stds/sti hth

viral stds; genital herpes

1 in 5 adults in the U.S. has genital herpes Two herpes simplex virus strains cause genital herpes and oral herpes (cold sores) Latent infections; virus migrates from skin to nerve cells HSV 1 (Type 1) Usually exposed to virus during childhood 50-80% of U.S. adults have antibodies to HSV-1 Oral herpes (cold sores) and genital herpes HSV 2 (Type 2) Genital or oral herpes Almost always sexually transmitted Usually occurs in adolescence and early adulthood Asymptomatic in 80-90% of people Symptoms 80-90% of infected people have no symptoms First episode causes flu-like symptoms and genital lesions Recurrent outbreaks Diagnosis and treatment Diagnosed through symptoms, physical examination, lab tests No cure - carry virus for life; stress can encourage outbreaks Virus can be transmitted even when no lesions present Antiviral drugs (Famvir, Valtrex, Zovirax) can help prevent and/or shorten severity and duration of symptoms during outbreak

bacterial stds; gonorrhea

820,000+ cases diagnosed each year; most cases ages 15-24 Bacterial pathogen Neisseria gonorrhoeae Can cause arthritis, rashes, eye infections, PID, epididymitis, urethritis, and gonococcal conjunctivitis or gonorrheal infection of blood or joints in infants of infected mothers Can infect urethra, genital tract, throat or rectum Symptoms Women: Usually asymptomatic, may have painful urination, increased vaginal discharge, and severe menstrual cramps Men: Painful urination, thick yellow-white discharge, lips of urethral opening may be inflamed and swollen, lymph glands in groin may be swollen; half of men have minor or no symptoms Treatment Oral antibiotics can cure the disease BUT...growing number of drug-resistant strains of gonorrheais a major concern; only one class of antibiotics remains consistently effective

the major stds

Also known as sexually transmitted infections (STIs) Spread of an infection from person to person mainly through sexual activity More than 20+ types; ½ new cases in ages 15-24 STDs that pose a major health threat: 1.HIV/AIDS 2.Syphilis 3.Chlamydia 4.Gonorrhea 5.Herpes 6.Human papillomavirus (HPV) CDC (2017) estimated 20 million Americans infected each year -incidence of STDs now at an all-time high!

more stds

Bacterial •Chlamydia - most common bacterial STD •Gonorrhea - 2nd most common bacterial •Pelvic Inflammatory Disease •Syphilis (can be fatal) •Bacterial vaginosis Viral •Human Papillomavirus - HPV vaccine •Genital Herpes •Hepatitis A & B Other Pathogens •Trichomoniasis (protozoal) •Pubic lice (ectoparasite) •Candidiasis (fungal/yeast)

bacterial stds; syphillis

Caused by treponema pallidum bacterium Can be effectively treated with antibiotics in early stages Symptoms Primary phase: 10-90 days after exposure Painless ulcers, called chancres; highly contagious Secondary phase: 1-12 months after chancre disappears Flulike symptoms and highly contagious skin rash or white patches Late, or tertiary, phase Damage to organs, dementia, cardiovascular damage, blindness, and deathDiagnosis and treatment Diagnosed by examination of infected tissues and with blood tests Treated by antibiotics but damage from late stages of infection can be permanent

viral stds; zika virus

First locally-transmitted U.S. cases in U.S. 2016; mosquitos main vector Can cause severe birth defects in children born to infected women Recent awareness that men can transmit to sexual partners of either sex, as virus lives longer in semen than in blood

HIV Infection and AIDS

Human immunodeficiency virus (HIV) causes AIDS (Acquired Immunodeficiency Syndrome) First diagnosed in the U.S. in 1981; worldwide epidemic possibly peaked in the 1990's, but still an enormous threat in developing countries. Without treatment, AIDS kills nearly all of its victims Approximately 78 million people worldwide have been infected with HIV since the epidemic began; 37 million estimated to be living with HIV or AIDS Nearly 1 percent of the world population; 3.5 million new infections per year U.S. = 1.2 million have been infected with HIV/ 50,000 new infections annually 21% of HIV-infected Americans are unaware of their condition "Universal precautions" began with HIV/AIDS!

viral stds; HPV

Most common STD in the U.S. (80%+ of sexually active by 50) Can cause: common warts, genital warts, genital and oropharynx cancers and virtually ALL cervical cancers !Highly contagious, can spread through oral sex Very common among young people Two vaccines for HPV (pg 416): 3-dose series over 6 months; recommended for girls/boys 11-12 years of age, or prior to start of sexual activity Gardasil and Gardasil 9 Protects against four types of HPV virus that account for 90% of genital warts and 70% of cervical cancers plus protection against cancers of the anus, vagina and vulva Most effective before the onset of sexual activity Also approved for boys and men Cervarix Doesn't protect against genital warts, but may be more effective in protections against cervical Symptoms Small bump on the skin or a large, warty growth Cauliflower-like mass or flat wart May cause irritation and bleeding, painful urination Diagnosis and treatment Diagnosed based on the appearance of lesions Often detected during routine PAP tests Special tests can detect HPV and distinguish among the more common strains, including those that cause most cases of cervical cancer Treatment focuses on reducing the number and size of warts Cryosurgery (freezing) Electrocautery (burning) Laser surgery Interferon injections

populations of special concern for hiv infection

Most common means of exposure: Sexual activity between men Injection drug use Heterosexual contact (aided by club drugs, meth, alcohol) African American men and women are vastly overrepresented among people newly diagnosed with AIDS Increasingly a disease that affects minorities, women, and the poor

bacterial stds; chlamydia

Most commonly reported bacterial STD in the U.S. (1.4+ million in U.S. 2015) Can cause sterility in men and womenCan lead to pelvic inflammatory disease, infertility and ectopic (tubal) pregnancy Can also affect prostate gland & seminal vesicles in men; cervix & oviducts in women Arthritic symptoms and damage to heart and blood vessels in both sexes Symptoms Usually asymptomatic in women - may have vaginal discharge, burning with urination, pain or bleeding with intercourse, and lower abdominal pain In men - painful urination, watery discharge from penis, pain around testicles and in lower abdominals Chlamydia can also infect the rectum of men/women CDC recommends annual testing for all sexually-active women 25 years and under Diagnosis and treatment Laboratory tests on a urine sample or a small amount of fluid from the urethra or cervix Once diagnosed, infected person and partner are given antibiotics "Expedited partner therapy" in some states

bacterial stds; pelvic inflammatory disease (PID)

Occurs when initial infection by chlamydia or gonorrhea travels upwards into reproductive organs Often serious enough to require hospitalization and surgery 25% of affected women have long-term problems - chronic pelvic pain, recurrent upper genital infections Leading cause of infertility in young women Smoking, large number of sexual partners, and IUD usage are all risk factors for infection Symptoms Women can be asymptomatic Long and painful periods, discharge, spotting, abdominal pain, fever, chills, nausea, vaginal discharge, vomiting Diagnosis and treatment Diagnosis made on basis of symptoms, physical examination, ultrasound, and laboratory tests, may require laparoscopy Antibiotics and sometimes hospitalization required for treatment Very important that partners be treated; many men are asymptomatic

other stds

Trichomoniasis (protozoal infection) One of most common curable STD in the U.S. (more common in women) Can also be spread by toilet seats, wet towels containing discharge Candidiasis (Moniliasis) Vaginal fungal/yeast infections (candida albicans) caused by chemical imbalance in vagina Treat with antifungal meds Bacterial vaginosis (BV) Most common cause of abnormal vaginal discharge Caused by unhealthy species of normal vaginal bacteria Pubic lice (ectoparaiste) Contagious parasitic infections

HIV testing

•CDC recommends everyone ages 13-64 be tested at least once! •Strongly recommended for anyone who has engaged in or has a partner who has: •Injected drugs, including steroids, or shared needles •Had unprotected sex (vaginal, anal, or oral) •Had multiple partners or has exchanged sex for drugs or money •Been diagnosed with an STD, hepatitis or tuberculosis •Have sex under influence of drugs or alcohol (↑ sexual risk-taking behavior) •Had a blood transfusion between 1978-1985

hiv/aids

•Cause: HIV virus attacks the helper T cells (CD4) and macrophages of the immune systems, inserting its own DNA into the host cell and replicating, destroying the CD4's immune function •Methods of transmission: •Direct contact involving the exchange of bodily fluids (blood, semen, vaginal secretions, breast milk) •Sharing of hypodermic needles •Through infected blood products• Perinatal transmission (mother to fetus) •NOT through casual contact!

treatment for hiv/aids

•No cure at this time, but disease can now be better controlled and lives extended with prompt medication •Drop in AIDS mortality rates since 1996 due to new treatment with 2-4 combined antiviral drug "cocktails" plus antibiotics to prevent opportunistic infections •Protease inhibitors block the HIV protease enzyme from cutting protein chains to form new viruses •Other drugs - such as AZT, ddI, ddC, d4T, and 3TC - inhibit the HIV enzyme reverse transcriptase before the virus has invaded the cell •COST can be prohibitive!•HIV vaccine?? Doubtful