Sexually Transmitted Disease SUSIE KRYZSKO DOCTORAL QUALITY IMPROVEMENT

Sexually Transmitted Disease SUSIE KRYZSKO DOCTORAL QUALITY IMPROVEMENT PROJECT

Purpose and objectives Provide education on the most prevalent sexually transmitted diseases (STDs) Measure increase in knowledge with pre and post tests with STDKQ Students will learn cause, symptoms , diagnosis and treatment for most prevalent STDs How to prevent infection Learn where to go for local testing and treatment

What is an STD/STI? A viral or bacterial infection passed from one person to another by close skin contact, genital touching, vaginal, oral or anal sex. Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Why are you telling me this? Young people age 15 -24 account for more then half of newly diagnosed STDs per year (CDC, 2017).

INCIDENCE In 2017 nearly 2. 3 million new cases of chlamydia, gonorrhea, and syphilis were diagnosed in the US. CDC has asked for STDs to be declared a public health crisis. Chlamydia –most prevalent reportable disease ever Gonorrhea 67% increase between 2013 and 2017 Syphilis 76% increase between 2013 and 2017 United States has the highest rates in the industrialized world. Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Why should I care? ?

Infertility Undiagnosed STDs cause 24, 000 women to become infertile each year Research ongoing as to affect on male fertility

Long Term Health Damage Cancer: cervical, throat and rectal Pelvic pain Pregnancy complications Eye inflammation Arthritis Pelvic inflammatory disease Infertility Heart disease Birth defects; intellectual and mental disabilities Death. National Institutes of Allergies ands Infectious Diseases, (2018) Sexually transmitted diseases. https: //www. niaid. nih. gov/diseases-conditions/sexually-transmitted-diseases

SILENT INFECTION Some STDs cause no symptoms at all No symptoms = delayed treatment and leads to virus spreading to others for years Delay of treatment increases risk of complications Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

What’s the Scoop? ?

Viral STDs

Herpes Virus Caused by herpes simplex virus; type 1 Cold sores and type 2 genital herpes. May be infected and not know it. Can be spread anytime even without an outbreak or visible sore. Condoms do not protect against this if lesion is not covered. Can be passed to baby from mom to baby during pregnancy or delivery and cause death of baby. Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Herpes Virus Symptoms Initial infection: Small, painful blisters in genital area, anus, buttocks, lip and mouth area Painful urination, flu like symptoms Latent phase: Virus is dormant in bundle of nerves at base of spine wont have any symptoms Recurrent Outbreaks: Painful blisters return Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Herpes Treatment No cure, lifelong. Antiviral medications now available Medication can reduce frequency of outbreaks Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

HPV Human Papilloma Virus Cancer causing STD. Cause of cervical cancer More than 100 different strains Genital warts Very common CDC estimates that more than 90% of men and 80%, of women will be infected with at least one type of HPV at some point in their lives. Around onehalf of these infections are with a high-risk HPV type Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

HPV Human Papilloma Virus Spread by skin to skin contact. Do not need to have sex to become infected Warts are not necessary for transmission Not the same as HIV No cure Vaccine can protect Gardasil-9 but only covers 9 of the >100 strains. Protects against the main strains that cause cancer. Condoms do not protect from this. Showering after sex will not prevent infection Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

HIV: Human Immunodeficiency Virus This is the virus that causes AIDS-Acquired Immune Deficiency Syndrome Not the same as Herpes virus or the HPV virus No Vaccine for this virus and there is no cure at this time Being infected with other STDs increases risk of contracting HIV Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

HIV Symptoms of HIV vary, depending on the phase of infection. Majority of people infected develop symptoms of a primary (acute) infection within a month or two after the virus enters the body. NO visible sores Symptoms can include: Fever, fatigue, rash, headache, muscle aches, swollen lymph glands, ulcers Newly infected people are immediately able to pass on the disease Without seeking treatment, HIV can develop into AIDS. Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

HIV Diagnosis Diagnoses with a blood test This test does not determine how sick you will become CDC recommends everyone be tested at least once as part of routine health care Testing more often if at increased risk Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

HIV Prevention Abstinence Natural (Lambskin) condoms do not protect against contracting HIV Truvada daily oral antiretroviral preexposure prophylaxis Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

HIV Treatment An expensive cocktail of antiviral medications Treatment is necessary for life Without seeking treatment, HIV can develop into AIDS.

Hepatitis B Virus All school children are immunized against this virus unless they opted out. Hepatitis means liver disease and can cause liver failure and death Diagnosed with a blood test Spread by body fluids. Transmission higher with anal sex Cannot determine by how you feel if you have hepatitis. Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Bacterial STDs

GONORRHEA (The Clap) Caused by a bacteria Very common with 820, 000 new infections per year Major cause of infertility Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Gonorrhea Symptoms Most women have no symptoms or mistake symptoms for a urinary tract infection or UTI. Men more likely to have symptoms of painful urination and white, yellow, or green discharge from penis usually within 1 -14 days of infection. Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Gonorrhea Diagnosis Urine testing Swab of secretions from vagina or penis Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Gonorrhea Prevention Abstinence Long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected There is no vaccine Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Gonorrhea Treatment Dual therapy antibiotics Resistant strains emerging Can be re-infected multiple times Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Chlamydia Bacterial Infection (very common) 2. 86 million infections per year in the US. Spread by oral, vaginal or anal sex Not the same as urinary tract infections. Estimated 1 in 20 sexually active women age 14 -24 are infected (CDC, 2017). Major cause of infertility Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Chlamydia Symptoms Silent STD: Up to 70% of women and 90% of men have no symptoms Those that do have symptoms they include: Urinary pain and frequency Abdominal and pelvic pain Males can have a mucus discharge from their penis Can’t tell if you are infected based on vaginal odor Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Chlamydia Diagnosis Can be diagnosed with urine test or vaginal swab Centers for Disease Control and Prevention (2016). Sexually transmitted disease surveillance 2015. Atlanta: U. S. Department of Health and Human Services

Chlamydia Prevention Abstain from oral, vaginal and anal sex There is no vaccine Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Chlamydia Treatment Can be cured with antibiotics Can be re-infected multiple times Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Syphilis Bacterial infection spread by close personal or sexual contact First symptom: painless sore that may go unnoticed Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Syphilis Symptoms Syphilis is divided into stages (primary, secondary, latent, and tertiary) Secondary syphilis include skin rash on palms of hands and soles of feet, swollen lymph nodes, and fever. Symptoms can be mild, and they might not be noticed Latent stage: No symptoms Tertiary syphilis is associated with severe medical problems. A doctor can usually diagnose tertiary syphilis with the help of multiple tests. It can affect the heart, brain, and other organs of the body. This would occur 10– 30 years after your infection began Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Syphilis Diagnosis Blood test used to diagnose Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Syphilis Treatment Can be cured with antibiotics. Treatment will not repair any damage done to heart, brain or other organs. Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Syphilis Prevention Abstinence Condoms do not provide complete protection Can become reinfected multiple times Can cause death of baby if mother infected during pregnancy Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Prevention Abstinence Mutually monogamous life-long relationship with a partner that is not infected. ie: Marriage Condoms will not protect 100% against most STDs Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services

Questions?

What if I think I need testing? Community Health Clinic Mary Lanning Health Care 715 North Hastings Street 402 -461 --5265 Wellspring Pregnancy and Health center: 223 E 14 th street 402 -463 -7785

Want more information? Ask me: Susie, call or text 402 -469 -5577. Will remain confidential CDC. gov has lots of information Mayoclinic. org

References Centers for Disease Control and Prevention (2017). Sexually transmitted disease surveillance 2016. Atlanta: U. S. Department of Health and Human Services National Institutes of Allergies and Infectious Diseases, (2018) Sexually transmitted diseases. https: //www. niaid. nih. gov/diseases-conditions/sexually-transmitteddiseases The Nemours Foundation/Kids. Health (2017) Kids Health in the Classroom: STDs. Retrieved from https: //classroom. kidshealth. org/classroom/9 to 12/problems/conditions/stds. pdf