SEXUALLY TRANSMITTED INFECTIONS AT ILLINOIS STATE UNIVERSITY 2007

SEXUALLY TRANSMITTED INFECTIONS AT ILLINOIS STATE UNIVERSITY © 2007 John B. Pryor, Ph. D. Department of Psychology

Top 6 STIs at ISU: July 1, 2005 - June 30, 2006 1. Genital Warts 2. Genital Herpes 3. Chlamydia 4. Scabies 5. Trichomoniasis 6. Gonorrhea

Human Papilloma Virus (HPV) • • Virus that causes genital warts - 60 known types estimated 20 million Americans infected In more than 90 percent of cases, the infections are harmless and go away without treatment. Related to the occurrence of pre-cancerous cells on the cervix. Persistent HPV infection is found in most cases of cervical cancer. A new vaccine, Gardasil, protects against four HPV types, which together cause 70% of cervical cancers and 90% of genital warts. The FDA recently licensed this vaccine for use in girls/women, ages 9 -26 years. Symptomatically treated by chemical agents (podophyllin), cryotherapy, or laser therapy

Genital warts - Initial Visits to Physicians’ Offices in the U. S. 1965 -2003 Source: CDC

Human Papilloma Virus warts Some carriers are asymptomatic

Human Papilloma Virus transmission through physical contact wart

Human Papilloma Virus Most common sites in men: penis, urethra, bladder, & anus warts

Human Papilloma Virus Most common sites in women: vulva, vagina, cervix, & anus

HPV - can be transmitted via oral sex

Genital Herpes Caused by a virus Two types: • 1) herpes simplex virus type 1( HSV-1) typically around mouth (cold sores) • 2) herpes simplex virus type 2 (HSV-2) - typically found in the genital region. • However, either can infect either place. •

Genital Herpes - incidence • • • HSV-1 antibodies are present in 95% of Americans. 31 million Americans have a genital herpes infection (about 1 in 6 people). Most people who are infected never recognize their symptoms.

Genital Herpes • • Transmission - through physical contact with infected area Transmission is possible even when someone is asymptomatic No cure Symptomatic treatment with acyclovir

Genital Herpes - Initial visit to physicians’ offices - 1965 -2003 Source: CDC

Genital Herpes

leision Genital Herpes

Genital Herpes leisions

Genital Herpes

scars Genital Herpes

Genital Herpes • • • Some myths about HSV-2: 1) Genital herpes is often transmitted through casual contact. 2) Women who have recurrent HSV-2 should not bear children because of dangers to the developing fetus.

Psychosocial Aspects of Herpes Survey of 3100 People with Herpes 84% -reported episodes of depression 70% -indicated feelings of isolation 40% -diminished work performance as the result of lowered self-esteem 35% -decreased sexual desire 25% -self-destructive thoughts 18% -the breakup of long term relationships

Chlamydia is the most frequently reported infectious disease in the United States. An estimated 800, 000 new cases occur annually.

Chlamydia -caused by a bacteria Up to 75 percent of women and 50 percent of men with uncomplicated chlamydia infection have no symptoms or signs of infection. If symptoms do occur, they typically appear within one week to a month after exposure to an infected person.

Chlamydia Symptoms - Men * pain or burning during urination * frequent urination * pain and swelling in the testicles * low-grade fever * burning and itching around the opening of the penis * watery or milky discharge from the penis

Chlamydia Symptoms - Women * irregular vaginal bleeding * burning with urination * itching and burning in the genital area * vaginal discharge * lower abdominal pain often accompanied by nausea and fever

Chlamydia - possible complications for women scared/blocked fallopian tubes pelvic abscess adhesions

Treatment of Chlamydia Curable with azithromycin or doxycycline; does not respond to penicillin. Poorly treated or undiagnosed cases may lead to: urethral damage epididymitis (infection of the epididymis) Reiter’s syndrome (inflammation throughout body; arthritis) proctitis in men who had anal intercourse Pelvic Inflammatory Disease (PID) Problems with pregnancy and risks for newborn infants of infected mothers

Chlamydia - possible complications for women Up to 40% of women with untreated chlamydia will develop PID. Undiagnosed PID caused by chlamydia is common. Of those with PID, 20% will become infertile; 18% will experience debilitating, chronic pelvic pain; and 9% will have a life-threatening tubal pregnancy. Tubal pregnancy is the leading cause of first-trimester, pregnancy-related deaths in American women.

Scabies is caused by tiny mites which are at most half a millimeter in length and are difficult to see.

Scabies

Scabies usually infest areas between the fingers and toes, wrists, elbows, armpits, buttocks, breasts, genitals, and other areas of contact.

Scabies Small red bumps or tiny lines (burrows) may appear.

Scabies CDC Recommended Regimen • Permethrin cream (5%) applied to all areas of the body from the neck down and washed off after 8 -14 hours Transmission • Scabies among adults may be sexually transmitted, although scabies among children is usually not sexually transmitted.

Trichomoniasis • • • affects 5 million Americans yearly caused by a single-celled protozoan parasite symptoms in women include a heavy, yellowgreen or gray vaginal discharge, discomfort during intercourse, vaginal odor, and painful urination

Trichomoniasis • • • symptoms also may include irritation and itching of the female genital area symptoms in men include a thin, whitish discharge from the penis and painful or difficult urination most men do not experience any symptoms, women also may be asymptomatic

Trichomoniasis • • • Sexual transmission is possible even when no symptoms are present. Metronidazole is the drug used to treat trichomoniasis. It is administered in a single dose.

Trichomoniasis Trichomoniasis in pregnant women may cause premature rupture of the membranes and pre-term delivery. The genital inflammation caused by trichomoniasis also might increase a woman's risk of acquiring HIV infection if she is exposed to the virus. Trichomoniasis in a woman who is also infected with HIV can increase the chances of transmitting HIV infection to a sex partner.

Gonorrhea is caused by the gonococcus, a bacterium that grows and multiplies quickly in moist, warm areas of the body such as the cervix, urethra, mouth, or rectum. .

GONORRHEA incidence & cost Nearly 700, 000 cases of gonorrhea are reported annually in the United States. Another 750, 000 unreported cases, mostly among teenagers and young adults, are believed to occur each year. The annual cost of gonorrhea and its complications is estimated at close to $1 billion.

Gonorrhea - transmission genital-to-genital contact • genital-to-oral contact • genital-to-anal contact • spread fromvagina to rectum •

Gonorrhea - Symptoms • • early symptoms often are mild most women who are infected have no symptoms if symptoms of gonorrhea develop, they usually appear within 2 to 10 days after sexual contact with an infected partner some may be infected for several months without showing symptoms.

Gonorrhea - Symptoms for Women • • • a painful or burning sensation when urinating an abnormal vaginal discharge more advanced symptoms, which indicate progression to PID, include abdominal pain, bleeding between menstrual periods, vomiting, or fever

Gonorrhea - Symptoms for Men • • • a discharge from the penis a burning sensation during urination symptoms of rectal infection include discharge, anal itching, and sometimes painful bowel movements.

Gonorrhea discharge

Gonorrhea Discharge

Both Gonorrhea & Chlamydia can cause future fertility problems in women Chlamydia Gonorrhea Possible scarring or blockage of fallopian tubes