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Human Sexuality November 28, 2012 Chapter 15: Sexually Transmitted Infections St. Bart’s Pathology Museum in London.

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Presentation on theme: "Human Sexuality November 28, 2012 Chapter 15: Sexually Transmitted Infections St. Bart’s Pathology Museum in London."— Presentation transcript:

1 Human Sexuality November 28, 2012 Chapter 15: Sexually Transmitted Infections
St. Bart’s Pathology Museum in London

2 What is an STI? Sexually transmitted infection: an infection that can be transmitted through sexual interaction (not just intercourse!) Some STIs can be cured, and others cannot Can cause embarrassment, compromised health, pain, infertility, and even death! Half of all STIs in the U.S. are believed to occur among 15- to 24-year-olds Most STIs can be prevented!

3 Factors contributing to STIs
Multiple sexual partners Having sex without a condom Increased use of oral contraceptives (?) Lack of information about STIs in young people and their health care providers Many STIs do not have obvious symptoms! Mr. Marcus adult film star, had syphilis and spread it to many partners

4 Most STIs are bacterial or viral
Bacteria larger than viruses; are cells, easier to kill

5 Bacterial infections are easier to treat than viral ones
Bacterial infections can be treated with antibiotic drugs, such as penicillin; these drugs have NO EFFECT on viruses!

6 bacterial infections

7 Chlamydia Most common bacterial STI in the U.S.
Rates of infection are highest among teenagers, especially girls Transmitted primarily through vaginal, anal, or oral sexual contact; can also be spread by fingers to other parts of the body, like the eyes

8 Chlamydia symptoms in women
Chlamydia usually affects women in one of two ways: Infection of the lower reproductive tract can cause inflammation of the urethra or infection of the cervix; this form usually causes few or no symptoms Infection of the upper reproductive tract causes pelvic inflammatory disease (PID): (also caused by gonorrhea infection) infection of the uterus, fallopian tubes, or ovaries, and can cause disrupted menstruation, chronic pelvic pain, lower back pain, fever, nausea, vomiting, and headaches PID can also leave scar tissue that can result in ectopic pregnancy or infertility

9 Chlamydia symptoms in men
Chlamydia symptoms in men may include: Discharge from the penis A burning sensation during urination Itching around the opening of the penis Pain & swelling of the testicles (less common) About half of men have minimal symptoms

10 Trachoma: a complication of chlamydia
Trachoma: an eye infection caused by the chlamydia bacterium World’s leading cause of preventable blindness Can be spread from infected moms to newborns as shown here Chlamydia can also cause pneumonia in babies or premature delivery The CDC recommends chlamydia testing for all pregnant women

11 The good news: Chlamydia is very curable
7 days of treatment with the antibiotic azithromycin can knock out most cases of uncomplicated chlamydia All sexual partners of an infected person should be tested!

12 Gonorrhea Caused by bacterial infection Also known as “the clap”
Second in prevalence only to chlamydia in the U.S. Highest incidence among lower socioeconomic groups Transmitted by penile-vaginal, oral-genital, oral-anal, or genital-anal contact Traditionally the most common STD

13 Symptoms and complications in females
In females, most gonorrhea infections occur in the cervix, and may not cause any symptoms May experience painful or burning sensation during urination, or increased vaginal discharge Complications: can spread to the upper reproductive tract and cause PID

14 Symptoms and complications in males
Symptoms in men typically appear 2-5 days after contact with an infected person Most common signs are a bad-smelling cloudy discharge from the penis and burning during urination Symptoms may clear up on their own, which may or may not mean the immune system has defeated the bacteria! Complications: untreated infection may spread to other organs, causing fever, painful bowel movements, discomfort, and eventually infertility

15 Other complications in both sexes
In 2% of cases, the bacteria can enter the bloodstream and spread throughout the body, causing widespread symptoms including possibly permanent joint damage Gonorrhea can also cause eye infections in infants, similar to chlamydia; adults can also transmit this infection to their own eyes with their hands Gonorrhea spread through non-vaginal-penile sex can result in infection of the throat or anus. This is most often asymptomatic

16 Gonorrhea can also be treated with antibiotics
Since 1976, strains of gonorrhea have emerged that are resistant to the common antibiotics penicillin & tetracycline Strains are increasingly also becoming resistant to the antibiotic fluoroquinolone, used subsequently A new class of antibiotics, called cephalosporins, are now used to treat gonorrhea; also treats chlamydia, which frequently co-occurs Talk about antibiotic resistance

17 Nongonococcal urethritis
Nongonococcal urethritis: any inflammation of the urethra that is NOT caused by gonorrhea infection Known to be caused by 3 different bacteria Common among men—actually more common than gonorrhea in the U.S. Symptoms include discharge from the penis and burning during urination Treatable with antibiotics

18 Syphilis Caused by the bacterium Treponema pallidum
Rates have been rising in recent years, especially among men who have sex with men Transmitted primarily from open lesions to mucous membranes of the vagina, mouth, or anus or to cuts in the skin Can be transmitted by penile-vaginal, oral-genital, oral-anal, or genital-anal contacts Al Capone, Scott Joplin died of syphilis Napoleon, Hitler suspected

19 Untreated syphilis progresses in 4 stages
Primary stage of syphilis is characterized by the appearance of a painless sore called a chancre Usually appears ~3 weeks after initial infection Usually occurs on the penis, vagina, or cervix, but can be elsewhere on the genitals or in the mouth or rectum Generally heals without treatment within 3–6 weeks SHANG-kur Because not painful, may not notice if is on cervix or elsewhere not visible Having sores increases your risk of getting HIV!

20 Secondary stage of syphilis
Usually occurs 2–8 weeks after exposure Skin rash appears on the body, most often on palms of hands and soles of feet Typically does not hurt or itch Can also have flulike symptoms

21 Latent syphilis The latent phase of syphilis infection is characterized by no observable symptoms Can last for years! After 1 year in the latent stage, infected individuals are typically no longer able to transmit the infection to partners, although pregnant women can transfer it to their babies

22 Tertiary syphilis About 15% of individuals who do not receive effective treatment for syphilis will enter the tertiary stage Usually occurs 10–20 years after initial infection Symptoms include heart failure, blindness, paralysis, skin ulcers, liver damage, and severe mental disturbance May be treatable in some cases

23 Treatment of syphilis Syphilis can usually be treated by antibiotic injections, most commonly penicillin May need greater number of treatments for later-stage syphilis picture: Mercury used to treat syphilis in England

24 viral infections

25 Herpes Caused by the herpes simplex virus
8 different but related herpes viruses can infect humans, HSV-1 and HSV-2 are commonly transmitted sexually HSV-1: usually results in lesions around the mouth (cold sores) HSV-2: usually results in genital lesions BUT, you can have oral-genital transmission of both of these

26 Prevalence More than 100 million Americans have oral herpes and at least 45 million have genital herpes Genital herpes is more common in women than in men (~1 out of 4 adult women and ~1 out of 8 adult men in the U.S. have genital herpes) fake ad for valtrex!

27 Preventing transmission of herpes
Genital herpes is spread through penile-vaginal, oral-genital, genital-anal, or oral-anal contact Condoms can prevent transmission from a man who only has lesions on his penis, but vaginal secretions containing the virus can still come in contact with a man’s scrotum Sexual contact should be avoided when herpes lesions are present BUT, herpes can be transmitted even when lesions are not present, so condoms should always be used! You can also spread herpes from one part of your own body to another with your hands

28 Genital herpes (HSV-2) symptoms
Incubation period is 2-14 days and symptoms usually last 2 to 4 weeks; small painful blisters full of virus particles can also have flu-like symptoms

29 Recurrence of herpes symptoms
Herpes cannot be cured; typically the virus will live in the nervous system and can “flare up” Flare ups can be caused by emotional stress, anxiety, depression, acidic food, ultraviolet light, fever, menstruation, being run-down, poor nutrition, and injury to the affected skin region

30 So I have herpes, so what? Herpes is merely irritating for most people who have it; however, complications can occur in women: HSV-2 may contribute to cancer of the cervix Pregnant women can transmit HSV-2 to babies passing through the birth canal; such an infection can cause severe illness and even death in babies. Luckily this is rare! Transmission of HSV-2 to the eye can cause eye damage

31 Treatment No cure for herpes! Two basic treatment strategies:
Suppressive therapy: drugs are given all the time to prevent flare-ups Reduces transmissibility of the virus between flare-ups Episodic treatment: drugs are given when flare-ups occur

32 Low-Cost reproductive health care options in the East Bay
Planned Parenthood (Oakland) Asian Health Services (Oakland) Native American Health Center (Oakland) La Clinica de la Raza (Oakland) Berkeley Free Clinic (Berkeley) STD community hotline

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