Sexually Transmitted Diseases/Infections (STDs/STIs) Infectious diseases spread from person to person through sexual contact

What is a Sexually Transmitted Disease? Diseases you can get by having sex – vaginal, oral, or anal – with someone who is already infected.

STDs in the United States An estimated 65 million people in the United States are living with an incurable STD Every 8 seconds, a teenager gets a STD 1 in 10 teenagers is infected with a STD Each year, more than 15 million Americans become infected with a STD. ¼ of these are teens 2/3 are under the age of 25

A Silent Epidemic Epidemics – occurrences of diseases in which many people in the same place at the same time are affected Why are they spreading so quickly? Many STDs are asymptomatic – showing no signs/symptoms Don’t get treatment because they don’t know they’re infected Don’t like to talk about it People are scared or embarrassed to get tested

STDs are a growing problem Rates of STD’s have steadily increased 1960’s = 2 STD’s of major concern – syphilis and gonorrhea (both can be cured) Today = more than 25 STD’s 1 in 4 sexually active adolescents will become infected before graduating high school

High-Risk Behaviors and STDs Being sexually active with more than one person Engaging in unprotected sex Selecting high-risk partners Using alcohol and other drugs

Teen are at a higher risk Teenager’s bodies may not fight infections as well as the bodies of healthy adults Their immune systems are still developing

How are STDs spread? ALL SEXUAL ACTIVITY Any type of sexual activity that brings an uninfected person in contact with body fluids from an infected person Any sexual activity that results in contact between one person’s genitals and another person’s skin or mucous membranes, in which one of the persons is already infected with an STD Direct contact with open sores A mother to her baby before birth, during birth, or during breast-feeding

Consequences of STDs Some STDs are incurable Can cause cancer Can cause complications that affect the ability to reproduce Some STDs can be passed from an infected female to her child before, during, or after birth

Importance of Abstinence Only 100% way to prevent STDs!!! A majority of teens (54.4%) in high school choose abstinence

Set your boundaries early!!!

PHYSICAL INTIMACY 9-12 = Sexual Activity Eye to body Eye to eye Voice to voice Hand to hand Hand to shoulder Hand to waist Face to face Hand to face Hand to body (over clothes) Touching above waist (under clothes) Touching below waist (under clothes) Intercourse – vaginal, oral, anal 9-12 = Sexual Activity

STDs caused by Bacteria Chlamydia, Gonorrhea Syphilis

Chlamydia Most common Bacterial STD Transmitted 2 million people currently infected 3 million more will acquire it this year Transmitted Through sexual activity During childbirth

Symptoms of Chlamydia 85% of women and 40% of men have no symptoms Vaginal or urethral discharge Burning with urination Pelvic Pain (women) Swelling and tenderness of the scrotum (men) Genital ulcers

Long-term effects of Chlamydia Pelvic Inflammatory Disease (PID) Can damage the fallopian tubes and result in tubal scarring and infertility Causes 25% of the infertility in women pursuing in vitro fertilization in the US Symptoms Pelvic and abdominal pain Fever Abnormal vaginal bleeding Ectopic (tubal) pregnancy Infants Illness Blindness

Diagnosis and Treatment Diagnosis – lab test (genital fluids or urine) Treated easily IF caught early Treatment Oral antibiotics Newborn infants routinely receive antibiotic eye drops/ointment to prevent eye infection

Gonorrhea – Skin Lesion

Gonorrhea – skin lesion on heel

Gonorrhea – in eye

Symptoms of Gonorrhea Discharge from vagina or urethra Pain during urination Abnormal vaginal bleeding (“spotting”) – women Pain and swelling around the testicles – men 25-80% of women and a smaller percentage of men have no symptoms

Long-term effects of Gonorrhea Pelvic Inflammatory Disease Pregnant women Spontaneous abortion Premature rupture of membranes Preterm birth May infect amniotic fluid Blindness Joint infection Life-threatening blood infections

Diagnosis and Treatment Diagnosis – Body fluids will be examined and tested Treatment Oral or injectable antibiotics After treatment, infected individuals should be re-examined and tested again

Syphilis Number of cases is again on the rise Between 1940’s and 2000 – number of cases fell from approximately 100,000 to less than 6,000 Today, beginning to rise again (36,000) Called “The Great Imitator” Many of the signs/symptoms resemble other diseases Transmitted Sexual activity Contact with syphilitic sores Passed to infants during childbirth

Symptoms of Syphilis Primary Stage (10-90 days after infection) Single sore (chancre) Firm, round and painless Occurs at spot where Syphilis entered body Heals in 3-6 weeks if left untreated Secondary Stage (2-8 weeks after infection) Itch-less rash Flu-like symptoms Fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue

Secondary syphilis- rash on palms of hands

Symptoms (cont) Latent stage (2 or more years after) Signs disappear and think cured Attacks heart, blood vessels, and CNS Late stage (10 to 30 years after) Heart, skin, brain, spinal cord affected Cannot be cured at this stage

Diagnosis and Treatment Diagnosis – blood test Treatment Can be cured if caught early Antibiotic Will not repair or reverse the damage already caused by the disease A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year.

STD’s caused by Viruses HPV, Genital herpes, Hepatitis, HIV CANNOT BE CURED!!!

Human Papilloma Virus (HPV) More than 100 strains of HPV 40 cause genital infections 6.2 million Americans are infected with genital HPV each year 50% of sexually active Americans are or have been infected 20 million currently have the virus Another 80 million have been infected some time in the past In 90% of cases, the body’s immune system clears the HPV infection naturally within two years By the age of 50, 80% of women will have acquired genital HPV Transmission Skin-to-skin contact Contact with infected body fluids

Symptoms of HPV Most patients have no symptoms Genital and Anal Warts 7% of infected people

Long-term effects of HPV Cervical Cancer – Women Genital Cancers – Men

Diagnosis and Treatment abnormalities detected on a Pap Smear – women Most asymptomatic men do not know they are infected Treatment Topical medications applied to the wart Decrease in size and disappear Surgical removal (burning with a laser) Freezing Even with treatment, warts will often return

Genital Herpes Most common sexually transmitted viral infection in US 45 million people infected 1 in 5 American age 12 or over have genital herpes 2 types of herpes HSV-1 and HSV-2 Most cases of genital herpes are HSV-2 HSV-1 can be transmitted to genitals via oral sex Greatest risk factor is the total number sexual partners a person has had in their life

Transmission of Herpes Skin to skin contact Kissing with a sore Touching a sore Sexual activity Exposure to infected body fluids During childbirth

Symptoms of Herpes Initial infection Other symptoms Fever, headache and muscle aches Lesions appear in area of exposure Blisters which break and become ulcers About 8 days after exposure Painful and often burn or itch Other symptoms Burning with urination, vaginal or urethral discharge, tender swollen lymph nodes Recurrent outbreaks Skin lesions

Long-term effects of Herpes NO CURE!!! Can transmit to others even at time when not experiencing symptoms 90% will experience at least one recurrence within 12 months of initial episode Recurrences can occur for the remainder of the person’s life Risk of spontaneous abortion and premature birth

Diagnosis and Treatment Diagnosis – Viral cultures As many as 90% do not know they are infected Treatment Anti-viral medications Reduces the duration and intensity of symptoms

Trichomoniasis Caused by a Parasite Most common curable STD in young, sexually active women 7.4 million new infections occur each year in the US Increases the risk of contracting HIV Transmission Sexual contact

Symptoms of Trichomoniasis 50-80% of women and some men don’t know they are infected Women Vaginitis and/or Cervicitis Vaginal discharge Abnormal vaginal bleeding Cervical irritation Swelling and irritation of the genitals Itching of the vulva Abdominal pain Men Urethritis Discharge from penis Burning during urination

Long-term effects Premature rupture of membranes Preterm labor

Treatment Oral medication (metronidazole)

Being Responsible About STDs Seek medical help right away Complete the full course of medications Have follow up testing done Avoid all sexual activity while being treated Notify ALL sexual partners

Contraceptives Don’t Stop STDs

Safe Sex? Safer… but not Safe Sex

Condoms Thin sheath that is placed on an erect penis to catch semen when a male ejaculates. Most effective kind of condom is a latex condom with a spermicide containing nonoxynol-9 Prevents pregnancy and HIV Does not prevent ALL STDs! (HPV or Herpes)

With 100% Correct Condom Use STD’s Approx. risk reduction Gonorrhea 50% Chlamydia Syphilis 30-50% Trichomoniasis No evidence HPV HIV 85% Think about it.  A condom covers one specific part of the body, right?  Many sexually transmitted diseases are spread through skin-to-skin contact. 

Spermicide Chemical that kills sperm Sold as jelly, foam, cream, film, or sponge Spermicides are most effective when used along with other forms of contraception, such as a condom Spermicides alone DO NOT protect against HIV or STDs.

Birth Control Pills Female hormones that are taken orally every day to prevent ovulation or affect the lining of the uterus so that it cannot support and nourish a fertilized egg. Does NOT protect from STDs or HIV.

Think about it… Approximately 1 in every 5 people using condoms for pregnancy protection will get pregnant during the first year

100% WAY TO AVOID GETTING ONE OF THOSE!! ABSTINENCE 100% WAY TO AVOID GETTING ONE OF THOSE!!

HIV and AIDS AIDS – Acquired Immune Deficiency Syndrome – a disease in which the immunes system of the patient is weakened 1982 – 1600 cases were reported…700 deaths resulted 2000 – AIDS was the 5th leading cause of death among adults from 25-44 years HIV – Human Immunodeficiency Virus – a virus that attacks the immune system Causes AIDS

Teens at Risk Teen have one of the fastest growing rates of HIV

How HIV Attacks Cells Invades certain cells of the immune system – including T cells HIV attaches to cell surface Virus core enters cell and goes to nucleus Virus makes a copy of its genetic material New virus assembles at cell surface New virus breaks away from host cell

HIV and the Human Body As the number of viruses increase…the number of T cells decrease…the immune system is weakened Opportunistic infections – infections that occur in individuals who do not have healthy immune systems HIV is progressive It destroys the cells of the immune system over many months or years AIDS is the advanced stage of HIV

Transmission of HIV NOT transmitted by Toilet seats Telephones Food Being in the same area Casual physical contact – shaking hands and hugging Insect bites Sweat Sneezing HIV lives inside cells and body fluids Transmitted though… Blood Semen Vaginal secretions Breast milk

Transmission of HIV Sexual intercourse (any form of sex) Secretions containing HIV can enter a partner’s blood through tiny cuts in the body Increases with number of sexual partners Increases by having another STD that causes sores Chlamydia, herpes, gonorrhea, syphilis Sharing needles Mother to baby Through the umbilical cord During delivery While nursing

Stages of HIV A person in considered infectious immediately after contracting the virus ½ of infected people develop symptoms 3-6 weeks after becoming infected Fever, rash, headache, body aches, and swollen glands Symptoms tend to disappear within a week to a month – mistaken for another viral infection (flu) Asymptomatic stage – a period of time during which a person infected with HIV has no symptoms May last 6 months to 10+ years Virus continues to grow Can still be passed on to others Immune system can keep up with the infection – produces billions of new cells

Stages of HIV Eventually, the immune system can’t keep up Symptomatic stage – the stage in which a person infected with HIV has symptoms as a result of a severe drop in immune cells Symptoms Swollen glands, weight loss, and yeast infections AIDS Later stage where more serious symptoms appear Presence of HIV infection Severely damaged immune system Measured by number of helper T cells – less than 200 per milliliter of blood Appearance of one or more opportunistic infections

Detecting HIV EIA test – a test that screens for the presence of HIV antibodies in the blood May be inaccurate Developing antibodies takes time False negative – the test is negative, but the person is positive Most people will test positive in the first 3-4 weeks…but some take up to 6 months Certain health condition Hemophilia, hepatitis, and pregnancy can lead to a false positive – the test is positive, but the person does not have the infection

Detecting HIV If the EIA test is positive…person is tested again If the repeat test is positive, another test is performed Western Blot Test – WB – the most common confirmation test for HIV in the US Tests for viral load in blood If done properly, it has 100% accuracy HIV positive = 2 EIA positive tests and positive Western Blot Test

Availability of Health Services No cure for HIV/AIDS Drugs treat HIV and treat and prevent the complications of opportunistic infections Drugs and vaccines are being researched To improve the quality of life Hard to find a cure HIV infects the cells that regulate the immune system New strains of the virus have emerged Treatment downfalls Side effect so severe, many people can’t stand to take medicine Expensive - $1000+ per month Worldwide people don’t have access to treatment

History of HIV/AIDS 1981: Clusters of previously rare diseases noticed in both LA and NYC 1982: Collection of symptoms is named AIDS – 14 nations report cases of AIDS 1984: 7,000 Americans have AIDS 1986: AIDS-causing virus is named HIV; first drug treatment for AIDS developed 1988: December 1 is declared annual World AIDS day

History of HIV/AIDS 1989: Several new drugs available to treat opportunistic diseases; FDA approves first drug treatments for more than trial use 1990: Estimated number of AIDS cases worldwide = 1 million 1991: Red ribbon announced as international symbol of AIDS; scientists report that drugs have limited use because HIV develops resistance to them; 1 million cases of AIDS and 133,000 death from the disease reported worldwide since 1882 1992: First combination drug therapy approved

History of HIV/AIDS 1994: Studies show that drug treatment greatly reduces risk of HIV transmission from an infected mother to her baby 1998: First trial of an AIDS vaccine begun using 5,000 US volunteers; estimates are that 70% of all new infections and 80% of all AIDS deaths are occurring in sub-Saharan Africa 2002: The disease is the 4th leading cause of death in the world; an estimated 40 million people around the world are living with HIV/AIDS

A continuing problem Number of reported AIDS cases in industrial world is decreasing Availability of drug cocktails – combination of drugs – slow the progression of HIV False security – research has identified new, drug-resistant strains Pandemic – a global outbreak of infectious disease – 40 million people infected worldwide (2002)

Staying safe Knowledge is the best defense! Abstinence from sexual activity or using drugs Avoid pressure situations Practice refusal skills Choose relationships carefully