December 3 2012 STIs The rates of STIs are reported being higher in women than men younger age groups like 15 19 are most likely More women get tested for STIs so the rates seem higher Are STIs Sexist Urination and ejaculation in men make it easier for infections to be cleared out The vagina has more surface area and is a dark and closed area great climate for growing infections Women are 2x more likely infected Men can see infections on their penis where women often cannot see any problems on them Women may misdiagnose the disease as a yeast infection where men would go to the doctor Gonorrhea and Chlamydia can lead of Pelvic inflammatory disease and then infertility more likely in women Other fluids breast milk spreads HIV HPV can lead to cervical cancer in women Pregnancy STIs can be passed on to the newborn during utero or childbirth Bacterial STIs Gonorrhea Chlamydia Syphilis Viral STIs starts with an H HPV Hepatitis HIV Herpes Reportable STIs Testing Bacterial infections are easier to treat and cure Viral infections are only treatable which is why we try to prevent them with education and vaccines What is a reportable STI Medical providers have to report the cases to the state health department The state health department can choose to report to the CDC Includes Chlamydia Gonorrhea Syphilis and HIV Our statistics are better for these infections Pelvic and physical exam Look for sign sof infection ex Warts rashes and discharge Blood sample Urine sample Fluid or tissue sample A swab collects a sample that can be looked at under a microscope or sent to a lab for testing Access to Testing Partner Therapy Yearly physical Doesn t find everything Gynecological annual exam May only test for Gonorrhea and Chlamydia Are people under age 18 able to give consent for STI testing In MD you do not need permission You can request to be tested Practice of treating the sexual partners of people diagnosed with chlamydia or gonorrhea by giving a prescription or medication to the diagnosed patient for their sexual partner s Has been shown to increase treatment and decrease re infection Controversial because you aren t supposed to give your prescription medication to anyone How do we balance encouraging people to use safer sex practices to prevent the spread of STIs while combatting he stigma of STIs Talking to a partner about STIs Sending an anonymous e card letting them know that they got an STI from you Talk with your partner about using condoms and getting tested before hand Get tested together How often should someone get tested Every time you have a new partner Once a year With your new partner before starting a sexual relationship with him or her If you have STI symptoms Window Periods Transmission Time between infection and detection incubation period Why does this matter with STIs Someone could be infected and not know it and infect the STI on to other people Having intimate sexual contact with someone who already has the infection o Skin to skin HPV herpes o Oral vaginal anal sex all o Body fluids semen vaginal fluids blood o Sharing needles HIV hepatitis and syphilis o Pregnant mothers to fetus during delivery o Infestations can be transmitted through sharing towels sheets etc Correct consistent use of barriers on body parts or toys for any kind of vaginal anal or oral sex Being mutually sexually exclusive Regular testing for STIs STI Prevention STIs To know for exam Transmission Symptoms Effects Testing Treatment Chlamydia Gonorrhea Syphilis HPV Herpes Chlamydia Gonorrhea Syphilis Transmission Vaginal anal oral sex Symptoms Discharge bleeding from the vagina burning while urinating need to urinate often pain in abdomen Effects Can lead to other infections and infertility PID pass during childbirth Testing Seab collects tissue or fluid sample from the infected area which is sent to a lab for testing or a urine sample Treatment Antibiotics Transmission Vaginal anal oral sex Symptoms Usually asymptomatic painful urination abnormal vaginal bleeding pain during sex Effects Can lead to other infections and infertility Pelvic inflammatory disease PID Testing swab or urine sample Treatment easily cured with antibiotics but any damage to the body cannot be repaired Stage 1 Stage 2 Herpes Transmission Vaginal anal oral sex sometimes skin to skin Testing blood sample fluid from the sore can be collected Treatment Easily cured with antibiotics but any damage done to the body cannot be repaired A painless sore called a chancre may be located on the genitals lips anus or other area of direct contact The chancre will last 1 5 weeks and heal without treatment The person can easily pass it on to sec partners Skin rashes lasting 2 6 weeks average of 4 weeks on the palms of the hands bottoms of the feet or any part of the body Other symptoms include fever swollen lymph glands headache hair loss and muscle ache Symptoms will go away without treatment The person may be able to pass it on to sex partners Syphilis Late Stage Paralysis Insanity Blindness Damage to knee joints Personality changes Impotency Aneurysm ballooning of a blood vessel Tumor on the skin or internal organs You have been in a long term monogamous relationship with someone for 2 years and they tell you that they just found out they have herpes Why The person could have had it previously and it has been in dormant stage There are 2 types of HSV HSV 1 and HSV 2 HSV 2 causes most genital infections HSV 1 causes oral infections cold sores and some genital infections 70 of Americans have cold cores Ask for type specific testing Episodes of numerous painful lesions On the penis vagina anus buttocks thighs mouth or finger Last up to 4 21 days Other symptoms include headache fever muscle aches swollen lymph nodes and difficult urination Symptoms may or may not come back Herpes Transmission oral anal vaginal sex skin to skin Many people with herpes do not have any symptoms or do not recognize that they have symptoms Most people with herpes can pass the virus to sex partners even when they do not have symptoms Prodrome period The time before the breakout Contagious during this time If you have a lesions go get a blood test Testing Treatment Can be detected by Type specific testing culturing the lesion blood test Herpes cannot be cured but symptoms can be treated with medicines called antivirals You can still spread herpes even if you are taking antiviral medicine Herpes It s not that big of a deal Not many long term circumstances not painful