Ch. 8 Sexually Transmitted Infections/ Diseases

Much of what we know about the long- and short-term effects of syphilis is based on unethical research conducted as part of the Tuskegee Syphilis Study. Who were the participants in this study? a. 400 Latina women not infected with syphilis b. 400 African American men infected with syphilis c. 200 Caucasian men who were not infected with syphilis d. 400 men and women infected with syphilis

b. 400 African American men infected with syphilis

What does the current research say about the transmission of herpes simplex virus type 2? a. Herpes is only transmissible when the sores are visible. b. Herpes is transmissible whether or not sores are present. c. Herpes is transmissible only when the sores break open. d. Since herpes is curable, it is no longer being transmitted at all.

b. Herpes is transmissible whether or not sores are visible.

If you are sexually active, the only way to know for sure that you are free of STIs is to ________. a. ask your partner if he or she has ever had an STI b. be tested c. look for signs of a rash or discharge d. notice if you experience flu-like symptoms shortly after sex

b. be tested

During which stage of syphilis does the infected person experience symptoms that include skin rashes, hair loss, fatigue, sore throat, and headache? a. primary b. secondary c. latent d. tertiary

b. secondary

Lois is diagnosed with genital herpes. What would be the recommended treatment? a. antibiotics b. antifungals c. antiherpetics d. antiretrovirals

c. antiherpetics

Key Point: Viral STIs

A vaccine (trade name Gardasil) is now available that will prevent genital HPV and the potential for related cancers of the cervix, anus, and throat.

hepatitis B virus (HBV)

A virus that may be sexually transmitted and may lead to inflammation and impaired functioning of the liver.

Key Point: The STI Pandemic

Gonorrhea, chlamydia, and the human papillomavirus (HPV), which causes genital warts, are the most common agents causing STIs among teens and young adults.

Key Point: Viral STIs

HIV, the virus that causes AIDS, has caused a pandemic, with an estimated 35 million individuals infected worldwide. In the United States, at least 48,000 news cases are reported each year.

asymptomatic

Having no noticeable symptoms despite the presence of an infectious agent.

Key Point: Viral STIs

No cure for HIV or AIDS exists. A recent increase in new cases of HIV and other STIs may reflect the mistaken belief that new HIV treatments and medications actually cure AIDS, which they do not.

What is bacterial vaginosis? What are the symptoms and risk factors related to it? [lecture]

Not necessarily considered an STI but often related to sexual activity - Bacterial Vaginosis (BV) is the most common cause of unhealthy vaginal discharge. Symptoms often include an increase in discharge and a strong "fishy" odor. Risk factors include multiple sexual partners, changing to a new partner, douching, inconsistent condom use.

pubic lice

Small, bug-like parasites, usually sexually transmitted, that infest the genital area, causing extreme itching; often referred to as "crabs" because of their resemblance to a sea crab.

chancre

A sore that typically appears at the site of infection with syphilis.

human immunodeficiency virus (HIV)

The virus that causes AIDs.

antiretroviral therapy (ART)

A combination of several medications prescribed for people who are HIV-positive to delay the onset of AIDS.

trichomaniasis

A commonly sexually transmitted protozoan parasite causing symptoms in women, including genital irritation, painful urination, and a foul-smelling vaginal discharge; infected men are typically asymptomatic, yet contagious.

acquired immune deficiency syndrome (AIDs)

A gradual failure of the immune system, leading to serious, opportunistic infections, which, in turn, may lead to death.

sexually transmitted infections (STIs)

A group of viral, bacterial, and other infections that are spread primarily by sexual behaviors; also called sexually transmitted diseases (STDs).

safe-sex fatigue

A loss of tolerance for practicing and a decrease in safer sex behaviors.

pelvic inflammatory disease (PID)

A painful condition in women marked by inflammation of the uterus, fallopian tubes, and ovaries; typically caused by one or more untreated STIs.

urethritis

A painful inflammation of the urethra; often caused by one or more untreated STIs.

epididymitis

A painful swelling and inflammation of the epididymis, the structure at the back of each testicle that stores maturing sperm; often caused by one or more untreated STIs.

cirrhosis of the liver

A potentially serious liver disease that may lead to liver cancer.

nongonococcal urethritis (NGU)

A sexually transmitted bacterial infection of the urethra characterized by urethral inflammation and discharge, but not caused by the gonorrhea bacterium.

syphilis

A sexually transmitted bacterium characterized by a sore, chancre at the point of infection; untreated, it may progress to more serious stages and even death.

Mycoplasma genitalium (M. genitalium)

A sexually transmitted bacterium that is responsible, along with chlamydia, for the largest percentage of nongonococcal urethritis.

gonorrhea

A sexually transmitted bacterium typically producing pain upon urination and a thick cloudy discharge from the penis or vagina; often asymptomatic, especially in women.

chlamydia

A sexually transmitted bacterium, often causing a thick, cloudy discharge from the vagina or penis; may be asymptomatic, especially in women.

human papilloma virus (HPV)

A sexually transmitted virus that is typically characterized by warts in the genital or anal area and that may lead to some forms of cancer; also known as genital warts.

Key Point: Viral STIs

STIs that are caused by viruses currently have no cure. (This is true of virtually all viruses.)

Key Point: Viral STIs

A simple oral saliva test is now available for HIV, and researchers are working around the clock to find an effective HIV vaccine, which still appears many years away from becoming a reality.

antibiotic-resistant strain

A strain of bacteria that has mutated and is no longer treatable with standard antibiotic therapy.

pandemic

A sudden outbreak of an illness/disease (an epidemic) of major proportions that spreads relatively quickly over a large region, entire continents or throughout the world.

jaundice

A symptom of hepatitis characterized by a yellowing of the skin and eyes.

retrovirus

A type of virus, such as HIV, that survives and multiplies by invading and destroying the DNA of normal body cells and the replicating its own DNA into the host cell's chromosomes.

incubation period

The time between infection and the appearance of physical symptoms of illness.

Key Point: Bacterial STIs

Although most bacterial STIs are readily cured with antibiotics, when they are asymptomatic and left untreated, they can lead to more serious conditions of the reproductive tract, including infertility.

genital herpes

An STI caused by the herpes simplex virus and characterized by painful sores and blisters, usually in the genital or anal area.

Key Point: The STI Pandemic

Approximately half of the population of the United States will contract and STI at some point in life, and an estimated 19 million people are newly infected with an STI each year. Sexually active people between the ages of 15 and 24 are at greater risk of contracting STIs.

How are bacterial STIs treated? Do they go away? [text & some lecture]

Bacterial - Chlamydia, Gonorrhea, Nongonococcal Urethritis (NGU), Syphilis • Treatable with antibiotics; Left untreated can lead to pelvic inflammatory disease, infertility, in rare cases death. Treatment is less complicated and typically fairly easy when bacterial STIs are treated early. • Chlamydia is the most common bacterial STI. • NGU is a newly classified STI. • Syphilis has been on the rise among men who have sex with men (MSM).

Key Point: Preventing STIs

Prevention is always preferable to curing STIs. This is true of any infection or disease.

Janet is at a parent meeting where parents are debating whether or not they should allow their children to get the HPV vaccine. Janet's daughter is in the fourth grade. She is worried that giving her child the vaccine means that she condones sex. Tell her why the vaccine is given to children between the ages of nine and twelve. a. Most children are engaging in sexual activities and the vaccine may cure HPV infections. b. Public health professionals are unsure about its effectiveness so they give it to children. c. Most children have not already been exposed to genital HPV so the vaccine is more effective for this group. d. The immune system of a child is more robust than that of an adult.

C. Most children have not already been exposed to genital HPV so the vaccine is more effective for this group.

What is the most common bacterial STI in the U.S.? How is it transmitted? What are the symptoms? [text and lecture]

Chlamydia is the most common bacterial STI.

celibacy

Choosing to engage in no sexual activities whatsoever.

selective abstinence

Choosing to engage in or avoid certain sexual behaviors on the basis of their risks of STIs or pregnancy.

asymptomatic shedding

Release of infectious virus particles when no symptoms of infection are present.

Key Point: Risk Factors for STIs

STIs are the most common illnesses throughout the world. Many STIs may have no obvious symptoms and may go undiagnosed and untreated, allowing them to spread more widely.

opportunistic infections

Diseases that establish themselves in the human body only when the immune system is weakened and incapable of fighting them off.

What is Gardasil? How many types of HPV does it protect against? Who should receive it according to the recommendations? [text & lecture]

Gardasil - protects against 4 HPV types (Types 6 & 11 the cause of 90% of genital warts and Types 16 & 18 which cause 70% of cervical cancer and many anal, vaginal, and penile cancers, potentially throat cancers associated with HPV as well) • Available for girls and boys age 9 and older • Cervarix - protects 2 HPV types (Types 16 & 18) • Only available for girls age 10 and older • Current recommendations for who should get vaccinated: • Teen girls and young women through age 26 (typically recommended at age 11 or 12) • Teen boys and young men through age 21 • Men who have sex with men and both men and women with compromised immune systems through age 26

prevalence

The total cumulative number of cases of a disease in a given population.

Key Point: The Tuskegee Syphilis Study

In the 1930s, in Tuskegee, Mississippi, doctors hid the diagnosis and denied treatment to a group of black men with syphilis in order to study the longterm effects of the disease. The study was publicly revealed in the 1970s, and President Clinton in 1997 issued a national apology to the victims and their families.

Key Point: Risk Factors for STIs

Lack of education, negative emotions about sex, poor communication, substance abuse, and risky sexual activities all contribute to the current worldwide STI epidemic.

antiherpetics

Medications available to treat (reduce or prevent but no cure) outbreaks of the herpes virus.

Key Point: Viral STIs

Millions of people in the United States are infected with viral STIs. The most common of these are herpes, hepatitis B, and the human papilloma virus.

Key Point: Parasitic STIs: Sexually Transmitted Bugs?

Parasitic STIs are caused by organisms that feed off the human body. The most common of these are trichomoniasis and pubic lice. The main symptoms of sexually transmitted parasites are vaginal irritation and/ or intense itching. These infections are relatively easy to treat and cure.

Key Point: Specific Sexually Transmitted Infections

STIs may be categorized according to the type of microbe causing the infection.

Key Point: Preventing STIs

Strategies for preventing STIs include becoming educated about their causes, symptoms, and treatments; overcoming negative sexual feelings that often interfere with treatment; maintaining effective communication between partners to help avoid transmission; resisting the use of mind-altering substances that cloud judgement and may lead to unsafe sexual practices; and engaging in safer sexual activities.

confidential testing

Test recipients' names are kept on file in the lab's records, but with the assurance of full confidentiality.

anonymous testing

Tests administered without collecting any personal information about clients, who are identified only by an assigned code number.

alcohol myopia theory

The belief that under the influence of alcohol, people are more likely to focus on immediate, "feel-good" behaviors (such as sexual arousal) and ignore future negative consequences.

acceptable level of risk

The level of risk one is willing to accept when making behavioral choices about one's health and well-being.

incidence

The number of new cases of a disease in a given population over a specific time period.

Key Point: The Tuskegee Syphilis Study

The racist aspects of the Tuskegee Syphilis Study still have repercussions today, as many minorities continue to mistrust the U.S. medical system.

viral shedding

The release of virus particles that can potentially spread the infection to others.

Key Point: Bacterial STIs

Virtually all bacterial STIs are spread primarily through unprotected oral, vaginal, or anal sexual activities. The most common bacterial STIs include chlamydia, gonorrhea, and syphilis.

prodromal symptoms

Warning signs, such as itching, burning, or pain, that an outbreak of an infection such as herpes may be impending.

Which bacterial STI is a new, emerging infection that is now diagnosed more than gonorrhea? a. mycoplasma genitalium b. chlamydia c. nongonococcal urethritis d. pelvic inflammatory disease

b. chlamydia