1. Unit 13: Sexually Transmitted Diseases

2. HIV/AIDS

3. Natural history of HIV/AIDS
Probably originated in Africa
AIDS (acquired immune deficiency syndrome) is caused by the HIV virus (Human immunodeficiency virus)
The HIV virus infects T-cells (white blood cells)
makes copies of itself
then destroy these T-cells
Destroyed T cells leave a person very susceptible to opportunistic infections

4. Natural history of HIV/AIDS
Early symptoms include fever, fatigue, swollen lymph glands
Most people who get HIV will eventually develop AIDS
However, AIDS has a long latent period (≈10 years)
People may infect others without even knowing because they don’t show the signs/symptoms of infection

5. Transmission NOT highly contagious
Transmission requires intimate contact between body fluids (blood, semen, breast milk) often through:
Unprotected sex
Unsterile needles
Mother to fetus or infant
Blood transfusion
Risk from highest to lowest:
Anal intercourse > vaginal intercourse >>oral sex
>>>>>>>>>> wet kissing , urine, sweat, tears

6. Transmission
More likely to occur during anal intercourse than vaginal intercourse because:
Rectum lining is thin
Rich blood supply in the rectum
Rectum has a lot of white blood cells that have the HIV receptor
The skin is often damaged
The vagina has better natural lubrication

7. HIV Prevalence

8. High Risk Groups

9. Canada Female incidence is increasing
It used to be that most cases (80%) were in men who have sex with men (MSM) (1989), now more heterosexuals are being diagnosed
The decline in mortality is attributed to:
Public education to use condoms
Antiretroviral drugs (ART) reduce infectiousness and transmission

10. New HIV Cases

11. HIV/AIDS Epidemiology
Kilmarx 2009

12. Epidemiology of HIV/AIDS
Higher risk groups include:
Men who have sex with men
Sex trade worker
Aboriginals
Injection drug users

13. Treatment/ prevention
No effective vaccine exists
Prevention is the key:
Practice safer sex!
Wear a condom!!!
Don’t combine drug use and sex
Avoid injection drugs
Avoid “sketchy” tattoos and body piercing
HIV testing (prevents transmission)

14. Herpes Simplex

15. Herpes Simplex Overview
Caused by the herpes virus
Two types
HSV1 typically affects the mouth/lips
HSV2 typically affect the genitals
Appears as recurrent temporary lesions (ex. Cold sores) on the lips, mouth genitals etc)
1/5 of sexually active people have had HSV infection

16. Herpes “fever blisters”
If you think this slide is bad.... Be thankful I didn’t post any genital herpes pictures!
Wear a Condom!!!!

17. Herpes simplex overview
There is no cure
Antiviral drugs may shorten episodes
Have it for life
HSV2 is easier to protect against
Don’t touch genitals as much
Can use a condom

18. Hepatitis

19. Hepatitis Overview Hepatitis = inflammation of the liver
There are six variations of the virus that causes it (A,B,C,D,E and G)
Initial symptoms are similar to the flu, may progress to nausea, vomiting, dark urine, abdominal pain, jaundice (yellow skin)
Chronic hepatitis can cause cirrhosis of the liver, liver cancer and death

20. Hepatitis

21. Hepatitis Overview
Hep A and Hep E transmitted through fecal-oral contact, typically through contaminated water
Hep B, and C transmitted through the exchange of bodily fluids
Sexual intercourse (B, not C), contaminated needles main route of transmission
Hep D/G usually occur as co-infections, not on their own

22. Prevention/Treatment
Vaccines are effective against HepA and B
HepB vaccine also confers protection against HepD/G
Safe sex (B, D, G)
Clean drinking water (A, E)
Treatment
There is no cure
Antiviral drugs may help
Liver transplants indicated in advanced cases

23. Other STDs

24. Gonorrhea/ Chlamydia Bacterial infections – cured by antibiotics
Often occur together
Can infect penis, rectum, throat, eyes, cervix
Often no symptoms
Typical symptoms
Increased vaginal discharge
Irregular bleeding
Abdominal pain
Pain while urinating
Thick greenish-yellow penile discharge
Pain in testicles

25. Syphilis Bacterial infection 1st symptom typically = sore
2nd symptom = body rash, flu-like symptoms
Untreated can damage heart, brain
Antibiotics (penicillin) can cure it

26. Pubic Lice Aka “crabs” Live by feeding on blood in the pubic area
Sexual transmission
Non-sexual contact
Towels, bed sheets, mattresses
Treated with creams, shampoos

27. Genital Warts
Genital warts are caused by the human papilloma virus (HPV) and often show no symptoms
If left untreated, genital warts can lead to cervical cancer and perhaps cancers of other genitalia
Warts can be surgically removed, burned/frozen off

28. TAKE HOME MESSAGE
WEAR A CONDOM!!!!!!