Chapter Eighteen Sexually Transmitted Diseases

The Major STD’s HIV/AIDSHIV/AIDS ChlamydiaChlamydia GonorrheaGonorrhea Herpes SimplexHerpes Simplex Syphilis Pelvic Inflammatory Disease Hepatitis HPV (genital warts)

HIV Infection It is estimated that more than 60 million people have been infected with HIVIt is estimated that more than 60 million people have been infected with HIV By 2004, it is estimated that 1 million Americans are living with HIVBy 2004, it is estimated that 1 million Americans are living with HIV HIV infection continues to spread, even though death rates have declined among Americans, however, a cure has not been discoveredHIV infection continues to spread, even though death rates have declined among Americans, however, a cure has not been discovered

What is HIV? Cause – HIV, virus that attacks the CD4 T cells of the immune systemCause – HIV, virus that attacks the CD4 T cells of the immune system SpreadSpread –direct contact involving the exchange of bodily fluids (blood, semen, vaginal secretions) –through infected blood products –prenatal transmission (mother to fetus) or during breast-feeding (Human Immuno-Deficiency Virus)

HIV Infection (cont.) Following several weeks after becoming infected, about half of those develop flu-like symptoms (Primary Infection Phase)Following several weeks after becoming infected, about half of those develop flu-like symptoms (Primary Infection Phase) Experts believe that half of all HIV cases are spread during this phaseExperts believe that half of all HIV cases are spread during this phase The next phase is known as the Chronic Asymptomatic Stage which can last 2-20 yearsThe next phase is known as the Chronic Asymptomatic Stage which can last 2-20 years During this time, the virus is progressively infecting and destroying cells of the immune systemDuring this time, the virus is progressively infecting and destroying cells of the immune system (Human Immuno-Deficiency Virus

Populations of Special Concern for HIV Infection Although the transmission of HIV occurs through specific individual behaviors, high levels of infection within certain groups are tied to social, cultural, and economic factorsAlthough the transmission of HIV occurs through specific individual behaviors, high levels of infection within certain groups are tied to social, cultural, and economic factors Such groups that are affected are:Such groups that are affected are: WomenWomen Gay menGay men Men who are having sex with other men but do not considered themselves ‘gay’Men who are having sex with other men but do not considered themselves ‘gay’ MinoritiesMinorities PoorPoor

HIV Symptoms Most infected people are asymptomatic or can remain symptom-free for years, even though antibodies have been formed within weeks of infectionMost infected people are asymptomatic or can remain symptom-free for years, even though antibodies have been formed within weeks of infection Eventually the following may appear (HIV with symptoms)Eventually the following may appear (HIV with symptoms) –tiredness –fever –loss of appetite/weight –diarrhea –night sweats –swollen glands

Diagnosis of HIV Infection Enzyme Linked Immunosorbent Assay (ELISA)Enzyme Linked Immunosorbent Assay (ELISA) Western BLOT testWestern BLOT test HIV Replication Capacity (viral fitness)HIV Replication Capacity (viral fitness) Rapid HIV test, home tests, and non-blood tests are currently availableRapid HIV test, home tests, and non-blood tests are currently available

Diagnosing AIDS AIDS is the more severe form of HIV InfectionAIDS is the more severe form of HIV Infection A diagnosis of AIDS has been made if a person is:A diagnosis of AIDS has been made if a person is: HIV positiveHIV positive Developed an infection as an AIDS indicatorDeveloped an infection as an AIDS indicator Has a severely damaged immune system based upon the number of CD4 T cellsHas a severely damaged immune system based upon the number of CD4 T cells

Treatment for HIV/AIDS No cure at this timeNo cure at this time Combination drugs reverse transcriptase inhibitors and protease inhibitors; both assist the body by disallowing replication of the virus in various cyclesCombination drugs reverse transcriptase inhibitors and protease inhibitors; both assist the body by disallowing replication of the virus in various cycles Fusion inhibitorsFusion inhibitors

How Can You Protect Yourself? Learn the sexual history and HIV status of your partnerLearn the sexual history and HIV status of your partner Limit the number of sexual partnersLimit the number of sexual partners Use lubricated condoms correctly and consistentlyUse lubricated condoms correctly and consistently Avoid contact with body fluidsAvoid contact with body fluids Curtail the use of drugsCurtail the use of drugs

Prevention of HIV Infection, cont’d Never share hypodermic needlesNever share hypodermic needles Refrain from sex with known injectable drug usersRefrain from sex with known injectable drug users Get regular tests for STD’sGet regular tests for STD’s Participate in an HIV Education ProgramParticipate in an HIV Education Program

Chlamydia Chlamydia (bacterium) – most prevalent in the U.S.Chlamydia (bacterium) – most prevalent in the U.S. Symptoms in males include:Symptoms in males include: Painful urinationPainful urination Slight watery dischargeSlight watery discharge Pain in the testesPain in the testes Symptoms in women include:Symptoms in women include: Vaginal dischargeVaginal discharge Burning urinationBurning urination Lower abdominal painLower abdominal pain Diagnosis: urine sampleDiagnosis: urine sample Treatment: antibioticsTreatment: antibiotics

Gonorrhea Gonorrhea (bacteria) – estimated 700,000 new cases in the United States annuallyGonorrhea (bacteria) – estimated 700,000 new cases in the United States annually Symptoms for men:Symptoms for men: Urethritis (yellowish discharge)Urethritis (yellowish discharge) Swollen lymph glands of the groinSwollen lymph glands of the groin Symptoms for women:Symptoms for women: Most females are asymptomatic but will have some discharge and pain during urinationMost females are asymptomatic but will have some discharge and pain during urination Diagnosis: culture from urine or discharge sampleDiagnosis: culture from urine or discharge sample Treatment: antibioticsTreatment: antibiotics

Pelvic Inflammatory Disease PID occurs when the initial infection of either gonorrhea or chlamydia enters beyond the cervixPID occurs when the initial infection of either gonorrhea or chlamydia enters beyond the cervix Even if the disease is treated successfully, 25% of women will have long-term problemsEven if the disease is treated successfully, 25% of women will have long-term problems PID is the leading cause of infertility for young womenPID is the leading cause of infertility for young women Diagnosis usually requires a pelvic exam and lab testsDiagnosis usually requires a pelvic exam and lab tests Treatment is usually with antibioticsTreatment is usually with antibiotics

Human Papillomavirus (HPV) HPV (virus) – genital warts which can lead to cervical cancer in women and penile cancer in menHPV (virus) – genital warts which can lead to cervical cancer in women and penile cancer in men HPV is very contagious and difficult to control since many infected people seem to be asymptomaticHPV is very contagious and difficult to control since many infected people seem to be asymptomatic Symptoms include: growths that cause irritation and bleedingSymptoms include: growths that cause irritation and bleeding Diagnosis: appearance of the lesions or biopsyDiagnosis: appearance of the lesions or biopsy Treatment: cryosurgery or laser surgeryTreatment: cryosurgery or laser surgery

Genital Herpes Caused by HS2 (Herpes Simplex 2 virus) which is sexually transmitted even though the partner may appear asymptomaticCaused by HS2 (Herpes Simplex 2 virus) which is sexually transmitted even though the partner may appear asymptomatic Herpes lesions may contain and transmit HIVHerpes lesions may contain and transmit HIV Symptoms include: flu-like symptoms accompanied with painful lesions around the genitalsSymptoms include: flu-like symptoms accompanied with painful lesions around the genitals Diagnosis: sample of fluid from lesions or blood testDiagnosis: sample of fluid from lesions or blood test Treatment: antiviral medications reduce symptoms even though a cure is not availableTreatment: antiviral medications reduce symptoms even though a cure is not available

Hepatitis A, B, C VirusVirus Inflammation of the liverInflammation of the liver Symptoms – fever, nausea, abdominal pain, jaundiceSymptoms – fever, nausea, abdominal pain, jaundice –Type A – associated with fecal contamination of food due to poor food handling –Type B – sexual contact, IV drug use, tattooing, piercing –Type C – similar to type B

Hepatitis B Inflammation of the liver which can cause serious damage and sometimes result in deathInflammation of the liver which can cause serious damage and sometimes result in death Transmitted by blood and bodily secretionsTransmitted by blood and bodily secretions Symptoms: many people do not have physical symptoms (silent symptoms), but may develop flu-like symptoms within several weeks of exposureSymptoms: many people do not have physical symptoms (silent symptoms), but may develop flu-like symptoms within several weeks of exposure Diagnosis: blood testsDiagnosis: blood tests Prevention: vaccinations and preventive measures against infected bodily fluidsPrevention: vaccinations and preventive measures against infected bodily fluids

Syphilis Caused by a spirochete (thin, corkscrew shaped bacterium)Caused by a spirochete (thin, corkscrew shaped bacterium) Transmitted by passing the pathogen through breaks in the skin or mucous membranes via kissing, or sexual activityTransmitted by passing the pathogen through breaks in the skin or mucous membranes via kissing, or sexual activity Symptoms are the presence of ‘chancre’ or sores that are usually painlessSymptoms are the presence of ‘chancre’ or sores that are usually painless Late Syphilis can damage many organs of the body, which eventually can lead to deathLate Syphilis can damage many organs of the body, which eventually can lead to death Diagnosis: blood testDiagnosis: blood test Treatment: antibioticsTreatment: antibiotics

Other Prevalent STD’s Vaginal infections (yeast) – can cause thrush, allowing colored discharges and itching. Protozoan infections are “trichomonisis.”Vaginal infections (yeast) – can cause thrush, allowing colored discharges and itching. Protozoan infections are “trichomonisis.” Bacterial vaginosis – common cause of abnormal vaginal dischargeBacterial vaginosis – common cause of abnormal vaginal discharge Chancroid - bacterial infection, creating sores on the genitalsChancroid - bacterial infection, creating sores on the genitals Public lice – ‘crabs’ that are highly contagious and feed on blood in and around the hairsPublic lice – ‘crabs’ that are highly contagious and feed on blood in and around the hairs Scabies – parasites that deposit eggs beneath the skin, creating an intense itchScabies – parasites that deposit eggs beneath the skin, creating an intense itch

What Can You Do? EducationEducation Get VaccinatedGet Vaccinated Be Alert for possible symptomsBe Alert for possible symptoms Get TestedGet Tested Inform your partnersInform your partners Get TreatmentGet Treatment

Chapter Eighteen Sexually Transmitted Diseases