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STDs
An Introduction to Sexually
Transmitted Diseases
Sexually
Transmitted
Diseases
In the United States more than
65 million people are currently
living with an incurable sexually
transmitted disease.
STDs Statistics
• STDs are the most common infectious
diseases in the United States.
• More than 20 STDs have now been
identified
• They affect more than 13 million men
and women in this country each year.
The annual
Comprehensive
Cost of STDs in
the United States.
In excess of $8,000,000,000.
(8 billion dollars)
Who STDs Affect?
• Men and women of all backgrounds and
economic levels.
• Most prevalent among teenagers and
young adults.
• Two thirds of all STDs occur in people
younger than 25 years old
Serious Problems Caused by
STDs
• Pelvic Inflammatory Disease (PID), which can
cause infertility and ectopic pregnancy. (The
later can be fatal.)
• Cervical Cancer
• STDs passed from mother to baby before and
during birth.
• Some of the infections of the newborn can be
cured easily, but others may cause a baby to
be permanently disabled or even die.
Well Known STDs
•
•
•
•
HPV (genital warts)
Trichomoniasis
Chlamydia
Herpes (HSV-2)
• Gonorrhea
• Hepatitis B
• Syphilis
CDC’s STD Incidence &
Prevalence Report July,20 2002
STD
Incidence
(per year)
Prevalence
HPV
5.5 million
20 million
5 million
3 million
1 million
650,000
120,000
70,000
N/A
2 million
45 million
N/A
417,000
N/A
(genital warts)
Trichomoniasis
Chlamydia
Herpes(HSV-2)
Gonorrhea
Hepatitis B
Syphilis
Attention!
You are about to be exposed to
the truth. STDs are not pretty,
so be prepared for grotesque
pictures.
Human Papilloma
Virus (HPV)
Genital Warts
HPV (genital warts)
• An estimated 75 percent of the reproductiveage population have been infected with
sexually transmitted HPV.
• When a person is infected with HPV it may
take one to three months for warts to appear.
• Some people who are infected never get
warts.
Where Can the Warts Grow?
•
•
•
•
•
•
•
•
Women
In the vagina
Around the vagina
On the Cervix
Around the anus
Men
On tip of penis
Shaft of penis
On the scrotum
Around the anus
• Genital warts can
also develop in the
mouth or throat of a
person who has had
oral sex with an
infected person.
What Does HPV Look Like?
• Small pink or red
growths in or around
the sex organs.
• Similar looking to
cauliflower.
• Found in groups of
three or four.
• Very tiny, difficult to
see
HPV Treatments
• There is no cure for
the HPV virus.
• Laser therapy will
remove warts.
• Surgery may be
needed for larger
growths.
Tests Used to Detect HPV
• Biopsy of cervical
tissue
• Examinations of
physical growths
• Examination of
rectum
•
•
•
•
Fluid sample
Blood sample
Pelvic exam
Pap smear
If it Goes Untreated
• Increased risk of cervical cancer
• Increased risk of cancer of the penis
Trichomoniasis
Most common STD in sexually
active young women.
Trichomoniasis
• The most common curable STD.
• Caused by a small organism called
Trichomoniasis vaginalis.
• Women more than men are affected by
the disease.
Signs and Symptoms
Male
• Irritation inside the
penis
• Mild discharge
• Slight burning after
urination or
ejaculation
•
•
•
•
•
Female
Greenish-yellow,
frothy vaginal
discharge
Strong odor
Painful urination
Discomfort during
intercourse.
Lower abdominal
pain (rare)
Tests and Treatment
Tests
• Pelvic Examination
• Laboratory tests
Treatments
• Oral Antibiotic
If it Goes Untreated
• Increased risk of acquiring HIV if
exposed.
• I pregnant women,Premature rupture of
membranes that protect the baby, and
preterm delivery.
Chlamydia
In the sexually active 18-30s
crowd, 50% are infected.
Chlamydia
• Most common sexually transmitted
disease in the USA.
• The infection is easily spread because it
often causes no symptoms.
• 75 percent of women and 50 percent of
men have no symptoms.
Signs and Symptoms
•
•
•
•
•
•
•
Women
Vaginal discharge
Strong foul odor
Painful periods
Abdominal pain with
fever
Pain when having
sex
Itching or burning in
or around vagina
Pain when urinating
Men
• Small amounts of
clear or cloudy
discharge
• Painful urination
• Pain and swelling
around testicles
Tests and Treatments
Tests
• Cervical swab
Treatments
• Oral antibiotics
If it Goes Untreated
•
•
•
•
•
•
Pelvic Inflammatory disease
Infertility
Risk of ectopic pregnancy
Damage of fallopian tubes
Premature births
Infection passed from mother to child,
causing an eye infection of pneumonia
in the newborn.
Herpes (HSV-2)
Genital Herpes is most
common in young white teens.
Herpes (HSV-2)
• A highly contagious infection
• Spread during intercourse, oral, or anal
sex through open sores
• Also can be spread to a newborn at
birth if the mother has an active
infection.
How Common is Herpes?
• More than one in five Americans- 50
million people- are infected with genital
herpes.
• Yet, At least 80 percent of those with
herpes are unaware they have it.
What Causes Herpes?
• The infection is
caused by the
herpes simplex
virus-2
• Herpes simplex
virus-1 is
responsible for cold
sores.
Signs and Symptoms
• Inflamed genitalia
• Skin may burn, itch
or be painful
• Blister like sores
appear on genitalia
• Sores open, scab
over than heal
This may also be
accompanied by:
•
•
•
•
Swollen glands
Fever
Headache
Burning when
passing urine
• Muscle aches
What Triggers an Outbreak?
•
•
•
•
•
•
Stress
Illness
Surgery
Vigorous sex
Diet
Monthly period
Treatment
• There is no cure.
• Antivirus medication
can help heal sores
faster.
• Antiviral medication
can help suppress
outbreaks.
How to Protect Yourself.
• Do not have sex with someone who has
an open sore.
• Always use latex condoms during sex.
• Use a spermicide that contains
nonoxynol-9.
• Limit your number of sex partners.
Gonorrhea
The highest rates of infections are
found in 15-19 year-old women
and 20-24 year-old men.
Gonorrhea
• Also called “The Clap” or “The Drip”.
• Caused by Neisseria gonorrhoeae, a
bacterium that can grow and multiply
easily in mucus membranes.
Where Does
Gonorrhea Grow?
•
•
•
•
•
•
•
•
Cervix
Uterus
Fallopian tubes
Urethra
Mouth
Throat
Anus
Eyes
Symptoms in Women
• Greenish yellow or
whitish discharge
from vagina
• Lower abdominal or
pelvic pain
• Burning when
urinating
• Conjunctivitis
• Bleeding between
periods
• Spotting after
intercourse
• Swelling of the
vulva(vulvitis)
• Burning in the throat
(due to oral sex)
• Swollen glands(due
to oral sex)
Symptoms in Men
• Greenish yellow or
whitish discharge
from the penis
• Burning when
urinating
• Burning in the throat
(due to oral sex)
• Swollen glands (due
to oral sex
Tests and Treatment
•
•
•
•
Tests
Fluid sample from
the urethra (in men)
Fluid sample form
cervix (in women)
Throat cultures
Anal cultures
Treatment
• There is a cure for
Gonorrhea.
• Oral or injected
antibiotic
What Happens When it Goes
Untreated?
•
•
•
•
In Women
Damage fallopian
tubes
Can cause Pelvic
Inflammatory
Disease
Infertility
Increased risk of
ectopic pregnancy
In Men
• Epididymitis, which
can cause infertility
• Prostate damage
• Scaring of the
urethra
Hepatitis B (Hep B)
Cost associated with sexually
transmitted hepatitis B in the United
States totaled $200 million in 2000.
Hepatitis B
• Hepatitis B is a virus caused by the
Hepatitis B virus (HBV).
• Hepatitis B is 100 times more infectious
than HIV.
• 40% of those infected do not know how
they acquired the infection.
Affects of the Hepatitis B Virus
•
•
•
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Scarring of the liver
Liver failure
Liver cancer
Death
How Hepatitis B is Spread
•
•
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Infected blood
Semen
Vaginal secretions
Saliva
Open sores
Breast milk
Hep B, Limited Infection
• In most cases Hep B causes limited infection.
(90% - 95%)
• Most people fight off the infection successfully
within a few months, developing an immunity
that lasts a lifetime.
• Blood tests will show evidence of this
immunity, but no signs of active infection.
Hep B Carriers
• If you are infected with Hep B for more
than 6 months, you are considered a
carrier. Even if you have no symptoms.
• In a small percentage of carriers the
infection eventually goes away for
unknown reasons.
Chronic Hep B
• Some carriers go on to develop chronic Hep B.
• Chronic Hep B is an ongoing infection of the
liver that can lead to cirrhosis.
• Cirrhosis, or hardening of the liver, causes liver
tissue to scar and stop working.
• 5%- 10% of people with the Hepatitis B
infection go on to develop chronic infection.
Signs and Symptoms
• Jaundice (yellowing
of the skin or whites
of the eyes and/or a
brownish or orange
tint to the urine.
• Unusually light
colored stool
• Unexplained fatigue
that persists for
weeks or moths
• Flu-like symptoms
such as fever, loss
of appetite, nausea,
and vomiting.
• Abdominal pain
Tests
• Complete physical exam
• Blood tests
If The Disease Becomes Chronic
• Liver biopsies (to detect the severity of
the disease.
Treatment
• Within two weeks of
exposure immediate
immunization with
Hep B vaccination
and a shot to boost
the immune system.
• Bed rest (to speed
recovery)
• Some doctors
recommend a highcalorie, high-fat diet.
• It is important to stay
away form alcohol
and acetaminophen,
as they can harm
the liver.
Treatment for Chronic Hep B
• Immune system boosting medicine
(interferon alpha is injected for at least 6
months.
• Lamivudine (Epivir) in combination with
interferon alpha
Risk of Pregnancy
• A pregnant woman can spread the
hepatitis B virus to her baby at the time
of birth.
• Many babies infected with hepatitis B
develop long-term liver problems.
How to Protect Yourself
• Get vaccinated
• Use condoms every
time you have sex
• Wear gloves when
touching or cleaning
up body secretions.
• Do not share razors,
toothbrushes,
manicuring tools, or
pierced earrings
with anyone.
• Do not share
chewing gum or prechew food for a
baby.
• Make certain that
any needles for
drugs, ear piercing,
or tattooing are
properly sterilized.
• Cover all open cuts
and wounds.
Is There a Cure?
Currently, there is not cure for
hepatitis B. Luckily, the disease
is limited in most acute cases
and occasionally disappears in
those with chronic disease.
Syphilis
This disease can not be spread by
toilet seats, door knobs, swimming
pools, hot tubs, bath tubs, shared
clothing, or eating utensils.
Syphilis
• A highly contagious disease caused by
the bacteria Treponema pallidum.
• A treatable infection that can spread
throughout the body and affect the
heart, brain,and nerves.
• Also known as “syph”.
Syphilis
• Since 1990 the rate of new cases of
syphilis per year has dropped 84%.
• Today Syphilis is one of the least
common STDs.
Three Distinct Phases
of Syphilis
Primary, Secondary, and
Tertiary
Primary
• Infection referred to as “great imitator”
• Signs are visible within 10-90 days.
• Infection can be mistaken for many other
conditions.
• Development of one or more chancre sores is
common.
• The sores look like large round bug bites and are
often hard and painless
• The sores occur on the genitalia or in or around
the mouth.
• The sores will heal and scar within 6 weeks.
Secondary
• May last 1-3 months
• Begins within 6 weeks to 6 months after
exposure
• A rosy “copper penny” rash typically on the
palms of the hands and bottoms of feet
appears.
• Moist warts may also appear on the groin.
• White patches inside the mouth, swollen
lymph glands, fever, and weight loss are also
symptoms
Latent Syphilis
• This is when the
infection lies
dormant (inactive)
without symptoms.
Tertiary
• Severe problems with the heart, brain,
and nerves
• Can result in blindness, dementia,
impotency, and even death if it goes
untreated.
Tests
• Blood test
• Chancre swab
Treatment
• If caught before 1
year a single dose
of penicillin is
usually enough to
destroy the
infection.
• If it is in a later stage
more doses of
penicillin will be
used to treat the
infection.
Effects of Syphilis on
Pregnancy
• Depending on how long the mother has
been infected she has a good chance of
having a stillbirth.
• There is also a great risk that the baby
will die shortly after birth.
• If not treated immediately the baby may
become developmentally delayed, have
seizures, or die.
Outlook
• There is a cure for Syphilis.
• Prompt diagnosis and treatment will
help prevent any serious problems.
• If treated too late, there may be
permanent damage to the heart and
brain.
Protection
• Using condoms during intercourse, oral and
anal sex is the only way to protect yourself
from STDs.
• Even those barrier methods are not always
safe.
• Every time you have sexual relations with
another individual you are at risk.
Is it worth it?
At Least One In Four Americans
Will Contract An STD At Some
Point In Their Life
Less than half adults age 18 to
44 have ever been tested for
an STD other than HIV/AIDS
Bibliography
• Aol Health with WebMD
http://aolsvc.health.webmd.aol.com/
• Center for Disease Control (CDC)
http://www.cdc.gov/
• Sexuality Information and Education Council of the
United States(SIECUS)
http://www.siecus.org/
• The Journal of the American Medical Association
(JAMA)
http://www.ama-assn.org/
Bibliography cont.
• Health Awareness Connection (HAC)
http://www.healthac.org/
• American Social Health Association
(ASHA)
http://www.ashastd.org/
• Pictures:
http://www.thebody.com/
http://www-nehc.med.navy.mil/