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  1. 1. Chapter 14 Preventing SexuallyTransmitted Infections
  2. 2. Objectives Name and describe the most common sexually transmitted infections. Outline the health consequences of sexually transmitted infections. Define the difference between HIV and AIDS. Explain the seriousness of the AIDS epidemic in the United States and worldwide. Describe ways to prevent acquiring sexually transmitted infections.
  3. 3. Preventing Sexually Transmitted Infections The WHO estimates 1 million people worldwide are infected daily with sexually transmitted infections (STIs) , not including HIV STIs have reached epidemic proportions in the U.S. Of the more than 25 known STIs, some are still incurable Currently, the U.S. has the highest rate of STIs of any country in the industrialized world
  4. 4. Chlamydia Most prevalent STI in the U.S. Caused by a bacterial infection that spreads  During vaginal, anal, or oral sex  From the vagina to a newborn baby during childbirth Can cause serious damage to the reproductive system Is a major factor in male and female infertility May not produce symptoms; thus 3 of 4 infected individuals don’t know they’re infected until the infection has become quite serious
  5. 5. Chlamydia• When symptoms are present, they include abdominal pain, fever, nausea, vaginal bleeding, and arthritis Treatment requires oral antibiotics Damage to the reproductive system is irreversible
  6. 6. Gonorrhea Caused by a bacterial infection  Transmitted through contact with the vagina, penis, anus, or mouth of an infected person Symptoms in men  Typical symptoms include a pus-like secretion from the penis and painful urination Symptoms in women  Women also may have discharge and painful urination  Up to 80% of infected women don’t experience symptoms until the infection has become fairly serious  At this stage, women develop fever, severe abdominal pain, and pelvic inflammatory disease
  7. 7. Gonorrhea• Untreated gonorrhea can produce – Infertility, widespread bacterial infection, heart damage, arthritis – Blindness in children born to infected women• Treated successfullywith penicillin and otherantibiotics
  8. 8. Pelvic Inflammatory Disease Each year more than 1 million women in the U.S. experience an episode of PID Not a true STI, but rather complications resulting from STIs, especially chlamydia and gonorrhea Often develops when the STI spreads to the fallopian tubes, uterus, and ovaries Sexually active women, especially those under age 25, are at higher risk The more sex partners a woman has, the greater the risk
  9. 9. Pelvic Inflammatory Disease Symptoms include  Fever, nausea, vomiting, chills, spotting between menstrual periods, heavy bleeding during periods  Pain in the lower abdomen during sexual intercourse, between menstrual periods, or during urination Many women do not know they have PID because symptoms are not always present PID is treated with antibiotics, bed rest, and sexual abstinence Surgery may be required to remove infected or scarred tissue or to repair or remove the fallopian tubes or uterus
  10. 10. Human Papillomavirus (HPV) & Genital Warts HPV is one of the most common causes of STI Some strains of HPV infect the genital area and can cause genital warts Others are “high risk” types and may lead to cancers of the cervix, vulva, vagina, anus, or penis Caused by a viral infection that is spread  Through genital or oral contact  From the vagina to a newborn baby Most people have no signs or symptoms and can transmit the virus to a sex partner
  11. 11. An advanced case of genital warts on thefemale and lesions on the male
  12. 12. Human Papillomavirus (HPV) & Genital Warts Warts appear anywhere from 1 to 8 months after exposure Warts can be found  On the penis and around the vulva and vagina  In the mouth, throat, rectum, the cervix, or around the anus
  13. 13. Human Papillomavirus (HPV) & Genital Warts Health problems include  Increased risk for cancers of the cervix, vulva, vagina, anus, and penis  Enlargement and spread of the warts, leading to obstruction of the urethra, vagina, and anus  Warts over the bodies of babies born to infected mothers (thus, Cesarean sections are recommended)
  14. 14. Human Papillomavirus (HPV) & Genital Warts Treatment requires complete removal of all warts by  Freezing them with liquid nitrogen, dissolving them with chemicals, or removing them through electrosurgery or laser surgery Patients may have to be treated more than once because genital warts can recur
  15. 15. Genital Herpes A common STI caused by the herpes simplex virus (HSV) Several types of HSV produce different ailments, including  Genital herpes, oral herpes, shingles, and chicken pox• The two most common forms of HSV are Types 1 and 2 • Type 1 is most commonly known to cause oral herpes • Cold sores or fever blisters appear on the lips and mouth• HSV Type 2 is better known as the virus that causes genital herpes
  16. 16. Genital Herpes HSV is a highly contagious virus HSV spreads by contact with an active sore HSV can also be spread through virus-containing secretions from the vagina or penis• A few days following infection, a tingling sensation and sores appear on the infected areas (mouth, genitals, rectum) but may also surface on other parts of the body
  17. 17. Genital HerpesHerpes Simplex Virus Type 1 is typically associated with oral herpes andHerpes Simplex Virus Type 2 which is typically associated with genital herpes.Between 50-80% of adults in the U.S. have HSV-1 and about 25% have HSV-2.Many do not know they have herpes because they don’t have any symptoms ordidn’t notice symptoms when they appeared.
  18. 18. Genital Herpes Along with sores, victims usually have mild fever, swollen glands, and headaches Symptoms disappear within a few weeks, causing some people to believe they are cured Herpes is presently incurable; its victims do remain infected  The virus can remain dormant for extended periods, but repeated outbreaks are common
  19. 19. Genital Herpes Both HSV Type 1 and 2 can cause oral and genital sores People who have an outbreak of oral herpes should not touch their genitals or someone else’s after touching the oral cold sores (doing so can lead to herpes infection of the genitals) Oral sex can also cause transmission of the HSV from the lips to the genitals and vice versa Hands should be carefully washed with soap following contact with cold or herpes sores
  20. 20. Syphilis Caused by a bacterial infection Transmitted through direct contact with a syphilis sore during vaginal, anal, or oral sex In the primary stage, about 3 weeks after infection, a painless sore appears where the bacteria entered the body A latent stage during which victim is not contagious may last up to 30 years (victims think they are healed) Some people develop paralysis, gradual blindness, heart disease, brain and organ damage, or die as a direct result of the infection
  21. 21. Syphilis A single injection of penicillin will cure individuals who have been infected for less than a year Additional treatments are needed for people infected longer than a year Victims must abstain from sexual activity until all syphilis sores have completely disappeared
  22. 22. Syphilis
  23. 23. HPV, Chlamydia, and Herpes are the three most common STI’s in college students, but are not the only ones that out there…Syphilis Pubic Lice
  24. 24. Critical Thinking Many individuals who have sexually transmitted infections withhold this information from potential sexual partners. Do you think that it should be considered a criminal action if an individual knowingly transmits a STI to someone else?
  25. 25. HIV and AIDS Human immunodeficiency virus (HIV): Virus that leads to acquired immunodeficiency syndrome (AIDS) Acquired immunodeficiency syndrome (AIDS): Any of a number of diseases that arise when the body’s immune system is compromised by HIV Opportunistic infections: Infections that arise in the absence of a healthy immune system, which would fight them off in healthy people
  26. 26. HIV and AIDS HIV is passed from one person to another through blood-to- blood (sharing hypodermic needles) and sexual contact Upon infection, the HIV virus multiplies, attacks, and destroys white blood cells As the number of white blood cells destroyed increases, the body’s immune system gradually breaks down or may be completely destroyed Without the immune system, a person becomes susceptible to various opportunistic infections and cancers
  27. 27. HIV and AIDS HIV is a progressive infection At first, people who become infected with HIV might not know they are infected An incubation period of weeks, months, or years may pass during which no symptoms appear The virus may live in the body 10 years or longer before symptoms emerge
  28. 28. HIV and AIDS When the infection progresses to the point at which certain diseases develop, the person is said to have AIDS HIV itself doesn’t kill, nor do people die of AIDS Death is caused by a weakened immune system that is unable to fight off opportunistic infections HIV infection is determined through an HIV antibody test
  29. 29. HIV and AIDS Early symptoms of AIDS include  Unexplained weight loss, constant fatigue, mild fever, swollen lymph glands, diarrhea, sore throat Advanced symptoms include  Loss of appetite, skin diseases, night sweats, deterioration of mucous membranes The two most common fatal conditions in AIDS patients are  Pneumocystis carinii pneumonia (a parasitic infection of the lungs)  Kaposi’s sarcoma (type of skin cancer)
  30. 30. Transmission of HIV HIV is transmitted by the exchange of cellular fluids, including blood and other body fluids containing blood, semen, vaginal secretions, and maternal milk These fluids can be exchanged:  During sexual intercourse  Sharing hypodermic needles with someone who is infected  Between a pregnant woman and her developing fetus  Infection of a baby from the mother during childbirth  During breast feeding (infrequent)  From a blood transfusion or organ transplant (rare)
  31. 31. Proportion of HIV/AIDS cases among adults and adolescents, bytransmission category, United States 2004-2007
  32. 32. Proportion of HIV/AIDS cases among adults and adolescents, bygender and transmission category, United States 2007
  33. 33. Estimated Number of Persons Living with HIV/AIDS, byrace/ethnicity in the United States, 2004-2007
  34. 34. Transmission of HIV People do not get HIV because of who they are but because of what they do HIV and AIDS can threaten anyone, anywhere Nobody is immune to HIV HIV can be transmitted between/from  Males  Females  Male to female  Female to male HIV and AIDS are preventable; nearly all of the people who get HIV do so because they engage in risky behaviors
  35. 35. Risky Behaviors The two most basic risky behaviors are:  Having unprotected vaginal, anal, or oral sex with an HIV-infected person  Sharing hypodermic needles or other drug paraphernalia with someone who is infected
  36. 36. Estimated Number of AIDS Cases, Deaths, and Persons Livingwith AIDS, 1985-2007, United States and dependent areas
  37. 37. HIV Testing In 2006, the CDC revised recommendations for HIV testing  All patients ages 13-64 in health care settings should be tested  Pregnant women during the routine panel of prenatal screening tests  Annual screenings for people at high risk for infection  Consent is now included in the general consent form for medical care; however, patients can decline testing
  38. 38. HIV Treatment HIV infection and AIDS have no known cure Medications are available that  Delay the progress of infection and allow HIV-infected patients to live longer  May keep some people from developing AIDS The sooner the treatment is initiated, the better the prognosis for a longer life Developing a vaccine to prevent HIV infection or AIDS seems highly unlikely in the near future Several AIDS clinical trials are available to evaluate experimental drugs and various therapies for people at all stages of HIV infection
  39. 39. Guidelines for Preventing Sexually Transmitted Infections A mutually monogamous sexual relationship Abstinence If you choose to delay sex, do not let peers pressure you into having sex Seek out people that hold your values Build your friendships and future around people who respect you and what you believe Be prepared and know your course of action before you get into an intimate situation
  40. 40. Reducing Risks for STIs and HIV Infection The following precautions can reduce your risk for STIs, including HIV infection and, subsequently, AIDS  Postpone sex until you and your uninfected partner are ready for a lifetime monogamous relationship  Unless in a monogamous relationship and you know your partner is not infected, practice safer sex every time you have sex and do not have sexual contact with anyone who doesn’t practice safe sex
  41. 41. Reducing Risks for STIs and HIV Infection Use barrier methods of contraception to help prevent disease from spreading Know your partner and limit your sexual relationships Don’t have sex with prostitutes Determine the conditions under which you will allow sex Plan before you get into a sexual situation Negotiate safer sex If sexually promiscuous, have periodic physical check-ups
  42. 42. Reducing Risks for STIs and HIV Infection Avoid sexual contact with anyone who has had sex with people at risk for getting HIV If you do have sex with someone who might be infected with HIV or whose history is unknown to you, avoid exchange of body fluids Don’t share toothbrushes, razors, or other implements that could become contaminated with blood with anyone who is or who might be infected
  43. 43. Reducing Risks for STIs and HIV Infection If you suspect that your partner is infected with an STI, ask, and if he/she is unsure, look for signs such as sores, rashes, discharge; abstain if you are unsure Be responsible enough to abstain from sexual activity if you have an infection Wear loose-fitting clothes made of natural fibers
  44. 44. Reducing Risks for STIs and HIV Infection Consider abstaining from sexual relations if you have any kind of an illness or disease, even a common cold Thoroughly wash immediately after sexual activity
  45. 45. Reducing Risks for STIs and HIV Infection Be cautious regarding procedures in which needles or other nonsterile instruments may be used If you are planning on artificial insemination, insist on frozen sperm obtained from a laboratory that tests all donors for HIV If you know you will be having surgery in the near future, and if you are able, consider donating blood for your own use
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