1. Case Control Study on Sexuall Transmitted Diseases
Jackeline Vega, Jean Fonrose, Maureen Mangroo
Shennel Caleb Clarke & Stephanie Echevarria
BLS 150
Hostos Community College
Professor D’Agostino
Fall 2011

2. Introduction Jean Fonrose: Evaluation of the risk factors for STD’s.
Defined according to two subtypes: Unprotected Sex, Multiple Sex Partners , Abusing alcohol or Using recreational drugs and being adolescent female
70 %of the population in USA is affected.
45 of the cases involve women.
Finally ,the CDC reports that there are 19 million STD infections each year –half of which occur among 15-to 24-year-olds.

3. introduction Stephanie: Extra Credit
A sexually Transmitted Infection(STI) can be transmitted by sexual contact
Some of these infections such as Chlamydia, Gonorrhea, and Trichomoniasis can be treated and cured with antibiotics.
Other infections such as AIDS and herpes can be treated but not cured.
If a person is sexually active they are at risk of exposure to a Sexually Transmitted Infection.

4. introduction
Shennel: Extra Credit
Alcohol users are likely to transmit sexually transmitted diseases.
Sexually transmitted diseases are infections transmitted mainly through sexual activity.
Over a 2million of the population in USA is affected.
Having an std in the past was more common among persons aged 18 to 25 who used alcohol of the cases involved by 2.5 percent.
1.3 percent less than those who used neither drug or alcohol.

5. Introduction Maureen:
Involves young adults Black, Hispanic and White race under the age of 25 living in the United States.
Common among minority communities, young people, men who have sex with men and is also found in people who network with others of the same age group, location or background.
There is 65 million people living in the U.S. with STD.
15 million of new STD cases are being diagnosed each year.
One in four new STD cases occur in teenagers.
Risky behavior is the leading cause of STD among young people today. For example abusing recreational drugs or alcohol maybe some.
others of the same aInvolves young adult from Black, Hispanic and White race under the age of 25 living in the ge group, locationor background.
Risky behavior is the leading cause of STDS among people

6. Introduction: What is a sexual transmitted disease?
Jackeline
An illness with high probability of significant transmission
Sexual behavior including vaginal intercourse, oral and anal sex
One million people affected everyday.
About 60% of these infections occur in young people of 25 to 30 year of age.
30% of these infections also occur in people that are between the ages of 14 and 19.
Females are more likely to contract an STD than males.

7. Risk factors of a sexual transmitted disease?
Jackeline
Anyone who is sexually active is at risk to exposure of a sexually transmitted infection. Factors that may increase risk include:
Having unprotected sex
Vaginal or anal penetration by an infected partner who is not wearing a latex condom.
A man who has gonorrhea has a 70 to 80 percent chance of infecting his female partner in a single act of vaginal intercourse.
Having multiple sex partners.
The more people you have sex with the greater is your risk .
This is true for concurrent as well as consecutive partner.
Each time you break up with one monogamous partner and move on to another partner, your STD risk is increased.

8. SYMPTOMS Stephanie: Genital Discharge Genital warts or sores
Painful or difficult urination
Painful intercourse
Swollen, tender lymph nodes in the groin
Irritation such as genital burning or itching
People can also have little or no symptoms at all

9. Early Symptoms of Sexually Transmitted Diseases-Maureen
FIRST SYMPTOMS
AIDS (Acquired Immune Early Deficiency Syndrome)
Headache, night sweats, unexplained weight loss, fatigue, swollen lymph nodes, persistent fever, persistent diarrhea, oral thrush (a heavy, whitish coating on the tongue and on the inside of the mouth).
Candidiasis
Itching in the genital area, pain when urinating, a thick odorless vaginal discharge.
Chlamydia
Often no symptoms at all for males or females
For women: pain during intercourse. For men: a clear, watery, urethral discharge
Genital Herpes
Itching, tingling sensation, burning in the genital area, fluid filled blisters on the genitals in males & females, usually painful or inflamed.
One in four Americans has the genital herpes virus. THE #1 STD because it is often "silent". You can spread the virus EVEN if you do not have symptoms. Please tell you sexual partner.
Genital Warts
Soft, cauliflower-like growths appearing in clusters or alone around the vagina, penis, anus, groin, and/or scrotum.
Gonorrhea
For females: a cloudy vaginal discharge, painful urination, vaginal itching. Often no early symptoms for women
For males: a yellowish, pus-filled discharge from the penis, burning with urination.
Hepatitis B
Fever, fatigue, nausea or no symptoms at all in either partner for months.
Pelvic Inflammatory Disease (PID)
Fever, lower abdominal pain, often a pus-filled discharge vaginal discharge.
Pubic Lice (Crabs)
Intense itching in both sexes. Crabs are tiny but visible in pubic hair and on thighs.
Scabies
Syphilis
A sore on the genitals of both sexes. (Chancre), rash, fever, sore throat, sores in the mouth or anus.
Trichomoniasis
For females: vaginal itching and pain, a foamy, greenish or yellow foul-smelling discharge.
For males: a clear discharge from the penis.

10. Treatment Stephanie: All cases require treatment Antibiotics
counseling
Sex education/prevention
Antiviral medication
Partner also needs treatment

11. CHART SHOWING SIDE EFFECT ASSOCIATED WITH DRUGS COMMONLY USED TO TREAT SEXUALLY TRANSMITTED DISEASE.
TABLE 6 Side Effects Associated with Drugs Commonly Used to Treat Sexually Transmitted Diseases
Senn & Carey, (2011). Age of partner at first adolescent intercourse and adult sexual risSenn & Carey, (2011). Age of partner at first adolescent intercourse and adult sexual risk behavior among women. Journal of woman’s health, 20 (1) 61-66k behavior among women. Journal of woman’s health, 20 (1) 61-66
Drug
Side effects
Cephalosporins
Pain at injection site, diarrhea, allergic reactions, Clostridium difficile colitis, hypoprothrombinemia, platelet dysfunction, eosinophilia, positive Coombs' test, serum sickness, cholelithiasis (associated with use of ceftriaxone [Rocephin]) and, rarely, hemolytic anemia, interstitial nephritis, hepatic dysfunction, convulsions (associated with renal failure), neutropenia, thrombocytopenia and confusion
Fluoroquinolones
Gastrointestinal intolerance, headache, insomnia, dizziness, allergic reactions, photosensitivity, elevated liver enzymes and, rarely, papilledema, nystagmus, C. difficile colitis, marrow suppression, anaphylaxis and central nervous system stimulation
Penicillins
Rash, serum sickness, positive Coombs' test and, rarely, neutropenia, thrombocytopenia, elevated liver function tests, increased blood urea nitrogen and creatinine levels, headache, confusion and seizures
Macrolide antibiotics
Diarrhea, nausea, abdominal pain, rash, cholestatic hepatitis and, rarely, C. difficile colitis and hemolytic anemia
Tetracyclines
Gastrointestinal intolerance, stained teeth (in children), hepatotoxicity, photosensitivity, pain with injection and, rarely, allergic reactions, visual disturbances, hemolytic anemia and C. difficile colitis
Shennel:

12. Mechanism Jackeline Recreational Drugs
Inhibits your judgment, making you more willing to participate in risky behavior.
Impair your judgment ,confuse your thoughts which can cause you to take part in activities you normally would not.

13. Mechanism
Stephanie:
Studies have shown that people who engage in risky sexual behavior are more likely to have unprotected sex.
Having sex without a condom exposes a person to body fluids that can possibly be infected.
Having unprotected sex can increase the chances of becoming exposed and infected with an STD.

14. Risk Factors Jackeline Having a history of one or more then one STDs
Being infected with one or more STD makes it easier for another STD to take hold.
People infected with herpes, syphilis, gonorrhea or Chlamydia and have unprotected sex with an HIV-positive partner are more likely to contract HIV.
It is also possible to be re-infected by the same infected partner if he or she isn’t treated for a long with you.
Abusing alcohol or using recreational drugs
Abusing alcohol and using recreational drugs make people engage in risky sexual behavior.
impairs your judgment , confuses your thoughts, slows down your nerve system, causing you to take part in activities you normally would not.
Injecting drug
Needle sharing spreads serious infections, including HIV and Hepatitis B
You acquire HIV by injecting drugs you can transmit it sexually.

15. Risk Factor: Being an adolescent female
Maureen:
MECHANISM:
Risky behavior as a whole has a ratio of 1-3 are likely to contract an STD due to their actions and individual factors may influence different outcomes in unique ways..
Involves the human reproductive system
The estimation of 68% are having unprotected sex which makes the teenage female more susceptible of contracting any disease that’s out there.
High exposure of 42% are sexually active with multiple sex partners.
Of all adolescent pregnancy 38% are due to risky behaviors.
Risky behaviors, unprotected sex and multiple partners and being an adolescent female leads to STD.

16. RISK FACTOR: Multiple Sex Partners
Jean:
MECHANISM:
Multiple sex partner has been shown to increase the risk factor for STD.
Variety of new sex partners increase so does the risk of exposure of individuals infected with STD.
Most important those who have multiple sex partners are less likely to use condoms during sex.
According to 95% of multiple sex partners don’t use condoms because they want to have a very nice feeling when they have sex.

17. Literature Review: Recreational drugs
Jackeline
Topic: Abusing alcohol and using recreational drugs
Article: Sexually transmitted diseases or (STD)by Mayo Clinical Health a CDC study found that a least one in four people between the ages of 14 to 35 has a sexually transmitted disease amount those female who admitted having unprotected sex while drinking or using recreational drugs, the rate was 40%.
A analysis was conducted using data from community base survey determinate correlation of alcohol and drugs abuse this reveal that more than 50% of the alcohol and drugs abuser had 1 or more STDs.

18. Literature Review: Unprotected Sex
Stephanie:
Topic: HIV/STD Risk Reduction Interventions for African American And Latino Adolescent Girls at an Adolescent Medicine Clinic (John B. Jemmott PHD, et. Al)
Materials/Method: Interventions with a group of girls with follow up 3, 6 and 12 months. Using questionnaire's at pre and post interventions.
Conclusion: Participant who received the skilled based interventions reported less unprotected sex at the 12 month follow up.

19. Literature Review: multiple sex partners
Jean:
Title: Multiple sex partner behavior in female undergraduate students in china in campus.
Author: Yan H. et al.
Publication: BMC Public Health 2009
Condition: Examined and determined multiple sex partners.
Materials/Method: A 2002 survey of students aged 17 to 28 in China estimated that 14% of undergraduate were sexually active 24% of students responding considered themselves to be moderated to very high risk.
Risk Factor: Having current close friends that were living with boyfriends poor academic performance and positive attitudes toward multiple partners.
Conclusion: Differences in having sex between university after adjusting for demographic variables bout 90% of the between university variance (model2) in model 3 current student factors only explained about 7% of the variation.

20. Literature Review: Being an Adolescent Female
Maureen:
Title: Risky Adolescent Sexual Behaviors and Reproductive Health in Young Adulthood.
Authors: Scott, Wildsmith, Welti, Ryan Schelar & Streward-Streng
Publication: Perspectives on Sexual & Reproductive Health
Condition: Adolescent female sexual behavior & STD’s.
Materials/Methods: Data from waves 1-4 of the National Longitudinal Study of Adolescent Health on 5, 798 sexually active adolescent ranging from Blacks, Hispanic and White race. The study examined association between risky behaviors both cumulative and individually. The adolescents come from individual homes, 2 family homes and adoptive parents.
Risk factors: Lack of contraceptive, not talking about contraceptive, age at first intercourse, risky behaviors among minority, multiple sex partners and a non-monogamous partner.
Conclusion: A teenager’s sexual behavior has long term and short term consequences such as teenage pregnancy for long term or contracting an STD for short term. For every 10 adolescent 4 gave an account of having at least 3 risk factor. One of 3 females had a multiple sex partner. One in five young adult 17% had an STD.

21. Literature review: Being an adolescent female
Maureen: Extra Credit
Title: Personal and Social Influences Regarding Oral Sex Among African American Female Adolescents.
Authors: Salazar, Ph.D., Crosby, Ph.D., Mc Dermott Sales, Ph.D., Wing, Sc.D., & Rosa M.P.H
Publication: Journal of Women’s Health
Condition studied: Personal & Social Influences Regarding Oral Sex
Materials /Methods: The data was collected from 715 African American female adolescents in different clinics in South Eastern United States. The females range from years old. The research was originally suppose to be done for a HIV prevention program.
Risk Factors: Higher sexual sensation seeking, risky sexual practices, less stress to refuse sex, personal factors, lower self-esteem, pleasure, peer influences, relational factors and fear of condom negotiation.
Conclusion: Social influences such as peer pressure did influence adolescents to have oral sex and at least 29% female were diagnosed with one STD.

22. Literature Review: Being An Adolescent Female
Maureen: Extra Credit
Title: Age of Partner at First Adolescent Intercourse and Adult Sexual Behavior Among Woman.
Authors: Theresa E. Sean, Ph. D., and Michael P. Carey, Ph.D.
Publication: Journal of Women’s Health, Vol 20. Num. 1, 2011.
Condition studied: Risky behavior and Sexually Transmitted Infection among adolescent.
Materials/Methods: A study was conducted in a STD clinic using 292 females, 66% were African American, 18% Whites and 16% of mixed race. The majority of female were single and 26 years old at the time of research but their first intercourse was at the age of 14.6.
Risk factors: Sexual risky behaviors, unprotected sex, older male partners and less condom use.
Conclusion: The sexual risky behaviors of adolescence was carried into adulthood by the same females who continued to be sexually active keeping sexually transmitted disease at a high risk level in their lives due to their risky behaviors.
83% of the participant reported contracting and STD.

23. Literature Review: Alcohol & Recreational Drugs
Shennel:
Title: Prevalence of sexually acquired antiretroviral drug resistance in a community sample of HIV-positive men who have sex with men in New York City.
Authors: Goldsamt, Clatts, Parker, Colon, Hallack & Messina.
Publications: Aids patient care and STDs.
Condition: Using drugs, having HIV and STDs.
Materials/Methods: An epidemiologic study was used targeted and chain - referrral sampling methods. 371 HIV positive men were recruited for participation. Participants had to be at least sexually active and 18 years old.
Rick factors: Unprotected sex, existing STDs, recreational drugs, alcohol use, and multiple sex partners.
Conclusion: A total of 347 participants (93.5%) agreed to donate a blood sample. We were able to make the plasma RNA in 188 (54.5%).

24. Literature Review: alcohol and recreational drugs.
Shennel: extra credit
Title: Sexually Transmitted disease.
Authors: PEPPERS SCHWARTZ AND ROGER GILLMOR
Methods: The national survey on drug use and health asks questions to examine health conditions including (std) it also ask persons aged 12 or older to report their use of alcohol drugs.
Conclusion: people who drink and use recreational drugs has a higher risk of getting an std rather a non drinker .
Linked Anorexia with stress-induced changes in opiate receptors of certain nerve cells.

25. Literature Review: Unprotected Sex
Stephanie:
Title: Multilevel Predictors of Inconsistent Condom use Among Adolescent Mothers (Bethanie S. Van Horne, MPH, et.al.)
Materials/Method: Adolescent mothers were interviewed 48hrs after delivery and surveyed 6 and 12 months after delivery. The analysis was used to examine the risk factors for inconsistent condom use at 12 months after delivery.
Conclusion:14-39% of adolescent mothers were diagnosed with an STD 6-10 months after delivery because of inconsistent condom use.

26. Hypothesis
Shennel:
Having multiple sex partners, unprotected sex, alcohol or using recreational drus and being an adolescent female are the risk factors for sexually transmitted diseases (STDs).
Mechanisms Summarized:
Unprotected Sex  94.6% are more likely to contract STDs in the past month due to the high levels of sexual activity.
Having an existing STD  78% will contract another one in their lifetime.
Alcohol or recreational drugs  17.4% will contract an STD due to drug use.
Adolescent female  will contract one or more STD.

27. Hypothesis Stephanie: Extra Credit
If a person has unprotected sex they are at a higher risk of contracting a Sexually Transmitted Infection.

28. Survey: Being Sexually Active
Maureen
1. Are you sexually active?
2. Have you ever had a Sexually Transmitted Infection (STI) in the past?
3. Have you ever had unprotected sex?
4. How many sex partners have you had?
5. Have you ever used recreational drugs?
6. If yes to recreational drugs, how often & how much?
7. Have you ever used alcohol?
8. If yes to alcohol, how often & how much?
9.What is your age?
10. What is your sex? Male/Female

29. Data Collection & odds ratio - maureen

30. Data collection & odds Ratio - Stephanie

31. Data collection & odds Ratio - Shennel

32. Data collection & Odds ratio - Jean

33. Data collection & odds ratio - Jackeline

34. Bibliography
Shennel’s Bibliograpy: avert staff. (2011, 09 12). chlamydia: symptoms, treatment & testing . Retrieved from
Goldsamt ,Lloyd A. ( Nov 5,2011). prevalence of sexually acquired antiretroviral drug resistance in a community sample oh hiv positive men who have sex with men in New York city. aids patient care and STDs, 25(2011),
mayo clinic staff. (2011, September 21). sexually transmitted diseases (STDs). Retrieved from
Stephanie’s Bibliography: CDC. “Common STDs and the Organisms That Cause Them.” STDs Today 1 (2011):n.pag. CDC NPIN. Web. 18 Oct A service of the Centers for Disease Control and Prevention.
Jemmott III, John B., Loretta Sweet Jemmott, Paula K. Braverman, and Geoffrey T. Fong. “A Randomized Controlled Trial.” HIV/STD Risk Reduction Interventions for African American and Latino Adolescent Girls at an Adolescent Medicine Clinic 159.5(2005): n. pag. google scholar. Web. 2 Oct. 2011
Mayo Clinic. “Risk Factors.” Sexually Transmitted Diseases (STDs) 1 (2011): n. pag. Mayoclinic. Web. 26 Sept. 2011
Van Horne, Bethanie S., Constance M. Wiemann, Abbey B. Berenson, Irwin B. Horwitz, and Robert J. Volk. “Research and Practice.” Multilevel predictors of Inconsistent Condom Use Among Adolescent Mothers 99.S2 (2009): n. pag. Google scholar. Web. 2 Oct. 2011

35. Bibliography
Jean’s Bibliography: Yan, H. (2009, 08 22). Multiple sex partner behavior in female undergraduate students in china.. Retrieved from www. biomedcentral.com
Mayo clinic Staff. (2011, 02 24). Sexually transmitted diseases. Retrieved from
Roberto , Carlyle , Zimmerman , Abner , Cupp , Hansen. (2008). The short term effects of a computer-based pregnancy, std, and HIV prevention program. The Short Term Effects Of a Computer -Based Pregnancy ,STD, and HIV Prevention Program, 56,
Jackeline’s Bibliography: Dr. Napier, Andrew. "major risk factors for acquiring a std." n. page. Print. <
sexually transmitted disease." n. page. Print. < transmitted disease>.
Mayo clinic, . " bing health. mayo clinic, 10/11/05. Web. 30 Nov 2011.

36. Bibliography
Maureen bibliography: (1) Mayo clinic staff. (2011, February 24). Sexually transmitted disease (STDS). Retrieved from
National institute of allergy and infectious disease staff. (2011, April 11). Sexually transmitted diseases (STDS). Retrieved from
Senn & Carey, (2011). Age of partner at first adolescent intercourse and adult sexual risk behavior among women. Journal of woman’s health, 20 (1) 61-66
Scott, Wildsmith, Welti, Ryan, Schelar & Steward-Streng. (2011). Risky adolescent sexual behaviors and reproductive health in young adulthood. Perspective on sexual and reproductive health, 43 (2)
Staff of sex Ed 101. ( ). Early symptoms of sexually transmitted diseases. Retrieved from
Salazar, Laura. "Personal & Social Influences Regarding Oral Sex Among African American Female Adolescents." Journal of Women's Health (2011): n. page. Print.