1. Sexually Transmitted Diseases/Infections

2. How well do you know the 63 people you had sex with last night?
Discuss hand shake activity

3. MYTHS OF STDs True or False
Most people with an STD experience painful symptoms.
Birth control pills prevent the spread of STDs.
Douching will cure and STD.
Abstinence is the best way to prevent STDs.
If you get an STD once, and are treated, you can’t get it again.
A person does not need to see a doctor if she/he notices sores on his/her genitals once, but then they go away.
Condoms help prevent the spread of STDs
As the following statements are read, have the students write True or False on their papers:
Most people with an STD experience painful symptoms.
(False. Most people who are infected with an STD, men and women alike, do not notice any symptoms until they visit their doctor or suffer from infertility. Sores do not have to be painful to be a problem.)
Birth control pills prevent the spread of STDs.
( False. Birth control pills prevent pregnancy, but do not offer protection from sexually transmitted diseases or infections. They may change the ph in the vagina and make the woman more susceptible to gonorrhea.)
Douching will cure and STD.
(False. Douching, or washing the vagina out, may only spread an infection from the vagina into the uterus. Unless specially prescribed by a doctor, douching will not cure an STD.)
Abstinence is the best way to prevent STDs.
(True. Abstinence from sexual intercourse is the most effective way to avoid becoming exposed to a sexually transmitted disease. However, some genital tract infections can be spread through oral sex and close body-to-body contact.)
If you get an STD once, and are treated, you can’t get it again.
(False. Even if a person has been treated with antibiotics, he/she can be re-infected if she/he has sexual contact with someone who carries the disease.)
A person does not need to see a doctor if she/he notices sores on his/her genitals once, but then they go away.
(False. Even if symptoms go away after a week or so, a person still needs to see a doctor. Just because the symptoms have abated, doesn’t mean the disease has disappeared.)
Condoms help prevent the spread of STDs
(True. Although condoms are not 100% effective in preventing exposure to STDs, they are much better than nothing. They prevent direct skin-to-skin contact. Genital areas not covered by the condom may still be infected.)

4. Sexually Transmitted Diseases/Infections
STDs are diseases and infections which are capable of being spread from person to person through:
sexual intercourse
oral-genital contact
anal-genital or anal-oral contact
non-sexual ways
IV drugs
blood transfusions
changes in the vaginal chemical balance
Diseases – lifelong
Infections – curable
Changes in the vaginal chemical balance - will cause infections. Antibiotics will trigger the chemical change and create a suitable setting for an infection to occur.

5. Sexually Transmitted Diseases/Infections
Symptoms will vary depending on the disease or infection by may include
Sores
Blood in urine
Burning sensation while urinating
Rashes/Itching
Bumps/Warts
Unusual discharge
Many STDs are asymptomatic, meaning there are not signs or symptoms
Many will continue to spread the disease and not get treatment
STD poster/presentation project

6. Sexually Transmitted Diseases/Infections
Considered to be primarily or frequently sexually transmitted:
Chancroid (haemophilus ducreyi)
Chlamydia (chlamydia trachomatis)
Gonorrhea (Neisseria gonorrhoeae)
Granuloma inguinale (Donovanosis)
Hepatitis B virus
Herpes (herpes simplex virus type 2)
Human Immunodeficiency Virus (HIV)
Human papillomavirus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42-45, 51, 52, 56 (genital warts)
Syphilis (treponema pallidum)
Trichomoniasis (trichomonas vaginalis)

7. Sexually Transmitted Diseases/Infections
Sexually Transmittable, although not generally considered to be STDs because they have more common routes of transmission:
Bacterial vaginosis
Candidiasis
Crabs and Scabies
Cytomegalovirus
Nongonococcal Urethritis (NGU)
Pelvic Inflammatory Disease (PID), secondary condition

8. Chancroid (haemophilus ducreyi)
Bacterial disease
Infection methods: sexual contact
Prevention: abstinence and condoms
Symptoms: genital ulcers, enlarged lymph nodes
Detection: examination of genital ulcers and lymph nodes
Treatment: antibiotics
Complications:
scarring may occur
higher risk of contracting
HIV
If you have HIV treatments do not respond well and ulcers don’t heal as quickly

9. Chlamydia (chlamydia trachomatis)
Bacterial infection
Infection methods: intercourse and anal sex
Prevention: condoms & regular medical screenings
Symptoms: 25% of men and 70% of women are asymptomatic
Fever and Diarrhea
Fatigue and weight loss
White spots in the mouth
Pain and swelling in genital area
Discharge from penis
Burning sensation while urinating
White or gray discharge from vaginal area

10. Chlamydia (chlamydia trachomatis)
Detection: collection of fluid from cervix or penis, urine samples
Treatment: antibiotics
Testing and treatment of all
sexual partners
Complications:
Pelvic Inflammatory Disease (PID)
Nonspecific utethritis (NSU)
Arthritis
Chronic pain and infertility
Babies born to infected mothers may have eye, ear & lung infections, or death

11. Gonorrhea - “The Clap” – “The Drip” (Neisseria gonorrhoeae)
Bacterial infection
Infection methods: sexual contact with mouth, vagina, penis or anus, and from mother to baby
Prevention: abstinence, monogamous, condoms
Symptoms:
sore or red throat
rectal pain
blood and pus in bowel movements
A watery discharge from the penis, which can become a thick yellow/green discharge
Itching or burning at the urethral opening
Pain with urination
Thick yellow or white vaginal discharge
Unusual lower abdominal pain

12. Gonorrhea - “The Clap” – “The Drip” (Neisseria gonorrhoeae)
Detection:
Gram stain - staining a sample of tissue or discharge and then looking at it under a microscope
Cultures (cells that grow in a lab dish) provide absolute proof of infection. Generally, samples for a culture are taken from the cervix, vagina, urethra, anus, or throat.
Treatment:
Antibiotics
Testing and treatment of all sexual partners
About half of the women with gonorrhea are also infected with chlamydia and will need treatment for that as well

13. Gonorrhea - “The Clap” – “The Drip” (Neisseria gonorrhoeae)
Complications
Pelvic inflammatory disease (PID)
Infertility
Scarring or narrowing of the urethra
Abscess (collection of pus around the urethra)
Joint infections
Heart valve infection
Meningitis
Pregnant women with severe gonorrhea may pass the disease to their baby while in the womb or during delivery
Premature delivery
Spontaneous abortion
Blindness, joint infection, or blood infection

14. Granuloma Inguinale (Donovanosis)
Bacterial infection
Infection methods: vaginal or anal intercourse
Prevention: abstinence and condoms
Symptoms:
Small, beefy-red bumps appear on the genitals or around the anus.
They are usually painless, but they bleed easily if injured.
The disease slowly spreads and destroys genital tissue.
Tissue damage may spread to the area where the legs meet the torso.
The genitals and the skin around them lose skin color.

15. Granuloma Inguinale (Donovanosis)
Detection: tissue samples and biopsy of lesions
Treatment: antibiotics
Complications:
Genital damage and scarring
Loss of skin color in genital area
Permanent genital swelling due to scarring

16. Hepatitis B virus Irritation and swelling of the liver
Infection methods:
Direct contact with blood
Sexual contact with an infected person
Tattoo or acupuncture with unclean needles or instruments
Shared needles/equipment during drug use
Shared personal items
Childbirth from infected mother to child
Prevention:
Vaccine
Avoid sexual contact with infected persons
Use a condom and practice safe sex
Avoid sharing personal items, such as razors or toothbrushes
Don’t do drugs
Properly clean blood spills

17. Hepatitis B virus Symptoms: Detection: blood tests
Many are asymptomatic
Appetite loss
Fatigue
Fever, low-grade
Muscle and joint aches
Nausea and vomiting
Yellow skin and dark urine due to jaundice
Detection: blood tests
Treatment: careful monitoring of liver and other body functions with blood tests
May need liver transplant if liver failure occurs
Complications: liver damage (cirrhosis)

18. Herpes (herpes simplex virus type 2)
Viral infection, lifelong
Infection methods:
Skin, vagina, penis, or mouth contact with someone infected
Passed to baby during a vaginal birth
Prevention: abstinence and condoms
Symptoms:
Itching and burning followed by small sore or cluster of blisters on the penis/in or around vagina
Blisters will heal and go away but lifelong “outbreaks” will still occur
Fever
Headaches

19. Herpes (herpes simplex virus type 2)
Detection: culture of fluid from sore and blood tests
Treatment: medications to help with the discomfort of outbreaks
Complications:
Lifelong outbreaks
May cause cervical cancer
Virus may spread to other parts
of the body
Baby may have physical or
mental damage

20. Human Immunodeficiency Virus (HIV)
Severely damages the immune system by infecting & destroying white blood cells
Infection methods:
Unprotected sex with an infected person
Needle sharing between intravenous drug users
Blood transfer
Infected woman to her baby
In RARE cases, accidents of needle stick injuries by healthcare providers
Small risk in oral sex
Oral sex transfer - May occur when the active partner gets sexual fluid (semen or vaginal fluid) or blood (from menstruation or a wound somewhere in the genital or anal region) into a cut, sore, ulcer or area of inflammation somewhere in their mouth or throat.
The linings of the mouth and throat are very resistant to viral infections such as HIV, so infection is unlikely if they are healthy.
HIV is normally only present in saliva in very low levels that are not sufficient to cause infection.
Risk would be from bleeding wounds or gums in the HIV positive person’s mouth or on their lips, which may transfer blood onto the mucous membranes of the other person’s genitals or anus, or into any cuts or sores they may have.

21. Human Immunodeficiency Virus (HIV)
HIV transmission can occur when fluids containing HIV from an infected person enter the body of an uninfected person. These fluids include:
HIV can enter the body through:
Lining of the anus or rectum
Lining of the vagina and/or cervix
Opening to the penis
mouth that has sores or bleeding gums
Blood
Semen
cuts and sores
Pre-seminal fluid
Needles (syringes)
Vaginal fluid
Breast milk
Healthy skin is an excellent barrier against HIV and other viruses and bacteria. HIV cannot enter the body through unbroken skin.
Other body fluids and waste products-like feces, nasal fluid, saliva, sweat, tears, urine, or vomit-don’t contain enough HIV to infect you, unless they have blood mixed in them and you have significant and direct contact with them.

22. Human Immunodeficiency Virus (HIV)
Prevention: abstinence, condoms, never share needles or take drugs, avoid getting drunk or high
Symptoms:
Primary stage – flu-like symptoms, few weeks
Clinically Asymptomatic Stage – mild infections and chronic disorders, average of 10 years
Symptomatic HIV Infection – emergence of certain opportunistic infections
AIDS (Acquired Immune Deficiency Syndrome) – low white blood cell counts
Very susceptible to infections
While drunk or high you may be less likely to protect yourself

23. Human Immunodeficiency Virus (HIV)
Detection: blood tests – rapid test, western blot
Treatment: variety of drugs to keep the virus under control
HAART therapy (highly-active anti-retroviral therapy)
Complications:
Opportunistic infections — diseases that wouldn't trouble a person with a healthy immune system
Other STDs
Death

24. Human papillomavirus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42-45, 51, 52, 56 (genital warts)
Soft growths on the skin and mucus membranes of the genitals
Infection methods: sexual contact
Prevention: abstinence, condoms, two vaccines (protect against four types)
Symptoms: flesh-colored spots that are raised or flat, growths that look like the top of a cauliflower
Detection: physical exam
Treatment: skin treatment at doctor’s office, Rx medicines, surgical removal of warts
Complications: cervical cancer, warts can become very large and numerous
More than 70 types of HPV

25. Syphilis (treponema pallidum)
Bacterial infection
Infection methods: direct contact with a syphilis sore during vaginal, anal, or oral sex
Prevention: abstinence

26. Syphilis (treponema pallidum)
Symptoms:
Primary Stage – 10 to 90 days after contact sore appears (mouth, anus, rectum, throat or sex organ) heals on its own in 3-6 weeks
Secondary Stage – lasts 3-6 weeks, copper-colored skin rash with fever, headache, loss of appetite, or loss of hair
Latent (hidden) Stage - damage to internal organs occurs with no symptoms
Late Stage - accumulated damage shows up in years after initial infection
Sudden heart attack, vision failure, loss of motor coordination , or mental disturbances
Stage 2 - Rash is on palms of hand and soles of feet and in severe cases will cover the whole body
Stage 3 – symptoms disappear

27. Syphilis (treponema pallidum)
Detection: examination of material from sore and blood tests
Treatment: antibiotics (penicillin)
One dose will work if you have had syphilis for under one year
Baby born with syphilis will have daily penicillin treatments for 10 days
Complications:
Sudden heart attack
vision failure
loss of motor coordination
mental disturbances
Death

28. Trichomoniasis (trichomonas vaginalis)
Caused by a parasite (protozoan)
Infection methods: intercourse
Prevention: monogamous and condoms
Symptoms: frothy greenish-yellow vaginal discharge, vaginal itching and odor, burning after urination or ejaculation, discharge from urethra
Detection: pelvic exam in women, men are diagnosed after their partner or after treatment for gonorrhea and chlamydia fail
Treatment: antibiotic
Complications: changes in cervical tissue

29. Bacterial vaginosis (BV)
Normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain bacteria
Infection methods: not fully understood but having a new sex partner or multiple sex partners and douching are some causes
Prevention: abstinence, limiting number of sex partners, don’t douche
Symptoms: abnormal vaginal discharge with an unpleasant odor, most report being asymptomatic
Detection: exam and lab tests on vaginal fluid
Treatment: antibiotics
Complications: increase susceptibility to HIV and other STDs, infection after surgery, preterm delivery

30. Candidiasis Yeast infection
Infection methods: antibiotics, steroids, pregnancy, menstruation, sperm, diabetes, and birth control pills
Prevention:
Symptoms: vaginal burning, itching, and discharge (white cheese look)
Detection: gynecological exam
Treatment: over-the-counter medications
Complications: people with weakened immune systems it can be hard to treat and get rid of

31. Crabs and Scabies Small, creatures that infect the
pubic hair area and lay eggs
Infection methods: sexual activity, toilet seats, sheets, blankets, or bathing suits
Prevention: limiting number of sexual partners, safe sex, good personal hygiene, ware underwear when trying on bathing suits
Symptoms: itching, bluish-gray colored skin, sores due to bites and scratching
Detection: examination of pubic area
Treatment: Rx wash
Complications: secondary infections may develop if scratching opens the skin

32. Cytomegalovirus
Form of the herpes virus, usually a harmless infection that stays for life
Infection methods: direct contact with bodily fluids (urine, saliva, breast milk), sexual activities, transplanted organs and blood transfusions
Prevention:
wash hands often
don’t share food/drinks, pacifier, toothbrush with young children
clean anything that comes in contact with a child’s saliva or urine

33. Cytomegalovirus Symptoms: Detection: blood, saliva, or urine test
Jaundice
Purple skin splotches
Enlarged spleen or liver
Pneumonia
Seizures
Visual impairment/blindness
Diarrhea/digestive ulcers
Detection: blood, saliva, or urine test
Treatment: most healthy people don’t need treatment
Complications: congenital infections cause many long-term problems and deaths

34. Nongonococcal Urethritis (NGU)
Inflammation or infection of the urethra, caused by something other than gonorrhea
Infection methods: sexual activities, UTIs, inflamed prostate
Prevention: abstinence and safe sex
Symptoms:
Itching and burning around genital area
Discharge (thin & watery to thick and white)
Detection: have inflammation of the urethra with out gonorrhea infection
Treatment: antibiotics
Complications: infertility, arthritis, conjunctivitis, PID, chronic pelvic pain, miscarriages

35. Pelvic Inflammatory Disease (PID)
Bacterial infection that moves from vaginal/cervical area into the uterus, fallopian tubes, ovaries, or pelvis
Infection methods: chlamydia or gonorrhea, IUD, sexual activity during adolescence
Prevention: prompt treatment for STDs, safe sex behaviors, monogamous
Symptoms: fever, pain in lower abdomen, vaginal discharge with abnormal color, texture or smell, chills, fatigue, painful urination, irregular menstrual bleeding or no menstruation

36. Pelvic Inflammatory Disease (PID)
Detection:
cervical exam
vaginal culture
ultrasound or CT scan
Treatment: antibiotics, may need surgery
Complications:
scarring of the pelvic organs
chronic pelvic pain
ectopic pregnancy
infertility