1. Sexually Transmitted Diseases
Chapter 18

2. Acquired Immunodeficiency Syndrome (AIDS)
Leading cause of death in many parts of the world.
Worldwide, AIDS is the leading cause of death for people age 15-59
Approximately 65 Million people around the world are infected with Human Immunodeficiency Virus (HIV).
More than 25 million have died worldwide
Human immunodeficiency virus (HIV) is the virus which causes AIDS.
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3. Approximate number of people living with HIV/AIDS in 2006
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The Major STDS (STD’s)
Seven different STDs pose major health threats
HIV/AIDS
Hepatitis
Syphilis
Chlamydia
Gonorrhea
Herpes
HPV
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HIV Infection and AIDS
By 2004, an estimated 1,000,000 Americans were believed to be living with HIV, with an estimated annual incidence of 40,000 cases
Estimated 1.5 million Americans have died
2006, researchers discovered a group of chimpanzees in Cameroon that carry SIVspc
1930s Genetic evidence shows that SIV first spread to humans
What is HIV Infections?
HIV attacks and invades CD4 T-cells, monocytes and macrophages.
AIDS opens the possibility for a opportunistic infections.
Once initial symptoms resolve, the asymptomatic period may last from 2 to 20 years.
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7. Transmitting the Virus
HIV lives only within cells and body fluids.
3 primary means of transmission are: (1)Specific kinds of sexual contact, (2) direct exposure to infected blood, and (3) HIV-infected women to her fetus.
Sexual contact
Direct contact with infected blood.
Mother-to-Child transmission.
Not through casual contact.
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8. Populations of Special Concern for HIV infection
Most common exposure has been sexual activity between men; injection drug use, and heterosexual contact.
African American men and women are vastly overrepresented among people newly diagnosed with AIDS.
See “HIV/AIDS Among African Americans and Latinos”
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9. Symptoms of HIV Infection
Few days or weeks, half the people will develop (Flu like symptoms)
Fever, fatigue, rashes, headache, swollen lymph nodes, body aches, night sweats, sore throat, nausea and diarrhea.
Specialized test HIV RNA assay.
Pneumocystis Carinii pneumonia (protozoal infection).
Kaposis sarcoma.
Difficult to treat yeast infections in women
Tuberculosis
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11. Diagnosing HIV Infection
Most common is tests for the presence of antibodies to the virus.
HIV antibody test
ELISA (first test) if positive then the.
Western blot (second test)
IF HIV-positive then check the status of the CD4-t cells.
New diagnostic test – HIV Replication Capacity.
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Diagnosing AIDS
Infection defined as an AIDS indicator.
Reporting.
Treatment (NO CURE).
Antiviral drugs.
Reverse transcriptase inhibitors.
Zidovudine (AZT).
Protease inhibitors.
Highly active antiretroviral therapy (HAART).
Structured intermittent therapy.
Fusion inhibitors
Enfuvirtide (Fuzeon)
Inhibit the fusion of viral and cell membranes
Post-Exposure prophylaxis.
Treatment for opportunistic infections.
HIV and Pregnancy
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Prevention
Make careful choices about sexual activity.
Do Not share drug needles.
Participate in an HIV educational program.
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16. Chlamydia Trachomatis
Most prevalent bacterial STD in the U.S.
Bacterial infection -
Can cause sterility in men and women
WOMEN infects the cervix and to urethra, fallopian tubes & ovaries, PID, bladder infections.
MEN- Epididymitis, urethra to testes, urethritis, bladder infections, watery discharge.
Symptoms –ASYMPTOMATIC : Discharge, pain and burning while urinating, vaginal bleeding, painful intercourse, abdominal pain, nausea, fever, inflammation of rectum or cervix, swelling and pain in the testes.
Symptoms appear in 7-21 days
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17. Chlamydia Trachomatis
Spread - vaginal and anal intercourse, from the birth canal to the fetus
Diagnosis - Examination of tissue samples or urine
Treatment - Both partners treated fully with antibiotics
Protection - Condoms and safe sex
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Gonorrhea
700,000 new cases every year in the U.S.
Bacterial infection - Can cause sterility, arthritis and heart problems
PID, can cause ectopic pregnancy, premature labor and still birth, arthritis, rashes
Symptoms –
Women - Asymptomatic - Frequent burning urination, menstrual irregularities, pelvic pain, discharge.
Males – thick yellow-white discharge, painful urination.
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Gonorrhea
Spread - Vaginal, anal and oral sex.
Diagnosis - Microscopic exam of discharge.
Treatment - Oral antibiotics - People often have chlamydia at same time.
Protection - Condoms and safe sex.
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20. Pelvic Inflammatory Disease PID
Progressive infection that harms a women’s reproductive system. Can lead to sterility, ectopic pregnancy and chronic pain - treated or not.
Caused by chlamydia and gonorrhea.
Symptoms - long and painful periods, discharge, spotting, low abdominal pain, fever, chills, nausea, vomiting, pain during intercourse.
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21. Pelvic Inflammatory Disease PID
Treatment - Antibiotics, bed rest, sexual abstinence and maybe surgery to remove scarring
Diagnosis - Pelvic Exam, cultures, laparoscopy
Protection - Condoms and safe sex
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Human Papilloma Virus
More than 80% of sexually active individuals will have been infected with HPV by the age of 50.
Symptoms
Small bump on the skin or a large, warty growth
Cauliflower-like mass
May cause irritation and bleeding
How is it spread
Diagnosis
Appearance of the lesions
Women who are positive should have a Pap test very 12 months
Treatment
Removed by cryosurgery, electrocautery or laser surgery
Protection
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Herpes
45 million have been diagnosed
Two forms - Herpes simples virus-1 and -2.
Type 1 is associated with cold sores and fever blisters.
50-80% of U.S. adults have anitibodies to HSV-1
Both are sexually transmitted.
Remains in the body for life.
Symptoms – 90% have no symptoms
Recurring rash, pain ulceration's.
Primary outbreak - pain and discomfort around infected area, itching, burning during urination.
2-20 days after infection - may years before outbreak.
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Herpes
Spread - Touching, sexual intimacy - including kissing, vaginal, oral and anal sex
Diagnosis - Examination of sores and culturing of fluid taken from sores
Treatment - No cure - symptoms are relieved by drugs
Protection - Refrain for sex during out break
HSV-1 and 2 can cause miscarriages or still births along with serious health issues of newborns
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25. Hepatitis B Virus (HBV)
Can cause liver disease and death
Preventable with vaccination.
750,000 total acquired sexually
Transmission - Semen, saliva, blood and urine
Symptoms - Extreme fatigue, headache, fever, hives, lack of appetite, nausea, vomiting, tenderness in lower abdomen
Diagnosis and Treatment
Blood Test
No cure
Prevention
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Syphilis
Syphilis organism remains in the body for life and leads to disfigurement, neurological disorders, or death.
Effective antibiotics and condom use.
Symptoms –
Primary phase- 3 weeks - 90 days - painless sores and wet ulcers (chancre) and swollen glands.
Secondary Phase weeks - up to 2 years body rash, mild fever, fatigue, sore throat (Flu like symptoms), and hair loss.
Late phase (tertiary)- Damage to organs and nervous system.
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Other STD’s
Trichomoniasis
Bacterial vaginosis (BV)
Pubic Lice
Scabies
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What You Can Do
Education.
Diagnosis and Treatment
Get vaccinated
Be alert for symptoms
Get tested
Inform your partners
Get Treated
Prevention
Use a barrier defense.
Know your potential partner.
Ask. Are you ready to have sex?
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29. Sexually Transmitted Diseases
Chapter 18