Chlamydia

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syphilis
warts
gonorrhea
pubic lice
chancroid
Chlamydia
NGU
scabies
Chapter 17 STDs
herpes
HIV/AIDS
candidiasis
trichomoniasis
vaginosis
PID
hepatitis
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Bacterial Infections - Chlamydia

• most common STD in U.S. (4 million)
• spread by vaginal oral and anal intercourse and
  from mom to newborn
• symptoms few or none mild irritation or
  itching burning slight discharge
• treatment antibiotics for all sex partners
  involved

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PID
pelvic inflammatory disease
symptoms severe abdominal pain fever
tenderness of reproductive organs causing pain
and vaginal discharge during vaginal intercourse
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Bacterial Infections - Gonorrhea

• Gonorrhea
• females gonococcal cervicitis
• symptoms 80 no early symptoms yellow-green
  discharge vulval irritation
• males gonococcal urethritis
• symptoms discharge burning swelling
• Gonorrhea (consequences)
• female PID ectopic pregnancy severe pelvic
  pain infant conjunctivitis
• male prostate abscesses painful BMs difficult
  urination possible sterility
• both transmitted to eyes anus throat may
  invade joints heart liver CNS
• Treatment antibiotics

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Bacterial Infections - Syphilis

• Syphilis
• primary red painless chancre
• secondary painless non-itching skin rash
  flu-like symptoms
• latent no observable symptoms
• tertiary severe disorder death

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Bacterial Vaginosis

• Causeoutgrowth of bacterium
• Gardnerella vaginalis
• Symptoms
• Foul-smelling thin discharge
• gray white yellow or green
• Bad odor
• Irritation of genital tissues
• Pain during urination
• Treatment antibiotics

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Nongonoccoccal Urethritis (NGU)

• Bacterial infection
• Inflammation of urethral tube
• Causes bacteria infectious agents other
  agents
• Symptoms
• female itching burning vaginal discharge or
  pus
• male penile discharge urinary burning

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Chancroid

• Bacterial disease
• Small bumps on genitals perineum anus
• Turn into painful foul
• smelling ulcers
• Treatment antibiotics

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Viral Infections - Herpes

• Herpes herpes simplex types 1 2 transmitted
  even when no blisters
• Prodromal symptoms before outbreak itching and
  burning
• symptoms painful red bumps develop into
  blisters that rupture form sores
• may or may not be recurrent
• consequences risk for cervical cancer
• newborn infected during delivery may die or
  suffer severe damage

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Viral Infections - Herpes

• C-section for women with active disease
• treatment no cure working on vaccine
• acyclovir may reduce length severity of
  outbreak may reduce recurring attacks
• hygiene stress reduction may provide relief

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Viral Infections - Hepatitis

• Viral hepatitis
• needle-sharing sexual transmission
• General symptoms few or none initially flu
  like incapacitating fever vomiting abdominal
  pain yellowed sclera skin
• consequences liver cancer death
• treatment bed rest fluids vaccines are
  available for Hepatitis A and B antiviral
  combination may help Hepatitis C

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Common Parasitic Infections Trichomoniasis

• Trichomoniasis
• symptoms copious odorous frothy white or
  yellow-green vaginal discharge inflamed
  irritated itchy and sore
• men more likely to be a-symptomatic
• Trichomoniasis
• consequences may increase risk of cervical
  cancer
• treatment both partners oral Flagyl topical
  cream

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Viral Infections Genital WartsHuman Papilloma
Virus

• symptoms moist soft cauliflower-like warts or
  dry yellow-gray hard warts
• consequences urinary obstruction bleeding
  greater risk of genital cancers
• respiratory infection in newborn
• treatment no cure removal

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Candidiasis Yeast Infection

• Normally certain amount present in many women
• Candida albicans
• Occurs under certain conditions
• Pregnancy use of pill diabetes
• other conditions that increase amt of sugar in
  vaginal walls
• Or use of products that reduce amt of
  lactobacilli

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Candidiasis Yeast Infection

• Transmission
• By wiping from back to front
• Sexual contact
• Organism may be harbored in male body under
  foreskin
• From partners mouth to womans vagina

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Candidiasis Yeast Infection

• Symptoms
• Females
• White clumpy discharge Intense itching soreness
• Painful coitus
• Others
• Males
• Burning sensation rash
• Treatment anti fungal suppositories creams or
  tablets

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Ectoparasitic Infections

• Pubic lice Crabs
• Yellowish gray under microscope
• Grips pubic hair w/ claws sticks head into skin
  feeds on blood
• Transmission
• When pubic areas are rubbed together
• Wearing infected persons clothes coming into
  contact w/ items infected person contacted
• Public Lice may live on bed clothes sheets
  etc. up to a day

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Pubic Lice - Crabs

• Symptoms little to severe itchiness
• Treatment
• Permithrin rinse to all affected areas all hair
  - even eyebrows armpits
• Wash scalp hair w/ Lindane shampoo
• Repeat treatment 7 days later (takes 7 days for
  eggs to hatch)
• Launder linens clothing
• Treated person can be reinfected if they contact
  items not washed!

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Scabies ectoparasitic infection
Caused by parasite mites Sarcoptes
scabiei Incidence - millions worldwide Highly
contagious through close sexual and nonsexual
contact Symptoms small pimple-like bumps red
rash around primary lesion Infested areas itch
badly Treatment topical scabicide or
Kwell launder or dry-clean linens clothing
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HIV AIDS

• HIV a retrovirus that targets destroys helper
  T-4 cells
• HIV becomes AIDS when
• HIV is present and
• T-4 count is

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AIDS

• Introduced through chimps
• SIV virus
• Converted to HIV
• Isolated to Africa until migration
• HIV identified in 1983

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AIDS - Incidence

• Decreasing MSM transmission
• Decreasing IDU transmission
• Increasing among adolescents

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AIDS - Incidence

• Increasing heterosexual transmission
• Especially among women minorities
• 3rd leading cause of death among American women
  ages 25-44
• 1 among African American women 25-44 year-old

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AIDS

• Transmission
• occurs in any bodily fluid
• Modes of transmission
• Sexual interaction (vaginal anal oral)
• Sharing needles
• Accidental needle sticks
• Organ transplants
• Perinatally
• Breastfeeding
• Blood transfusions

Risk through saliva tears urine extremely low
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AIDS

• Transmission through sexual contact depends on
  viral load and route of HIV exposure
• VIRAL LOAD Amount of virus present in infected
  persons blood
• Low risk casual contact (hugging shaking hands
  cooking/eating together etc.)

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AIDS

• High risk
• when transmitted directly into blood
• tears in rectal/vaginal tissue/foreskin of
  uncircumcised man prone to tears
• sharing needles
• tongue/mouth during oral sex (may be safer than
  anal/oral but risk still exists)

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• Generally high risk behaviors to avoid
• Multiple sex partners
• Unprotected sex
• Sex w/ high risk people
• IDUs
• Prostitutes
• Folks w/ multiple sex partners
• Sharing needles/syringes
• Using drugs/alcohol (leads to increased risky
  behs)
• Cocaine users have disproportionately high rates
  of STDs

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• SYMPTOMS
• Brief flu-like symptoms shortly after initial
  infection acute retroviral syndrome
• fever
• muscle aches
• skin rashes
• loss of appetite
• swollen lymph glands

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Symptoms over timeBodys immune system is
depleted

• Bloody stools
• Easy bruising
• Persistent headaches
• Chronic dry cough
• Oral candidiasis

• Repeated/persistent fevers
• Night sweats
• Weight loss
• Fatigue
• Persistent diarrhea

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• HIV antibody tests
• most develop antibodies in a few months but can
  take three years (silent infection) to
  seroconvert
• thus that long to be detected!
• PCRs

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AIDS

• Treatment
• no cure or vaccine at this time
• improvement in life-expectancy after onset of
  full-blown AIDS improved since 80s due to
  advancements in drug therapy
• combination drug therapy (HAART 3 drugs) shows
  best results for slowing progress (read more
  pages 509-511)
• zidovudine may significantly decrease maternal
  transmission

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AIDS Prevention

• Prevention is the best solution!
• do not share needles
• avoid contact with bodily fluids
• avoid sexual behaviors involving anus
• seek mutually monogamous relationship w/ HIV-free
  partner

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AIDS Prevention

• Prevention is the best solution
• avoid implements that could be contaminated with
  blood (e.g. razors)
• avoid sexual contact with prostitutes

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Preventing STDs(see pages 514-521 for details)

• obtain prior medical examinations
• always use condoms spermicide
• avoid multiple sexual partners
• inspect and wash genitals
• disclose your STD status

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If you have an STD you are obligated to tell all
sex partners (past and present) and take
appropriate measures to prevent transmission!
For additional info contactAmerican Social
Health AssociationNational AIDS
Hotline[phone] (English)open
24/71-800-344-7432 (Spanish7 Days/wk 8am-2am
(EST)American Federation for the Prevention of
VD799 Broadway Suite 638New York NY
10003National STD Hotline[phone]M-F
8am-11pm (EST)National Herpes Hotline(919)
361-8488M-F 9am-7pm (EST)