •  The spirochete is a worm-like spiral-shaped organism. It infects the person by burrowing into the moist, mucous-covered lining of the mouth or genitals.

16. Syphilis cont. • How do people get it? • Syphilis is passed from person to person through direct contact with a syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. Transmission of the organism occurs during vaginal, anal, or oral sex. Pregnant women with the disease can pass it to the babies they are carrying. Syphilis cannot be spread through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils. • Who is at risk? • Any sexually active person can be infected with syphilis.

17. Syphilis cont. • What are the signs and symptoms? • Syphilis is unique because it has several stages that may overlap. • Primary stage: • A painless sore or open, wet ulcer, which is called a chancre, appears. You may have just one, or a few. Chancres appear about 3 weeks after infection. Without treatment they can last 3-6 weeks. Chancres can appear on the genitals, in the vagina, on the cervix, lips, mouth, breasts, or anus. Swollen glands may also occur during the primary stage.

18. Syphilis cont. • Secondary stage: • Other symptoms often appear 3-6 weeks after the sores appear. These syphilis symptoms may come and go for up to two years. They include body rashes that last 2-6 weeks (often on palms and soles of feet). Mild fever, fatigue, sore throat, hair loss, and weight loss are a few. • Late stage: • One out of three people that have it that is not treated suffer serious damage to the nervous symptom, heart, brain and other organs, and death may result. This can occur anywhere from 1-20 years after infection!

19. Syphilis • Is there treatment? • Yes! The early stages are easy to treat. You and your partner may need an antibiotic. However, keep in mind that any damage caused in the later stages cannot be redone.

20. Chancroid • It is an old STI making a comeback. • It is a bacterial infection with sores and swelling usually in genital area, but can be anywhere on the body in the form of bright read blisters or pimples with ragged edges. • Its primary danger is that the open sores make it easy to pick up other STDs, like HIV and AIDS virus. • Much more common in warm climates.  Less common in cooler climates but it's increasing.

21. Chancroid cont. • How do people get it? • Sexual contact (direct transmission) or from skin to skin contact with someone who has infected sores.  Sores may be in other places than the genitals.  You can get chancroid from a person who has no visible signs of having it.  • Who is at risk? • Anyone that has sexual intercourse, sexual contact, or oral and anal sex.

22. Chancroid cont. • Is it treatable? • It must be diagnosed and treated by a health professional who will prescribe proper antibiotic for cure.  Follow prescribed treatment and don't have sex until the sores go away. is it treatable?

23. Viral STIs • Viral • Herpes • Hepatitis • HPV (Human papilloma virus) • HIV (Human immunodeficiency virus)

24. Herpes • Genital herpes is a sexually transmitted infection caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). • Most genital herpes is caused by HSV-2 • Both HSV-1 and HSV-2 are easy to catch and remain in the body for life. • Both forms can affect the oral area, the genital area, or both. • *When the infection is on or near the mouth it is called oral herpes. Oral herpes is often caused by HSV-1 • *When an infection is on or near the sex organs it is called genital herpes. Genital herpes is often caused by HSV-2.

25. Herpes cont. • How do people get it? • HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to have a sore. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected • Who is at risk? • Anyone who has oral sex, vaginal sex, or anal sex, or anyone that has direct contact.

26. Herpes cont. • What are the signs and symptoms? • Most people have no symptoms, or they have very mild symptoms that go unnoticed. Some people don’t even recognize them as an infection. The first time herpes symptoms occur is referred to as “first episode”. • Both sexes: A crop of blisters that appear around the penis, vagina, cervix, anus, or mouth. They usually appear after 2 weeks of infection, and can last from 2-4 weeks. The sores are open sores, that can be tender and itchy.

27. Herpes cont. • Is it treatable? • Yes! You can take certain medications to help manage the infections. This will help speed up the healing of the sores, and prevent them from returning as frequently. • *Although herpes treatment is helpful, there is no cure! • Myth: Herpes can’t be transmitted through the sharing of toilet seats. The herpes virus dies out once exposed to the air. • Myth: You can still get herpes if your partner doesn’t have an outbreak, or shows signs and symptoms.

28. Hepatitis • The term hepatitis means “Inflammation of the liver”. There are more than 7 different types, but there are 3 types that are sexually transmitted. • The most common type spread sexually is hepatitis B. • It is spread through semen, vaginal fluids, blood and urine. • 46,000 men, women, and children become infected each year. • Hepatitis B (HBV) can lead to death!

29. Hepatitis cont. • How do people get it? • It is very contagious and is spread through an exhange of semen, vaginal fluids, blood and urine. Having unproteceted sexual intercourse, or oral sex with an infected person can transmit Hepatitis B. 9 out of 10 babies born by mothers with it will pass it to their child. • Who is at risk? • Anyone who has oral sex, vaginal sex, or anal sex, or anyone that has direct contact with an infected person.

30. Hepatitis cont. • What are the signs and symptoms? • Hepatitis B often has no symptoms. If symptoms occur it is usually between 6 weeks to 6 months after infection. Symptoms may be extreme tiredness, loss of appetite, vomiting, pain in the joints, fever, headache, dark urine, sever abdominal pain, and jaundice (yellowing of the skin and eyes). • Hepatitis A (HAV) • Occurs when a person gets infected fecal matter in their mouth- from contaminated food. It can spread from not washing their hands after restroom use. • Hepatitis C(HAC) • Passes through direct contact with an infected person’s blood. Sharing needles or during sexual intercourse if one partner already has an STI.

31. Hepatitis cont. • Is it treatable? • Hepatitis B usually is not treated unless it becomes chronic. Chronic hepatitis B is treated with drugs that slow or stop the virus from damaging the liver. The length of treatment varies. Your doctor will help you decide which drug or drug combination is likely to work for you and will closely watch your symptoms to make sure treatment is working.

32. HPV • *HPV stands for human papillomaviurs. A family of over 100 viruses including those which cause warts and are transmitted by contact. Also known as genital warts. • There are more than 100 different strands of HPV, and about 30 attack the genital, mouth, or anal areas. • Plantar warts and hand warts can also be a strand of HPV, but those strands are not sexually transmitted. • It is estimated that every minute in the United States that there is a new case of genital warts. • An estimated 8 out of 10 women will have HPV in their lifetime.

33. HPV cont. • *Some types of HPV may cause genital warts, and these are called low-risk types of HPV. • *Some types of HPV may cause cell changes that can lead to cervical cancer and other cancers. These are called high-risk types of HPV. • *For most, HPV will clear on its own through the body’s defense in 8-13 months. For those that do not go away the virus can “hide” in the body for years making it difficult to detect and know when a person was infected. • Condyloma – A raised growth on the skin resembling a wart, typically in the genital area.

34. HPV cont. • How do people get it? • HPV is spread through skin-to-skin contact. Usually during vaginal, anal, or oral sex. • Who is at risk? • Anyone that is having sexual contact or having sexual intercourse, anal sex, or oral sex can contract HPV. Also, mothers who have it can pass it along to their newly born babies.

35. HPV cont. • Is it treatable? • There is no treatment to cure HPY itself. Most strands will go away on its own. If not you can treat warts by having them surgically frozen off or burnt off. • Gardasil? • Gardasil is a vaccine that helps protet against the 4 main types of HPV. Gardasil is available as a three dose shot for girls and boys ages 9-26. In boys Gardasil will protect against 90% of all genital warts, and in females it will protect against 75% of all genital warts.

36. HIV • HIV stands for human immunodeficiency virus. • HIV is a virus that breaks down the immune system. • *HIV is the virus that causes AIDS. • AIDS is short for acquired immune deficiency syndrome. • In the United States about 1 million cases of AIDS have been reported. • On average 40,000 people in the United States gets AIDS/HIV each year.

37. HIV cont. • What are the symptoms? • Thrush-a thick whitish coating of the tongue or mouth that is caused by a yeast infection. • PID • Chronic infections • Tiredness • Bruising • Diarrhea • Unexplained bleeding from growths on the skin • How do you know if you have it? • You can only find out for sure by getting tested

38. HIV cont. • How can a person get HIV? • It is transmitted through blood, semen, vaginal fluids, and breast milk. • Having vaginal or anal intercourse without a condom with someone who has HIV. • Sharing needles or syringes with someone who has HIV. • An infected mother to her newly born baby. • Who is at risk? • People who share needles, people who have unprotected sexual or anal intercourse.

39. HIVcont. • Is it treatable? • If you have HIV/AIDS you can take medicines called “cocktails”. They are designed to strengthen the immune system to help prevent the onset of AIDS. There is no cure, but these “cocktails” can allow people to live for many more years. • How does a person get AIDS? • A person with HIV continues to have HIV until their t-cells(white blood cells that destroy bacteria and diseases that enter the body) fall below 200. Normal t-cell amount is 1,200-500. The average survival time once AIDS is diagnosed is 24-30 months.

40. Parasites • Pubic Lice • Scabies • Trichomoniasis

41. Pubic Lice • *Pubic lice are tiny insects that attach themselves to the skin and hair in the pubic area. They are also called “crabs”. • Every year, millions of people get pubic lice. • Public lice have 3 forms: • Egg (Nit) • Nymph • Adult • 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.

42. Pubic lice cont. • 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: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

44. Pubic lice cont. • What are the symptoms? • Usually after five days on infection a person will start feeling symptoms. Symptoms may be intense itching in the genital area, mild fever, feeling run-down, and the presence of lice or small egg sacs in the pubic hair. • How is it transmitted? • They are easily spread. Most of the time it is during sex play. You can get them from sleeping in a bed where they are infested, sharing clothing, toilet seats, furniture, or close physical contact.

45. Pubic lice cont. • Is it treatable? • Yes! Treatment is available. Over the counters and certain shampoos can help destroy them. • *Shaving of your pubic hair will not work! • All towels and clothing must be thoroughly washed and dry cleaned. • Any bed sheets must be thoroughly washed and even ironed. • Your house should be thoroughly vacuumed as well.

46. Scabies • A skin condition caused by the scabies mite. The mite burrows under the skin. • It is so small it can hardly be seen by the naked eye. • They are usually passed through sexual contact, but children can pass them through everyday contact. • What are the signs and symptoms? • Intense itching, usually at night. • Small bumps or rashes that look dirty, small curling lines on the penis, between the fingers, or buttocks.

47. Scabies cont. • How do people get scabies? • It is easily spread sexually. • Close personal contact. • Through bedding and clothing • Is it treatable? • Yes! Your healthcare provider may subscribe Nix, Elimite, pr Scabene. • All towels and clothing must be thoroughly washed and dry cleaned. • Your house should be thoroughly vacuumed as well.

48. Trichomoniasis • Trichomoniasis (or “trich”) is a very common sexually transmitted infection (STI) that is caused by infection with a protozoan parasite called Trichomonasvaginalis. Although symptoms of the disease vary, most women and men who have the parasite cannot tell they are infected. • It is considered the most common curable STI. • 3.7 million people have the infection, but only 30% develop any symptoms. • Infection is more common in women than men. • Trich is one of the most common causes of vaginitis.

49. Trichomoniasis cont. • What are the signs and symptoms? • Usually there are none. It is very difficult for men to realize if they have the infection. Men may have: • Discharge from the urethra • Urge to urinate frequently • When women have the infection they may have: • Frothy, often unpleasant-smelling discharge • Blood in the discharge • Itching around the vagina • The urge to urinate frequently • Swelling in the groin

50. Trichomoniasis cont. • How do people get it? • Trich is easily passed between sex partners. It can be spread through vaginal intercourse, the sharing of sex toys, and mutual masturbation if fluids from one partner are passed to the genitals of the other. • Who is at risk? • Anyone that has vaginal intercourse, or has direct skin-to-skin contact with their partners genitals and theirs.