Texas Department of State
Health Services
Anita Swayze, BA
Training Specialist
Topics
Gonorrhea
Chlamydia
Syphilis
Herpes
Human Papilloma Virus - HPV
Human Immunodeficiency Virus - HIV
Tuberculosis - TB
BACTERIAL vs VIRAL
Curable vs Treatable
Gonorrhea
Herpes
Chlamydia
HPV
Syphilis
HIV
Gonorrhea
GONORRHEA IN TEXAS
2009
Total Cases = 28,782
Hispanic Men = 3119
Hispanic Women = 4246
Hispanics account for 26% of all GC
cases in Texas
Gonorrhea
Gonorrhea is caused by a bacteria
Gonorrhea is curable!
Incubation Period: 1-30 days
The person can pass it on even without
symptoms
Gonorrhea Transmission
Sexual Contact with infected person
Penis – Vagina
Penis – Anus
Oral - Genital
Birth – Mother to Baby
Gonorrhea Symptoms in
Males
Discharge from
the penis (may
be thick, milky
white, yellowish,
or greenish)
Burning upon
urination
Source: CDC/NCHSTP/Division of STD Prevention, STD Clinical Slides
Complications in Males
Epididymitis
*Swelling of the testicles / scrotum w/
severe pain
Chronic Pain
*Infertility
Epidiymitis
Gonorrhea Symptoms
in Females
Painful urination
Abnormal
bleeding
Pain during sex
Most are
asymptomatic
Gonorrhea Complications in
Females
PELVIC INFLAMMATORY DISEASE
(PID)
Infection of the uterus, fallopian tubes &
reproductive organs
1,000,000,000 females experience PID
each year in the US.
Chlamydia
Chlamydia in Texas
2009
Total Cases = 103,829
Hispanic Men = 8316
Hispanic Women = 35,037
Hispanics account for 42% of cases in
Texas
Chlamydia
Chlamydia is caused by a bacteria
Chlamydia is curable!
Incubation Period: 1-3 weeks
It can be passed on with or without
symptoms
Chlamydia Transmission
Sexual contact with infected person
Oral-genital
 Penis-vagina
 Penis-anus

Birth – Mother to Baby
Chlamydia
Symptoms in Men
Discharge from penis
(may be runny, whitish)
Burning on Urination
Chlamydia
Symptoms in Women
Abnormal vaginal discharge
Pain during vaginal sex
Complications of Chlamydia
Men = Epididymitis
(swollen, tender testicles)
Women = PID
(Pelvic Inflammatory Disease)
Same Complications as Gonorrhea!
Percentage of Patients
Co-infected with
Chlamydia and Gonorrhea
Men

15% to 25%
Women

15% to 40%
Gonorrhea & Chlamydia
Testing & Treatment
Easily detected by simple lab test
Easily cured with antibiotics
Any damage to the body cannot be
repaired!
Syphilis
Syphilis in Texas
2009
Total Cases = 6989
Hispanic Men = 1406
Hispanic Women = 662
Hispanics count for 30% of cases in
Texas
SYPHILIS
Syphilis is caused by a bacteria
Syphilis is curable!
Incubation 10 – 90 days
(AVE. = 21 days) Blood Test Negative
Syphilis is passed by direct contact with ‘the
sore’
Syphilis Transmission
Sexual contact with infectious sore
(chancre)
In Utero – Mother to Baby
Symptoms of Syphilis
PRIMARY SYPHILIS = Painless Sore (chancre)
Appears where syphilis enters the body
Lasts 1 - 5 weeks
Sore spreads syphilis
Sore heals without treatment
Primary Syphilis Chancre
Source: Florida STD/HIV Prevention Training Center
Primary Syphilis
Source: Centers for Disease Control and Prevention
Symptoms of Syphilis
SECONDARY SYPHILIS = Skin Rash
Rash appears on palms of hands and
soles of feet
Rash may also appear on any part of body
Rash may last 2 – 6 weeks (ave. 4 weeks)
Fever, swollen lymph glands, headache, hair loss
and muscle aches may accompany rash.
Can transmit syphilis during this state
Secondary Syphilis
Palm Rash
Source: CDC/ NCHSTP/ Division of STD Prevention, STD Clinical Slides
Secondary Syphilis Rash
Source: Florida STD/HIV Prevention Training Center
Secondary Syphilis
Body Rash
Source: CDC/ NCHSTP/ Division of STD Prevention, STD Clinical Slides
Secondary Syphilis:
Generalized Body Rash
Source: CDC/NCHSTP/Division of STD Prevention, STD Clinical Slides
Testing & Treatment for
Syphilis
Easily detected by a
blood test
Easily cured with
antibiotics
But any damage
done to the body
cannot be repaired
Symptoms of Syphilis
LATENT STAGE
Begins after primary and secondary
symptoms disappear
Infection remains in the body
May last for years
Still Curable
Symptoms of Syphilis
LATE STAGE
Damage internal organs: brain, nerves,
eyes, heart, blood vessels, liver, bones,
Neuromuscular Damage: muscles
coordination, paralysis, numbness
Dementia
Death
HERPES SIMPLEX VIRUS
Herpes is caused by a virus
Herpes cannot be cured – only treated!
Herpes occurs above and below the
waist
Herpes blisters are painful
Herpes is passed as the body ‘sheds’
the virus
Herpes Simplex Virus
HSV I = Oral Herpes
*Blister or Cold Sore
*Herpes ABOVE THE WAIST
*Can be passed to genital area!
Herpes Simplex Virus
HSV II = Genital Herpes
Small red sores or blisters on:
*Penis
*Vagina (inside and out)
*Anus
*Buttocks
*Thighs
Symptoms may or may not recur. On
average, symptoms recur about 5 times a
year
Symptom Facts
Blisters can last 2 – 3 weeks
Blisters are painful
Flu-like symptoms
(swollen lymph glands, fever, headache,
muscle aches)
Symptoms may or may not re-occur
(average re-occurrence every 5 years)
Genital Herpes
Phases of Active Infection
Inflammation or itchy rash
Blisters
Ulcers
Crusting over
Healing
Genital Herpes in a Male
Source: CDC/NCHSTP/Division of STD, STD Clinical Slides
Herpes in a Male
Source: Cincinnati STD/HIV Prevention Training Center
Herpes in a Female
Source: CDC/NCHSTP/Division of STD,
STD Clinical Slides
Source: Cincinnati STD/HIV Prevention Training Cen
Genital Herpes Simplex in
Females
Source: Centers for Disease Control and Prevention
Testing & Treatment for
Genital Herpes
Can be detected by
culturing the lesion
Symptoms can be treated
with prescribed
medications
Herpes cannot be cured
You can still spread
Herpes even if you
are taking medicine!
Human Papilloma Virus
(HPV)
Genital Warts
Human Papillomavirus
(HPV)
Genital Warts
Human Papilloma Virus (HPV) is also
known as “genital” warts
HPV is caused by a virus
HPV cannot be cured, only treated!
HPV is spread by skin to skin contact
THE WARTS
Single or multiple fleshy growths IN or
ON the penis, scrotum, groin, vulva,
vagina, anus, and/or urethra
Warts may : itch, bleed, burn
Warts may recur from time to time
Genital Warts
Source: CDC/ NCHSTP/ Division of STD Prevention,
STD Clinical Slides
Source: Cincinnati STD/HIV Prevention
Training Center
Source: Cincinnati STD/HIV Prevention Training Center
HPV Warts on the Thigh
Source: Cincinnati STD/HIV Prevention Training Center
Perianal Warts
Source: Cincinnati STD/HIV Prevention Training Center
Testing & Treatment for
Genital Warts
Warts can be
detected in a clinical
exam
Warts can be
treated by removing
the warts
Warts may grow
back
HIV/AIDS
HIV IN TEXAS
2009
Total New Diagnosis = 4355
Hispanic Men = 1130
Hispanic Women = 192
Hispanics account for 30% of all new HIV
cases in Texas
HIV
HIV is caused by a virus
HIV is the virus that causes AIDS
HIV is not curable, only treatable
HIV is a disease passed thru infected
body fluids
Incubation period: 1 – 90 days
HIV Transmission
Transmitted through body fluids
• Blood
• Semen
• Vaginal Secretions
• Breast Milk
Body Fluid Transfer
During Sex (oral, anal, vaginal)
Sharing needles and all drug using
equipment
(water, cookers, cotton, pipes)
Mother to Baby
HIV Testing
Who Should Test?
All persons between the ages of 13-64
All persons seeking treatment for STDs
All patients initiating treatment for tuberculosis (TB)
High-risk patients should be screened annually
The Life of HIV
Flu-like symptoms may appear, then
disappear at the time of infection
Most people may not exhibit symptoms for
up to 10 years
HIV can be spread with or without
symptoms
People can live for many years with HIV
HIV INFECTION
Symptoms could include:
Fever
Fatigue/malaise
Headache
Muscle/joint pain
Oral ulcers
Night sweats
Anorexia
Weight Loss
Rash
GI symptoms
HIV in Pregnancy
Texas = Opt Out Testing
Tested at first prenatal visit
During 3rd trimester
More frequently if the provider feels the
patient is high-risk
Again at delivery if attending personnel are
unable to establish 3rd trimester results;
results must be available within six hours
Tuberculosis in Texas
2009
HIV/STD/TB Epidemiology and Surveillance Branch
Texas Department of State Health Services
Tuberculosis
(TB)
TB is caused by a germ
TB is spread thru the air
TB usually affects the lungs
TB can cause death if not treated
Symptoms of TB
Constant Cough *
Coughing up Blood *
Chest Pain
Weight Loss
Fever
Night Sweats
How is TB Spread?
TB GERMS ARE PUT IN THE AIR BY:
Coughing
Sneezing
Speaking
Singing
TB Germs stay in the air for hours!!!
TB Cases by
Race/Ethnic Group
Texas, 2009
Other 16%
White
12%
Black
21%
Hispanic
52%
Affected Populations
Male or Female?

Males 64% of cases
Racial/Ethnic group?

Hispanics account for largest proportion of
cases (52%)
SUMMARY
STD’s & TB may be cured, treated or
both!
STD’s do not always show signs or
symptoms!
STD’s cause permanent damage &
death without treatment!
STD’s are seriously affecting our
population!!!
THANK YOU!
WHAT QUESTIONS DO
YOU HAVE?