Sexually Transmitted Diseases
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CHLAMYDIA
HPV
GENITAL HERPES
HIV/AIDS
GONORRHEA
SYPHILIS
TRICHOMONIASIS
PELVIC LICE
Chlamydia
 Bacterium that is spread by sexual contact and infects the genital
organs of males and females.
 Approximately 975,000 new cases are reported each year.
 Adolescent girls have a particularly high rate of infection.
Chlamydia
Symptoms:
 Men:
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Thin, usually clear discharge and mild discomfort on urination, appearing 7 to 14 days after
infection.
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50 percent of cases are asymptomatic.
 Women:
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75 percent of cases are asymptomatic.
 Diagnosis:
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Men - urine sample
Women - cell sample from cervix or urine
sample.
Chlamydia
Treatment:
 Curable with azithromycin or doxycycline; does not respond to
penicillin.
 Poorly treated or undiagnosed cases may lead to:
 urethral damage
 epididymitis (infection of the epididymis)
 Reiter’s syndrome
 proctitis in men who had anal intercourse
 Pelvic Inflammatory Disease (PID)
 Problems with pregnancy and risks for newborn infants of infected
mothers
Chlamydia
Risks from Pelvic Inflammatory Disease:
 Possible infertility, due to scarring of the fallopian tubes
 Ectopic (tubal) pregnancy
 Chronic pelvic pain
Chlamydia
Prevention:
 Many infected people are asymptomatic and
spread the disease unknowingly.
 Screening programs can identify, treat, and
cure asymptomatic carriers.
 The best method of prevention is the consistent
use of a condom.
HPV
 Human papillomavirus causes genital warts:
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Around the urethral opening of the penis
On the shaft of the penis
On the scrotum
On the vulva
On the walls of the vagina
In the cervix
On the anus
HPV
 The majority of people infected with HPV are asymptomatic.
 HPV is the single most important risk factor for cervical cancer.
 Also associated with cancer of the penis and the anus.
 Individuals infected by oral sex have an increased risk of cancers of the
mouth and throat.
HPV
 Diagnosis is done by inspecting the warts or analyzing DNA of the
patient.
 Several treatments are available:
 Podophyllin acid or bichloroacetic acid - applied directly to the warts
 Cryotherapy - warts are frozen off
 Laser therapy can also be used to destroy the warts.
 Several vaccines are currently being tested.
Genital Herpes
 A disease of the genital organs caused by a herpes simplex virus (HSV-
1or HSV-2).
 Symptoms - small, painful bumps or blisters
 Usually found on the vaginal lips, penis, or anus.
Genital Herpes
Treatment:
 Drug acyclovir prevents or reduces recurring symptoms, but there is no
cure.
 Valacyclovir and famciclovir are new drugs that are even more effective
at shortening outbreaks and suppressing recurrences.
 Scientists are actively working to create an immunization against
herpes.
Genital Herpes
Complications:
 Meningitis
 Narrowing of the urethra due to scarring
 Increased risk of becoming infected with HIV
 Transfer of virus from mother to infant in childbirth
 Psychological consequences need to be taken as seriously as the
medical consequences.
 One highly effective treatment program combines information on
herpes, relaxation training, stress management training, and imagery
technique.
HIV Infection and AIDS
 AIDS - acquired immune deficiency syndrome
 HIV - human immune deficiency virus; the virus that causes AIDS.
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Opportunistic diseases make take over once HIV has damaged an
individual’s immune system.
HIV Infection and AIDS
 By the end of 2005, more than 1 million persons in the United States
had been diagnosed with AIDS; 550,000 had died from it.
 It is estimated that 40 million are infected with HIV worldwide.
 In the early years of the U.S. epidemic, gay male sex accounted for the
majority of cases.
 Today, women are the fastest growing group for new HIV infection.
HIV
HIV Infection and AIDS
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HIV Infection and AIDS
Transmission:
 Exchange of body fluids
 Contaminated blood and needles
 From infected woman to baby during pregnancy, childbirth, or
breastfeeding
HIV Infection and AIDS
Transmission:
 Anal intercourse is the sexual behavior most likely to spread AIDS.
 Heterosexual, penis-in-vagina intercourse spreads HIV as well.
 The greater your number of sexual partners, the greater your risk of
getting infected with HIV.
 Condoms are 87 percent effective in protecting against HIV
transmission during heterosexual intercourse.
HIV
 HIV is one of a group of retroviruses
Retroviruses reproduce only in living cells of the host species, in this
case humans.
 HIV invades a group of white blood cells (lymphocytes) called T-helper
or T4 cells.
 These cells are critical to the body’s immune response in fighting off
infections.
 When HIV reproduces, it destroys the infected T cell.
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HIV
 The Centers for Disease Control has established the following
categorization of HIV infection:
 Early Stage – initial infection
 Middle Stage – may have no symptoms
 AIDS
HIV
Diagnosis:
 Two major tests for HIV infection:
 ELISA (enzyme-linked immunosorbent assay) - blood test that detects
the presence of antibodies to HIV
 Produces a substantial number of false positives.
 Western blot or immunoblot method
 Highly accurate though more expensive and difficult to perform.
HIV
Diagnosis:
 ELISA test involves a waiting period of more than a week before results
are known.
 OraQuick rapid HIV test for blood and OraQuick rapid HIV test for oral
fluid both provide test results in 20 to 30 minutes.
 Both tests must be done in clinics.
HIV
Treatment:
 No cure for AIDS.
 AZT (azidothymidine zidovudine, ZDV) stops virus from multiplying.
 DDI (dideoxyinosine or didanosine) slows the progression of the
disease.
 DDC (dideoxycytidine) stops the virus from replicating.
HIV
Treatment:
 Protease inhibitors - attack the viral enzyme protease, which is
necessary for HIV to make copies of itself and multiply.
 HAART (highly active anti-retroviral therapy)
 Patients take a “drug cocktail” of protease inhibitor combined with
AZT and another anti-HIV drug.
 Helping people survive much longer
 Concern about the emergence of resistant strains
HIV
 HIV/AIDS is now the fifth leading cause of death for U.S. women
between the ages of 25 and 44.
 Leading cause of death for African American women between the
ages of 25 and 34.
 Intervention programs should include sexual assertiveness training, in
which women are empowered to insist that their sex partners use
condoms.
HIV
 Children become infected:
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From an infected mother at birth
(89 percent)
Because of hemophilia (4 percent)
From transfusions of contaminated blood (6 percent)
 African Americans
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12 percent of population
50 percent of AIDS cases
 Hispanics
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13 percent of the population
18 percent of AIDS cases
 Asian Americans and Native Americans have less than
1 percent of cases.
HIV
 Many patients experience a reaction that is a typical
response to receiving a diagnosis of incurable
disease.
 Denial
of the reality
 Anger
 Depression
 AIDS is a socially stigmatized disease.
HIV/AIDS
Progress in AIDS Research:
 Vaccine
 Researchers are working to develop a vaccine, but this is more
difficult than was expected.
 Research on Nonprogressors
 HIV-infected people who go for 10 years or more
without symptoms are being studied.
 They have high levels of chemokines
(HIV-suppressor factors), which can block HIV
from entering cells.
HIV/AIDS
Robust People:
 Studying people who resist infection may also yield clues to a vaccine or
a cure.
 Some researchers believe that HIV’s property of rapid mutation could
be used against it by forcing it to mutate to a harmless form.
Gonorrhea
 Also called “the clap” or “the drip”
 Caused by a bacterium
 Oldest of the sexual diseases
 Symptoms:
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Men: pus-like discharge and painful, burning urination
Women: asymptomatic
Gonorrhea
Diagnosis:
 Men:
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Sample of discharge is examined.
A urine test is also available.
 Women:
 Cervical discharge is taken and cultured.
 A pelvic exam should also be performed in women.
 Both:
 A swab from the throat or rectum should be taken and cultured
if necessary.
Gonorrhea
Treatment:
 The traditional treatment was a large dose of penicillin or tetracycline.
 Ceftriaxone is highly effective antibiotic, even against resistant strains.
Syphilis
 Caused by the treponema palliduma bacterium.
 Incidence is much less than that of gonorrhea or chlamydia.
 Can damage the nervous system and even cause death.
 Syphilis infection makes one more vulnerable to HIV and vice versa.
Syphilis
 Major early symptom - chancre
A round, ulcerlike lesion with a hard, raised edge, resembling a
crater
 Syphilis proceeds in stages:
 Primary-stage syphilis
 Secondary-stage syphilis
 Latent syphilis
 Late syphilis
 Congenital syphilis - passed from mother to infant.
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Syphilis
 Diagnosis:
Physical exam; examination of fluid from chancre
 VDRL - fairly accurate blood test; cheap and easy to perform
 Treatment - antibiotics
 Penicillin, tetracycline, or doxycycline
 Total elimination of syphilis seems to be a feasible goal.
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Viral Hepatitis
 There are 5 types of viral hepatitis but hepatitis B is of most interest in
a discussion of STDs.
 People with long-term hepatitis B may develop serious liver disease
involving cirrhosis or cancer.
 Treatment - rest, symptom relief, antiviral treatments
 Prevention - vaccine for hepatitis B.
Trichomoniasis
 Caused by Trichomonas vaginalis protozoan.
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Transmitted mainly through sexual intercourse.
Occasionally transmitted nonsexually -organism can survive
on toilet seats and other objects
 Can lead to pelvic inflammatory disease and
problems with birth.
Pelvic Lice (Crabs)
 Tiny lice that attach to the base of pubic hairs and feed on blood from
their human host.
 Symptom - itching
 Treatment - Nix and Rid both are available without prescription.
Prevention of STI’s
 Abstain from sexual activity.
 Limit oneself to monogamous relationship with an uninfected person.
 Condoms can help.
 Careful washing and inspecting of genitals.
 Urinating before and after intercourse helps keep bacteria out of the
urethra.
Other General Infections
 Vaginitis –
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Vaginal inflammation or irritation.
 Monilia (candida) –
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Yeast infection.
 Bacterial vaginosis
 Cystitis –
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Infection of the urinary tract or bladder in women.
 Prostatitis –
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Inflammation of the prostate gland.