Preventing Sexually Transmitted Diseases CHAPTER OUTLINE Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Chapter 14 Preventing Sexually Transmitted Diseases

Sexually Transmitted Diseases Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Sexually Transmitted Diseases Have reached epidemic proportions in the U.S. 25% of all Americans will acquire at least one sexually transmitted disease (STD) in their lifetime Each year, more than 19 million people in the U.S. are newly infected with STDs Each year more than 19 million Americans are newly infected with an STD The highest rate of STD infections are seen in young people between the ages of 15 and 24 Worldwide, 1 million people are infected daily with STDs not including HIV

Chlamydia Caused by a bacterial infection that spreads Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Chlamydia 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 75% of infected individuals don’t know they’re infected until the infection has become quite serious 2.8 million new cases are reported each year in the U.S. 15- to 19-year-old girls represent 46% of infections 20- to 24-year-old women represent another 33%

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV 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

Gonorrhea Caused by a bacterial infection Symptoms in men Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Gonorrhea Caused by a bacterial infection Transmitted through vaginal, anal, and oral sex 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

Gonorrhea Untreated gonorrhea can produce Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV 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

Pelvic Inflammatory Disease (PID) Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Pelvic Inflammatory Disease (PID) Not a true STD, but rather a condition resulting from complications of chlamydia or gonorrhea Often develops when the STD spreads to the fallopian tubes, uterus, and ovaries Each year more than 1 million women in the U.S. develop PID Complications include scarring and obstruction of the fallopian tubes, infertility, ectopic pregnancies, and chronic pelvic pain

Pelvic Inflammatory Disease (PID) Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Pelvic Inflammatory Disease (PID) Women with PID who become pregnant may have an ectopic (tubal) pregnancy which destroys the embryo and can result in the mother’s death 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

Pelvic Inflammatory Disease (PID) Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Pelvic Inflammatory Disease (PID) 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

Human Papillomavirus (HPV) Genital Warts Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Human Papillomavirus (HPV) Genital Warts Caused by a viral infection that is spread Through vaginal, anal, or oral sex From the vagina to a newborn baby More than 100 types of HPV, some cause 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

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Genital Warts One million new cases of this genital warts are diagnosed yearly in the U.S. In some cities, nearly half of all sexually active teenagers have genital warts

Genital Warts Health problems include Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Genital Warts Health problems include Increased risk for cancers of the cervix, vulva, 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)

Genital Warts Treatment requires complete removal of all warts by Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV 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

Genital Herpes A common STD caused by the herpes simplex virus (HSV) Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Genital Herpes A common STD caused by the herpes simplex virus (HSV) Several types of HSV produce different ailments, including Genital herpes, oral (lip) herpes, shingles, and chicken pox The two most common forms of HSV are Types I and II Type I is most commonly known to cause oral herpes Cold sores or fever blisters appear on the lips and mouth About 135 million people over the age of 12 carry HSV Type I HSV Type II is better known as the virus that causes genital herpes About 45 million people over 12 are infected with HSV Type II More than 1 million new cases are diagnosed each year

Genital Herpes HSV is a highly contagious virus Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV 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

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Genital Herpes A few days following infection, sores may appear on the infected areas (mouth, genitals, rectum) but may also surface on other parts of the body Victims usually have mild fever, swollen glands, and headaches Symptoms usually 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

Herpes Virus Both HSV Type I and II can cause oral and genital sores Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Herpes Virus Both HSV Type I and II 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 People with cold sores on the lips or mouth should exercise care not to touch these sores Hands should be carefully washed with soap following contact with cold or herpes sores

Syphilis Caused by a bacterial infection Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Syphilis Caused by a bacterial infection 3 weeks after infection, a painless sore appears where the bacteria entered the body The sore disappears on its own in a few weeks If untreated, 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)

Syphilis During the final stage Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Syphilis During the final stage People may develop paralysis, crippling, blindness, heart disease, brain damage, insanity Some infected people die from the disease Penicillin and other antibiotics are used in its treatment

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Critical Thinking Many individuals who have sexually transmitted diseases withhold this information from potential sexual partners. Do you think that it should be considered a criminal action if such an individual knowingly transmits a STD to someone else?

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Key Terms Acquired immunodeficiency syndrome (AIDS): Any of a number of diseases that arise when the body’s immune system is compromised by HIV Human immunodeficiency virus (HIV): Virus that leads to acquired immunodeficiency syndrome (AIDS) Opportunistic diseases: Diseases that arise in the absence of a healthy immune system, which would fight them off in healthy people

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV HIV & AIDS Upon infection, the HIV virus multiplies, attacks, and destroys white blood cells White blood cells are part of the immune system that fights infections and diseases As the number of white blood cells killed 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 diseases and cancers HIV infection is determined through an HIV antibody test

HIV & AIDS HIV is a progressive disease Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV HIV & AIDS HIV is a progressive disease 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

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV HIV & AIDS As 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 diseases

Current Modes of HIV Transmission in the U.S. 14.2

Proportion of AIDS Cases by Race/Ethnicity in the U.S., 1985–2002 14.3

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV HIV & AIDS People do not get HIV because of who they are but because of what they do HIV and AIDS can threaten anyone, anywhere Men, women Children, teenagers, young people, older adults Whites, African Americans, Hispanic Americans, Asian Americans, Native Americans, Africans, Europeans Homosexuals, heterosexuals, bisexuals Drug users Nobody is immune to HIV

The Two Most Risky Behaviors for HIV Transmission Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV The Two Most Risky Behaviors for HIV Transmission Having unprotected vaginal, anal, or oral sex with an HIV-infected person Sharing hypodermic needles or other drug paraphernalia with someone who is infected

Estimated Incidence of AIDS Cases and Deaths Reported in the U. S 14.5

HIV & AIDS Treatment HIV infection and AIDS have no known cure Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV HIV & AIDS Treatment HIV infection and AIDS have no known cure The best advice is to take a preventive approach 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 within the next few years

Prevention of STDs Abstinence A monogamous sexual relationship Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Prevention of STDs Abstinence A monogamous sexual relationship If you choose to delay sex, do not let peers pressure you into having sex Manhood and womanhood are not proven during sexual intercourse but, instead, through mature, responsible, and healthy choices

Reducing the Risk for STDs Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Reducing the Risk for STDs Plan before you get into a sexual situation Know your partner Discuss STDs with the person you are contemplating having sex with before you do so Limit the number of sexual partners you have If sexually promiscuous, consider periodic physical check-ups Use barrier methods of contraception to help prevent disease from spreading

Reducing the Risk for STDs Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Reducing the Risk for STDs Negotiate safer sex Think “no condom, no sex” Be responsible enough to abstain from sexual activity if you have an infection Urinate immediately following sexual intercourse Although not entirely reliable, it may help flush bacteria and viruses from the urinary tract

Reducing the Risk for STDs Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Reducing the Risk for STDs Thoroughly wash immediately after sexual activity Although not a guarantee, it can prevent you from spreading germs on your fingers and may wash away bacteria and viruses that have not yet entered the body If you suspect that your partner is infected with an STD, ask Consider abstaining from sexual relations if you have any kind of an illness or disease, even a common cold

Reducing the Risk for HIV Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Reducing the Risk for HIV Postpone sex until you and your uninfected partner are prepared to enter into 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 Use a latex condom with the spermicide nonoxynol-9 from start to finish for each sexual act If you think your partner should use a condom but refuses, say “no” to sex

Reducing the Risk for HIV Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Reducing the Risk for HIV Don’t have multiple and anonymous sexual partners Don’t have sexual contact with anyone who doesn’t practice safer sex Avoid sexual contact with anyone who has had sex with people at risk for getting HIV Don’t have sex with prostitutes If you do have sex with someone who might be infected, avoid exchange of body fluids Don’t share toothbrushes, razors, or other implements that could become contaminated with blood with anyone who might be infected

Reducing the Risk for HIV Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Reducing the Risk for HIV Be cautious regarding procedures (such as acupuncture, tattooing, and ear piercing) 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

Chlamydia Gonorrhea Pelvic Inflammatory Disease Human Papillomavirus and Genital Warts Genital Herpes Syphilis HIV and AIDS Reducing the Risks for STDs Reducing the Risks for HIV Critical Thinking Discuss how the information presented in this chapter has affected your feelings and perceptions about sex. What impact will this information have on your wellness lifestyle?

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