1. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Sexually Transmitted Diseases Chapter 14

2. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Estimated STD Incidence and Prevalence Estimated Annual Estimated Incidence Prevalence Trichomoniasis 7,400,000 n/a HPV infection 6,200,000 20,000,000 Chlamydia 2,800,000 1,900,000 Genital herpes 1,600,00045,000,000 Because viral STDs are incurable, the number of currently infected people capable of transmitting the infection (prevalence) greatly exceeds the annual number of new cases (incidence).

3. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Estimated STD Incidence and Prevalence Estimated Annual Estimated Incidence Prevalence Gonorrhea 718,000 n/a Hepatitis B 81,000 1,250,000 Syphilis (all stages) 61,000 n/a HIV Infection 40,000 900,000 Because viral STDs are incurable, the number of currently infected people capable of transmitting the infection (prevalence) greatly exceeds the annual number of new cases (incidence).

4. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. The Major STDs HIV / AIDS Chlamydia Gonorrhea Pelvic inflammatory disease Genital warts (HPV infection) Genital herpes Hepatitis B Syphilis

5. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Acquired Immunodeficiency Syndrome (AIDS) Leading cause of death worldwide for people ages 15 - 59 years Worldwide, more than 40 million people are infected with human immunodeficiency virus (HIV); more than one million Americans are infected

6. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Acquired Immunodeficiency Syndrome (AIDS) HIV Infection A chronic, progressive disease that damages the immune system AIDS A generally fatal, incurable, sexually transmitted disease Severe stage of HIV infection HIV is the virus that causes HIV Infection and AIDS

7. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS Over time, HIV damages the immune system, signaled by the loss of CD4 - T cells (a type of white blood cell that helps coordinate the activity of the immune system)

8. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS A person with HIV infection is diagnosed with AIDS when he or she develops a marker condition or when the CD4 count drops below 200 / µl The asymptomatic period in an untreated adult averages 11 years

9. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Transmitting the Virus Sexual contact Unprotected anal or vaginal intercourse is riskiest Presence of lesions, blisters, or trauma Male - to - female more likely than female - to - male

10. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Transmitting the Virus Direct exposure to infected blood Injection drug use or sharing of other needles or blades Blood and blood products (prior to testing)

11. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Transmitting the Virus Vertical or perinatal transmission An HIV - infected woman to her fetus during pregnancy or childbirth or to her infant during breastfeeding Risk is greatly reduced with treatment

12. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Symptoms Flulike symptoms of acute HIV infection may occur within a few days or weeks of infection

13. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Symptoms Opportunistic infections occur later, as the immune system weakens Pneumocystis carinii pneumonia Kaposi’s sarcoma Frequent and difficult - to - treat vaginal yeast infections Tuberculosis

14. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Diagnosis HIV antibody test detects the presence of antibodies to HIV, indicating infection ELISA = first stage of test Western blot = confirmatory test Blood, urine, or oral fluid; rapid tests are available May take up to six months following infection for antibodies to appear

15. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Diagnosis HIV RNA assay measures the amount of the HIV virus in the blood; used to detect HIV infection in the earliest stages and to track the status of the infection

16. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Treatment Antiviral drugs Reverse transcriptase inhibitors Protease inhibitors Fusion inhibitors Drugs to prevent and treat opportunistic infections Cost, access, side effects, effectiveness

17. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Prevention Abstinence is the only truly safe option unless you are in a long - term monogamous relationship with an uninfected partner Don’t drink or use drugs in sexual situations

18. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Prevention Limit the number of partners, especially those who have engaged in risky behavior; remember that many people are not truthful about their sexual history Use latex condoms correctly during every act of intercourse and oral sex

19. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. HIV Infection and AIDS: Prevention Avoid sexual contact that could cause cuts or tears Don’t share needles, syringes, or anything that could have blood on it Get screened, get tested, get vaccinated for hepatitis B

20. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Chlamydia Caused by the bacterium Chlamydia trachomatis Can cause PID, infertility, epididymitis, urethritis Often asymptomatic Diagnosed with urine or lab tests Treated with antibiotics

21. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Gonorrhea Caused by the bacterium Neisseria gonorrhoeae, which affects mucous membranes Can cause PID, infertility, epididymitis, urethritis, rashes, arthritis; in infants, it can cause the serious eye infection gonococcal conjunctivitis

22. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Gonorrhea Often asymptomatic in women; in men, it causes urinary discomfort and penile discharge Diagnosed with urine or lab tests Treated with antibiotics; many strains are resistant

23. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Pelvic Inflammatory Disease (PID) PID is an infection that progresses from the vagina and cervix to the uterus, oviducts, and pelvic cavity Common following untreated cases of gonorrhea or chlamydia

24. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Pelvic Inflammatory Disease (PID) Leading cause of infertility in young women; also increases risk of ectopic pregnancy and chronic pelvic pain Symptoms highly variable Treated with antibiotics; may require hospitalization

25. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Genital Warts Viral infection characterized by growths on the genitals; also called condyloma or genital HPV infection; caused by infection with human papillomavirus (HPV)

26. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Genital Warts Most of the more than 20 million infected Americans have no symptoms but can still transmit the virus Infected tissue may appear normal or may have obvious bumps or large warty growths

27. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Genital Warts Treatment does not eliminate the infection HPV infection is the key cause of cervical cancer

28. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Genital Herpes Persistant viral infection affecting about 45 million American adults; infants can be infected during birth HSV - 1 usually causes cold sores HSV - 2 usually causes genital herpes

29. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Genital Herpes Symptoms Recurrent outbreaks of painful genital lesions; often asymptomatic Diagnosed from symptoms or blood test

30. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Genital Herpes Treatment with antivirals can reduce the frequency and severity of outbreaks The virus remains in the body and can be transmitted even if no lesions are present

31. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Hepatitis B Inflammation of the liver that can cause permanent damage to the liver and death Some people recover, some become chronic carriers, some develop chronic liver disease or liver cancer Hepatitis B virus can be transmitted sexually and through close nonsexual contact

32. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Hepatitis B Symptoms may include flulike illness Jaundice Increased bile pigment levels, causing yellowing of the skin and whites of the eyes Diagnosed with blood tests No cure, but a vaccine is available

33. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Syphilis Caused by the spirochete Treponema pallidum Potentially fatal if not treated

34. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Syphilis Symptoms at different stages of infection Primary Syphilis = an ulcer called a chancre Secondary Syphilis = flulike symptoms and a skin rash Late, or tertiary, Syphilis = asymptomatic or symptoms of severe organ damage

35. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Syphilis Diagnosed with blood tests Treated with antibiotics Infants can also be infected

36. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. Other STDs Trichomoniasis (Trich) Bacterial vaginosis (BV) Pubic lice (crabs)

37. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved. What You Can Do Education Diagnosis and treatment Prevention Abstain Mutually monogamous relationship with one uninfected partner Plan ahead for and practice safer sex

38. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 14 ©2007 McGraw-Hill Higher Education. All rights reserved.