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Sexually Transmitted Diseases

Chapter 18. Sexually Transmitted Diseases. Sexually Transmitted Diseases (STDs). Also known as Sexually Transmitted Infections (STIs) Spread of an infection from person to person mainly through sexual activity. STDs that pose a major health threat: HIV/AIDS Hepatitis Syphilis Chlamydia

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Sexually Transmitted Diseases

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  1. Chapter 18 Sexually Transmitted Diseases

  2. Sexually Transmitted Diseases (STDs) • Also known as Sexually Transmitted Infections (STIs) • Spread of an infection from person to person mainly through sexual activity. • STDs that pose a major health threat: • HIV/AIDS • Hepatitis • Syphilis • Chlamydia • Gonorrhea • Herpes • Human papillomavirus (HPV) • CDC (2008) estimated 65 million Americans were infected with an STD, and about 19 million Americans become newly infected with an STD each year.

  3. Table 18-1 Annual New Cases of STDs in the United States

  4. Table 18-2 Sexually Transmitted Pathogens and Associated Disease

  5. 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 have been infected with Human Immunodeficiency Virus (HIV) since the epidemic began. • Nearly 1% of the world’s population • About 3 million infections per year • 1.1 million Americans have been infected and about 500,000 have died since the start of the epidemic. • Human immunodeficiency virus (HIV) is the virus which causes AIDS.

  6. What is HIV Infections? HIV attacks and invades CD4 T-cells, monocytes and macrophages. HIV enters a human cell and coverts its own genetic material, RNA, into DNA AIDS opens the possibility for a opportunistic infections. Once initial symptoms resolve, the asymptomatic period may last from 2 to 20 years.

  7. Figure 18-1 The general pattern of untreated HIV infection

  8. Transmitting the Virus Sexually Transmitted Diseases • 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. • Vertical or perinatal, transmission • Not through casual contact.

  9. 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”

  10. Figure 18-2 Routes of HIV transmission among adults

  11. 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 (fungal infection). • Kaposis sarcoma. • Difficult to treat yeast infections in women • Tuberculosis

  12. 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), Immunoflourescence assay)) • IF HIV-positive then check the status of the CD4-t cells. • New diagnostic test – HIV Replication Capacity.

  13. Diagnosing AIDS Sexually Transmitted Diseases • Infection defined as an AIDS indicator. • Reporting. • All diagnosed cases of HIV or AIDS must be reported to public health authorities • Treatment (NO CURE). • Antiviral drugs. • Reverse transcriptase inhibitors. • Zidovudine (AZT). • Inhibiting the enzyme reverse transcriptase, uses to integrate its genetic material into human cells. • Protease inhibitors. • Highly active antiretroviral therapy (HAART). • Structured intermittent therapy. • Entry inhibitors • Enfuvirtide (Fuzeon) • Block HIV from entering and infecting cells. • Integrase inhibitor • Blocks the incorporation of newly formed HIV DNA into the host cell’s chromosome. • Post-Exposure prophylaxis. • Treatment for opportunistic infections. • HIV and Pregnancy

  14. What about a Vaccine? • Vaccines are being tested in humans • Licensed AIDS vaccine is not estimated to be at least a decade away • Some experts concede the possibility that a vaccine may never be devleoped • How Can You Protect Yourself? • Make careful choices about sexual activity. • Do Not share drug needles. • Participate in an HIV educational program.

  15. 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.

  16. 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

  17. Gonorrhea • 350,000 new cases reported to the CDC in 2006. • 5.5% increase over 2005. • Bacterial infection -Can cause sterility, arthritis and heart problems • PID, can cause ectopic pregnancy, premature labor and still birth, arthritis, and rashes • Gonococcal conjunctivitis • Eye infection of a infant that can cause blindness if not treated • Symptoms – • Women - Asymptomatic - Frequent burning urination, menstrual irregularities, pelvic pain, discharge. • Males – thick yellow-white discharge, painful urination.

  18. 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.

  19. Pelvic Inflammatory DiseasePID 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.

  20. Pelvic Inflammatory DiseasePID Treatment - Antibiotics, bed rest, sexual abstinence and maybe surgery to remove scarring Diagnosis - Pelvic Exam, cultures, laparoscopy Protection - Condoms and safe sex

  21. Human Papilloma Virus • More than 80% of sexually active individuals will have been infected with HPV by the age of 50. • Vaccine • Is not a treatment for HPV for girls or women who are infected with HPV. • 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

  22. Genital Herpes • 1 in 5 adults in the U.S. has genital herpes • Two forms - Herpes simples virus-1 and -2. • HSV 1 (Type 1) is associated with cold sores and fever blisters. • Oral-labial herpes • 50-80% of U.S. adults have antibodies to HSV-1 • HSV 2 (Type 2) • Usually occurs during adolescence and early adulthood • Between 18 -25 years old • Approximately 22% of adults have antibodies to HSV 2 • 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.

  23. 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

  24. Hepatitis B Virus (HBV) • Can cause liver disease and death • Inflammation of the liver • Preventable with vaccination. • 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

  25. Syphilis • 7000-10,000 new cases of early syphilis in the U.S. • 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 - 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. • Diagnosis and Treatment • Examination of infected tissues and with blood tests • Treated by antibiotics

  26. Other STD’s • Trichomoniasis • “Trich” • Single-celled organism • Bacterial vaginosis (BV) • Abnormal vaginal discharged caused unhealthy species of normal vaginal bacteria • Pubic Lice “Crabs” • Contagious parasitic infections • Scabies • Contagious parasitic infections

  27. 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?

  28. Chapter 18 Sexually Transmitted Diseases

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