What are some of the myths you have heard about STDs/STIs and why do you think people still believe them?
C H A P T E R 8 : S E X U A L LY TRANSMITTED INFECTIONS/ DISEASES
ROGER R. HOCK
HISTORICAL PERSPECTIVE
• The Tuskegee Syphilis Study
– One of the most unethical studies in the history of modern medicine
– Denied treatment to 400 low-income African American men
– Opted not to administer penicillin, in favor of continuing study
THE TUSKEGEE SYPHILIS STUDY WA S O NE O F T H E M O ST UNET H I CA L ST UDI E S I N T H E
H I ST OR Y OF M ODER N M EDI CI NE. I N 1 997, P R ESI DENT B I L L CL I NT O N O FFE R ED T H E
VICT I M S A ND T H EIR FA M IL IES A N OFFICIA L A P OLOGY A ND COM P ENSATION FOR TH E
I NJUST ICE DONE T O T H EM .
THE STI PANDEMIC
• Among most common causes of illness and disease worldwide
– 20 million new cases are reported in U.S. annually.
– Approximately half of all people will contract an STI at some point in life.
• People between ages 15 and 24 at greatest risk
– Most common STIs are gonorrhea, chlamydia, and the human papillomavirus (HPV)
• HIV and AIDS are major pandemics
– Approximately 1.2 million people in the U.S.
– 56,000 new cases per year
FIGURE 8.1 CHLAMYDIA AND GONORRHEA INFECTION INCIDENCE BY AGE GROUP
SOURCE: CDC, “REPORTED STDS” (2014).
RISK FACTORS FOR STIS
• No Warning Signs or Symptoms
– Some STIs produce no clear symptoms at all; they are asymptomatic.
• Lack of Accurate Information
– Inconsistent, poor, or nonexistent sex education programs
• “Unhealthy” Sexual Emotions and Attitudes
– Guilt, shame, fear of stigma, and embarrassment
• Poor Sexual Communication
• Substance Abuse
– Drugs, especially alcohol, can cause the user to take sexual risks.
RISK FACTORS FOR STIS
• High-Risk Sexual Behaviors
– More bodily fluids and/or sexual penetration involved, more risk.
• Self-Discovery: STI Risk Scale
O N E E X P L A N AT I O N F O R W H Y A LC O H O L U S E L E A D S T O P O O R S E X U A L D E C I S I O N M A K I N G I S
C A L L E D T H E A LC O H O L M Y O P I A T H E O R Y.
SPECIFIC SEXUALLY TRANSMITTED
INFECTIONS
• Categories based on the type of pathogen
– Viral
– Bacterial
– Parasitic
VIRAL STIS
• Herpes Simplex Virus (HSV)
– HSV-2: The Primary Cause of Genital Herpes
– Symptoms
– Transmission
– Diagnosis and Treatment
FIGURE 8.2 HERPES SIMPLEX VIRUS
S H O W N H E R E A R E M A L E A N D F E M A L E E X A M P L E S O F A C T I V E G E N I TA L H E R P E S L E S I O N S .
VIRAL STIS
• Human Papilloma Virus (Genital Warts)
– Symptoms
– Transmission
– Diagnosis and Treatment
F I G U R E 8 . 3 G E N I TA L W A R T S
SHOWN HERE ARE T YPICAL , OBSERVABLE CASES (WHEN SYMPTOMS ARE PRES ENT) OF MALE
A N D F E M A L E G E N I TA L W A R T S .
VIRAL STIS
• In Touch with Your Sexual Health
– HPV, Cervical Cancer, and the Pap Test: Advances in Cervical Cancer Screening
• Hepatitis B Virus (HBV)
– Symptoms
• Jaundice
• Cirrhosis of the liver
– Transmission
– Diagnosis and Treatment
– Incubation period
F I G U R E 8 . 4 J A U N D I C E C A U S E D B Y H E PAT I T I S
O N E O F T H E M O S T O B V I O U S S I G N S O F A N A C T I V E H E PAT I T I S I N F E C T I O N I S A Y E L LO W I N G O F
THE SKIN AND EYES.
VIRAL STIS
• HIV and AIDS
– Sexuality and Culture: The HIV/AIDS Pandemic
– Background and Origins of HIV and AIDS
HIV AND AIDS ORPHANS OUTSIDE AN ORPHANAGE IN CHANGHAI MAI, THAILAND. HIV
INFECTIONS CONTINUE TO INCREASE WORLDWIDE.
F I G U R E 8 . 5 E S T I M AT E D N U M B E R S O F P E O P L E L I V I N G W I T H H I V, N E W H I V I N F E C T I O N S , A N D
A I D S D E AT H S , 2 0 0 1 – 2 0 1 2 , G LO B A L LY.
S O U R C E : U N A I D S , G LO B A L R E P O R T ( 2 0 1 3 ) . W W W. U N A I D S . O R G .
T H E S E M A P S S H O W T H E N U M B E R O F P E O P L E E S T I M AT E D T O B E L I V I N G W I T H H I V/ A I D S
W O R L D W I D E A S O F T H E E N D O F 2 0 1 2 , A N D T H E E S T I M AT E D N U M B E R O F N E W H I V I N F E C T I O N S
AROUND THE WORLD RECORDED IN 2012.
T H E S E M A P S S H O W T H E N U M B E R O F P E O P L E E S T I M AT E D T O B E L I V I N G W I T H H I V/ A I D S
W O R L D W I D E A S O F T H E E N D O F 2 0 1 2 , A N D T H E E S T I M AT E D N U M B E R O F N E W H I V I N F E C T I O N S
AROUND THE WORLD RECORDED IN 2012.
VITAL STIS
• HIV and AIDS
– Prevalence and Incidence of HIV/AIDS
– Symptoms
– Transmission
– HIV Testing
F I G U R E 8 . 6 R E L AT I V E R I S K O F V A R I O U S S E X U A L B E H AV I O R S I N T H E T R A N S M I S S I O N O F H I V
S O U R C E : C D C , “ R I S K C H A R T. ” A D A P T E D F R O M
W W W. C D C . G O V/ H I V/ T O P I C S / T R E AT M E N T/ P I C / P D F / C H A R T. P D F.
VIRAL STIS
• HIV and AIDS
– Treatment
• Antiretroviral therapy (ART)
– Living with HIV
– HIV, Lifestyle, and Health
– The Future of HIV/AIDS
F I G U R E 8 . 7 T H E I M PA C T O F A R T O N H I V S U R V I VA L R AT E S
S O U R C E : N I H ( 2 0 1 2 ) . D R U G FA C T S : H I V/ A I D S A N D D R U G A B U S E : I N T E R T W I N E D E P I D E M I C S .
N AT I O N A L I N S T I T U T E S O F H E A LT H , N AT I O N A L I N S T I T U T E O N D R U G A B U S E . R ET R I E V E D F R O M
W W W. D R U G A B U S E . G O V/ P U B L I C AT I O N S / D R U G FA C T S / H I V A I D S – D R U G – A B U S E – I N T E R T W I N E D EPIDEMICS.
BACTERIAL STIS
• Chlamydia
– Symptoms
• PID in females
• Urethritis or Epididymitis in males
– Transmission
– Diagnosis
FIGURE 8.8 CHLAMYDIA INFECTION
D I S C H A R G E C O M M O N LY O B S E R V E D I N M A L E S W I T H C H L A M Y D I A . M O S T F E M A L E S W H O
C O N T R A C T T H E C H L A M Y D I A B A C T E R I U M S H O W N O S Y M P T O M S AT A L L . T H E C H L A M Y D I A
B A C T E R I U M I S S H O W N O N T H E R I G H T.
BACTERIAL STIS
• Gonorrhea
– Symptoms
– Transmission
– Diagnosis
– Nongonococcal Urethritis (NGU)
FIGURE 8.9 GONORRHEA SYMPTOMS IN THE MALE
T H E M O S T C O M M O N S Y M P T O M S O F G O N O R R H E A I N T H E M A L E A R E A C LO U D Y D I S C H A R G E
F R O M T H E P E N I S A N D PA I N F U L U R I N AT I O N . I N W O M E N , A S W I T H C H L A M Y D I A , T H E I N F E C T I O N
U S U A L LY H A S N O O B V I O U S S Y M P T O M S , B U T W H E N S Y M P T O M S D O A P P E A R , A S I M I L A R
D I S C H A R G E F R O M T H E V A G I N A M AY B E O B S E R V E D , A C C O M PA N I E D B Y PA I N F U L U R I N AT I O N .
BACTERIAL STIS
• Syphilis
– Symptoms
• Chancre
– Transmission
– Diagnosis
FIGURE 8.11 SYPHILIS CHANCRE
THE FIRST SIGN OF SYPHILIS INFECTION FOR MALES AND FEMALES IS A CHANCRE, OR SORE,
AT T H E P O I N T O F I N I T I A L I N F E C T I O N .
BACTERIAL STIS
• Pelvic Inflammatory Disease (PID)
– Symptoms
– Transmission
– Diagnosis
• Treatment for Bacterial STIs
– Antibiotics
– Antibiotic-Resistant Strains
PARASITIC STIS
• Sexually Transmitted Bugs?
– Trichomoniasis
– Pubic Lice
PREVENTING STIS
• Seeing or Feeling STI Symptoms Is Not Enough
• Obtaining Accurate Information about STIs
• Overcoming Unhealthy Emotions about Sex
• Self-Discovery: STI Testing
• Communicating Effectively about Sex
• Avoiding Mixing Sex and Drugs (Especially Alcohol)
• Refraining from Risky Sexual Behaviors