• Acquired Immune Deficiency Syndrome• is a disease of the human immune system caused bythe human immunodeficiency virus (HIV). The illness interfereswith the immune system, making people with AIDS much morelikely to get infections, including opportunisticinfections and tumors that do not usually affect people withworking immune systems.
Sexual - The majority of HIV infections are acquired through unprotected sexual relations where one partner has HIV. Body fluids - The second most frequent mode of HIV transmission is via blood and blood products.Mother-to-child - HIV can be transmitted from mother to child during pregnancy, during delivery, and after delivery via breastfeeding
Mother – to – Child • This primarily involves the use of a combination of antivirals during pregnancy and after birth in the infant but also potentially include bottle feeding rather than breastfeeding Sexual Contact • Where one partner of a couple is infected, consistent condom use results in rates of HIV infection for the uninfected person of below 1% per year.
• Sexually transmitted diseases (STDs) are infections that can betransferred from one person to another through any type of sexualcontact. STDs are sometimes referred to as sexually transmittedinfections (STIs) since they involve the transmission of a disease-causing organism from one person to another during sexualactivity.
What is gonorrhea?• Gonorrhea is a bacterial infectioncaused by the organism Neisseriagonorrheae (also known asgonococcus bacteriae) that istransmitted by sexual contact.
•Over 50% of infected women have no symptoms,especially in the early stages of the infection. Symptoms ofgonorrhea include burning or frequent urination, ayellowish vaginal discharge,redness and swelling of thegenitals, and a burning or itching of the vaginal area.
• Testing for gonorrhea is done by swabbing the infected site(rectum, throat, cervix) and identifying the bacteria in thelaboratory either through culturing of the material from theswab (growing the bacteria) or identification of the geneticmaterial from the bacteria. Sometimes the tests do not showbacteria because of sampling errors (the sampled area doesnot contain bacteria) or other technical difficulties, even whenthe woman has an infection. Newer tests to diagnosegonorrhea involve the use of DNA probes or amplificationtechniques (for example, polymerase chain reaction, or PCR) toidentify the genetic material of the bacteria. These tests aremore expensive than cultures but typically yield more rapidresults.
• In the past, the treatment of uncomplicated gonorrhea wasfairly simple. A single injection of penicillin cured almostevery infected person. Unfortunately, there are new strains ofgonorrhea that have become resistant to various antibiotics,including penicillins, and are therefore more difficult to treat.Fortunately, gonorrhea can still be treated by otherinjectable or oral medications.
What is chlamydia?• Chlamydia (Chlamydia trachomatis)is a bacterium that causes aninfection that is very similar togonorrhea in the way that it is spreadand the symptoms it produces
The majority of women with chlamydia do not have symptoms.Cervicitis (infection of the uterine cervix) is the most commonmanifestation of the infection. While about half of women withchlamydial cervicitis have no symptoms, others may experiencevaginal discharge or abdominal pain. Infection of the urethra isoften associated with chlamydial infection of the cervix.
• Chlamydia can be detected on material collected byswabbing the cervix during a traditional examination using aspeculum, but noninvasive screening tests done on urine or onself-collected vaginal swabs are less expensive and sometimesmore acceptable to patients. While culturing of the organismcan confirm the diagnosis, this method is limited to researchlaboratories and forensic investigations. For routine diagnosticuse, newer and inexpensive diagnostic tests that depend uponidentification and amplification of the genetic material of theorganism have replaced the older, time-consuming culturemethods.
• Treatment of chlamydia involves antibiotics. A convenientsingle-dose therapy for chlamydia is oral azithromycin(Zithromax, Zmax). Alternative treatments are often used,however, because of the high cost of this medication. Themost common alternative treatment is doxycycline(Vibramycin, Oracea, Adoxa, Atridox, and others). Unlikegonorrhea, there has been little, if any, resistance ofchlamydia to current antibiotics. There are many otherantibiotics that also have been effective against chlamydia.As with gonorrhea, a condom or other protective barrierprevents the spread of the infection.
What is syphilis?• Syphilis is an STD that has been around forcenturies. It is caused by a bacterialorganism called a spirochete. The scientificname for the organism is Treponemapallidum. The spirochete is a wormlike,spiral-shaped organism that wigglesvigorously when viewed under amicroscope. It infects the person byburrowing into the moist, mucous-coveredlining of the mouth or genitals. Thespirochete produces a classic, painlessulcer known as a chancre.
Abnormal bulging of the large vessel leaving the heart (theaorta), resulting in heart problems. The development of large nodules (gummas) in various organsof the body. Infection of the brain, causina stroke,mental confusion, meningitis(type of brain infection),problems with sensation, or weakness (neurosyphilis). Involvement of the eyes leading to sight deterioration. involvement of the ears resulting in deafness. The damagesustained by the body during the tertiary stage of syphilis issevere and can even be fatal.
• Depending on the stage of disease and the clinicalmanifestations, the treatment options for syphilis vary.Long-acting penicillin injections have been very effectivein treating both early and late stage syphilis. The treatmentof neurosyphilis requires the intravenous administration ofpenicillin. Alternative treatments include oral doxycyclineor tetracycline. Women who are infected duringpregnancy can pass on the infection to the fetus throughthe placenta. Penicillin must be used in pregnant patientswith syphilis since other antibiotics do not
What is chancroid?Chancroid is an infection caused bythe bacterium Hemophilus ducreyi,which is passed from one sexualpartner to another.
•A clinical diagnosis of chancroid (which is made from themedical history and physical examination) can be made if thepatient has one or more painful ulcers in the genital area andtests are negative for syphilis or herpes. (Theword chancroid means resembling a chancre, the genital ulcerthat is caused by syphilis. Chancroid sometimes is called softchancre to distinguish it from the chancre of syphilis that feelshard to the touch. The ulcer of chancroid also is painful, unlikethe ulcer of syphilis that is painless.) The diagnosis of chancroidcan be confirmed by a culture of the material from within theulcer for the bacterium Hemophilus ducreyi. The clinicaldiagnosis justifies the treatment of chancroid even if cultures arenot available.
•Chancroid is almost always cured with a single oral dose ofazithromycin (Zithromax) or a single injection of ceftriaxone(Rocephin). Alternative medications are ciprofloxacin (Cipro)or erythromycin. Whichever treatment is used, the ulcersshould improve within seven days. If no improvement is seenafter treatment, the patient should be reevaluated for causesof ulcers other than chancroid. HIV-infected individuals are atan increased risk for failing treatment for chancroid and shouldbe observed closely to assure that the treatment has beeneffective.