1. Chapter 15 Preventing Sexually Transmitted Disease
A Wellness Way of Life
Ninth Edition
Robbins/Powers/Burgess
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2. Chapter 15 Objectives
After reading this chapter, you will be able to:
Describe symptoms of AIDS and the most common sexually transmitted diseases.
Identify the three curable and four incurable sexually transmitted diseases.
Describe at least four ways HIV is transmitted.
Recognize the latency period for AIDS.
Identify three high-risk and three low-risk sexual activities.
Discuss the five ways to deter unwanted sexual behavior.
List three actions you can take to decrease the risk of acquiring a sexually transmitted disease.
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3. 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.
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4. Curable and Incurable STDs
Bacterial (curable)
Chlamydia
Gonorrhea
Syphilis
Viral (incurable)
Genital herpes
Genital warts
Hepatitis B
AIDS
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5. 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.
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6. 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.
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7. 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.
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8. AIDS Cases by Transmission Category and Gender
Figure 15-4
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9. 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).
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10. 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.
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11. 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.
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12. 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.
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13. 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.
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14. 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.
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15. Hepatitis B: virus Transmission Incubation Typical Symptoms Diagnosis
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.
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16. 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.
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17. 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.
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18. 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.
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19. 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
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20. 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.
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21. Copyright © The McGraw-Hill Companies, Inc
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
How to Use a Condom
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22. 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.
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23. 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.
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24. 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
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25. 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?
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26. Questions?
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