Sexually Transmitted DiseasesSexually Transmitted Infections

Infections diseases spread from person to person through sexual

contact

STD’s: The Facts

• We are facing an epidemic-an epidemic of STD’s.• An estimated 65 million people in the US are living

with an incurable STD!• USA=highest rates of STD’s in the industrialized world• STD’s account for more than 85% of the most

common communicable diseases in the US• Many people with STD’s are asymptomatic• Even when STD’s are diagnosed, they may not be

reported to health departments.

High Risk Behavior

• Being sexually active with more than one person.

• Engaging in unprotected sex.• Selecting high-risk partners.• Using alcohol and other drugs.

Consequences of STD’s

• Some STD’s are incurable.• Some STD’s cause cancer.• Some STD’s can cause complications that

affect the ability to reproduce.• Some STD’s can be passed from an infected

female to her child before, during, or after birth.

Chlamydia

• Due to bacteria from sexual contact

• Symptoms:– Men: 50% asymptomatic

• clear, thin discharge and mild discomfort

– Women: 75% asymptomatic• Abdominal pain, abnormal

discharge, bleeding between periods, low-grade fever, bleeding after intercourse, urge to urinate more than usual

Chlamydia (cont.)

• Long-term effects:– Men: urethral damage, epididymis

infection– Women: damage cervix, fallopian

tubes, pelvic inflammatory disease, infertility

• Increases susceptibility to HIV– Prevention: vaccine in progress, use

of a condom• Treatment: curable with antibiotics• Hey There Chlamydia

Gonorrhea• One of the oldest STIs• Due to bacterial infection during

penile-vaginal intercourse– Also transmitted through mouth,

throat, anus, rectum, and eyes• Prevalence:

– dropped dramatically from 1980 to early 1990s

– From 1997 – 2001 increase in men aged 30-39 by 68%

– In 15-19 year olds, rate has increased from 1997-2001

Gonorrhea (cont.)• Symptoms:– In men: pus-like substance from

urethra– In women: invades cervix but can

spread to urethra, anus, and rectum

• Treatment: women are asymptomatic early so many do not receive treatment until late– Antibiotics– Recent resistance to common

antibiotics

Syphilis

• Very old STI• Due to bacteria• Can be transmitted through

genital contact but also cut in the skin or touching chancres

• Increases susceptibility to HIV

• Can lead to cognitive impairment and death

Famous Syphilis Cases

• Christopher Columbus• Beethoven• Abraham Lincoln• Van Gogh• Adolph Hitler• Oscar Wilde• Franz Schubert• Al Capone• Henry VIII

Syphilis (cont.)• Symptoms:

– 1st stage: chancre sore on cervix, mouth, external genitals

– 2nd stage: 1-6 months later: hair loss, generalized rash

– 3rd stage: latent; no symptoms of bacteria, but still very active in blood vessels, CNS, and bones• After 1st year, no longer infectious unless during

childbirth– Late stage: heart and major blood vessels &

brain attacked• Completely curable with a single dose of

penicillin• Tuskegee

Herpes Simplex Virus

• Non-reportable virus• 2 types:– HSV I – blisters on non-genital

areas– HSV II – blisters on genitals

• Infectious all the time, but especially during an outbreak

• Can remain dormant for lifetime

Herpes (cont.)

• No cure• Some treatments reduces

recurrences and transmissibility• Long-term consequences:– Scarring can lead to meningitis or

urethra damage– Increases risk of contracting HIV– Transmitted to infant during

childbirth (can cause) serious illness or death

– Does Michael have Herpes?

Human Papilloma Virus (HPV)• Most common STI• Viral transmission• Transmission is less efficient from

mouth < genitals• Symptoms:

– May cause local cell proliferation which can develop into plantar or common warts

– Warts internally or externally on genitals or on other areas (face, oral cavity)

• Most sexually active people will be exposed to HPV

HPV (cont.)

• 40 types of HPV– 13 are considered cancer

causing• Persistent infection with

high-risk HPV established as a necessary cause of cervical cancer– HPV DNA found in 99.7% of

cervical cancer patients• There is a vaccine (gardasil)!• HPV Myths

Importance of Abstinence• A deliberate decision to avoid

harmful behaviors, including sexual activity before marriage and the use of tobacco, alcohol, and other drugs.

• There is a clear cause-and-effect relationship between sexual intercourse in any form and STD’s.

• Use refusal skills to avoid situations in which you may be at risk.

• Choose friends who are abstinent and who support your decision to abstain.

STI Autograph Game• You will become aware of how rapidly an STI can spread with

unprotected sex through this STI Game• You will each get 1 card• Do not repeat partners during this game• Mingle and find 1 partner and sign each others card

– Discuss some names and characteristics of the STI’s we have just learned about

• Mingle and find another partner and sign each others cards– Discuss reasons people do not protect themselves from STI’s

• Mingle and find another partner and sign each others cards– Discuss ways people can protect themselves from STI’s

• Sit down-your card should have 3 different names on it

STI Autograph Game JOURNAL

• How does this activity relate to the spread of disease?

• How can you tell if someone has an STI?• How can you 100% protect yourself from STIs?• How did it feel to find out your were exposed

to an STI?• How did it feel to expose others to an STI?

HIV & AIDS

• Acquired Immune Deficiency Syndrome (AIDS)-a disease in which the immune system of the patient is weakened.

• Human Immunodeficiency Virus (HIV)-a virus that attacks the immune system.

• In July 1981, an outbreak of a rare form of skin cancer (Kaposi’s sarcoma) was reported. A year later it was called AIDS.

• In 2003, AIDs was the 6th leading cause of death among adults from 25-44 yrs old.

HIV and the Human Body

• Lymphocytes are white blood cells that help your body fight pathogens (body contains billions).

• When HIV enters that blood, it invades certain cells of the immune system, including T cells, which help identify and destroy pathogens.

• As the number of viruses increase and the T cells decrease the immune system becomes less capable of fighting infections and cancer.

• AIDS is the advanced stage of HIV

Modes of Transmission

• Sexual intercourse– Includes penile-vaginal and anal– (Some evidence for oral sex)

• Contaminated blood– Accidents, blood transfusions

• Hypodermic needles– Injection drug use, accidents

• Pregnancy and childbirth

What does not lead to HIVtransmission?

• Saliva• Urine• Tears• Kissing, hugging, cuddling, body rubbing,

masturbation, or massaging

Stage of HIV Infection• Half of all persons develop symptoms 3-6 weeks after becoming

infected and the symptoms disappear within a week to a month. – Symptoms: fever, rash, headache, body aches, and swollen glands.

• Asymptomatic stage-a period of time during which a person infected with HIV has no symptoms (6 months to 10 years)

• Symptomatic stage-the stage in which a person infected with HIV has symptoms as a result of a sever drop in immune cells (swollen glands, weight loss, and yeast infections).

• AIDS-presence of HIV infection, severely damaged immune system, appearance of one or more illnesses and infections

Detecting HIV• EIA Test-a test that screens for the

presence of HIV antibodies in the blood. Can give inaccurate results:– developing antibodies takes time – certain health conditions can cause

it to give a false positive (hemophilia, hepatitis, pregnancy)

• Western Blot Test-the most common confirmation test for HIV in US. If done properly it is 100%.

HIV/AIDS Research Activity• With a partner and the Internet, find the answers to these questions: How does HIV get transmitted? What

happens to the body once someone contracts the virus? What groups are most at risk? How do you contract HIV? How can you avoid getting HIV?

• These are some of the different populations that can be at risk for AIDS if they do not behave responsibly: – Homosexual men– Heterosexual men– Heterosexual women– Adolescents– Drug users– Minority youth– Pregnant women– Homeless and poor people– Prisoners– Armed forces

• Research the answer to these questions for one of the groups listed above:– What are the specific dangers for this population?– How has the risk of contracting HIV/AIDS changed for this population over the past several years? (Provide statistics

when possible.)– What behaviors put this population at risk for HIV/AIDS?– How could members of this population change their behavior to avoid getting or spreading HIV/AIDS?

• Now you will create a public awareness campaign for that audience. You should be creative and consider the tone, language, and medium that would be most appropriate for that audience. For example, they may create a public service announcement for teens, a brochure for obstetrics offices, a needle exchange program for public health clinics, a poster for clubs frequented by homosexual men, a Web page for young professional men and women, or a bulletin board for their school hallway.

• This is due at the end of class (:

Adults and Children living with HIV/AIDS in 2005

Incidence (new cases) of HIV/AIDS in adultsand children in 2005

Estimated Child and Adult Deaths from HIV/AIDS in 2005

HIV-A continuing Problem

• At the end of 2002, an estimated 40 million people worldwide were infected with HIV/AIDS.

• HIV is now a pandemic (a global outbreak of infectious disease)

• In 2002 alone, 5 million people became infected with HIV

• Despite the progress of treatment options, HIV/AIDs is still a fatal disease for which there is no cure!

STI Role Plays1. Re-read the scenario you have been assigned.2. Ensure your answers to this scenario are detailed and correct.3. Choose a role for each partner to play as you present this

scenario to the class.– One of the people in the scenario– A friend of someone in the scenario– A nurse or doctor

4. Plan a presentation that dramatizes and answers the scenario questions.

5. Practice your presentation6. Present your scenario to the class.

Oregon STD Stats• Statewide for Oregon during 2004 – 2006 some important trends in HIV, sexually

transmitted disease and tuberculosis include:– The number of new HIV infections diagnosed by year of diagnosis has remained stable at

approximately 300 per year, and the number of deaths have remained constant at approximately 100 per year.

– Approximately 59% of all reported cases of HIV infection were residents of Multnomah County at the time of their case report.

– Persistently, approximately 40% of newly reported HIV infections have progressed to AIDS at the time of diagnosis or within 12 months.

– After a two-year increase, gonorrhea rates appear to have leveled off in 2006. – Tuberculosis cases have declined in 2006 compared with 2004- 2005 for unknown reasons. – Early syphilis cases have declined from a recent high of 74 cases in 2004 to 55 and 57 in

2004- 2005 and appear to have dropped again in 2006 through the 3rd quarter. Most cases are occurring in men, many of whom report sex with other men.

– Chlamydia cases have increased in 2006. The reason is not known, but the increase cannot easily be attributed to increases in screening.

STD’s: The Facts

• We are facing an epidemic-an epidemic of _____• An estimated __________ people in the US are living

with an incurable STD!• _____=highest rates of STD’s in the industrialized world• STD’s account for more that ____ of the most common

communicable diseases in the US• Many people with STD’s are ________________• Even when STD’s are diagnosed, they may not be

reported to _________________

High Risk Behavior

• Being sexually active with more than one person.

• ____________________________• Selecting high-risk partners.• ____________________________

Consequences of STD’s

• __________________________• __________________________• Some STD’s can cause complications that

affect the ability to reproduce.• Some STD’s can be passed from an infected

female to her child before, during, or after birth.

Chlamydia

• Due to _____________ from sexual contact• Symptoms:– Men: 50% _______________• clear, thin discharge and mild discomfort

– Women: _____asymptomatic• Abdominal pain, abnormal discharge, bleeding

between periods, low-grade fever, bleeding after intercourse, urge to urinate more than usual

Chlamydia (cont.)

• Longterm effects:– Men: _______________, epididymis infection– Women: _____________, fallopian tubes, pelvic

inflammatory disease, infertility– Increases susceptibility to ______

• Prevention: vaccine in progress, use of a condom

• Treatment: curable with _______________

Gonorrhea

• One of the __________ STIs• Due to ____________ infection during penile-vaginal

intercourse– Also transmitted through _______, throat, _______,

rectum, and ________• Prevalence:– ____________ dramatically from 1980 to early 1990s– From 1997 – 2001 increase in ____ ages 30-39 by 68%– In ___________ year olds, rate has increased from 1997-

2001

Gonorrhea (cont.)

• Symptoms:– In men: ___________ substance from urethra– In women: invades _________ but can spread to

urethra, anus, and rectum• Treatment: women are ____________ early so

many do not receive treatment until late– _______________– Recent resistance to common antibiotics

Syphilis

• Very old STI• Due to _________• Can be transmitted through ____________

contact but also cut in the skin or touching chancres

• Increases susceptibility to ______• Can lead to ____________ impairment and

_________

Famous Syphilis Cases

• Christopher Columbus• _____________• Abraham Lincoln• _____________• Adolph Hitler• _____________• Franz Schubert• _____________• Henry VIII

Syphilis (cont.)

• Symptoms:– 1st stage: ___________ sore on cervix, mouth, external

genitals– 2nd stage: 1-6 months later: ___________, generalized rash– 3rd stage: ________; no symptoms of bacteria, but still very

active in blood vessels, CNS, and bones• After 1st year, no longer infectious unless during ______________

– Late stage: __________ and major blood vessels & brain attacked

• Completely curable with a single dose of ______________

Herpes Simplex Virus

• Non-reportable virus• 2 types:– HSV I – blisters on ___________________– HSV II – blisters on _____________

• Infectious all the time, but especially during an _________________

• Can remain ____________ for lifetime

Herpes (cont.)

• No __________• Some treatments reduces recurrences and

transmissibility• Long-term consequences:– ___________ can lead to meningitis or urethra

damage– Increases risk of contracting ________– Transmitted to infant during ______________ (can

cause) serious illness or death

Human Papilloma Virus (HPV)

• Most ___________ STI• Viral transmission• Transmission is less efficient from mouth < genitals• Symptoms:– May cause local cell proliferation which can develop into

plantar or common __________– __________ internally or externally on genitals or on

other areas (face, oral cavity)• Most sexually active people will be exposed to

________

HPV (cont.)

• ______ types of HPV– _______ are considered cancer causing

• Persistent infection with high-risk HPV established as a necessary cause of __________________– HPV DNA found in ________ of cervical cancer

patients• There is a vaccine (gardasil)!

Importance of Abstinence• A deliberate ________ to avoid

__________________, including sexual activity before marriage and the use of tobacco, alcohol, and other drugs.

• There is a clear cause-and-effect relationship between sexual intercourse in any form and STD’s.

• Use ______________ to avoid situations in which you may be at risk.

• Choose _________ who are abstinent and who ___________ your decision to abstain.

HIV & AIDS

• ______________________________________-a disease in which the immune system of the patient is weakened.

• _______________________________-a virus that attacks the immune system.

• In July 1981, an outbreak of a rare form of skin cancer (________________) was reported. A year later it was called AIDS.

• In 2003, AIDs was the _____ leading cause of death among adults from _________ yrs old.

HIV and the Human Body

• _____________________________________ _____________________________________

• When HIV enters that blood, it invades certain cells of the immune system, including T cells, which help identify and destroy pathogens.

• As the number of viruses increase and the T cells decrease the immune system becomes less capable of fighting infections and cancer.

• ________________________________

Modes of Transmission

• _______________________– Includes penile-vaginal and anal– (Some evidence for oral sex)

• _______________________– Accidents, blood transfusions

• _______________________– Injection drug use, accidents

• _______________________

What does not lead to HIVtransmission?

• _________• _________• _________• Kissing, hugging, cuddling, body rubbing,

masturbation, or massaging

Stage of HIV Infection• Half of all persons develop symptoms __________ after becoming

infected and the symptoms disappear within a week to a month. – Symptoms: ________________________________________

_____________________________• __________________-a period of time during which a person

infected with HIV has no symptoms (6 months to 10 years) • __________________-the stage in which a person infected with

HIV has symptoms as a result of a sever drop in immune cells (swollen glands, weight loss, and yeast infections).

• ______-presence of HIV infection, severely damaged immune system, appearance of one or more illnesses and infections

Detecting HIV• __________-a test that screens

for the presence of HIV antibodies in the blood. Can give inaccurate results:– developing antibodies takes time – certain health conditions can cause

it to give a false positive (hemophilia, hepatitis, pregnancy)

• ________________-the most common confirmation test for HIV in US. If done properly it is 100%.

HIV-A continuing Problem

• _____________________________________ ___________________________

• HIV is now a pandemic (a global outbreak of infectious disease)

• _____________________________________ ____________________________

• Despite the progress of treatment options, HIV/AIDs is still a fatal disease for which there is no cure!