Sexually Transmitted
Diseases
If you have a sexually
transmitted disease, you will
know it. True or False?
False. Many people with STDs have no
symptoms and do not know they are
infected; however, they can still pass
an infection on to their partners.
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2
Worldwide, HIV infection is
spread primarily via which of the
following?
A.
B.
C.
D.
Injection drug use
Sex between men
Mother-to-child transmission
Heterosexual sex
D. The vast majority of HIV infection cases
worldwide result from heterosexual contact,
and nearly two-thirds of all new cases occur
in teenage girls and young women.
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3
Of the developed countries,
which one has the highest rate
of sexually transmitted diseases?
A.
B.
C.
D.
Germany
United States
Canada
France
B. The United States has the highest rate of
STDs of any developed nation. If current
trends continue, 50% of all Americans will
contract a sexually transmitted disease by
age 25.
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4
A man with an STD is more likely
to transmit the infection to a
female partner than vice versa.
True or False?
True. For many STDs, infected men are
at least twice as likely as infected
women to transmit an STD to their
partner. And many STDs are more
physically damaging to women than
to men.
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After you have had an STD
once, you become immune to
that disease and cannot get it
again. True or False?
False. Reinfection with STDs is very common.
For example, if you are treated and cured of
chlamydia and then you have sex with your
untreated partner, the chances are very
good that you will be infected again.
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What is an STD?
• Sexually Transmitted Diseases (STDs) are serious,
sometimes painful and can cause a lot of damage.
• Some STDs infect your sexual and reproductive
organs. Others cause general body infections
• Sometimes you can have an STD with no signs or
symptoms. Other times the symptoms go away on
their own. Either way you still have an STD until you
get treated.
• Some STDs cannot be cured. But most STDs can be
cured if you get treated.
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The Major STDs
• Seven different STDs pose major health
threats
–
–
–
–
–
–
–
HIV/AIDS
Hepatitis
Syphilis
Chlamydia
Gonorrhea
Herpes
HPV
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Which type of infection is it?
• Infections are either viral, bacterial or
fungal infections.
Virus:
Bacteria:
•HIV/AIDS
•Chlamydia
•Herpes
•Gonorrhea
•HPV (warts)
Fungal:
•Hepatitis
•Canidiasis
Protozoa:
Spirochetes:
•Trichomoniasis
•Syphilis
All infections are treatable but viral infections
are not curable.
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How is an STD spread?
• STDs are spread during close, sexual
activity and during all types of
intercourse.
• Some STDs are also spread by contact
with infected blood.
• Most STD germs need to live in warm,
moist areas. That’s why they infect the
mouth, rectum and sex organs
(vagina, vulva, penis and testes).
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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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11
Approximate number of people
living with HIV/AIDS in 2006
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12
AIDS and HIV
• AIDS – a disease caused by a virus, HIV
– Acquired – to get or catch
– Immune – to be protected from disease
– Deficiency – a lack of effort
– Syndrome – a group of symptoms
• HIV – the virus that causes AIDS
– Human – it doesn’t infect animals, only man
– Immunodeficiency – lowers your resistance to
infection
– Virus – a very small germ
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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 a HIV Infection?
– HIV attacks and invades CD4 T-cells, monocytes and
macrophages (white blood cells).
– 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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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.
• How can you be infected with HIV?
– Sexual contact (body fluids)
– Direct contact with infected blood (such as with IV
drug use, using dirty needles and sharing needles).
– Mother-to-Unborn Child transmission.
• But NOT through casual contact.
• Can you tell if a person is infected with HIV?
– No, an infected person can appear completely
healthy.
© 2008 McGraw-Hill Companies. All Rights Reserved.
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17
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.
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18
“HIV Positive Man… “
Answer the following questions by underlining
or highlighting the answers in the article.
1. How many girls did Williams allegedly
have sex with?
2. How many girls are infected with the
AIDS virus?
3. His sex partners may have infected how
many other people?
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19
Who has been infected?
• Blood and Blood Products used in Blood Transfusions
before 1985 were not tested for infection
– Arthur Ashe – blood transfusion during surgery
– Ryan White – hemopheliac who was given infected blood
product during a transfusion
– Elizabeth Glaser – blood transfusion during surgery
• Others through sexual activity and IV drug use
–
–
–
–
–
–
–
Freddy Mercury – IV drug use
Rock Hudson – sexual activity
Magic Johnson – sexual activity
Tommy Morrison – sexual activity
Easy E – sexual activity
Pedro Zamora – sexual activity
Greg Louganis – sexual activity
20
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
• Opportunistic Infections
– Pneumocystis Carinii pneumonia (protozoal
infection)
– Kaposis sarcoma
– Tuberculosis
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Routes of HIV transmission among adults
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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 T4
cells.
• What is the difference between HIV and AIDS?
– The HIV infection is considered AIDS when the
T4 cell count gets less than 200/mm3 blood.
• New diagnostic test – HIV Replication Capacity.
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23
Treatment for AIDS
• There are only Treatments (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
– Usually consists of an AIDS cocktail – as much as 20
pills a day
• Treatments for opportunistic infections
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24
Prevention
• Abstinence.
• If you have sex you must use a
condom.
• Do Not share drug needles or do
drugs.
• You can also Participate in an HIV
educational program.
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26
Questions:
• Can you get AIDS by donating blood?
• Can you get AIDS by getting a tattoo?
• Can you get AIDS by getting a body
piercing?
• Can you get AIDS the first time you
have sex?
• Once you become HIV positive can
you ever be negative?
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27
National Statistics
• CDC (Center for Disease Control)
estimates that 19 million STD infections
occur annually, almost half of them
among youth ages 15 to 24.
• Because many cases are not reported
or even diagnosed, it is estimated that
there are over a million new cases of
each year.
National Statistics cont.
• Chlamydia remains the most
commonly reported infectious disease
in the United States. In 2003, 877,478
chlamydial infections were reported to
CDC.
• Gonorrhea is the second most
commonly reported infectious disease
in the U.S., with 335,104 cases reported
in 2003.
National Statistics cont.
• There were more than 32,000 cases of
Syphilis in 2003. Also, the total number
of reported Primary and Secondary
cases of Syphilis increased from 6,862
to 7,177 in 2003.
Herpes Simplex Virus
• Herpes is a virus; Remains in the body for life
• 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 can be sexually transmitted.
– HSV-1 and 2 can cause miscarriages or still births along
with serious health issues of newborns
• Symptoms – 90% have no symptoms
– Recurring rash, painful ulcerations or cold sores/fever
blisters
– Primary outbreak - pain and discomfort around infected
area, itching, burning during urination.
– 2-20 days after infection - may be years before outbreak.
– Burning during urination, fever, headache
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31
Genital Herpes
•
•
•
•
The first outbreak usually occurs
within two weeks after the virus is
transmitted, and the sores typically
heal within two to four weeks.
Other signs and symptoms during
the primary episode may include a
second crop of sores, and flu-like
symptoms, including fever and
swollen glands.
When signs do occur, they typically
appear as one or more blisters on or
around the genitals, rectum, or
mouth.
There is no treatment that can cure
herpes, but antiviral medications
can shorten and prevent outbreaks
during the period of time the person
takes the medication.
Genital Herpes
• Most people diagnosed
with a first episode of
genital herpes can expect
to have several
outbreaks within a year.
You can get herpes
anywhere . . .
Source: Cincinnati STD/HIV Prevention Training Center
Herpes
34
Herpes
• Transmission
– Touching, sexual intimacy - including kissing,
sexual intercourse, sharing infected linens
• Diagnosis
– Examination of sores and culturing of fluid taken
from sores
• Treatment
– No cure - symptoms are relieved by prescription
drugs
• Protection
– Abstinence
– Refrain for sex during an out break
– Having protected sex with a condom*
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35
Human Papilloma Virus
• Also known as HPV or Genital Warts
• Caused by a Virus; there are several types of HPV
• More than 80% of sexually active individuals will
have been infected with HPV by the age of 50
• Can cause cervical cancer and other diseases
• Symptoms
– Small bump on the skin or a large, warty growth
– Cauliflower-like mass
– May cause irritation and bleeding
• Transmission
– Intimate sexual contact with an infected
person
– Direct contact with infected bed linen, towels,
clothes
© 2008 McGraw-Hill Companies. All Rights Reserved.
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36
Genital Warts
Chapter eighteen
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37
Genital Warts
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38
HPV (genital warts)
• Diagnosis
– Appearance of the lesions
– Women who are positive should have a Pap test very
12 months
• Treatment
– Topical medications can be used with sores and
warts
– Warts can be removed by cryosurgery,
electrocautery or laser surgery but may later come
back
– There is no cure!
• Protection
– Abstinence
– Having protected sex with a condom
– Gardasil vaccine for young girls can help for some
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39
Hepatitis B Virus (HBV)
• Another virus with no cure; Preventable with vaccination
• Can cause liver disease and death
• Transmission
– Unprotected sexual contact; 750,000 total acquired
sexually
– Sharing needles, IV drug use
– Can be found in 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 to know status
– Abstinence and have protected sex only
– Don’t use drugs
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40
“STD rates high among Shore teens”
– The Daily Times 4/16/12
Answer the following questions by underlining
or highlighting the answers in the article.
1. Wicomico County ranks _______ state-wide
in numbers of STD cases.
2. What is abstinence?
3. If someone has an STD will they always
have signs or symptoms?
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41
“Vaccinating boys against HPV
makes good sense”
The Daily Times 10/15/12
Find the answers to the following:
1. HPV has been known to cause cancers in
what areas of the body?
2. What is the name for the HPV vaccination
that is currently available for both girls and
boys?
3. How many HPV-related cancers occur in
men each year?
42
Gonorrhea
• 700,000 new cases every year in the U.S.
• Bacterial infection – Can cause other problems such as
• sterility, arthritis and heart problems, PID,
ectopic pregnancy, premature labor and
still birth, arthritis, rashes
• Symptoms
– Women – Can be asymptomatic
• Frequent burning urination, menstrual
irregularities, pelvic pain, discharge.
– Males
• thick yellow-white discharge, painful
urination.
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43
Gonorrhea
• 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.
Gonorrhea
Disseminated Gonococcal
(Gonorrhea) Infection
Source: CDC/NCHSTP/Division of STD Prevention, STD Clinical Slides
45
Gonorrhea
• Transmission
– Sexual contact
• Diagnosis
– Microscopic exam of discharge
• Treatment
– Oral antibiotics – People often have
chlamydia at same time.
• Protection
– Abstinence
– Protected sex with condoms
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Chlamydia Trachomatis
• Most prevalent bacterial STD in the U.S.
• Can cause sterility in men and women
– WOMEN - infects the cervix and urethra, fallopian
tubes & ovaries; Can cause PID and bladder
infections.
– MEN- Epididymitis, urethra and testes; Can cause
urethritis, bladder infections, watery discharge.
• Symptoms – Can be 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.
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Chlamydia
•
•
•
Chlamydia is known as a
“silent” disease. If symptoms
do occur, they usually appear
within 1 to 3 weeks after
exposure.
Women who have symptoms
might have an abnormal
vaginal discharge or a burning
sensation when urinating. Men
with signs or symptoms might
have a discharge whitish
discharge from their penis or a
burning sensation when
urinating.
Chlamydia can also be found in
the throats of women and men
having oral sex with an infected
partner.
Chlamydia
• Transmission
– Sexual contact, babies can be infected inside
the birth canal
• Diagnosis
– Examination of tissue samples or urine
• Treatment
– Both partners treated fully with antibiotics
• Protection
– Abstinence
– Condoms and safe sex
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Pelvic Inflammatory Disease
PID
• Progressive infection that harms a woman’s
reproductive system.
• Can lead to sterility, ectopic pregnancy and
chronic pain - treated or not.
• Caused by chlamydia and gonorrhea.
• Symptoms
– long and painful menstrual periods, discharge,
spotting, low abdominal pain, fever, chills,
nausea, vomiting, pain during intercourse
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Gonorrhea
Pelvic Inflammatory Disease
(PID)
Source: Cincinnati STD/HIV Prevention Training Center
51
Pelvic Inflammatory Disease
PID
• Treatment
– Antibiotics, bed rest, sexual abstinence during
treatment, surgery may be necessary to remove
scarring
• Diagnosis
– Pelvic Exam, cultures, laparoscopy
• Protection
– Abstinence
– Condoms and safe sex
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Syphilis
• Caused by spirochetes
• Syphilis organism remains in the body for life and
leads to disfigurement, neurological disorders, or
death.
• Symptoms –
– Primary phase- 3 weeks - 90 days - painless
sores and wet ulcers (chancre) and swollen
glands.
– Secondary Phase - 3-6 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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Primary Syphilis
•
•
•
The primary stage of syphilis is
usually marked by the
appearance of a single sore,
but there may be multiple
sores.
The time between infection with
syphilis and the start of the
first symptom can range from
10 to 90 days. The chancre is
usually firm, round, small, and
painless. It appears at the spot
where syphilis entered the
body.
The chancre lasts 3 to 6 weeks,
and it heals without treatment.
Syphilis
Oral Primary Syphilis Chancre
Source: CDC/ NCHSTP/ Division of STD Prevention, STD Clinical Slides
55
Secondary Syphilis
• This stage typically starts
with the development of
a rash on one or more
areas of the body.
• In addition to rashes,
symptoms of secondary
syphilis may include
fever, swollen lymph
glands, sore throat,
patchy hair loss,
headaches, weight loss,
muscle aches, and
fatigue
Late Syphilis
• Without treatment, the
infected person will continue
to have syphilis even though
there are no signs or
symptoms; infection remains
in the body.
• In the late stages of syphilis,
it may subsequently damage
the internal organs, including
the brain, nerves, eyes, heart,
blood vessels, liver, bones,
and joints
Late Stage Syphilis
Ulcerating Gumma
Source: CDC/ NCHSTP/ Division of STD Prevention, STD Clinical Slides
Syphilis
58
Syphilis
• Transmission
– Unprotected sexual contact; from infected
mother to baby
• Diagnosis
– Culture of discharge; blood test
• Treatment
– Effective antibiotics
• Protection
– Abstinence
– Protected sex with condoms
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Other STDs
• Trichomoniasis (protozoa)
– Direct contact with infected people, bed linens
and towels
• Pubic Lice (Crabs)
– Direct contact with infected people, bed linens,
towels, toilet seat
• Bacterial vaginosis (BV)
• Scabies
• Candiasis (fungi)
• Nongonococcal Urethritis (NGU)
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Pubic Lice
• Signs and symptoms of
pubic lice include
• Itching in the genital
area
• Visible nits (lice eggs) or
crawling lice
Pubic Lice
• Pubic lice have six legs,
but 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.
• A lice-killing shampoo
made is recommended to
treat pubic lice.
What You Can Do
• Educate Yourself
• Prevention
– Use a barrier defense such as a condom
– Know your potential partner
– Abstinence until monogamous
• Diagnosis and Treatment
–
–
–
–
–
Get vaccinated
Be alert for symptoms
Get tested
Inform your partners
Get Treated
• Ask. Are you ready to have sex?
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63
Sexually Transmitted
Diseases