Womens Health 14


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Womens Health 14

  1. 1. Chapter Fourteen Preventing Sexually Transmitted and Other Infectious Diseases
  2. 2. The Increasing Threat of Infectious Diseases <ul><li>The significant advances in antibiotics and vaccines to fight infectious diseases during the 20th century lulled many health officials and the public into thinking that the primary diseases of the 21st century would be chronic diseases caused primarily by lifestyle choices </li></ul><ul><li>The CDC states that the emergence and reemergence of many infectious disease agents have been fueled by the following: </li></ul><ul><li>-unprecedented worldwide population growth -increased international travel </li></ul><ul><ul><ul><li>- increased transport of animals and food products </li></ul></ul></ul><ul><ul><ul><li>-changes in food processing and handling </li></ul></ul></ul><ul><ul><ul><li>-human encroachment on wilderness habitats </li></ul></ul></ul><ul><ul><ul><li>-microbial evolution with resistance to antibiotics and other antimicrobial drugs </li></ul></ul></ul>
  3. 3. Primary Burden of STIs on Women <ul><li>Sexually transmitted infections (STIs) can be physically, emotionally, and spiritually devastating for women </li></ul><ul><li>The emotional and spiritual impact may range from feelings of shame to fear of reprisal and feelings of isolation to disconnection from others </li></ul><ul><li>The stigma attached to many STIs (particularly HIV/AIDS) can cause women to deny the possibility of having a STI, leading to a delay of testing and treatment </li></ul><ul><li>Women need to become knowledgeable about the most common STIs and infectious diseases by asking questions and seeking information </li></ul><ul><li>A woman should know the risks associated with STIs and practice assertive skills to prevent illness and unprotected sex </li></ul>
  4. 4. Common Bacterial Sexually Transmitted Infections <ul><li>Chlamydia </li></ul><ul><ul><ul><li>Most common bacterial sexually transmitted infection in the United States </li></ul></ul></ul><ul><ul><ul><li>Reported rates are higher than men, suggesting that many male partners are not screened </li></ul></ul></ul><ul><ul><ul><li>The bacterium Chlamydia trachomatis causes the symptoms via sexual intercourse </li></ul></ul></ul><ul><ul><ul><li>75% of women are asymptomatic until they experience fever and pain associated with PID </li></ul></ul></ul><ul><ul><ul><li>Symptoms include: </li></ul></ul></ul><ul><ul><ul><ul><ul><li>Vaginal discharge </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Burning urination </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Lower abdominal pain </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Bleeding between menstruation </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Fever </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>nausea </li></ul></ul></ul></ul></ul>
  5. 5. Chlamydia <ul><li>It can persist for a long period of time without symptoms </li></ul><ul><li>The exposure to chlamydia is usually sexual intercourse, and the site of infection is typically the cervix </li></ul><ul><li>A variety of tests including cell culture, antigen detection tests, nucleic acid hybridization tests, and nucleic acid amplification tests are used to diagnose chlamydia infection </li></ul><ul><li>Antibiotics are given to treat chlamydia </li></ul>
  6. 6. Common Bacterial Sexually Transmitted Infections (cont.) <ul><li>Gonorrhea </li></ul><ul><ul><ul><li>Caused by the Neisseria gonorrhea bacterium </li></ul></ul></ul><ul><ul><ul><li>Infection often is asymptomatic until complications such as PID occurs </li></ul></ul></ul><ul><ul><ul><li>Symptoms include: </li></ul></ul></ul><ul><ul><ul><ul><ul><li>Thick yellow or white vaginal discharge </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Burning during urination </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Severe menstrual or abdominal cramps </li></ul></ul></ul></ul></ul><ul><ul><ul><li>The incidence of gonorrhea continues to decline and the CDC reports rates of 113.5 per 100,000 persons annually </li></ul></ul></ul><ul><ul><ul><li>Left untreated, can lead to arthritis, dermatitis, and tenosynovitis </li></ul></ul></ul>
  7. 7. Common Bacterial Sexually Transmitted Infections (cont.) <ul><li>Syphilis </li></ul><ul><ul><ul><li>Caused by the spriochete, Treponema pallidum </li></ul></ul></ul><ul><ul><ul><li>Primarily passed via sexual intercourse </li></ul></ul></ul><ul><ul><ul><li>Consists of four phases: </li></ul></ul></ul><ul><ul><ul><ul><ul><li>Primary: painless brown or red sores </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Secondary: rash on the palm of hands/sole on feet </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Latent: no symptoms </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Tertiary: destructive lesions and damage to the CNS </li></ul></ul></ul></ul></ul><ul><ul><ul><li>Syphilis has been linked to increased susceptibility to HIV </li></ul></ul></ul><ul><ul><ul><li>Condoms are a good source of protection but only protects the covered areas </li></ul></ul></ul>
  8. 8. Common Bacterial Sexually Transmitted Infections (cont.) <ul><li>Chancroid </li></ul><ul><ul><ul><li>Caused by the bacterium H. ducreyi </li></ul></ul></ul><ul><ul><ul><li>Characterized by a painful genital ulceration </li></ul></ul></ul><ul><ul><ul><li>Most prevalent in Africa and Asia </li></ul></ul></ul><ul><ul><ul><li>Risk factor for HIV transmission </li></ul></ul></ul><ul><ul><ul><li>Difficult to culture or to test </li></ul></ul></ul>
  9. 9. Common Viral Sexually Transmitted Infections <ul><li>Herpes Simplex Virus (HSV) </li></ul><ul><ul><ul><li>Spreads from direct skin to skin contact </li></ul></ul></ul><ul><ul><ul><li>Can affect oral (Type 1) and genital areas (Type 2) </li></ul></ul></ul><ul><ul><ul><li>Either can manifest on any side of the body </li></ul></ul></ul><ul><ul><ul><li>Symptoms include: </li></ul></ul></ul><ul><ul><ul><ul><ul><li>Itching, burning, and swelling </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Small painful blisters appear in the genitalia (type 2) </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Common viral symptoms such as fever, headaches, muscular aches, and chills </li></ul></ul></ul></ul></ul><ul><ul><ul><li>There is no cure for Herpes Simplex but medications can reduce the severity of breakouts </li></ul></ul></ul>
  10. 10. Common Viral Sexually Transmitted Infections (cont.) <ul><li>Human Papilloma Virus (HPV) </li></ul><ul><ul><ul><li>Related to the formation of cervical cancer </li></ul></ul></ul><ul><ul><ul><li>Known as genital warts which grow on or around reproductive organs </li></ul></ul></ul><ul><ul><ul><li>Spread by direct skin contact </li></ul></ul></ul><ul><ul><ul><li>There is no cure for HPV but lesions can be removed with proper treatment </li></ul></ul></ul><ul><ul><ul><li>Most HPV infections are transmitted by sexual activity and diagnosed by an abnormal Pap smear </li></ul></ul></ul>A vaccine is now available which protects against 2 forms of HPV
  11. 11. Vaginitis <ul><li>One in ten women who visit their health care provider complain of vaginal discharge </li></ul><ul><li>Types of Vaginitis: </li></ul><ul><ul><ul><li>Bacterial vaginosis (BV): non-specific vaginitis </li></ul></ul></ul><ul><ul><ul><li>Trichomoniasis: one cell parasite that causes vaginal irritation </li></ul></ul></ul><ul><ul><ul><li>Candidiasis: yeast infection, not usually sexually transmitted </li></ul></ul></ul>
  12. 12. Pelvic Inflammatory Disease <ul><li>PID is an infection of the upper portion of the female reproductive tract beyond the cervix </li></ul><ul><li>Common symptoms include: </li></ul><ul><ul><ul><li>Severe pelvic pain </li></ul></ul></ul><ul><ul><ul><li>High fever </li></ul></ul></ul><ul><ul><ul><li>Chills </li></ul></ul></ul><ul><ul><ul><li>Nausea </li></ul></ul></ul><ul><ul><ul><li>Vomiting </li></ul></ul></ul><ul><li>PID is diagnosed through a pelvic exam or by analysis of vaginal or cervical secretions </li></ul><ul><li>Treatment includes antibiotics, rest, and sexual abstinence </li></ul><ul><li>PID is the only cause of infertility that is preventable </li></ul>
  13. 13. Women and HIV/AIDS <ul><li>In the United States, the AIDS epidemic has increased most dramatically among women of color </li></ul><ul><li>These women are faced with an array of psychosocial, economic, cultural, and relational issues </li></ul><ul><li>In 2002, HIV/AIDS was the leading cause of death for African American women aged 25-34 years </li></ul><ul><li>The most common methods for heterosexual women to contract AIDS are through contact with bisexual or heterosexual men or by injecting drug use </li></ul><ul><li>It appears that the level of infection and the method of exposure both contribute to a woman’s susceptibility </li></ul>
  14. 14. HIV/AIDS <ul><li>HIV (Human Immunodeficiency Virus) is the organism that causes Acquired Immune Deficiency Syndrome (AIDS) </li></ul><ul><li>The immune system breaks down, allowing pathogens to invade the body </li></ul><ul><li>HIV infected people who have a t-cell count of less than 200 develop AIDS </li></ul><ul><li>AIDS includes: </li></ul><ul><ul><ul><li>Pulmonary TB </li></ul></ul></ul><ul><ul><ul><li>Recurrent pneumonia </li></ul></ul></ul><ul><ul><ul><li>Invasive cervical cancer </li></ul></ul></ul>
  15. 15. Contracting AIDS <ul><li>HIV is transmitted by blood, semen, and/or vaginal secretions from: </li></ul><ul><ul><li>One person to another </li></ul></ul><ul><ul><li>Sharing injecting drug needles </li></ul></ul><ul><ul><li>Mother to infant </li></ul></ul><ul><ul><li>Through breast feeding </li></ul></ul><ul><ul><li>Receiving blood or blood products that is infected </li></ul></ul><ul><li>HIV cannot be transmitted via tears, saliva, or sweat </li></ul><ul><li>Transmission usually occurs when skin or mucous membranes are exposed to infected blood </li></ul>
  16. 16. Symptoms of HIV <ul><li>Recurring fever </li></ul><ul><li>Night sweats </li></ul><ul><li>Rapid weight loss </li></ul><ul><li>Diarrhea lasting several weeks </li></ul><ul><li>White, thick spots on the tongue </li></ul><ul><li>Dry cough </li></ul><ul><li>Shortness of breath </li></ul><ul><li>Purple bumps on the skin, inside the mouth, and rectum </li></ul>
  17. 17. Diagnosis of HIV <ul><li>Elisa test </li></ul><ul><li>Western Blot test </li></ul><ul><li>Oraquick test </li></ul><ul><li>Home HIV tests </li></ul><ul><ul><ul><li>Home Access Express </li></ul></ul></ul>
  18. 18. Treatment of HIV <ul><li>Drug treatment focuses on reducing the viral load or reinforcing the immune system by: </li></ul><ul><ul><ul><li>Blocking HIV attachment to the CDR cell </li></ul></ul></ul><ul><ul><ul><li>Blocking antigens on the virus envelope </li></ul></ul></ul><ul><ul><ul><li>Interfering with the uncoating of the virus as it enters the cell </li></ul></ul></ul><ul><ul><ul><li>Blocking RNA to DNA </li></ul></ul></ul><ul><ul><ul><li>Disrupting the assembly of needed particles to form HIV </li></ul></ul></ul>
  19. 19. What Lesbians Should Know about HIV Exposure <ul><li>Exposure of a mucous membrane to vaginal secretions and menstrual blood is potentially infectious </li></ul><ul><li>Condoms, dental dams, or plastic wrap can help during oral sex </li></ul><ul><li>Condoms should be used correctly when using sex toys </li></ul><ul><li>Bacteria in the rectum can cause infections in the vagina and urethra </li></ul><ul><li>Contact with a towel, underwear, bed linens, etc. can transmit some STIs from an infected woman </li></ul><ul><li>Self contact after touching a partner’s genitals can transmit some STIs </li></ul><ul><li>STIs can be transmitted from vulva to vulva contact </li></ul><ul><li>A woman’s own and her partner’s HIV status can increase the risk of infection </li></ul>
  20. 20. Prevention Strategies <ul><li>Abstinence </li></ul><ul><li>Monogamy </li></ul><ul><li>Engaging in less risky behaviors with partners </li></ul><ul><li>Oral contraceptives </li></ul><ul><li>Male condoms </li></ul><ul><li>Female condoms </li></ul>
  21. 21. Other Infectious Diseases <ul><li>Epstein-Barr Virus (EBV) </li></ul><ul><li>Influenza (flu) </li></ul><ul><li>Hepatitis A </li></ul><ul><li>Hepatitis B </li></ul><ul><li>Encephalitis and West Nile Disease </li></ul><ul><li>Hepatitis C </li></ul><ul><li>Tuberculosis (TB) </li></ul><ul><li>Streptococcal Disease </li></ul><ul><li>Varicella (Chickenpox and Shingles) </li></ul><ul><li>Lyme Disease </li></ul>
  22. 22. Chapter Fourteen Preventing Sexually Transmitted and Other Infectious Diseases