Chlamydia is the most prevalent bacterial STD in the United States today. It is difticult to diagnose because it often coexists with other diseases.

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1 Leader Resource 40 SESSION TWENTY-THREE STD INFORMATION Types of Sexually Transmitted Diseases 1. Chlamydia Chlamydia is the most prevalent bacterial STD in the United States today. It is difticult to diagnose because it often coexists with other diseases. Symptoms: Fifty percent of infected men show no symptoms; those who do may experience a painful or burning sensation when they urinate and/or a watery or milky discharge from the urethra. Seventy-five percent of infected women show no symptoms; those who show symptoms may have abnormal vaginal discharge, irregular vaginal bleeding, and/or pelvic pain, accompanied by nausea and fever. In women, chlamydia can also cause painful urination, blood in the urine, or a frequent urge to urinate. Eyes of men and women may become infected, producing redness, itching, and irritation. Infection of eyes does not require sexual contact. Damage: Untreated, chlamydia may cause severe complications, especially for women. It can infect a womans Fallopian tubes and cause lasting pain. It can also lead to scarring of the tubes, which can result in sterility. In rare cases, chlamydia can also cause sterility in men. :2 I ;J... ''01,0-0'.., 0:J t fj >- ;J (]< U.\J «: n..j 1... l5 \ Diagnosis and treatment: There are several ways to test for chlamydia, including a urine test or the use of a cotton swab to collect a small amount of fluid from a mans penis or a woman's cervix. A Pap smear does not test for chlamydia, and the tests for chlamydia and gonorrhea are different. A chlamydial infection can be effectively eliminated with appropriate antibiotics. Penicillin will not eliminate the infection. 2. Genital Herpes Genital herpes is caused by one of two viruses-herpes Simplex 1 (HSV-l) or herpes Simplex 2 (HSV-2). The virus sets up a lifelong presence in the body, called latency The virus can travel the nerve pathways in a particular part of the body and hide away in the nerve roots for long periods of time. Symptoms: When a person is first infected with HSY, the bodys immune response is not well developed, and therefore, signs and symptoms are often pronounced. Symptoms vary from person to person and from episode to episode. There may be breaks in the skin, small sores, or blisterlike lesions on or around genitals or in anus. In the first episode, symptoms usually appear within two weeks and can take from two to four weeks to heal completely. Some people also experience!1ulike symptoms. Others have no symptoms..'.".'.' Damage: Genital herpes is a common and usually mild infection. Approximately one out of four women and one out of five men in the United States has herpes. It is estimated that 80 percent of people with herpes don't know that they have it., Outbreaks of genital herpes can be painful and upsetting but lead to no real physical Session Twenty-three STO FACTS 269

2 damage. Herpes can be transmitted to a baby during childbirth, but this is a rare occurrence. An infant who contracts herpes can become very ill; therefore, if a woman has active herpes at the time of delivery, a cesarean section is usually performed. Diagnosis and treatment: Microscopic examination of blister tissue identifies herpes infection. If no visible symptoms are present, a blood test can be used. Genital herpes f is caused by a virus and currently has no cure. There are medications that can keep the virus in check. Currently three prescription drugs, Acyclovir, Valacyclovir and Famciclovir, have been approved for treatment of genital herpes. 3. Gonorrhea Gonorrhea is an infectious disease caused by the bacterium Neisseria gonorrhea and transmitted through sexual activity, including genital, ora], and ana] sex. Although 80 percent of infected females show no symptoms, some experience a puslike vaginal discharge, vaginal soreness, painful urination, and lower abdominal pain two to ten days after contact with an infected person. Damage: Possibility of sterility; Pelvic Inf1ammatory Disease (PID) in women, which can recur even after the gonorrhea and the original PID have been cured. Symptoms: Males often experience a thick, grayish-yellow, puslike discharge from the penis and a burning sensation during urination. Symptoms appear two to ten days after contact with an infected person. Ten percent of infected males show no symptoms. Diagnosis and treatment: The patient should inform the physician of all points of sexual contact (genitals, mouth, or anus). In males, the medical practitioner examines genitals, mouth, or anus for signs of irritation, soreness, or discharge and takes a bacterial culture from the infected areas. For females, the medical practitioner examines genitals, mouth and anus, lymph glands, and cervical discharges and takes a bacterial culture. Penicillin or similar antibiotics can kill the bacteria within one to two weeks. 4. Genital Warts f I >, III U0(...Il,J 01 \:J 1l O/> 0.0.-< t"- 0> ;:J Ultl " ::c 0> 0>,.J >-..: \J EQ I There are more than 100 different types of human papillomavirus (HPV) Some types of HPV cause warts on the hands or feet, while others cause warts on the genitals. HPV is the most common STD among young people in the United States. Symptoms: Genital warts are bumps or growths that appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. They can be raised or l1at, small or large, single or multiple. Sometimes they grow together in little clusters resembling caulillower. Other times HPV causes microscopic warts that cannot be seen without special instruments, or there can be no warts at all. Damage: Some types of HPV have been linked to cervical cancer, but these are usually not the types that cause genital warts. A woman with genital warts should get annual Pap smears. Genital warts can sometimes cause problems during pregnancy and delivery as hormone changes can cause the warts to grow in size and number during pregnancy and make delivery more dillicult. In rare cases, babies exposed to HPV during birth may develop warts in the throat. A pregnant woman with genital warts should inform her physician. C 270 UNIT NINE Sexually Transmitted Diseases (STDs)

3 f Diagnosis and treatment: Individuals can check themselves and their partners for warts, but some can be very hard to see. If a person suspects he or she is infected with genital warts, he or she should see a health practitioner, who can use a variety of ( methods to check more closely There is no cure for the virus, but there are a variety of treatments aimed at removing visible warts and ridding the patient of annoying symptoms. Most treatments involve using a cream or solution on the affected areas. Some must be applied by a health-care provider, while others can be applied by the patient. 5. Hepatitis B Hepatitis B is a virus that is a hundred times more infectious than HIV It is contracted through contact with infected blood or body fluids (semen, vaginal secretions, and saliva). Symptoms: Many people with hepatitis B have no symptoms, but others experience a general feeling of being ill, fatigue, nausea, fever, dark urine, or jaundice (yel1owing of the skin and eyes). Even people with no symptoms may be carriers who can pass the disease to others. Only a blood test can determine whether someone is infected. Damage: In addition to the symptoms described above, some people infected with hepatitis B develop chronic liver disease, including cirrhosis of the liver or liver cancer. Diagnosis and treatment: Diagnosis is through a blood test. There is no cure for hepatitis B, but there is a vaccine for prevention. The Centers for Disease Control and Prevention (CD C) recommends vaccination to protect sexual1y active adolescents and to control the spread of the disease in the United States. 1l.z :J U al ::E J: :r U :J.D 0',... :>- :J 0'.5' Q"tI t- 9I <C 0' 0 lj..j!(i I, 6. Hepatitis C About 4 million people in the United States are infected with hepatitis C, which kills about 10,000 in the United States annually and is the leading reason for liver transplants in this country It is transmitted through blood contact. The vast majority of people in the United States with hepatitis C have been infected by contaminated intravenous needles used for drugs. Contaminated needles used for body piercing and blood transfusions before 1992 also account for a number of cases. Hepatitis C can be transmitted through sexual contact when smal1 amounts of blood pass from one person to another. Symptoms: Unlike hepatitis A and B, which often produce symptoms such as fatigue, fever, or jaundice, hepatitis C usually produces no symptoms. People often have the infection for years without knowing it and find out only when they suffer liver damage. In contrast to those with hepatitis A and B, few people recover from hepatitis C and become immune. Eighty-five percent of hepatitis C infections persist in the body for life. Damage: Hepatitis C causes liver damage, including cirrhosis, a fatal disease. Diagnosis and treatment: Diagnosis is through a blood test. There is no cure, but there are treatments that attempt to slow the diseases attack on the liver. Interferon and ribavarin are two drugs that can be used to treat hepatitis C. Interferon can be taken alone or in combination with ribavarin. Combination therapy is currently the ) most effective treatment. Session Twenty-three STD FACTS 271

4 7. HIV Infection and AIDS HIV (human immunodeficiency virus) gradually destroys a person's immunity (ability to defend the body) against disease. People with HIV infection become susceptible are working. to a variety People of with illnesses HIV who not develop usually found the most in people serious whose form of immune the disease, systems Acquired Immune Deficiency Syndrome (AIDS), usually die from opportunistic diseases that occur when the immune system is damaged. HIV is present in an infected person's blood and bodily fluids (such as semen or vaginal secretions). It is transmitted by an exchange of these fluids either through sexual contact, sharing intravenous needles, or blood transfusions prior to ] 985. HIV is not transmitted through casual contact with infected people.. Symptoms: Early signs are similar to those of a cold or the flu: night sweats or swollen lymph glands. Individuals then enter a symptom-free phase that may be followed by unexplained weight loss, yeast infections, diarrhea, persistent cough, fatigue, and loss of appetite. Damage: People with HIV may live for 10 to IS years in relatively good health and without serious symptoms. Eventually, however, HIV-infected individuals may develop one or more life-threatening diseases, usually forms of pneumonia or cancer. Without effective treatment-and researchers are still searching for effective treatments-the long-term outcome is gradual debilitation and, ultimately, death. Treatment: There is no cure yet for HIV infection. Maintaining a healthy lifestyle helps delay the onset of serious diseases. Short-term symptoms can be alleviated with medical treatment. New drugs are being developed and tested at this time. Some people with AIDS are treated with a combination of drugs that do not cure the disease but can prolong life and alleviate symptoms. People who are infected with the virus but do not yet have AIDS are also being treated with ome of these drugs. For many people, early treatment delays the onset of more serious symptoms. The treatment regimen is expensive and requires a diligent commitment to taking medications on time. Drugs such as AZT have been used successfully to prevent the transmission of HIV from pregnant mothers to infants. Look for reports in the news media for the latest developments in this area of medical research. >- III U <: :r: I'" lc U :r: :J.n 01 "- "-.!l Q\... Q ij -< " " I Q\ '" 1:) E'J 13 Q\,..l > Monilia Monilia is a yeast infection. It is not an STD because it occurs naturally, although it can be passed between sexual partners. In women, it is caused by an imbalance of bacterial organisms that grow naturally in the vagina. Pregnancy and taking antibiotics are two conditions that can cause this imblance. Symptoms: Monilia causes vaginal dryness, itching and burning, and may produce a whitish, lumpy (cottage cheeselike) discharge that smells like yeast. Male sex partners who become infected may experience inflammation of the penis. Treatment: Local application of a therapeutic cream. 9. Pubic Lice (Crabs) About the size of pin heads, pubic lice Iive and hreedin puhic hair. They are spread primarily through bodily contact but can also he spread through heckling, clothing, toilet seats, or towels. 272 UNIT NINE SexlIa/l1' Transmitted Diseases (STDs)

5 Symptoms: Intense itching. Treatment: Wash the affected area with a topically applied lotion that kills adult lice and their eggs. Launder any previously infected clothing or linen. I 10. Scabies Ij Scabies is a highly contagious infestation of tiny mites that burrow under the skin. Symptoms: Scabies causes intense itching and redness of the skin. Areas most commonly affected include the wrists, the space between the fingers, the buttocks, and the underside of the breasts. Treatment: A topically applied lotion, cream, or shampoo containing an insecticide usually kills the mites in one application. 11. Syphilis Syphilis is a three-stage STD caused by a bacterium. Symptoms: A painless chancre (sore or ulcer) on or in genitals, anus, mouth, or throat appears 10 days to 3 weeks after infection. The chancre will heal, but if the disease is left untreated, a skin rash will develop, often on the hands and soles of the feet, about six weeks after the chancre. This is the second stage of the disease. Damage: Loss of hair in patches. If left untreated after the rash appears, syphilis can eventually cause heart failure, blindness, and damage to the brain and spinal cord. Diagnosis and treatment: A medical practitioner examines chancre site, eyes, throat, heart, lungs, and abdomen; performs a microscopic examination of chancre pus and a.. blood test. Penicillin or similar antibiotic usually will kill the bacteria within one to two weeks, but some strains of this bacterium are resistant to penicillin. 12. Trichomoniasis 01 :2 :t: ::J U U.D Q' :J >- III.( S :J n1] Q " (,i) t- Q'..\'l,..J 0 if> 0. cr $ In women, a vaginal infection caused by a single-cell organism present in the bladder of some individuals. It can be transmitted by wet clothing, washcloths, or towels. Symptoms: Infected females experience a burning sensation during urination, an odorous, foamy discharge, and a reddening and swelling of the vaginal opening. Infected males may produce a discharge but usually show no symptoms. An infected male must be treated whether or not he shows symptoms because he can pass the infection to his partner. Treatment: Oral medication. Session Twenty-three STO FACTS 273

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