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Chapter 15 Preventing Sexually Transmitted Disease A Wellness Way of Life Ninth Edition Robbins/Powers/Burgess © 2011 McGraw-Hill Higher Education. All rights reserved.
Chapter 15 Objectives After reading this chapter, you will be able to: 1.Describe symptoms of AIDS and the most common sexually transmitted diseases. 2.Identify the three curable and four incurable sexually transmitted diseases. 3.Describe at least four ways HIV is transmitted. 4.Recognize the latency period for AIDS. 5.Identify three high-risk and three low-risk sexual activities. 6.Discuss the five ways to deter unwanted sexual behavior. 7.List three actions you can take to decrease the risk of acquiring a sexually transmitted disease. © 2011 McGraw-Hill Higher Education. All rights reserved.
Sexually Transmitted Disease One in two sexually active people will acquire an STD by age 24. There are over 25 known STDs, some of which are incurable. More sexual partners increases risk. Alcohol and drug use increases risk. Risk is determined by your behavior, not your age or sexual orientation. Risk can be reduced or eliminated through long- term monogamy or abstinence. If you are sexually active you should get a yearly screening. © Thinkstock © 2011 McGraw-Hill Higher Education. All rights reserved.
Curable and Incurable STDs Bacterial (curable) Chlamydia Gonorrhea Syphilis Viral (incurable) Genital herpes Genital warts Hepatitis B AIDS © 2011 McGraw-Hill Higher Education. All rights reserved.
What are HIV and AIDS? AIDS is a syndrome or group of symptoms caused by the Human Immunodeficiency Virus (HIV). Symptoms include chronic fatigue, swollen lymph glands, unexplained weight loss, fevers, and night sweats. HIV attacks lymphocytes (white blood cells) called T- cells. The virus penetrates T-cells and forces them to make copies of HIV which causes the T-cell to die. Fewer T-cells result in a weakened immune system and risk for opportunistic diseases. HIV infection and certain opportunistic diseases or HIV infection and a low T-cell count (200 or less) will result in an AIDS diagnosis. © 2011 McGraw-Hill Higher Education. All rights reserved.
How Is HIV Transmitted Through blood, semen, vaginal secretions and breast milk. Through sexual intercourse with an HIV carrier. Through sharing of hypodermic needles. By pregnant women to their fetus or mother to their baby (breast milk). Rarely through a transfusion of blood. © 2011 McGraw-Hill Higher Education. All rights reserved.
HIV: What is Safe? Safe Casual contact. Hugging. Eating together. Massage. Masturbation. Insects (they do not spread HIV). Unsafe Vaginal sex. Anal sex. Oral sex. Deep kissing. Multiple partners. Sharing needles. © 2011 McGraw-Hill Higher Education. All rights reserved.
AIDS Cases by Transmission Category and Gender Figure 15-4 © 2011 McGraw-Hill Higher Education. All rights reserved.
Students and STDs Over 50% report having sexual intercourse with more than one partner and sporadic or no use of condoms – why?? They feel invincible. They lack social skills and have low self-esteem. They engage in unwanted sexual behavior. They are victims of sexual assault. Society sends mixed messages. They share needles (mostly steroids). © 2011 McGraw-Hill Higher Education. All rights reserved.
Should I Be Tested? You should be tested if: You have had any STD. Shared drug needles. Had sex with a prostitute. Had sex with a man who had sex with another man. Had unprotected sex with three or more partners. Remember that the test looks for HIV antibodies. It could take 3 to 6 months before antibodies appear in the blood. A person should have 6 months with no risk behavior before a test can be accurate. For more information contact your local health department. © 2011 McGraw-Hill Higher Education. All rights reserved.
Chlamydia: bacteria Chlamydia trachomatis Transmission Passed during direct sexual contact and hand to eye. 3 million cases annually. (10% of college women infected). Incubation Poorly defined, probably 7-14 days or longer. Typical Symptoms Up to 80% of women and 50% of men have no symptoms. When symptoms do occur, they are often mild. Symptoms include discharge, itching and burning, painful urination, and flu-like symptoms. Diagnosis Culture tests of discharge collected from around the cervix and in the urethra. Reliable and affordable. Treatment Curable with certain antibiotics (not penicillin). Danger If untreated, can cause Pelvic Inflammatory Disease. © 2011 McGraw-Hill Higher Education. All rights reserved.
Genital Herpes: Herpes Simplex Virus (HSV) Transmission Direct contact with infectious blisters or sores usually on genitals, anus, or mouth. May also be passed through asymptomatic viral shedding. Incubation 2-30 days Typical Symptoms Painful blisters or sores form, break, crust over, and heal in 1 to 3 weeks. Sores may reappear throughout life, but heal faster, are less painful and occur less frequently. Factors like stress, fatigue, and other illness may bring on reoccurrences. Diagnosis Visual examination and tissue culture. Treatment No cure at present time. Medications (acyclovir) used to relieve pain, shorten outbreak, or prevent infection in open sore. Danger Can be fatal to infants who acquire the disease. © 2011 McGraw-Hill Higher Education. All rights reserved.
Genital Warts: Human Papilloma Virus Transmission Direct contact with warts in genital area. May be transmitted without visible warts. Incubation Range from 1-8 months. Some never become visible. Typical Symptoms Flat or round bumps with cauliflower-like appearance occurring on moist areas of genitals and anus. Many have no symptoms. Diagnosis Visual examination, tissue cultures. Pap smears can detect warts not visible. Common cause of cervical cancer. Treatment Freezing, laser, chemical prep, and surgery. May not “cure” the infection. Danger HPV causes cervical cancer. Pap smears are important. There is now a vaccine available. © 2011 McGraw-Hill Higher Education. All rights reserved.
Gonorrhea: bacteria Transmission Direct contact between mucous membranes, i.e., genitals, anus, and mouth. Contaminated fingers can pass organism to the eye. People can not get gonorrhea from objects. Incubation Usually 2-14 days. Typical Symptoms Genitals, anus, throat, and eyes can be infected. Symptoms include discharge, burning and itching, painful urination, or a mild sore throat. Up to 80% of women and 20% of men have no symptoms. Diagnosis Microscopic observation of discharge. Culture from site. Treatment Curable with antibiotics. Some strains may become resistant. Danger Can cause PID and sterility in men and women. © 2011 McGraw-Hill Higher Education. All rights reserved.
Hepatitis B: virus Transmission Vaginal, anal and oral sex, sharing needles, and mother to baby. Incubation 1 – 9 months but people can carry the virus with no active infection (and spread to others) Typical Symptoms Most have none or mild flu-like feelings, itching, and joint pain. Eventually leads to liver enlargement and failure. Diagnosis Through a blood test. Treatment A vaccine is available. Dangers Progressive destruction of liver cells, cirrhosis, or liver cancer. © 2011 McGraw-Hill Higher Education. All rights reserved.
Syphilis: Bacteria Treponema Pallidum Transmission Direct contact with infectious sore or lesionous rashes. Incubation 1 to 12 weeks before primary stage. Typical Symptoms Primary: painless chancre sore at site of entry of germ and lasts 1–5 weeks. If not treated, leads to secondary syphilis. Secondary: 2 weeks to 6 months after chancre. Rash, flu-like symptoms, patchy hair loss. Secondary will go away without treatment, but will lead to latent syphilis. Latent: no longer infectious to carry bacteria and lead to tertiary. Tertiary Stage: 3 to 40 years later, damage to body organs such as the brain and heart, paralysis and death. Diagnosis Physical examination, microscopic test from sore, blood tests. Treatment Cured with antibiotics. Tissue damage cannot be treated. © 2011 McGraw-Hill Higher Education. All rights reserved.
Other STIs Trichomonas – treatable parasite Vaginosis – imbalance in bacteria Chancroid – curable genital sore Pubic lice – treatable parasite Scabies – treatable parasite Vaginosis, Pubic lice and Scabies can occur without sexual contact. © 2011 McGraw-Hill Higher Education. All rights reserved.
Prevention of STDs Abstinence Avoid sexual intercourse. Infected persons should avoid intimate contact with others when symptoms are present. Stay Faithful Maintain a long-term trusted relationship with one uninfected partner who is having sex only with you (monogamy). Use good communication. Choose Lower Risk Behaviors No fluid exchange Take Precautions Limit the number of sex partners and use a latex condom during the entire sex act (vaginal, anal, and oral) before any direct contact. Avoid Drug Use Mind-altering drugs, including alcohol, reduce our ability to reason, which can lead to risky behavior and risky sex. If you are sexually active Observe your partners for sores, discharge or needle tracts, and get an STD exam every 6 months. © 2011 McGraw-Hill Higher Education. All rights reserved.
How to Avoid an STD The only 100% guaranteed way to avoid getting an STD: **DON’T HAVE SEXUAL CONTACT** If you make a well thought-out decision to have sexual contact: Stay with one sexual partner Choose your sex partner carefully Use condoms Wash genital area after having sex Urinate after sex If you think you might have an STD, see a doctor Get screened every 6 months if you have a new partner © 2011 McGraw-Hill Higher Education. All rights reserved.
How to Use a Condom Step 1 Open the package only when you are ready to use it. Air, heat, and light can spoil latex condoms. When you are opening the package, be careful not to tear the condom. Put the condom on before penetration. Step 2 Squeeze the tip of the condom so there is no air trapped in the end. This is important so there is room for the semen during ejaculation. Unroll the condom onto the penis as soon as the penis becomes erect and before the penis is used in any foreplay. Step 3 If you want to use a lubricant, make sure to use one that is water based. Do not use oil-based lubricants such as Vaseline, baby oil, vegetable oil, or cold cream. Oil-based lubricants break down the latex in a condom, making it more likely to break. Step 4 After ejaculation, hold on to the condom at the rim and pull out while your penis is still hard. If you wait until the penis is soft, the condom may slip off and semen may spill out. Throw the condom away. Use it only once. Female condoms are also available if the male is unwilling. © 2011 McGraw-Hill Higher Education. All rights reserved.
How to Use a Condom Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. © 2011 McGraw-Hill Higher Education. All rights reserved.
Coping with Unwanted Sexual Pressure and Avoiding Assault Attend parties with friends you can trust. Be selective. Avoid isolation. Communicate your limits clearly. Listen closely to what a person is saying. Ask for clarification. Make sure your actions agree with what you are saying. Be aware of what is happening. Speak up if you believe someone is at risk. Stay sober! No means No. Don’t make assumptions about a person’s behavior. Don’t assume that silence is consent for sex. © 2011 McGraw-Hill Higher Education. All rights reserved.
Coping with Unwanted Sexual Pressure and Avoiding Assault What can a person do to prevent unwanted sexual behavior? Build skills in assertiveness, self-esteem, decision making, running a relationship, and dealing with intimacy. If you are sexually assaulted, follow these steps: Once out of immediate danger, call the police. Do not do anything that might destroy evidence. Go with a trusted friend to the ER for a rape exam. © 2011 McGraw-Hill Higher Education. All rights reserved.
Rx for Action If you are sexually active and have not been screened for STDs in the last year, call to schedule a checkup with you physician or health clinic. Plan how you will deal with unwanted sexual pressure, and what you can do to avoid an unsafe situation. Think about how you will bring up the subject of safer sex or abstinence to a potential partner. Consider ways to express affection physically without sexual intercourse. If you have questions about STDs, write them down and phone an appropriate STD hotline listed at the end of this chapter. Download a fact sheet on STDs at © 2011 McGraw-Hill Higher Education. All rights reserved.
What Do You Think? Are you surprised that 50% of sexually active people will get an STD before they are 24? What is your risk for contracting an STD? Have you ever thought about getting tested for HIV? What are low-risk sexual behaviors? What actions can you take to decrease the risk of acquiring an STD? Do you know how to reduce the risk of unwanted sexual pressures or sexual assault? © 2011 McGraw-Hill Higher Education. All rights reserved.
Questions? © 2011 McGraw-Hill Higher Education. All rights reserved.
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