Transcript STD 101 Unlocking Good Health with Prevention and Control

STD 101
Unlocking Good Health with Prevention and Control
Miami-Dade STD Program
Florida Department of Health
A presentation for our community partners
“Early knowledge of STD infection is a
critical component in preventing & controlling
the spread of STDs, including HIV.”
Who Are We?
STD Program objectives:

Intervene
in the spread of HIV and other sexually transmitted diseases

Reduce
the complications brought on by sexually transmitted diseases

Protect
the community from sexually transmitted disease related outbreaks
STD Clinic offers:

Four convenient sites

Routine voluntary HIV test with STD exam

Multilingual & culturally competent trained staff

Private Setting

Client Confidentiality

Community & Case Specific Screenings

Educational Presentations
STD Screening & Care
“Clients who are HIV-infected or at
increased risk for HIV are at risk for other
STDs and should receive or be referred for
STD screening and treatment.”
Types of STD Clinical Services

Comprehensive Exam &
Screening for common
STDs

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
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



Chlamydia
Gonorrhea
Syphilis
Herpes
BV
Trichomoniasis
Genital Warts





HIV Testing



Blood
Orasure
Rapid Test

Treatment available for
common STDs
Hepatitis A & B & C
Testing
Hepatitis A vaccination
for eligible clients
Hepatitis B vaccination
available
Pap Smear Testing
Start-up Birth Control for
STD Clients
Pregnancy Testing for
STD Clients
Disease Intervention &
Prevention Services


General & Specific Patient Education & Counseling
HIV Counseling & Testing in Field Setting


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
Risk & Harm Reduction Counseling
HIV Post Test Counseling






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
Confidential
Anonymous
Negative
Positive
Indeterminate
Disease Intervention Interviews
Partner Counseling & Referral Services (PCRS)
Community Awareness & Sexual Health Promotion
Referrals
Other STD Testing in Field Setting
How We Work?
STD Prevention & Control
Residents & Visitors
Send
Lab
Report
to STD
At-A-Glance
Positive Laboratory Reports Received by STD Surveillance
January – December 2005 vs. 2006
2%
14%
Gonorrhea
Chlamydia
Syphilis
HIV
23%
61%
2005 Total = 25,087
58%
8%
3%
31%
2006 Total = 31,423
Communicable Disease Screening in the Jails Project
Type & Number of Services Provided
Chlamydia
Gonorrhea
Syphilis
HIV
HIV PTC
Hepatitis ABC Panel
2000
1800
1974 1974
1600
1400
1200
1000
1078 1008
800
600
400
601 601
540 540
200
213 323
0
2005
2006
What’s
Happening
Locally?
Infectious Syphilis
Dade & Florida Peer Counties
January-December 2000 - 2006
Palm Beach
Broward
Dade
250
231
213
200
194
179
185
196
203
183
168
154
150
133
126
100
50
54
36
47
27
27
36
38
31
13
0
2000
2001
2002
2003
2004
2005
2006
Early Latent Syphilis
Dade & Florida Peer Counties
January-December 2000 - 2006
Palm Beach
Broward
Dade
400
350
345
329
300
294
253
250
221
200
186
176
150
127
100
50
98
89
83
170
147
122
114
33
27
94
59
47
48
0
2000
2001
2002
2003
2004
2005
2006
Congenital Syphilis
Dade & Florida Peer Counties
January-December 2000 - 2006
Palm Beach
Broward
Dade
20
19
18
16
14
12
10
10
9
8
7
6
4
4
6
5
5
4
5
4
3
2
1
2
0
0
2000
2001
2002
2003
2004
1
0
2005
1
0
2006
Gonorrhea
Dade & Florida Peer Counties
January-December 2000 - 2006
Palm Beach
Broward
Dade
2500
2342
2000
2137
1995
2010
1964
2047
1981
1912
1774
1911
1891
1981
1931
1661
1500
1000
953
1045
915
788
769
820
856
500
0
2000
2001
2002
2003
2004
2005
2006
Chlamydia
Dade & Florida Peer Counties
January-December 2000 - 2006
Palm Beach
Broward
Dade
6000
5000
4711
4158
4000
3000
4431
4363
4933
4550
3800
3653
5260
4870
4313
3892
3286
3032
2030
2000
1998
2230
2298
2198
2227
1663
1000
0
2000
2001
2002
2003
2004
2005
2006
Miami-Dade County
2005
2006
168
203
Males
143 (85%)
172 (85%)
Females
25 (15%)
31 (15%)
Co-infected HIV
44 (26%)
51 (25%)
15-19
6 (4%)
26 (13%)
20-24
21 (13%)
25-29
20 (12%)
33 (16%)
30-34
34 (20%)
26 (13%)
35-44
63 (38%)
45+
24 (14%)
32 (16%)
African American/Hispanic/White/Other
42%/38%/19%/1%
48%/35%/16%/1%
Primary & Secondary
Syphilis
2006 Data Provisional
29%
72%
32 (16%)
53 (26%)
45%
55%
Miami-Dade County
2005
2006
Chlamydia
3,892
5,260
Males
764 (20%)
1306 (25%)
Females
3128 (80%)
3953 (75%)
Co-infected HIV
28 (.07%)
65 (1.2%)
15-19
1289 (33%)
20-24
1465 (38%)
1919 (37%)
25-29
559 (14%)
809 (15%)
30-34
268 (7%)
356 (7%)
35-44
196 (5%)
279 (5%)
45+
67 (2%)
100 (2%)
African American/Hispanic/White
66%/22%8%/4%
64%/26%/5%/5%
2006 Data Provisional
71%
1708 (33%)
70%
Miami-Dade County
2005
2006
Gonorrhea
1,661
1,931
Males
839
1027
Females
822
904
Co-infected HIV
45 (2.7%)
71 (3.7%)
15-19
396 (24%)
20-24
466 (28%)
588 (30%)
25-29
241 (15%)
312 (16%)
30-34
163 (10%)
182 (9%)
35-44
259 (16%)
198 (10%)
45+
103 (6%)
130 (7%)
African American/Hispanic/White
70%/20%/7%/3%
77%/15%/5%/2%
2006 Data Provisional
52%
496 (26%)
56%
Chlamydia & Gonorrhea Infection Among Adolescents & Young
Adults (Age 10-24) in Miami-Dade County, Florida 2002-2006
4000
3683
3442
3500
3079
3000
2785
2768
2500
2000
Chlamydia
Gonorrhea
1500
1127
1131
1057
886
1104
1000
500
0
2002
2003
2004
2005
2006
What’s A STD?
Sexually Transmitted
Disease (STD)?
A sexually transmitted disease is a broad term that
refers to as many as 20 different infections, all of
them transmitted by sex. STDs are serious,
sometimes painful and can cause a lot of damage in
your body. Some STDs infect your reproductive and
sexual organs. Others (HIV, hepatitis B, and
syphilis) cause general body infections.
How are STDs spread?

Through the exchange of body fluids such as
semen, vaginal fluid, and blood with someone
who is infected.

Through vaginal, anal and oral sex.

STDs can be given by mothers to their babies

You can get some STDs, such as herpes, by
kissing and caressing or close contact with
infected areas—not just intercourse.
Asymptomatic Vs
Symptomatic disease
Asymptomatic – Sometimes a person can have
an STD with no signs or symptoms.

Symptomatic – Other times, a person will have
symptoms that go away on their own.

Either way, the person will still have the STD until he/she gets treated.
A few STDs can not be cured. But most can be cured with treatment.
How common are STDs?
STDs are increasingly common in the
United States today. That’s distressing
news, because STDs are also easy to
prevent.
STD FACT SHEET
According to CDC, each year

An estimated 19 million new infections occur, almost half of them
among young people ages 15 to 24

Direct medical costs associated with STDs in the United States are
estimated at up to $14.1 billion annually

An estimated 2.8 million new cases of chlamydia occur in the
United States

Gonorrhea is the second most commonly reported infectious
disease in the U.S. Like chlamydia, however, gonorrhea is
substantially under-diagnosed and under-reported, and
approximately twice as many new infections are estimated to occur
each year as are reported.
Types of Organisms
responsible for STDs
Bacteria
 Viruses
 Fungi
 Protozoa
 Metazoa

Bacteria (including mycoplasmas and chlamydiae)
Types of Bacteria that affects humans

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Spirilla-syphilis, yaws
Cocci-gonorrhea, meningitis
Bacilli-typhoid fever, tetanus
Mycoplasmas-nongonococcal urethritis (NGU),
pneumonia
Chlamydia trachomatis-chlamydial urethritis,
mucopurulent cervicitis (MPC)
Viruses
A few of the significant viral STDs are




hepatitis B
genital herpes
condylomata acuminata (genital warts)
acquired immunodeficiency syndrome (AIDS)
Fungi
Fungi causes




Candidiasis
Other vaginal yeast infections
Lung diseases
Ring worm
Protozoa
Protozoa are responsible for


Trichomoniasis
Malaria
Metazoa

Metazoa causes many diseases and
infestations

Scabies
Guinea worm infection
Pediculosis pubis
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Common STDs
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Bacterial Vaginosis (BV)
Chlamydia
Gonorrhea
Genital Warts
Herpes (HSV types I and II)
Hepatitis B (Hep B)
Human Immunodeficiency Virus (HIV)
Lice & Scabies
Syphilis
Trichomoniasis (Trich)
Chlamydia

Chlamydia is a sexually transmitted disease that is caused
by the bacterium Chlamydia trachomatis.
Signs and Symptoms

Pain and burning when urinating, discharge. 75% of women and
50% of men have no signs or symptoms.
Diagnosis

Lab exam of fluid from the infected area
Treatable?

Yes
Therapy

Antibiotic pills that kill bacteria
Result if Left Untreated

Pelvic infections such as Pelvic Inflammatory Disease (PID).
Chlamydia

Chlamydia
trachomatis in a
Thin Prep PAP
Test
Chlamydia

Chlamydia Trachomatis in
a Thin Prep PAP Test
Chlamydia
urethritis, penile

Gonorrhea

Gonorrhea is a sexually transmitted disease that is caused
by the bacterium Neisseria gonorrhoeae.
Signs and Symptoms
 Pain or burning when urinating, yellow discharge
Diagnosis
 Lab exam of fluid from the infected area
Treatable?
 Yes
Therapy
 Antibiotic pills that kill bacteria
Results if Left Untreated
 Pelvic Infections, PID, and Sterility
Gonorrhea
Positive Gram Stain from
Urethral Discharge
Studies suggest that the
presence of gonorrhea infection
makes an individual three to five
times more likely to acquire HIV,
if exposed
Gonoccocal Urethritis
Gonoccocal Cervicitis
Gonorrhea

Bartholin’s
abscess
Bartholin’s
abscess
Gonococcal
ophthalmia
Gonorrhea

Disseminated
gonorrhea – skin
lesion
Disseminated
gonorrhea – skin
lesion
Genital Warts
Genital warts is a sexually transmitted disease that is
caused by the virus Human Papilloma.
Signs and Symptoms
 Bumpy warts on/near genitals
Diagnosis
 Visual
Treatable?
 Yes (but can’t be cured)
Therapy
 Burning or liquid removal of warts
Result if Left Untreated
 May lead to some cancers

Genital Warts

Condyloma
acuminata, vaginal
wall
Genital Warts
Condyloma Acuminata
Anal
Meatus
Genital Warts
Condyloma Acuminata
Vulva
Meatus
Herpes

Herpes is a sexually transmitted disease caused by the herpes
simplex virus (HSV).
Signs and Symptoms
 HSV-type 1 (oral herpes) commonly causes fever blisters on the
mouth or face
 HSV-type 2 (genital herpes) typically affects the genital area
causing red bumps/blisters.
However, both viral types can cause either genital or oral
infections.
Diagnosis
 Lab exam of fluid from the sore
Treatable?
 Yes (but can’t be cured)
Therapy
 Pills and ointment
Results if Left Untreated
 Prolonged and more severe symptoms
Herpes
Primary
Same Patient,
4 Days Later
Herpes
Primary
Recurring
Herpes
Vulva
Cervicitis
Lice and Scabies

Lice (Crabs) is a sexually transmitted diseases caused by the
metazoa Pediculosis Pubis. You get crabs by having sex, sharing
clothes, bed sheets, or towels with someone who is infected.
Scabies is a contagious skin disease caused by the metazoa
Sarcoptes scabiei, a very small mite.
Signs and Symptoms
 Severe itching, rashes
Diagnosis
 Visual
Treatable?
 Yes
Therapy
 Over-the-counter or prescription lotion
Results if Left Untreated
 Continuing symptoms
Lice
Female Crab
Louse
Lice in the
pubic Area
Scabies
Scabies Mite
Eczema
Scabies
Syphilis

Syphilis has been called “the great
imitator” because so many of the
signs and symptoms are
indistinguishable from those caused
by other diseases.
Syphilis

Syphilis is a sexually transmitted disease caused by the
bacterium Treponema Pallidum.
Signs and Symptoms
 Chancre sore, rash, genital ulcers
Diagnosis
 Lab exam of tissue, fluids/blood test
Treatable?
 Yes
Therapy
 Penicillin shots to kill bacteria or antibiotic pills
Results if Left Untreated
 Blindness, Heart disease, Brain damage
Syphilis
Stages:




Primary
Secondary
Latent
Late Latent
Treponema Pallidum
Primary Stage
The most infectious stage of the
disease.
Primary Syphilis
Chancres
Vaginal
Penile
Primary Syphilis
Vaginal
Anal
Chin
Secondary Stage
Lesions of the mouth, throat, and
cervix (mucous patches) frequently
occur during this stage.
Secondary Syphilis
Papulo-pustular rash
Condyloma Lata
Secondary Syphilis
Nickel and Dime Lesion
Alopecia
Palmer Rash
Latent Syphilis

The stage in which no
clinical signs or symptoms
are present to suggest
infection and serologic tests
for syphilis are reactive. An
early latent stage of syphilis
can appear between the
primary and secondary
stages; between secondary
relapses; and after the
secondary stage, continuing
to the late latent stage, late
syphilis, or cure.
Late Syphilis

Untreated late syphilis may
present a wide range of
signs and symptoms, varying
from none which are
apparent to those which
indicate severe damage to
one or more body systems.
Late syphilis is classified as
neurosyphilis, cardiovascular
syphilis, and late benign
syphilis.
Congenital syphilis
Through the 18th week of gestation the Langhan’s cell
layer of the early placenta may help in restricting the
treponema from crossing the placenta to infect the
fetus. Thus, pregnancy while the mother is in the
primary or secondary stages of infection frequently
terminate in a stillbirth, whereas pregnancy occurring
during the later stages of syphilis may result in a clinical
spectrum from a fulminating fatal congenital syphilis
Congenital Syphilis
IS Preventable
Congenital Syphilis

Primary chancre
of syphilis that
appeared at the
age of 4 wks
Congenital Syphilis
Perforation
of Palate
Mucous
Patches
Congenital Syphilis
Hypertropic
Skin
Hemorraoic
Snuffles
Syphilis

Congenital syphilis –
Hutchinson’s teeth
The link between syphilis and HIV

While the health
problems caused by the
syphilis bacterium for
adults and newborns
are serious in their own
right, it is now known
that the genital sores
caused by syphilis in
adults also make it
easier to transmit and
acquire HIV infection
sexually.

There is a 2- to 5- fold
increased risk of
acquiring HIV infection
when syphilis is present.
Areas of the U.A. that
have the highest
number rates of syphilis
also have the fastest –
growing HIV infection
rates in women of
childbearing age.
Why We Care?
Sexual Health Prevention Strategies:

Cancer Prevention

HIV Prevention through
STD Intervention

Healthy Moms and
Healthy Babies through
Reproductive Health

Eliminating Health
Disparities
Unlocking Good Health
Disease Prevention Messages

Practice sexual abstinence, or limit sexual contact to one
uninfected partner.

Limit the number is sexual partners, and do not go back
and forth between partners

Use latex condoms correctly every time you have sex.

Condoms do not provide complete protection from all
STDs. Sores and lesions of other STDs on infected men
and women may be present in areas not covered by the
condom, resulting in transmission of infection to another
person.
Unlocking Good Health
Disease Prevention Messages

Any genital symptoms such as discharge or burning
during urination or unusual sore or rash should be a
signal to stop having sex and to consult a health care
provider immediately.

If you are told you have syphilis, gonorrhea, or any other
STD and receive treatment, you should notify all of your
recent sex partners so that they can see a health care
provider and be treated. This will reduce the risk that
your partner(s) will develop serious complications from
the disease and will reduce your own risk of becoming
reinfected.
Unlocking Good Health
Disease Control Messages!!!

If you think you might have an STD, get checked out.
Don’t just hope the STD will go away. It won’t!

You must get treatment for the STD, even if it is a hard
thing for you to do. This is the only way you will get well.

Most STDs can be treated with antibiotics. Do exactly
what you doctor tells you. Be sure to use all of your
medicine. If you do not use all of your medicine, the STD
will not go away.

Medicine you buy off the streets will not get you well. In
fact, it may only hide your symptoms. You will still have
the STD.
Unlocking Good Health
Disease Control Messages!!!

You must tell your sexual partner(s). If they aren’t
treated, they can spread the STD. They might even give
it to you again!

The health department can arrange confidential partner
counseling and referral services for you if you don’t feel
comfortable telling your partner(s).

If you have any questions about STDs, services or clinic
hours, please contact one of the four local STD clinics
Where Are We?
Miami-Dade County Health Department
Sexually Transmitted Disease Clinics
Downtown STD Clinic
1350 NW 14th St, Bldg. #4
Miami, Fl 33125
Mon-Fri 7:30am-3:00pm
(305) 324-2422
www.dadehealth.org
English, Spanish, Creole
Walk-in
12 years old and above
Central Miami-Dade County
West Perrine STD Clinic
18255 Homestead Avenue
Perrine, Fl 33157
Mon-Thurs 8:00am-11:00am
And 1:00pm-3:00pm
(305) 256-6315
www.dadehealth.org
English, Spanish
Walk-in
12 years old and above
South Miami-Dade County
Little Haiti Health Center
300 N.E. 80th Terrace
Miami, Fl 33137
Mon, Wed, & Fri 8am-3:00pm
(305) 795-2100
www.dadehealth.org
English, Creole, Spanish
Walk-in
12 years old and above
North Miami-Dade County
Miami Beach STD Clinic
615 Collins Ave.
Miami Beach, FL 33139
Mon , Wed & Fri 8:00am-11:00am
1:00pm-4: 00pm
(305) 535-5540
www.dadehealth.org
English, Spanish, Creole
Walk-in
12 years old and above
East Miami-Dade County
“April is STD Awareness Month”
“STD Awareness”
STD Awareness : www.std-awareness.com
HPV Awareness : www.hpv-awareness.com
THANK YOU!
Need more information about STD Facts
or reporting STDs to the county health
department?
Contact the Miami-Dade STD Program
@
(305) 325-3242