HUMAN PAPILLOMAVIRUSES (HPV)

• • • • a sexually transmitted disease (STD) that is caused by human papillomavirus (HPV). Human papillomavirus is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Most people who become infected with HPV will not have any symptoms and will clear the infection on their own.

HPV- UNDER A MICROSCOPE

SIGNS AND SYMPTOMS • Some of these viruses are called "high-risk" types, They may lead to cancer of the cervix, vulva, vagina, anus, or penis. • Others are called "low-risk" types, and they may cause genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped.

Most people who have a genital HPV infection do not know they are infected. The virus lives in the skin or mucous membranes and usually causes no symptoms, which is why HPV is spread so easily.

Genital warts

usually appear as soft, moist, pink, or flesh-colored swellings, usually in the genital area. • They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. • They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. • After sexual contact with an infected person, warts may appear within weeks or months, or not at all.

FEMALE GENITAL WARTS MALE GENITAL WARTS

TREATMENT

• Visible genital warts can be removed by topical medications the patient applies, or by • treatments performed by a health care provider.

Methods of removal by a health provider, can be freezing the warts off with liquid nitrogen, burning the warts off with a laser, or cutting the warts out with a scalpel. • Removal of warts is not a cure. They may reappear again.

• • •

Chlamydia

Chlamydia (kluh-MID-ee-uh) is a sexually transmitted infection (STI). STIs are also called STDs, or sexually transmitted diseases. Chlamydia is an STI caused by bacteria called chlamydia trachomatis. Chlamydia is the most commonly reported STI in the United States. Women, especially young women, are hit hardest by chlamydia.

Women often get chlamydia more than once, meaning they are “reinfected.” This can happen if their sex partners were not treated. Reinfections place women at higher risk for serious reproductive health problems, such as infertility.

CHLAMYDIA -UNDER A MICROSCOPE

SIGNES AND SYMPTOMS Chlamydia is known as a "silent" disease. This is because 75 percent of infected women and at least half of infected men have no symptoms. If symptoms do occur, they most often appear within 1 to 3 weeks of exposure. WOMEN WITH CHLAMYDIA MAY HAVE: Abnormal vaginal discharge---------Burning when passing urine Lower abdominal pain----------------Low back pain Nausea-----------------------------------Fever Pain during sex-------------------------Bleeding between periods MEN WITH CHLAMYDIA MAY HAVE: Discharge from the penis Burning when passing urine Burning and itching around the opening of the penis Pain and swelling in the testicles

FEMALE CHLAMYDIA (Internal) MALE CHLAMYDIA

TREATMENT

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Antibiotics are used to treat chlamydia.

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If treated, chlamydia can be cured.

• • • •

Gonorrhea

Gonorrhea is a sexually transmitted disease (commonly known as "the clap") caused by the bacterium Neisseria gonorrhea.

Gonorrhea is one of the most common infectious diseases. Anyone who has any type of sex can catch gonorrhea. The infection can be spread through the mouth, vagina, penis, or anus. The bacteria grow in warm, moist areas of the body, including the tubes that carry urine out of the body (urethra). In women, the bacteria may be found in the fallopian tubes, uterus, and cervix. The bacteria can even grow in the eyes.

GONNERHEA- UNDER A MICROSCOPE

SIGNS AND SYMPTOMS

• Symptoms of gonorrhea usually appear 2 - 5 days after infection, however, in men, symptoms may take up to a month to appear. • Some people do not have symptoms. They may be completely unaware that they have caught the disease, and therefore do not seek treatment. • This increases the risk of complications and the chances of passing the infection on to another person.

Symptoms in men include:

• Burning and pain while urinating • Increased urinary frequency or urgency • Discharge from the penis (white, yellow, or green in color)

• Red or swollen opening of penis (urethra) • Tender or swollen testicles • Sore throat

Symptoms in women can be very mild or non-specific, and may be mistaken for another type of infection. They include:

• Vaginal discharge • Burning and pain while urinating • Increased urination • Sore throat • Painful sexual intercourse • Severe pain in lower abdomen • Fever (if the infection spreads to the fallopian tubes and stomach area)

• More than 700,000 persons in the United States get gonorrhea every year, according to the Centers for Disease Control and Prevention (CDC). • In general, gonorrhea is most common in people 20 to 24 years old.

GONNERHEA OF THE EYE

GONNERHEA OF THE EYE PASSED FROM MOTHER TO BABY DURING BIRTH .

TREATMENT

• • Early treatment is simple & effective, & involves a single dose of antibiotics. In addition, the treatment of chlamydia is also advocated. (It is common to have these two STD infections together – 50% of those infected have both)

IF LEFT UNTREATED:

• Gonorrhea infection can spread through the bloodstream to other parts of the body, causing damage & serious problems.

In women, it can cause:

• life-threatening complications such as ectopic pregnancy (outside the womb) • blocked fallopian tubes (the tubes which carry the egg from the ovaries to the womb), which can result in reduced fertility or infertility • long-term pelvic pain

In men, it can lead to:

• painful inflammation of the testicles, which may result in reduced fertility or sterility

Herpes Simplex I/II

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There are two different strains of herpes simplex viruses:

• • • • •

Herpes simplex virus type 1 (HSV-1)

is usually associated with infections of the lips, mouth, and face. It is the most common herpes simplex virus and most people develop it in childhood. HSV-1 often causes lesions inside the mouth, such as cold sores (fever blisters), or infection of the eye (especially the conjunctiva and cornea). It can also lead to infection of the lining of the brain (meningoencephalitis). t is transmitted by contact with infected saliva. By adulthood, up to 90% of people will have antibodies to HSV-1.

• • • • •

Herpes simplex virus 2 (HSV-2)

Herpes simplex virus 2 (HSV-2) is sexually transmitted. Symptoms include genital ulcers or sores. In addition to oral and genital sores, the virus can also lead to complications such as infection of the lining of the brain and the brain itself (meningoencephalitis) in neonatal infants due to infection during birth. However, some people have HSV-2 but do not show symptoms. Up to 30% of U.S. adults have antibodies against HSV-2. Cross-infection of type 1 and 2 viruses may occur from oral-genital contact

HERPES SIMPLEX II- UNDER A MICROSCOPE

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SIGNS AND SYMPTOMS

Mouth sores Genital lesions -- there may first be a burning or tingling sensation Blisters or ulcers -- most often on the mouth, lips and gums, or genitals Fever blisters Fever -- especially during the first episode Enlarged lymph nodes in the neck or groin

Herpes and pregnant females:

• • • The herpes virus can infect the fetus and cause abnormalities. A mother who is infected with herpes may transmit the virus to her newborn during vaginal delivery, especially if the mother has an active infection at the time of delivery.

It's possible for the virus to be transmitted even when there are no symptoms or visible sores.

HERPES FROM MOTHER TO BABY

HERPES SIMPLEX II

• • • •

TREATMENT

Although there is no cure for herpes, some drugs have been effective in reducing the frequency and duration of outbreaks. It might be a good idea to discuss options with your doctor. Most people find some relief and recover more quickly from the first (primary) outbreak of genital herpes by taking antiviral medicines. Use medicines to relieve symptoms and speed healing of blisters and sores. Antiviral medicines, such as acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex) are recommended for treating primary genital herpes outbreaks.

HERPES IS A LIFETIME DESEASE.

REMEMBER THERE IS NO CURE.

SYPHILIS

• • • • Syphilis is an infectious disease. The bacteria that causes it spreads through broken skin or mucous membranes. It is most often spread by sexual contact.

Pregnant mothers infected with the disease can pass it to the baby developing in their womb. This is called congenital syphilis.

Syphilis is widespread in the United States. It mainly involves sexually active adults between ages 20 to 29.

Syphilis has several stages.(primary, secondary, and tertiary stages)

SYPHILIS UNDER A MICROSCOPE

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SIGNS AND SYMPTOMS

The symptoms of syphilis depend on the stage of the disease. Many people do not have symptoms.

In general, painless sores and swollen lymph nodes are symptoms of primary syphilis. Those with secondary syphilis may also have fever, fatigue, aches and pains, and loss of appetite, among other symptoms. Tertiary (final stage) syphilis causes heart, brain, and nervous system problems.

• • • • •

Primary syphilis is the first stage

The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores. The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days). The chancre is usually firm, round, small, and painless. It appears at the spot where syphilis entered the body. The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to the secondary stage.

PRIMARY SYPHILIS (CHANCRE)

• • • •

Secondary Stage

Skin rash and mucous membrane lesions characterize the secondary stage. This stage typically starts with the development of a rash on one or more areas of the body. The rash usually does not cause itching. Rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed. The characteristic rash of secondary syphilis may appear as rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet.

Secondary Stage Continued:

• However, rashes with a different appearance may occur on other parts of the body, sometimes resembling rashes caused by other diseases.

• Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. • In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. • The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent and possibly late stages of disease.

SECONSARY STAGE-SKIN RASH

RASH ON THE TORSO RASH ON THE HANDS

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Tertiary (final stage)

The tertiary(final) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. This latent stage can last for years. The late stages of syphilis can develop in about 15% of people who have not been treated for syphilis, and can appear 10 – 20 years after infection was first acquired.

In the late stages of syphilis, the disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

TERTIARY STAGE

SYPHILIS HAS EATEN AWAY THE CONNECTIVE TISSUE BETWEEN THE FOLDS OF THE BRAIN.

TERTIARY STAGE

BLINDNESS CAUSED BY UNTREATED SYPHILIS

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TREATMENT

Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis.

Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done. Because effective treatment is available, it is important that persons be screened for syphilis on an on-going basis.

Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

PUBIC LICE

• • • • Pubic lice (often called "crabs" because of their crab-like appearance under a microscope) are six-legged creatures that most commonly infest hair in the pubic area.

Although they also can infest other body hair. In most cases, pubic lice are transmitted sexually from the pubic hair of one person to another. But lice can be contracted in other ways, too — from infested clothing, towels, and bedding

PUBIC LICE UNDER A MICROSCOPE

PUBIC LICE UNDER A MICROSCOPE

SIGNS AND SYMPTOMS:

• • • Although it's possible to be infested and have no symptoms, people with pubic lice usually experience itchiness. This can worsen at night when the lice become active and bury their heads inside pubic hair follicles to feed on a person's blood.

Sometimes, lice bites can also cause the infested area to become inflamed because of a reaction to the proteins in the saliva of the lice.

SIGNS AND SYMPTOMS CONTINUED:

• • • Constant itching and scratching can cause the area to become raw and lead to a secondary bacterial infection. Scratching also can help the pubic lice to spread.

If the infestation consists of many adult lice, symptoms may be noticeable immediately. But if the infestation initially involves a few lice that then lay eggs, a person may not experience any symptoms for 2 to 4 weeks until the eggs hatch

PUBIC LICE BITES PUBIC LICE INFESTATION OF THE EYE AND EYELASHES

TREATMENT

• • • • • • Pubic lice are best treated with a prescription wash. Thoroughly work the shampoo into the pubic hair and surrounding area for at least 5 minutes. Rinse well. Comb the pubic hair with a fine-toothed comb to remove eggs (nits). Applying vinegar to pubic hair before combing may help loosen nits, but the hair should be dry when applying the shampoo.

A single treatment is all that is usually needed. If another treatment is recommended, it should be done 4 days to 1 week later.

TREATMENT CONTINUED:

• • • • Over-the-counter medications for the treatment of lice is another treatment option.

While you are treating pubic lice, wash all clothing and linens in hot water. Items that cannot be washed may be sprayed with a medicated spray or sealed (suffocated) in plastic bags and not used for 10 - 14 days. It is important for all intimate contacts to be treated at the same time.

TRICHOMONIASIS

• • • Trichomoniasis is a common sexually transmitted disease (STD) that affects both women and men, although symptoms are more common in women.

Trichomoniasis is the most common curable STD in young, sexually active women.

An estimated 7.4 million new cases occur each year in women and men.

TRICHOMONIASIS

• • • • • Trichomoniasis is caused by the single-celled protozoan parasite, Trichomonas vaginalis. The vagina is the most common site of infection in women. The urethra (urine canal) is the most common site of infection in men. The parasite is sexually transmitted through intercourse with an infected partner. Women can acquire the disease from infected men or women, but men usually contract it only from infected women.

TRICHOMONIASIS UNDER A MICROSCOPE

SIGNS AND SYMPTOMS

• • •

Women:

Signs and symptoms of infection range from having no symptoms (asymptomatic) to very symptomatic. Typical symptoms include foul smelling or frothy green discharge from the vagina, vaginal itching or redness. Other symptoms can include painful urination, lower abdominal discomfort, and the urge to urinate.

SIGNS AND SYMPTOMS

• •

Men:

Most men with this infection do not have symptoms. When symptoms are present, they most commonly include discharge from the urethra, the urge to urinate, and a burning sensation with urination.

Trichomoniasis of the cervix:

The typical "strawberry" appearance can be seen. Usually accompanied with a pungent itchy discharge.

• • •

TREATMENT

Trichomoniasis can usually be cured with prescription drugs given by mouth in a single dose. Other medications may take up to seven days.

The symptoms of trichomoniasis in infected men may disappear within a few weeks without treatment. However, an infected man, even a man who has never had symptoms or whose symptoms have stopped, can continue to infect or re infect a partner until he has been treated.

HIV/AIDS

• • • • HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system (the body's defense against infection). HIV uses healthy white blood cells to replicate itself, breaking down the immune system and leaving the body more susceptible to illness.

Without treatment, most people infected with HIV become less able to fight off germs that we are exposed to every day.

Someone who has HIV is called "HIV positive" or "HIV+".

• • • • • •

HIV/AIDS

AIDS (Acquired Immune Deficiency Syndrome) is a late stage of HIV infection.

An HIV positive person is diagnosed with AIDS when their immune system is so weakened that it is no longer able to fight off illness. (T-cell count below 200) People with immune deficiency are much more vulnerable to infections such as pneumonia and various forms of cancer. These diseases are called opportunistic infections because they take advantage of the weakened immune system. Ultimately, people do not die from AIDS itself, they die from one or more of these opportunistic infections.

It is believed that all people who become HIV+ will eventually have AIDS.

• • • •

HIV/AIDS

It can take several years before HIV breaks down a person's immune system and causes AIDS, and people may show few symptoms for several years after they are infected. People who appear perfectly healthy may not know they have the virus and can pass it on to others. 1 out of 4 Americans with HIV do not know they have the virus.

The only way to know if you have HIV is to GET TESTED.

HIV/AIDS UNDER A MICROSCOPE

Colored scanning electron micrograph of a single HIV budding from a T4 cell

TRANSMISSION

• • HIV is transmitted from person to person through the exchange of bodily fluids. While the HIV virus can be found in all bodily fluids of an infected person only these fluids contain a high enough concentration of HIV to transmit the virus: – Blood – Semen (including pre-cum) – Vaginal secretions – Breast milk

• •

TRANSMISSION CONTINUED

Modes of Transmission

– Sexual - unprotected anal, vaginal or oral sex – Sharing needles - IV drug use, tattooing, piercing – Maternal/Child – before, during & after birth, including breast-feeding – Blood transfusion before 1985 – Donor Products – Job Injury

HIV has not been proven transmittable by saliva, urine, feces, sweat, tears, vomit or mucus.

• HIV is NOT transmitted through casual contact including: hugging, kissing, using public toilets, sharing eating utensils, pools or coughing.

SIGNS AND SYMPTOMS

• • • • • • When first infected with HIV, you may have no signs or symptoms at all, although it's more common to develop a brief flu-like illness two to four weeks after becoming infected. Signs and symptoms may include: Fever Headache Sore throat Swollen lymph glands Rash

SIGNS AND SYMPTOMS CONTINUED

• • • Even if you don't have symptoms, you're still able to transmit the virus to others. Once the virus enters your body, your own immune system also comes under attack. The virus multiplies in your lymph nodes and slowly begins to destroy your helper T cells (CD4 lymphocytes) — the white blood cells that coordinate your entire immune system.

SIGNS AND SYMPTOMS CONTINUED

• • • • • • You may remain symptom-free for eight or nine years or more. But as the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic symptoms such as: Swollen lymph nodes — often one of the first signs of HIV infection Diarrhea Weight loss Fever Cough and shortness of breath

• • • •

SIGNS AND SYMPTOMS CONTINUED

During the last phase of HIV — which occurs approximately 10 or more years after the initial infection — more serious symptoms may begin to appear, and the infection may then meet the official definition of AIDS.

In 1993, the Centers for Disease Control and Prevention (CDC) redefined AIDS to mean the presence of HIV infection as shown by a positive HIV-antibody test plus at least one of the following: The development of an opportunistic infection — an infection that occurs when your immune system is impaired — such as Pneumocystis carinii pneumonia (PCP) A CD4 lymphocyte (T-cell) count of 200 or less — a normal count ranges from 800 to 1,200

• • • • • • • • •

SIGNS AND SYMPTOMS CONTINUED

By the time AIDS develops, your immune system has been severely damaged, making you susceptible to opportunistic infections. The signs and symptoms of some of these infections may include: Soaking night sweats Shaking chills or fever higher than 100 F (38 C) for several weeks Dry cough and shortness of breath Chronic diarrhea Persistent white spots or unusual lesions on your tongue or in your mouth Headaches Blurred and distorted vision Weight loss

LESIONS THAT ARE FOUND ON THE BODY

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TREATMENT

Over the past 10 years, several drugs have become available to fight both the HIV infection and its associated infections and cancers. These drugs are called highly active antiretroviral therapy (HAART) and have substantially reduced HIV-related complications and deaths. However, there is no cure for HIV/AIDS. Therapy is initiated and individualized under the supervision of an expert physician in the care of HIV infected patients. A combination of at least three drugs is recommended to suppress the virus from replicating and boost the immune system.

• • • •

TESTING

A Western blot assay – One of the oldest but most accurate confirmatory antibody tests. It is complex to administer and may produce indeterminate results if a person has a transitory infection with another virus.

An indirect immunofluorescence assay – Like the Western blot, but it uses a microscope to detect HIV antibodies.

A line immunoassay - Commonly used in Europe. Reduces the chance of sample contamination and is as accurate as the Western Blot.

A second ELISA – In resource-poor settings with relatively high prevalence, a second ELISA test may be used to confirm a diagnosis. The second test will usually be a different commercial brand and will use a different method of detection to the first.

REMEMBER ONE THING:

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THE ONLY WAY TO 100% AVOID GETTING AN STD IS TO PRACTICE ABSTINENCE!