1. Chapter 14 Preventing Sexually Transmitted Infections
Outline:
Chlamydia
Gonorrhea
Pelvic Inflammatory Disease
Human Papillomavirus & Genital Warts
Genital Herpes
Syphilis
HIV & AIDS
Guidelines for Preventing Sexually Transmitted Infections
Chapter 14 Preventing Sexually Transmitted Infections

2. 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
Each year, more than 19 million people in the U.S. are newly infected with STIs, almost half of which are seen in young people between the ages of 15 and 24
Currently, the U.S. has the highest rate of STIs of any country in the industrialized world

3. 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
2.3 million cases are reported each year in the U.S.
About 80% of these cases are reported in women between the ages of 15 and 24

4. 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
Sexually active women under 25, older women with multiple partners and/or previous STIs, and those who do not regularly use condoms should be tested regularly for chlamydia

5. More than 25 diseases are spread through sexual contact
More than 25 diseases are spread through sexual contact. About 1 in 4 adults in the United States has a sexually transmitted disease.

6. Gonorrhea Caused by a bacterial infection Symptoms in men
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. Gonorrhea Untreated gonorrhea can produce
Infertility, widespread bacterial infection, heart damage, arthritis
Blindness in children born to infected women
Treated successfully with penicillin and other antibiotics

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. Pelvic Inflammatory Disease
Complications include scarring and obstruction of the fallopian tubes, infertility, ectopic pregnancies, and chronic pelvic pain
Women with PID who become pregnant may have an ectopic (tubal) pregnancy which destroys the embryo and can result in the woman’s death
More than 100,000 women in the U.S. become infertile as a result of PID

10. 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

11. Human Papillomavirus (HPV) & Genital Warts
HPV is one of the most common causes of STI
There are over 100 strains of HPV; over 30 are sexually transmitted
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
At least 80% of women will acquire genital HPV infection by age 50
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

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
One million new cases of genital warts are diagnosed yearly in the U.S.
In some cities, nearly half of all sexually active teenagers have genital warts

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. 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. Human Papillomavirus (HPV) & Genital Warts
Prevention is best accomplished through a mutually monogamous sexual relationship with an uninfected partner
2006, the FDA approved Gardasil, the first vaccine to prevent cervical cancer and other diseases in women caused by HPV
Gardasil protects against 4 HPV types that cause 70% of cervical cancers and 90% of genital warts
The vaccine is approved for females between 9 and 26
To get the full benefits, women should get the vaccine before they become sexually active and not be infected with any of the 4 HPV types covered by the vaccine
It has not been widely tested in women over 26

16. 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
About 135 million people over the age of 12 carry HSV Type I, most of which acquired the virus as children
Another 45 million people over the age of 12 carry HSV Type 2
1 in 4 women, 1 in 5 men, 1 in 5 adolescents are currently infected with genital herpes (HSV 2)

17. Genital Herpes HSV is a highly contagious virus
Victims are most contagious during an outbreak
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

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
Outbreaks can be precipitated by excessive fatigue, stress, cold, wind, wetness, heat, sun, sweating, friction, lack of sleep, illness, restrictive clothing, popcorn, coffee, peanuts, chocolate, and alcohol

19. 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
The sore disappears on its own in 3-6 weeks
If untreated, the infection progresses to the secondary stage in which a rough/reddish-brown rash appears on the palms of the hands and bottoms of the feet
Additional sores may appear within 6 months of initial outbreak but will also disappear by themselves
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

20. 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

21. 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
White blood cells are part of the immune system, which fights infections and diseases
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

22. 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
AIDS is the term designating the final stage of HIV infection
Death is caused by a weakened immune system that is unable to fight off opportunistic infections

23. HIV and AIDS Early symptoms of AIDS include Advanced symptoms 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)

24. HIV and AIDS HIV infection is determined through an HIV antibody test
Once infected, the immune system forms antibodies that bind to the virus
Most infected people will show these antibodies within 3 months of infection; the average is 20 days
In rare cases, they are not detectable until after 6 months or longer

25. 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)

26. Myths about HIV Transmission
HIV virus can not be transmitted through perspiration
Sporting activities with no physical contact pose no risk to uninfected individuals
Blood from an infected person cannot penetrate the skin of an uninfected person except through an opening in the skin
A person should use vinyl or latex gloves when performing work that requires direct contact with someone else’s blood or open wound

27. Myths about HIV Transmission
HIV is not transmitted through casual contact
It cannot be caught by shaking hands with or hugging an infected person; using a toilet seat, dishes, or silverware used by an infected person; sharing a drink, food, a towel, or clothes with a person who has HIV
The chances of getting infected during physical or medical procedures are nil as health care workers take extra care to protect themselves and their patients from HIV
You cannot catch HIV from animals or insects as animals do not contract HIV

28. Trends in HIV Infection and AIDS
As of 2007, estimates indicate that
About 33 million people worldwide have HIV
More than 25 million have died from AIDS since the epidemic began in 1981
15.4 million women now live with HIV
About 1.2 million people in the U.S. have HIV and about 25% of them are unaware of the infection
1 in every 300 Americans is infected

29. HIV Testing A person can be tested in several ways
Public Health Department
Access the CDC website (
Call the National AIDS Hotline (1-800-CDC-INFO)
STI Hotline ( )
for local testing facilities