Transcript Psychology 3533 Understanding Human Sexuality

Sexually Transmitted Infections
(STIs)
U.S. Data (CDC):
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About half the population will have one at
some point in their lives
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An estimated 19 million people infected each
year in the U.S. alone
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At greatest risk: age 15-24
STDs or STIs
 In
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this age group, most common STIs
Chlamydia
Gonorrhea
HPV
 Most
have no symptoms early on!
 Transmitted
by both intercourse (vaginal
or anal) and oral sex
STDs or STIs
 Emotional
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fall-out:
embarrassment
shame
guilt
despair
fear
 These
negative emotions can make
people go in denial and avoid taking
precautions or disclosing to partners.
STDs or STIs
 Bacterial
or viral diseases that are sexually
transmitted through genital/oral/anal
contact but also other conduits
 Bacterial STIs:
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can be cured if caught early
 Viral:
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can NOT be cured
STDs or STIs
 Difference
between most common
reportable STI and most common STI

not all STIs are required to be reported
 Many
if not most (depending on disease
and gender) are ASYMPTOMATIC

So: can transmit unknowingly
STDs or STIs
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Most Common:
 HPV human papilloma virus (warts), not
reportable
 HPV:
 over 150 different strains
 transmitted not only sexually but by skin to
skin in genital, oral and anal contact
 cauliflower-like warts in vulva, vagina, penis,
pubic area and anus but can be asymptomatic
 leads to cervical cancer; recently vulvar
precancerous growths, especially women
over 40 (e.g. labia, clitoris)
STDs or STIs
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HPV: (Cont’d)
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oral cancer : increase of oral sex
• oropharyngeal cancer (mouth and throat) associated
with HPV in the oral cavity. Far fewer oral sex partners
result in increased cancer risk than with genital
partners, rivaling oral cancers due to tobacco and
alcohol
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can cause penile and anal cancer
100 MUN female students a year have
precancerous changes due to HPV
birth control pill interaction
• hormones in contraceptive promotes changes
in cervical cells that make it more vulnerable
(squamous cells)
STDs or STIs
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HPV (Cont’d):
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smoking interaction:
• nicotine metabolites increase cervical cancer risk
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early sex (13-15) is a risk factor (more likely to have more
partners)
multiple partners, also a risk factor, including multiple
partners of partner
effect of alcohol and drugs:
• weaken immune system, impair judgment of risk
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condoms not very effective in protecting against HPV:
• warts can be in areas other than penis or vagina, e.g. pubic
area, anus
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no cure
it’s estimated that 85% of sexually active people have it,
but strong immune system can fight it off
STDs or STIs
HPV (Cont’d):
 A new vaccine for HPV prevention is
available since July ’06
Gardasil (contraindication: yeast allergy)
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the vaccine prevents four strains of HPV,
which happen to be the ones that most
commonly (70%) cause cervical cancer. The
recommendation is to vaccinate girls between
ages 9 and 14, before they become sexually
active. Girls chosen due to cervical cancer
risk.
Currently tested on boys.
STDs or STIs
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Chlamydia:
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± 400 per 100,000 depending on location
• 600 female
• 200 male
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most common reportable STI in Canada
very high incidence
more in women, but less reporting from men
age 15-24 women highest rate
75% women asymptomatic until it spreads to uterus
damage to:
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cervix
uterus
fallopian tubes
peritoneum
liver
STDs or STIs
 Chlamydia
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(Cont’d):
causes:
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PID
tubal blockage
ectopic pregnancies
infertility
prematurity and low birth weight
STDs or STIs
 Chlamydia
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males:
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(Cont’d):
50% asymptomatic
50% have urethral discharge
burning urination
epididymitis
infertility
Reiter’s syndrome (conjunctivitis and arthritis)
if having anal sex:
• proctitis and proctocolitis
STDs or STIs
 Genital
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Herpes:
± 25% incidence
 Caused
by herpes simplex virus, Type I
(cold sores) and Type II – both cause the
STI
 2010 study: HSV I more common in
genital infections in university students
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Can be transmitted through kissing, oral,
genital or anal sex
STDs or STIs
 Most
are asymptomatic:
 if symptomatic: small, painful blisters
on genitals
 also, fever, painful urination,
headaches, vaginal and urethral
discharge, enlarged lymph nodes
 Oral HSV also includes malaise,
muscle aches, lesions in the soft
palate, tongue, gums, lips and face
STDs or STIs
 Genital
Herpes (Cont’d):
 These symptoms last 3 weeks, then virus
goes dormant, but still contagious. Genital
herpes lodges at base of spinal cord, while
oral herpes infects top of spinal cord and
base of brain. Symptoms may recur
randomly.
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Children of mothers with GH Type II have higher
rates of schizophrenia or other psychoses.
Correlational data.
STDs or STIs
 Genital
Herpes (Cont’d):
 Pregnant women can transfer to fetus, can
lead to fatal brain infection even if no
genital blisters present at the delivery 
C-section recommended.
 Correlation between HSV I and cognitive
deficits.
 No cure, some antiviral drugs lessen
severity of symptoms and shorten the
outbreak but always contagious.
STDs or STIs
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Long term: can lead to meningitis, narrowed urethra
UTIs, increased HIV infection, genital scarring,
encephalitis (fatal), blindness (from rubbing eyes
after touching blisters elsewhere)
No cure and always contagious
Recently, a gel developed to protect women from
HIV proved effective in protecting against herpes
(51%)
STDs or STIs
GONORRHEA
 Used to be a serious problem but penicillin
cured it and it ceased to be such a threat.
However, it's making a comeback, as we
become resistant to antibiotics.
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thin mucous discharge that becomes thick and
creamy, pus
painful, burning urination
groin glands enlarged and tender
Can cause inflammation of the urethra, bladder,
prostate, epididymis, seminal vesicles. If
untreated spreads to testes: infertility.
STDs or STIs
GONORRHEA
 Most males are symptomatic, most females are
not. In females, affects reproductive tract and
anus and rectum. Affects Bartholin glands. Can
move up and cause PID.
 Can also affect mouth and throat and eyes
(mother can transmit to newborn at birth).
STDs or STIs
 Hepatitis:
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± 3 per 100,000
Viral disease of the liver.
 Types
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A, B, C, D, E.
Type B most common STI.
Next is Type C.
STDs or STIs
Hepatitis (Cont’d):
 Hep B:
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Symptoms:
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Through blood, saliva, semen, vaginal secretion,
other body fluids, IV drugs, piercing, tatoos.
Enlarged liver, fever, fatigue, jaundice, vomiting. But
some asymptomatic. No cure, can lead to liver
degeneration and death.
Liver cirrhosis, cancer:
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Second leading cause of cancer world-wide (after
smoking).
But – there is a vaccine: prevention.
 200 times more common than HIV.
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STDs or STIs
 Hepatitis
 Hep
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(Cont’d):
C:
Can also lead to liver cirrhosis and cancer of
the liver. Found in users of IV drugs, nasal
coke, tattoos and piercings. Also
contaminated water.
Recent increase in incidence (2011 data)
STDs or STIs
 HIV:
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Human Immunodeficiency Virus
 HIV/AIDS:
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By 2007 almost 80,000 in Canada reported
cases.
67% had died. But now a chronic illness
thanks to medications.
 AIDS:
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Acquired Immune Deficiency Syndrome
• Estimate (2009): 65,000 Canadians live with HIV.
One third not aware.
• Worldwide: 40 million have HIV (estimate)
STDs or STIs
 AIDS
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(Cont’d):
Transmission:
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body fluids (not saliva)
sex (penis/vagina or penis/anus)
contaminated blood
hypodermic needles
during pregnancy and childbirth
 Condoms
87% effective for HIV
 No cure but effective treatments make it a
chronic illness
 Recent studies: health problems of
HIV/AIDS patients in middle/old age
STDs or STIs
 TRICHOMONIASIS:
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Caused by neither bacterium nor virus.
 Trichomonas
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vaginalis:
single cell protozoan, a parasite that attaches
to vaginal cells.
transmitted mostly through sex, but the
organism can survive for some time on toilet
seats and other surfaces.
more common in women, very widespread
(8,000,000 in North America, 170 million
worldwide).
STDs or STIs
TRICHOMONIASIS (Cont’d):
 Men are asymptomatic, 50% women have
symptoms:
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Can cause:
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vaginal itch
smelly (fishy), frothy vaginal discharge
PID
increased female vulnerability to HIV
people with HIV transmit it more easily if they have
trichomoniasis
in pregnancy, premature birth and/or low birth weight
Treatment:
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Flagyl (metronidazole) or other antibiotics for
protozoa
LYMPHOGRANULOMA (LPV)
 Same
type as chlamydia (bacterial
infection)
 Affects the lymphatic system
 Much more invasive
 More common in men, many HIV positive
(gay sex a risk factor)
 Through oral, vaginal, anal sex
 Symptoms (3-30 days): small painless
sore in initial phase, in the genitals
LYMPHOGRANULOMA (LPV)
 Low
grade fever, swelling and redness
and enlarged lymph nodes in the groin,
blood or pus in stools, painful bowel
movements, abdominal pain, fatigue,
muscle and joint aches
 Treatable with antibiotics
 Infection can spread to lymphatic system,
lower GI tract, internal reproductive organs
in women – if not treated early
STDs or STIs
Safe Sex vs. safER sex
 Two monogamous people who have
tested negative for STIs or have
never had any sexual contact before.
 Issue of trust.