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Bacterial or viral diseases that are sexually transmitted through genital/oral/anal contact but also other ... vaginal secretion, other body fluids, IV drugs, piercing, tatoos. ...

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HAPPY VALENTINE’S DAY

Love … Very Carefully!!!


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STDs or STIs

  • Bacterial or viral diseases that are sexually transmitted through genital/oral/anal contact but also other conduits

  • Bacterial STIs:

    • can be cured if caught early

  • Viral:

    • can NOT be cured


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STDs or STIs

  • Difference between most common reportable STI and most common STI

    • not all STIs are required to be reported

  • Many if not most (depending on disease and gender) are ASYMPTOMATIC

    • So: can transmit unknowingly


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STDs or STIs

  • Most Common:

    • HPV human papilloma virus (warts)

  • HPV:

    • over 100 different strains

    • cauliflower-like warts in vulva, vagina, penis, pubic area and anus but can be asymptomatic

    • leads to cervical cancer

    • can cause penile and anal cancer

    • 100 MUN female students a year have precancerous changes due to HPV

    • birth control pill interaction

      • hormones in contraceptive promotes changes in cervical cells that make it more vulnerable (squamous cells)


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STDs or STIs

  • HPV (Cont’d):

    • smoking interaction:

      • nicotine metabolites increase cervical cancer risk

    • early sex (13-15) is a risk factor

    • multiple partners, also a risk factor

    • effect of alcohol and drugs:

      • weaken immune system, impair judgment of risk

    • condoms not effective in protecting against HPV:

      • warts can be in areas other than penis, e.g. pubic area, anus

    • no cure

    • 20-33% people have it – some studies report almost 100% incidence but strong immune system can fight it off


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STDs or STIs

HPV (Cont’d):

  • A new vaccine for HPV prevention is available since July ’06

    • the vaccine prevents four strains of HPV, which happen to be the ones that most commonly (70%) cause cervical cancer. The recommendation is to vaccinate girls between ages 9 and 14, before they become sexually active. Girls chosen due to cervical cancer risk

  • New study (Feb. ’08): HPV causes oral cancer in men via oral sex, rivaling oral cancers due to tobacco and alcohol. Vaccine currently being tested in men


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STDs or STIs

  • Chlamydia:

    • most common reportable STI in Canada

    • decrease since 90’s but still very high

    • more in women, but less reporting from men

    • age 15-24 women highest rate

    • 75% women asymptomatic until it spreads to uterus

    • damage to:

      • cervix

      • uterus

      • fallopian tubes

      • peritoneum

      • liver


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STDs or STIs

  • Chlamydia (Cont’d):

    • causes:

      • PID

      • tubal blockage

      • ectopic pregnancies

      • infertility

      • prematurity and low birth weight


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STDs or STIs

  • Chlamydia (Cont’d):

    • males:

      • 50% asymptomatic

      • 50% have urethral discharge

      • burning urination

      • epididymitis

      • infertility

      • Reiter’s syndrome (conjunctivitis and arthritis)

    • if having anal sex:

      • proctitis and proctocolitis


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STDs or STIs

  • Genital Herpes:

    • children of mothers with GH Type II have higher rates of schizophrenia (preliminary study) or other psychoses. Correlational data.

  • Caused by herpes simplex virus, Type I (cold sores) and Type II – both cause the STI

  • Most are asymptomatic:

    • if symptomatic: small, painful blisters on genitals

    • also, fever, painful urination, headaches


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STDs or STIs

  • Genital Herpes (Cont’d):

  • These symptoms last 3 weeks, then virus goes dormant, but still contagious. Symptoms may recur randomly

  • Pregnant women can transfer to fetus, can lead to fatal brain infection

  • No cure, some antiviral drugs lessen severity of symptoms and shorten the outbreak but always contagious

  • Long term: can lead to meningitis, narrowed urethra, increased HIV infection, genital scarring

  • No cure


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STDs or STIs

  • Hepatitis:

    • Viral disease of the liver.

  • Types A, B, C, D, E.

    • Type B most common STI.

    • Next is Type C.


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STDs or STIs

  • Hepatitis (Cont’d):

  • Hep B:

    • Through blood, saliva, semen, vaginal secretion, other body fluids, IV drugs, piercing, tatoos.

  • Symptoms:

    • Enlarged liver, fever, fatigue, jaundice, vomiting. But some asymptomatic. No cure, can lead to liver degeneration and death.

  • Liver cirrhosis, cancer:

    • Second leading cause of cancer world-wide (after smoking).

  • But – there is a vaccine: prevention.

  • 200 times more common than HIV.


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STDs or STIs

  • Hepatitis (Cont’d):

  • Hep C:

    • Can also lead to liver cirrhosis and cancer of the liver. Found in users of IV drugs, nasal coke, tattoos and piercings. Also contaminated water.


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STDs or STIs

  • HIV:

    • Human Immunodeficiency Virus

  • HIV/AIDS:

    • By December ’03 almost 20,000 in Canada reported cases.

    • 67% had died.

  • AIDS:

    • Acquired Immune Deficiency Syndrome

      • Estimate (2003): 56,000 Canadians live with HIV. One third not aware.

      • Worldwide: 40 million have HIV (estimate)


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STDs or STIs

  • AIDS (Cont’d):

    • Transmission:

      • body fluids (not saliva)

      • sex (penis/vagina or penis/anus)

      • contaminated blood

      • hypodermic needles

      • during pregnancy and childbirth

  • Condoms 87% effective for HIV

  • No cure but effective treatments make it a chronic illness

  • Recent studies: health problems of HIV/AIDS patients in middle/old age


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STDs or STIs

  • TRICHOMONIASIS:

    • Caused by neither bacterium nor virus.

  • Trichomonas vaginalis:

    • single cell protozoan, a parasite that attaches to vaginal cells.

    • transmitted mostly through sex, but the organism can survive for some time on toilet seats and other surfaces.

    • more common in women, very widespread (8,000,000 in North America, 170 million worldwide).


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STDs or STIs

  • TRICHOMONIASIS (Cont’d):

  • Men are asymptomatic, 50% women have symptoms:

    • vaginal itch

    • smelly (fishy), frothy vaginal discharge

  • Can cause:

    • PID

    • increased female vulnerability to HIV

    • people with HIV transmit it more easily if they have trichomoniasis

    • in pregnancy, premature birth and/or low birth weight

  • Treatment:

    • Flagyl (metronidazole)


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LYMPHOGRANULOMA (LPV)

  • So far mostly men/men

  • Same type as chlamydia

  • Much more invasive

  • Through oral, vaginal, anal sex

  • Treatable with antibiotics

  • Symptoms (3-30 days): vaginal painless sore in initial phase

  • Low grade fever

  • Fatigue

  • Muscle and joint aches


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STDs or STIs

Safe Sex vs. safER sex

  • Two monogamous people who have tested negative for STIs or have never had any sexual contact before.

  • Issue of trust.


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