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Intro
SEXUALLY TRANSMITTED DISEASES
CHAPTER 24
The Numbers in STD
STDs
Can become infected by one or more over and over again
Can become infected with more than one at a time
Can pass any or all to partner
Most STDs infect the reproductive organs
STDs infect the skin or mucous membranes of the reproductive organs.
Symptoms of STDs
Nature of STD
Symptoms may be overlooked.
Asymptomatic
Person with no obvious signs or symptoms of a disease.
Dont know they are infected until they pass it.
Common STDs
What are some common STDs?
Chlamydia
Gonorrhea
Syphilis
Genital Herpes
Genital Warts
HIV/AIDS
Teen Sexuality
Chlamydia
Introduction of Chlamydia
Chlamydia is a bacterial infection of your genital tract that spreads easily through
sexual contact.
You may not know you have Chlamydia because the signs and symptoms of pain and fluid
discharge don't show up right away, if they show up at all.
Many people experience no signs and symptoms
Intro
Each year, nearly 3 million people in the United States are infected with Chlamydia.
The disease affects both men and women and occurs in all age groups.
Chlamydia is most prevalent among U.S. teenagers.
Signs and symptoms
When signs or symptoms do occur, they usually start one to three weeks after you've been
exposed to Chlamydia.
Even when signs and symptoms do occur, they're often mild and passing, making them easy
to overlook.
Signs and symptoms
Signs and symptoms of Chlamydia infection may include:
Painful urination
Lower abdominal pain
Vaginal discharge in women
Discharge from the penis in men
Painful sexual intercourse in women
Testicular pain in men
Chlamydia (Female)
Chlamydia (Males)
Chlamydia (eye)
Causes
Caused by a bacteria.
The condition most commonly spreads through sexual intercourse and other intimate
contact between genitals and the rectal area.
It's also possible for a mother to spread Chlamydia to her child during delivery,
causing pneumonia or a serious eye infection.
Prevention
The surest way to prevent a Chlamydia infection is to abstain from sexual activities.
Prevention
Use condoms. Use a male latex condom or a female polyurethane condom during each sexual
contact. Condoms, used properly during every sexual encounter, reduce but don't eliminate the
risk of infection.
Limit your number of sex partners. Having multiple sex partners puts you at a high risk
of contracting Chlamydia or other sexually transmitted diseases.
Prevention
Get regular screenings for sexually transmitted diseases. If you're sexually active,
particularly if you have multiple partners, talk with your doctor about how often you should be
screened for Chlamydia and other sexually transmitted diseases.
Avoid douching. Women shouldn't use douche because it decreases the number of good
bacteria present in the vagina, which may increase the risk of infection.
Treatment
Doctors treat Chlamydia with prescription antibiotics.
In most cases, the infection resolves within one to two weeks. During that time you
should abstain from sex.
Your sexual partner or partners also need treatment even though they may not have signs
or symptoms.
Otherwise, the infection can be passed back and forth.
It's possible to be reinfected with Chlamydia.
Gonorrhea
Introduction
Gonorrhea, a highly contagious sexually transmitted disease (STD), is one of the most
common STDs in the United States.
Sometimes referred to as "the clap," gonorrhea may produce signs and symptoms such as a
burning sensation when urinating or a thick discharge from the penis or vagina.
Gonorrhea
It is characterized by a discharge of pus and primarily involves the mucous membranes of
the urogenital tract, although the bacteria may also infect such areas as the mouth, throat, and
rectum.
The incubation period in males is 2 to 14 days.
In women, symptoms tend to start appearing within 7 to 21 days after infection.
Introduction
Many people experience mild or no signs or symptoms. Left untreated, gonorrhea can cause
serious complications, especially in women.
The disease can also be passed from a mother to her child during birth.
In Men
Gonorrhea tends to be much more obvious in males, who often develop an acute discharge
of pus from the urethra when infected.
Scant at the start, it becomes progressively thicker and heavier and causes frequent
urination, often with a burning sensation.
Should the prostate become infected, the passage of urine is partly obstructed.
Gonorrhea (male)
In Females
In females the infection occurs generally in the urethra, the vagina, or the cervix.
Although discharge and irritation of the vaginal mucous membranes may be severe, more
often few or no early symptoms appear.
Gonorrhea is diagnosed readily in males by staining a smear of the discharge to reveal
the bacteria; this so-called Gram stain technique is much less accurate for women..
Signs and symptoms
Signs and symptoms of gonorrhea may include:
Thick, cloudy or bloody discharge from the penis or vagina
Pain or burning sensation when urinating
Frequent urination
Pain during sexual intercourse
Gonorrhea (Mouth & Eyes)
Pregnant Women
Gonorrhea in pregnant women may be transmitted to the infant during birth and may, if
untreated, cause a serious eye infection, a joint infection, or a potentially life-threatening
infection of the blood.
Treatment
Treatment in the early stages is usually effective.
If the disease is untreated in the male, the early symptoms may subside but the
infection may spread to the testicles, causing sterility.
In the untreated female the infection usually spreads from the cervix into the uterus
and Fallopian tubes, causing pelvic inflammatory disease
Treatment
Severe pain may occur, or the infection may linger with few or no symptoms, gradually
damaging the tubes and rendering the woman sterile.
In both sexes the gonococcus may enter the bloodstream, resulting in arthritis, heart
inflammation, or other diseases.
Risk factors
The more sexual partners you have, the greater your risk.
Casual contact, such as kissing, doesn't spread the disease.
About three out of four reported cases of gonorrhea in the United States occur in people
younger than 30.
The highest rates of infection often are present in 15- to 19-year-old women and 20- to
24-year-old men.
Complications
Pelvic inflammatory disease. In women, the bacteria can spread into the uterus and
fallopian tubes, causing pelvic inflammatory disease (PID), which may result in scarring of the
tubes, greater risk of ectopic pregnancy and infertility.
PID may lead to abdominal pain, backache, irregular menstrual periods, pain during
intercourse and foul-smelling vaginal discharge. It's a serious infection that requires
immediate treatment by a doctor.
Complications
Spread of the infection during childbirth.
A pregnant woman with untreated gonorrhea may spread the infection to her baby as the
baby passes through the birth canal during delivery.
In an infant, gonorrhea may cause complications such as blindness and widespread
infection of the joints and blood.
Complications
Irritation of your throat and tonsils. Oral sex can lead to gonorrhea in the mouth, with
a sore throat, pain on swallowing and redness of the throat and tonsils.
Eye inflammation. Infection may sometimes spread to the eye by touching or rubbing the
eye with your hand after it has been in contact with infected discharge.
Complications
Widespread infection in your body. Rarely, the bacterium that causes gonorrhea can
spread through the bloodstream to cause infection in other parts of your body.
Fever, rash, skin sores, joint pain, swelling and stiffness are possible results.
Gonorrhea
Infected individuals, even those without symptoms, can spread the disease to others if
they do not use a latex condom during sex.
Stats
The officially reported U.S. gonorrhea rate generally declined between the mid-1980s and
the end of the 20th century.
Approximately 355,000 cases were reported in 1998, or about 132.9 per 100,000 persons;
three-fourths of the reported cases occurred in persons aged 15 to 29 years.
Stats
Some experts estimated the true number of new infections annually near the end of the
20th century at about 600,000.
One of the most difficult tasks in controlling gonorrhea is locating all recent sexual
contacts of an infected person in order to prevent further spread of the disease.
Syphilis & Gonorrhea
Syphilis
Introduction
Syphilis is a bacterial infection usually transmitted by sexual contact.
The disease affects your genitals, skin and mucous membranes, but it may also involve
many other parts of your body, including your brain and your heart.
Syphilis
Usually transmitted by sexual contact or kissing.
Infection from contaminated objects is infrequent, because drying quickly kills the
organisms.
A fetus carried by a woman with syphilis may contract the disease, a condition called
congenital syphilis. People with syphilis run an increased risk of contracting AIDS.
History
Some authorities believe that syphilis was introduced into Europe in 1493 by crew
members returning from Christopher Columbus's first expedition to America; the geographical
origin of the disease, however, remains a subject of controversy.
History
In 1943 the antibiotic penicillin was shown to be highly effective against syphilis,
and it is still the preferred treatment.
The government in 1974 agreed to a $10 million settlement of a class-action suit that
had been brought against it after the existence of the Tuskegee Study of Untreated Syphilis in
the Negro Male became public knowledge, and President Bill Clinton rendered a public apology to
the survivors in 1997.
History
During the 1970s most cases of syphilis in men occurred in homosexuals, but the increase
in the 1980s appeared to be largely among heterosexuals--a trend that increased the incidence of
congenital syphilis, which causes a high rate of morbidity and mortality in infants.
History
The 1990s saw a decline in cases, and near the end of the decade a national campaign to
virtually eliminate the disease was launched by the U.S. Centers for Disease Control and
Prevention (CDC).
History
In 2000, only about 6000 cases of primary and secondary syphilis were reported by the
CDC, and reported cases of congenital syphilis in newborns totaled a few hundred.
Stages of Syphilis
Primary
Secondary
Latent
Tertitary
Primary
The primary stage is characterized by a small, firm, painless lesion, called a chancre,
which appears at the site of infection generally 10 to 90 days after exposure.
Lymph glands near the site may become swollen. Fluid from the chancre is extremely
infectious.
The chancre usually disappears in a few weeks.
Primary Stage
Secondary
In the secondary stage, occurring as, or more often within a few weeks after, the
chancre fades away, a generalized rash appears.
Painless ulcers may develop in the mouth, and broad, wartlike lesions, which also are
highly infectious, may appear in the genital area.
Headache, sore throat, hair loss, weight loss, muscle pains, fever, and enlarged lymph
glands are sometimes observed.
Secondary
The secondary stage symptoms may last a couple of months or more, and in some cases may
fade away and then reappear.
The disease then enters a latent stage in which no outward signs or symptoms occur, but
inflammatory changes may take place in the internal organs
First Sore to appear
Latent
In some people, a period called latent syphilis - in which no symptoms are present - may
follow the secondary stage.
Signs and symptoms may never return, or the disease may progress to the tertiary stage.
Latent
The latent stage can last anywhere from months to a lifetime.
In most cases, no further symptoms appear.
Symptoms of neurosyphilis are seen in about 5 percent of untreated cases of the disease.
Syphilis (Female)
Last Stage
When the final stage, tertiary syphilis, does occur, however, it may produce hard
nodules, called gummas, in the tissues under the skin, the mucous membranes, and the internal
organs.
The bones are frequently affected, as well as the liver, kidney, and other visceral
organs. Cardiovascular syphilis, which may lead to an aneurysm of the aorta or leakage in the
aortic valve, accounts for most deaths.
Tertiary
Patients may show a lack of muscular coordination, loss of urinary control, and
degeneration of the reflexes; psychosis may ensue.
Infection in the uterus may lead to miscarriage, to stillbirth, or to the birth of a
child with congenital syphilis.
Syphilis (Toe & Mouth)
In Children
Infected children often bear typical signs, such as high forehead, saddlenose, and peg-
shaped teeth.
By the second decade of life, central nervous system deterioration may appear.
Causes
Syphilis is contagious during its primary and secondary stages, and sometimes in the
early latent period.
The bacterial organism that causes syphilis, enters your body through minor cuts or
abrasions in your skin or mucous membranes.
The most common route of transmission is through contact with an infected person's sore
during sexual activity.
Other routes are through transfusion of infected blood, through direct unprotected close
contact with an active lesion (such as during kissing), and through an infected mother to her
unborn child during pregnancy.
Risk factors
High-risk sexual activity puts you at risk of syphilis and other sexually transmitted
diseases (STDs).
Men who have unprotected sex with other men are at greater risk, and about half the men
recently diagnosed with syphilis are also infected with (HIV).
Risk Factors
Young adults between the ages of 15 and 25 years currently appear to be at highest risk
of contracting syphilis.
However, anyone who has unprotected sex is at risk of developing syphilis.
Even if you've had syphilis and been treated for it previously, you can contract it
again.
Complications
If you're pregnant, it's possible for you to pass syphilis to your unborn child.
Almost half the babies who contract syphilis from their mothers will die - either
through miscarriage, stillbirth or within a few days of birth.
Complications
Babies born with syphilis who aren't treated early may experience serious complications,
including:
Bone abnormalities and pain
Depressed nose bridge (saddle nose)
Swollen joints
Vision and hearing problems
Disfigured, screwdriver-shaped teeth (Hutchinson's teeth)
Scarring at the site of early sores
Death
Complications
Adults with sexually transmitted syphilis or other genital ulcers also have an increased
risk of contracting HIV.
A syphilis sore can provide an easy way for HIV to enter your bloodstream during sexual
intercourse.
Prevention
To reduce your risk of syphilis and other sexually transmitted diseases, practice safe
sex:
Avoid sex, or limit sexual relations to a single, uninfected partner.
If you don't know the STD status of your partner, use a latex condom with each sexual
contact.
Avoid excessive use of alcohol or other drugs, which can cloud judgment and lead to
unsafe sexual practices.
Treatment
Early diagnosis and treatment with penicillin - or another antibiotic if you're allergic
to penicillin - can kill the organism that causes syphilis and stop the progression of the
disease.
Left untreated, the disease can lead to serious complications or death.
Genital herpes
Introduction
Genital herpes is a highly contagious sexually transmitted disease. Features of genital
herpes include pain, itching and sores in your genital area.
Signs and symptoms
The majority of people who've been infected with HSV never know they have the disease
because they have no signs or symptoms.
The signs and symptoms of HSV can be so mild they go unnoticed.
The first outbreak is generally the worst, and some people never experience a second
outbreak.
Other people, however, can experience outbreaks as long as 40 years after the initial
outbreak.
Herpes (male)
Signs and symptoms
When present, genital herpes symptoms may include:
Small, red bumps, blisters (vesicles) or open sores (ulcers) in the genital, anal and
nearby areas
Pain or itching around your genital area, buttocks or inner thighs
Herpes (female)
Signs and symptoms
The initial symptom of genital herpes usually is pain or itching, beginning within a few
weeks after exposure to an infected sexual partner.
After several days, small, red bumps may appear. They then rupture, becoming ulcers that
ooze or bleed.
Eventually, scabs form and the ulcers heal.
Herpes (mouth)
Signs and symptoms
In women, sores can erupt in the vaginal area, external genitals, buttocks, anus or
cervix.
In men, sores can appear on the penis, scrotum, buttocks, anus or thighs or inside the
urethra, the channel between the bladder and the penis.
Signs and symptoms
While you have ulcers, it may be painful to urinate.
You may also experience pain and tenderness in your genital area until the infection
clears.
During an initial outbreak, you may have flu-like signs and symptoms, such as headache,
muscle aches and fever, as well as swollen lymph nodes in your groin.
Herpes (male)
Recurrences
Genital herpes is different for each person.
The signs and symptoms may recur for years.
Some people experience numerous episodes each year.
For many people, however, the outbreaks are less frequent as time passes.
Recurrences
Various factors may trigger outbreaks, including:
Stress
Menstruation
Immune system suppression, from medications such as steroids or chemotherapy, or due to
infections, such as HIV/AIDS
Illness
Surgery
Friction, such as that caused by vigorous sexual intercourse
Fatigue
In some cases, the infection can be active and contagious even when lesions aren't
present.
Causes
Two types of herpes simplex virus infections can cause genital herpes:
HSV type 1 (HSV-1). This is the type that usually causes cold sores or fever blisters
around your mouth, though it can be spread to your genital area during oral sex.
HSV type 2 (HSV-2). This is the type that commonly causes genital herpes. The virus
spreads through sexual contact and skin-to-skin contact. HSV-2 is very common and highly
contagious whether or not you have an open sore. However, in many people the infection causes no
recognized signs or symptoms and can still be spread to a sexual partner.
Causes
Because the virus dies quickly outside of the body, it's nearly impossible to get the
infection through contact with toilets, towels or other objects used by an infected person.
Complications
In healthy adults, genital herpes generally doesn't cause other serious permanent
complications besides the sores. These other complications may occur:
Contraction of other STDs. Having genital herpes can increase your risk of transmitting
or contracting other sexually transmitted diseases, including the AIDS virus.
Newborn infection. A mother with open sores can spread the infection to her newborn as
the infant passes through the birth canal.
Genital herpes may result in brain damage, blindness or death for the newborn.
Treatment
There's no cure for genital herpes.
However, genital herpes treatment includes oral prescription antiviral medications,
such as (Valtrex), to help heal the sores sooner and reduce the frequency of relapses.
If taken daily, these medications may also reduce the chance you'll infect your partner
with the herpes virus.
Genital warts
Introduction
genital warts affect the moist tissues of the genital area.
They may look like small, flesh-colored bumps or have a cauliflower-like appearance.
Genital warts may be as small as 1 millimeter in diameter - smaller than the width of a
ballpoint pen refill - or may multiply into large clusters.
Introduction
In women, genital warts can grow on the vulva, the walls of the vagina, the area between
the external genitals and the anus, and the cervix.
In men, they may occur on the tip or shaft of the penis, the scrotum or the anus.
Genital warts can also develop in the mouth or throat of a person who has had oral
sexual contact with an infected person.
Causes
Like warts that appear on other areas of your skin, genital warts are caused by a virus -
HPV - that infects the top layers of your skin.
There are more than 100 different types of HPV, but only a few can cause genital warts.
These strains of the virus are highly contagious and spread through sexual contact with
an infected person.
About two-thirds of people who have sexual contact with someone who has genital warts
develop the condition - usually within three months of contact, but in some cases not for years.
Risk factors
Having unprotected sex with multiple partners increases your risk of becoming infected
with HPV. Other risk factors include:
Having had another sexually transmitted disease
Having sex with a partner whose sexual history you don't know
Becoming sexually active at a young age
Genital Warts
Genital Warts (male)
Complications
Cervical cancer has been closely linked with HPV infection.
Certain types of HPV also are associated with cancer of the vulva, cancer of the anus
and cancer of the penis.
Human papillomavirus infection doesn't always lead to cancer, but it's still important
for women, particularly those who've been infected with certain higher risk types of HPV, to
have regular Pap tests.
Genital Warts (Female)
Warts (hand)
HIV/AIDS
Introduction
HIV is an acronym that stands for human immunodeficiency virus and it causes acquired
immune deficiency disease or AIDS.
AIDS is a chronic disease made up of a series of symptoms and infections caused by the
damage to the immune system done by the HIV virus.
Facts about AIDS
World-wide Pandemic
Roughly 40,000 Americans become infected with HIV every year.
More than 500,000 have died of AIDS.
Half of all new cases in the US occur among people 25 years old and younger.
Every hour, someone in the US between ages 13 and 24 contracts HIV.
Facts about AIDS
More than 22 million people around the world have died of AIDS.
An estimated of 252,000 to 312,000 Americans infected with HIV do not know they have it.
Timeline
1959- Scientists isolate what is thought to be the earliest case of AIDS, though it was
not identified as such until many years later.
1978- Some gay men in the US show signs of what will later be called AIDS.
1982- CDC identifies AIDS as a blood-borne disease; Term used for the 1st time.
Timeline
1983- Scientists identify HIV as the virus that causes AIDS.
1985- The FDA approves the first HIV test.
1987- AZT becomes the first HIV drug approved by the FDA.
1988- December 1 is World AIDS Day.
1990- Ryan White dies of AIDS at age 19. (blood transfusion).
Timeline
1991- Magic Johnson announces he has HIV.
1995- First protease-inhibitor drug, which reduces the viruss ability to spread to new
cells, is approved.
1998- Clinical trials begin on an AIDS vaccine.
Timeline
2003- Bush announces PEPFAR, a $15 billion, 5 year plan to combat AIDS in African and
Caribbean nations.
2006- FDA approves the first single-pill once-a-day AIDS treatment.
MTCT
Mother-to-child transmission.
In 1991, 1,650 infants were born in the US with HIV.
In 2002, 250 US babies were born with HIV.
Around the world, 630,000 children contracted AIDS through MTCT.
AIDS & Poverty
Signs and symptoms
The symptoms of HIV and AIDS vary, depending on the phase of infection.
When first infected with HIV, you may have no symptoms at all, although it's more common
to develop a brief flu-like illness two to six weeks after becoming infected.
But because the signs and symptoms of an initial infection - which may include fever,
headache, sore throat, swollen lymph glands and rash - are similar to those of other diseases,
you might not realize you've been infected with HIV.
Signs and symptoms
Even if you don't have symptoms, you're still able to transmit the virus to others.
Once the virus enters your body, your own immune system also comes under attack.
The virus multiplies in your lymph nodes and slowly begins to destroy your helper T
cells - the white blood cells that coordinate your entire immune system.
Signs and symptoms
You may remain symptom-free for eight or nine years or more. But as the virus continues
to multiply and destroy immune cells, you may develop mild infections or chronic symptoms such
as:
Swollen lymph nodes - often one of the first signs of HIV infection
Diarrhea
Weight loss
Fever
Cough and shortness of breath
Signs and symptoms
During the last phase of HIV - which occurs approximately 10 or more years after the
initial infection - more serious symptoms may begin to appear, and the infection may then meet
the official definition of AIDS
Signs and symptoms
By the time AIDS develops, your immune system has been severely damaged, making you
susceptible to opportunistic infections
The development of an opportunistic infection - an infection that occurs when your
immune system is impaired
Signs and symptoms
The signs and symptoms of some of these infections may include:
Soaking night sweats
Shaking chills or fever higher than 100 F for several weeks
Dry cough and shortness of breath
Chronic diarrhea
Persistent white spots or unusual lesions on your tongue or in your mouth
Headaches
Blurred and distorted vision
Weight loss
Signs and symptoms
If you're infected with HIV, you're also more likely to develop certain cancers,
especially Kaposi's sarcoma, cervical cancer and lymphoma, although improved treatments have
reduced the risk of these illnesses.
Symptoms of HIV in children
Children who are HIV-positive often fail to gain weight or grow normally.
As the disease progresses, they may have difficulty walking or delayed mental
development.
Causes
Normally, white blood cells and antibodies attack and destroy foreign organisms that
enter your body.
This response is coordinated by white blood cells known as CD4 lymphocytes.
These lymphocytes are also the main targets of HIV, which attaches to the cells and then
enters them.
Once inside, the virus inserts its own genetic material into the lymphocytes and uses
them to make copies of itself.
Causes
When the new copies of the virus break out of the host cells and enter the bloodstream,
they search for other cells to attack.
In the meantime, the old host cells and some uninfected CD4 cells die from the effects
of the virus.
The cycle repeats itself again and again.
Causes
In the process, billions of new HIV particles are produced every day.
Eventually, the number of CD4 cells in the body decreases, leading to severe immune
deficiency, which means your body can no longer effectively fight off viruses and bacteria that
cause disease.
The man who cant get AIDS
How HIV is transmitted
Sexual transmission. You may become infected if you have vaginal, anal or oral sex with
an infected partner whose blood, semen or vaginal secretions enter your body.
You can also become infected from shared sexual devices if they're not washed or covered
with a condom.
How HIV is transmitted
Transmission through infected blood. In some cases, the virus may be transmitted through
blood and blood products that you receive in blood transfusions
How HIV is transmitted
Transmission through needle sharing. HIV is easily transmitted through needles and
syringes contaminated with infected blood.
Sharing intravenous drug paraphernalia puts you at high risk of HIV and other infectious
diseases such as hepatitis.
How HIV is transmitted
Transmission through accidental needle sticks. Transmission of the virus between HIV-
positive people and health care workers through needle sticks is low.
Experts put the risk at far less than 1 percent.
How HIV is transmitted
Transmission from mother to child. Each year, nearly 600,000 infants are infected with
HIV, either during pregnancy or delivery or through breast-feeding.
Other methods of transmission. In rare cases, the virus may be transmitted through organ
or tissue transplants or unsterilized dental or surgical equipment.
AIDS in the Future
Staying Safe
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