Sexually Transmitted
Infections/Diseases
BACTERIA
bacterial infections can be treated
with antibiotics
chlamydia -------- Chlamydia trachomatis
gonorrhea --------
Neisseria gonorrhoeae
syphilis ---------- Treponema pallidum
PID = Pelvic Inflammatory Disease (multiple
organisms cause this)
Q. What organism causes a Chlamydia
infection?
the bacterium Chlamydia trachomatis
Q. How common are Chlamydia infections?
the most common reportable bacterial STI
in the US
1,708.569 cases reported in 2017
2007-2012, chlamydia test positivity
1.7% = M and F aged 14-39
4.7% = F aged 13-24
Q. How does someone get Chlamydia?
from a partner during sexual activity
(vaginal, anal or oral sex)
from a mother during birth
from a contaminated finger or object touching
the eye
Q. What can happen to a person with a
Chlamydia infection?
women:
no symptoms (very
common)
vaginal discharge
burning sensation when
urinating
cervicitis
urethritis
pelvic inflammatory
disease
infertility
pelvic pain
perihepatitis
men:
no symptoms (very
common)
penile discharge
burning sensation when
urinating
urethritis
epididymitis
men and women:
conjunctivitis
(trachoma)
oropharyngeal infection
proctitis/proctocolitis
reactive arthritis
Chlamydia trachomatis
causes trachoma
world’s leading cause
of
preventable blindness
most common cause of
eye infections in newborns
Q. What can happen to babies born to
infected moms?
conjunctivitis (trachoma)
pneumonia
urogenital infection
baby born too early
Q. How can a person be tested for
Chlamydia?
NAATs (Nucleic Acid Amplification Tests)
(1) M and F urine
samples
(2) endocervical,
vaginal, and M urethral samples (collected by the clinician)
(3) vaginal swabs
(collected by the patient)
cultures
Q. How is a Chlamydia infection treated?
antibiotics
Q. What organism causes a Gonorrhea
infection?
the bacterium Neisseria gonorrhoeae
Q. How common are Gonorrhea infections?
555,608 cases reported in 2017
171.9 cases / 100,000 population in 2017
Q. How does someone get Gonorrhea?
from a partner during sexual activity
(vaginal, anal or oral sex)
from a mother during birth
from a contaminated finger or object
touching the eye
Q. What can happen to a person with a
Gonorrhea infection?
no symptoms (at least 50% of women,
small percentage of men)
penile or vaginal discharge
burning sensation during urination
throat symptoms
rectal symptoms
periurethral fistula or abscess
conjunctivitis
disseminated gonococcal infection
women only: bleeding between periods
pelvic
inflammatory disease
tubal
infertility
ectopic
pregnancy
Q. What can happen to babies born to
infected moms?
conjunctivitis (can be prevented
with eye drops for newborns)
infected pharynx
infected respiratory tract
infected anal canal
Q. How can a person be tested for
Gonorrhea?
NAATs (Nucleic Acid Amplification Tests)
gram stains
cultures (can look for antibiotic sensitivity / resistance)
Q. How is a Gonorrhea infection treated?
antibiotics
Q. What organism causes Syphilis?
the bacterium Treponema pallidum
Q. How common is Syphilis?
101,567 reported cases (of all stages)
in 2017
Q. How does someone get Syphilis?
from a partner during sexual activity
(contact with sore or rash)
from a mother through the placenta
from a contaminated finger or object
touching the eye
Q. What can happen to a person with
syphilis?
Primary Syphilis
chancre appears about 3
weeks (range 10 to 90 days) after infection
chancre progresses from
papule to ulcer
typically painless
chancres are highly
infectious
heal spontaneously
within 1 to 6 weeks
Q. What can happen to a person with
syphilis?
Secondary Syphilis
T. pallidum travels through the blood to
everywhere
4 to 8 weeks after the
onset of the primary chancre
may be the first thing
noticed
if the chancre was
hidden in the vagina or anus
Q. What can happen to a person with
syphilis?
Secondary Syphilis
rash 75-100%
lymphadenopathy 50-86%
malaise, fever (often)
mucous patches 6-30%
condylomata lata 10-20%
alopecia (hair loss) 5%
sometimes organs are
affected:
liver, kidney, lungs, gastrointestinal tract,
and spleen
neurosyphilis (can
happen at any stage):
asymptomatic infection, acute
syphilitic meningitis,
headache, stiff neck, hearing
loss, facial weakness, visual
disturbances, strokes
Q. What can happen to a person with
syphilis?
Latent Syphilis
persistence of T. pallidum
organisms in the body without causing signs or symptoms
Q. What can happen to a person with
syphilis?
Tertiary Syphilis
without treatment
approx. 30% progress to tertiary syphilis
1 to 20 years after
infection
gummatous lesions
(destructive and resemble cancer)
skeletal, spinal,
mucosal areas, eyes,
viscera (lung, stomach,
liver, genitals, breast, brain, heart)
10 to 15 years after
infection
cardiovascular syphilis
ascending aortic
aneurysm, aortic insufficiency, coronary ostial stenosis - 20 to 30 years after
infection
neurosyphilis, eye
infections
Q. What can happen to babies born to
infected moms?
die before birth
die soon after birth
neurologic impairment
deafness
bone deformities
liver and spleen enlargement
blood abnormalities (anemia,
thrombocytopenia)
skin lesions
hair loss
lymph node enlargement
hole in roof of mouth
abnormal teeth
Q. How can a person be tested for Syphilis?
blood tests
Q. How is Syphilis treated?
Antibiotics
Q. What organisms cause PID?
PID = Pelvic Inflammatory
Disease
in most cases of PID - multiple bacteria
are present
most common:
N. gonorrhoeae or C. trachomatis (or both)
other bacteria:
aerobic gram-negative rods (e.g. E. coli)
anaerobes (Bacteroides species, Prevotella
species, Peptostreptococcus species)
gram-positive organisms (Streptococcus species)
Q. How common is PID?
2001 estimate >750,000 cases of PID
in the U.S.
2013–2014 estimate lifetime PID
prevalence
4.4%
of sexually experienced F aged 18-44
=
2.5 million women
Q. How does someone get PID?
from a vaginal infection that travels
upward:
into the uterus
and/or fallopian tubes
and/or ovaries
and/or pelvic cavity
Q. What can happen to a person with PID?
no symptoms
painful sex
painful urination
lower abdominal or pelvic pain
intermittent bleeding
bleeding after sex
vaginal discharge
fever, chills, nausea, vomiting
pain when clinician examines the: cervix,
uterus, fallopian tubes, ovaries
infertility
ectopic pregnancy
pelvic pain
ectopic pregnancies
19.7 cases / 1,000
pregnancies
>95% fallopian tubes
2.5% cornua of uterus
<2.5% ovary, cervix,
abdominal cavity
Q. How can a person be tested for PID?
examination by a clinician
Q. How is PID treated?
antibiotics
viral
infections
antibiotics are of NO use for viruses
herpes
------- Herpes simplex (HSV)
genital warts -------- human papillomavirus (HPV)
hepatitis -------- hepatitis A,
B, or C virus
AIDS -------- human
immunodeficiency virus (HIV)
Q. What organism causes a Herpes
infection?
the Herpes Simplex virus (HSV)
HSV-1 more frequently associated with
mouth & lip lesions
can
be transmitted by kissing
HSV-2 more frequently associated with
genital lesions
almost
always sexually transmitted
Q. How common are Herpes infections?
HSV-2 Seroprevalence NHANES 2007-2010
10.6% All Males
20.3% All Females
7.2% Non-Hispanic White Males
15.3% Non-Hispanic White Females
31.7% Non-Hispanic Black Males
49.9% Non-Hispanic Black Females
Q. How does someone get Herpes?
from a partner during sexual activity
from a mother during birth
from a contaminated finger touching the
eye
herpes can be
transmitted even when there are no visible
lesions present (asymptomatic viral shedding)
genital HSV-2 shedding detected on 17%
of days
genital HSV-1 shedding detected on 2% of
days
antiviral treatment can reduce shedding
by 70-80%
>85% of persons with herpes don’t
know they have it
Q. What can happen to a person with a
Herpes infection?
genital ulcers, pain, itching, painful
urination, vaginal or urethral discharge, enlarged tender inguinal lymph nodes
fever, muscle pain, headaches, aseptic
meningitis or symptoms of autonomic nervous system dysfunction such as urinary
retention (being unable to urinate)
constipation, pain, discharge in anal
region
first episode
lesions for 2-3 weeks
more likely to have
systemic symptoms
recurrent episodes
lesions for 3-5 days
rarely have systemic
symptoms (like fever)
HSV-2 year 1: 4-5x/yr
(median)
HSV-2 later: 3-4x/yr
(median)
HSV-1 year 1: 1x/yr
(median)
HSV-1 later: 0x/yr
(median)
recurrences are:
more frequent in F then
M
more frequent if
initial episode was very bad
prodromal symptoms:
localized tingling,
burning due to HSV traveling
begin 12 to 24 hours
before the appearance of lesions
reactivation triggers:
trauma
fever
ultraviolet light
physical or emotional
stress
immunosuppression
fatigue
menses
sexual intercourse
unknown factors
Q. What can happen to babies born to
infected moms?
transmission more likely if 1st
attack during pregnancy
occurs approx. 1/3,200 U.S. deliveries
approx. 70% of infected babies will
develop skin lesions
can affect - liver, lungs and CNS
CNS disease:
lethargy
poor feeding
temperature instability
encephalitis
seizures
Q. How can a person be tested for
Herpes?
PCR and culture tests from active
lesions
blood tests (for antibodies)
Q. How is Herpes treated?
episodic therapy
treats
first clinical and recurrent episodes
lessens
severity and duration of an episode
suppressive therapy
used
daily to decrease recurrences or transmission
medications:
Acyclovir
Valacyclovir
Famcyclovir
Q. What organism causes an HPV
infection?
the human papillomavirus (HPV)
>170 types of HPV
>40 types of HPV infect human
genitals
low-risk types (non-oncogenic)
not
associated with cancer
cause
genital warts
cause
benign or low-grade cervical cellular changes
high-risk types (oncogenic)
cause
low-grade cervical cellular changes
cause
high-grade cervical cellular changes
(moderate
to severe Pap test abnormalities)
cause
cancer
Q. How common are HPV infections?
most sexually active men and women will
acquire genital HPV
approx. 90% of infections are clinically
silent
most infections resolve spontaneously
within 2 years
since vaccines have been introduced HPV
infections are decreasing
Q. How does someone get HPV?
from a partner during sexual activity
from a mother during birth
Q. What can happen to a person with an
HPV infection?
no symptoms
genital warts
abnormal pap smears
cancer of the cervix
cancer of the vulva
cancer of the vagina
cancer of the anus
cancer of the penis
cancer of the oropharynx (mouth and
throat)
Q. What can happen to babies born to
infected moms?
rarely HPV can be transmitted during
childbirth
may cause respiratory tract warts in
child (recurrent respiratory papillomatosis)
value of cesarean delivery for
prevention is unknown
Q. How can a person be tested for HPV?
visible warts
an abnormal pap smear
HPV test of cell scrapings from the
cervix
Q. How is HPV treated?
hope the immune system clears the HPV (but
keep checking on abnormalities)
treatment depending on severity of
abnormality on pap smears (possibly remove abnormal tissue)
remove/destroy warts (which may come
back and need additional treatment)
treating warts
patient applied therapy
podofilox
solution or gel
imiquimod
cream
sinecatechins
ointment
clinician administered therapy
cryotherapy
with liquid nitrogen or cryoprobe
surgical
removal with scissors, scalpel, CO2 laser, or curettage
trichloroacetic
acid or bichloroacetic acid solution
Q. What can the HPV vaccine prevent?
2vHPV prevents infection with HPV types
16 and 18
4vHPV prevents infection with HPV types
6, 11, 16, and 18
9vHPV prevents infection with HPV types
6, 11, 16, 18, 31, 33, 45, 52, and 58
9vHPV offers protection against
7 oncogenic HPV types
(16,
18, 31, 33, 45, 52, and 58)
that
cause approx. 80% of cervical cancers
2 HPV types
(6
and 11)
that
cause approx. 90% of genital warts
Q. How is the HPV vaccine created?
HPV L1Coding Region is inserted into
Yeast Plasmid DNA
Yeast males L1 Molecule that self
assembles into Viral-Like Particle
Q. What organism causes a hepatitis
infection?
the hepatitis A, B, C, D, or E virus
Q. How common are hepatitis infections?
>2,000 hepatitis A cases reported
2016
>3,000 hepatitis B cases reported
2016
3,000 hepatitis C cases (approximately)
reported 2016
Q. How does someone get hepatitis A?
hepatitis A – most commonly by
contact with infected stool particles on food or in water
sexual contact
sharing contaminated needles
caring for infected persons when they
are ill
changing infected children’s diapers
eating food that was grown by, harvested
by, processed by, or handled by infected persons
Q. How does someone get hepatitis B?
hepatitis B – most commonly (in
US) by sexual contact – most commonly (worldwide) birth to infected mom
contact with contaminated needles
outbreaks in health care settings (rare)
Q. How does someone get hepatitis C?
hepatitis C – most commonly by
contact with infected blood
contact with contaminated needles
blood transfusions & organ
transplants (before 1992)
sexual transmission (rare)
outbreaks in health care settings (rare)
getting tattoos & body piercings
with nonsterile instruments
6% of infants born to infected mothers
sharing blood-contaminated razors, nail
clippers, tooth brushes, glucose monitors
Q. What can happen to a person with
hepatitis?
no symptoms
fever, feeling tired, joint pain
not wanting to eat, upset stomach,
throwing up
dark urine, grey colored stool
yellow skin and eyes
(long term) liver disease, liver
failure, liver cancer
hepatitis A –short term only (months -
not years)
hepatitis B –short term & long
term-90% infants-5% adults
hepatitis C –short term & long
term-80%
HBV
2nd leading cause of cancer
worldwide
Q. What can happen to babies born to
infected moms?
they can get hepatitis
Q. How can a person be tested for
hepatitis?
blood tests
Q. How is hepatitis treated?
short term hepatitis A, B, C:
rest
adequate
nutrition and fluids
long term hepatitis B:
close
medical monitoring
checking
for liver problems
long term hepatitis C:
expensive
medications can cure many people
Q. What hepatitis vaccines are
available?
1996 hepatitis A vaccine
recommended in the U.S.
1997 hepatitis B vaccine
mandatory FL middle schools
1998 hepatitis B vaccine
mandatory FL elementary schools
hepatitis C – NO VACCINE AVAILABLE
1988 – HCV discovered
1991 – HCV tests available
pre-1992 – transfusion recipients at risk
1960-1965 – HCV infected 1/3 of transfusion recipients
2002 –3-4 million U.S. carriers mostly don’t know it
Newsweek April 22
2002, p.46-53
newer drugs can cure up to 96% of people
who take them
the new drugs can cost $1,000 per pill
pills are taken once a day for 12 – 24
weeks
generic name / brand name / manufacturer
/ approx cost 12 week Tx / date FDA approved
sofosbuvir – Sovaldi – Gilead Sciences -
$84,000 - 12/2013
ledipasvir/sofosbuvir – Harvoni – Gilead
Sciencesa - $94,500 – 10/2014
simeprevir – Olysio – Janssen
Therapeutics - $66,360 – 11/2013
ombitasvir/paritaprevir/ritonavir –
Viekira Pak – AbbVie - $83,319 – 12/2014
ombitasvir/paritaprevir/ritonavir –
Technivie – AbbVie - $76,653 – 7/2015
daclatasvir – Daklinza – Bristol-Meyers
Squibb - $63,000 – 7/2015
common
vaginal infections
bacterial vaginosis --------
Gardnerella vaginalis
-------- bacterium
and other species
candidiasis --------
Candida albicans
-------- fungus
trichomoniasis --------
Trichomonas vaginalis
-------- protozoan
Q. What organism causes bacterial
vaginosis?
Women normally have predominantly
lactobacilli in their vaginas.
Lactobacilli help create an acidic
environment in the vagina that inhibits other bacteria.
If there are not enough lactobacilli,
other bacteria will multiply such as:
Gardnerella
vaginalis
Atopobium vaginae
Fusobacterium species
Mobiluncus curtisii
Mycoplasma hominis
Prevotella bivia
Peptostreptococcus species
Haemophilus species
Ureaplasma species
Bacteroides species
Q. How common is bacterial vaginosis?
about 29% of women have bacterial
vaginosis
the actual % varies by population
higher among sexually active women
Q. How does someone get bacterial
vaginosis?
we don’t know
it has not classically been considered a
sexually transmitted disease
but it is more common in sexually active
women
Q. What can happen to a person with
bacterial vaginosis?
no symptoms (common)
bad smelling vaginal discharge (“fishy
odor”)
PID
post-operation infections after
gynecological procedures
2X risk of acquiring STDs: chlamydia,
gonorrhea, HSV-2, and HIV
milky or creamy vaginal discharge of
bacterial vaginosis
Q. What can happen to babies born to
infected moms?
late miscarriage
premature rupture of membranes
premature delivery
low birthweight infants
Q. How can a person be tested for
bacterial vaginosis?
vaginal pH >4.5
“clue cells”
“fishy odor”
homogenous, nonviscous, milky white
discharge on vaginal walls
DNA test
Q. How is bacterial vaginosis treated?
antibiotics (pills or vaginal creams)
Q. What organism causes vulvovaginal
candidiasis?
Q. What organism causes a “yeast”
infection?
Candida albicans (85%-95%
of U.S. cases)
Candida glabrata and
other species
Q. How common is vulvovaginal
candidiasis?
20%
of asymptomatic women have Candida
70-75% 1/>1 episode
40-50% 2 episodes
5-10% recurrent vulvovaginal candidiasis
(4/>4 episodes / year)
Q. How does someone get vulvovaginal
candidiasis?
Candida species = normal flora (skin, vagina)
risk factors for frequent episodes:
uncontrolled
diabetes
corticosteroids
repeated
courses of antibiotics
pregnancy
HIV
infection
hormone
replacement therapy
oral
contraceptives
intrauterine
devices
condoms
spermicides
genetic
predisposition
Q. What can happen to a person with
vulvovaginal candidiasis?
itching
vaginal soreness
painful sex
vulvar burning
painful urination
redness of vulva and labia
vaginal discharge
thick,
white, and clumpy ("cottage-cheese-like")
or
watery, minimal, or not present,
little
or no odor
Q. What can happen to babies born to
infected moms?
certain antifungal medications should
not be used during pregnancy because they might cause defects in the baby
Q. How can a person be tested for
vulvovaginal candidiasis?
normal pH
microscopic exam
Q. How is vulvovaginal candidiasis
treated?
antifungal creams
antifungal pills
Q. What organism causes trichomoniasis?
Trichomonas vaginalis a
protozoan
Q. How common is trichomoniasis?
about 3.7 million people have it (in the
U.S.)
1.1 million new cases each year
3.1% of reproductive age women
much higher in certain sub groups
Q. How does someone get trichomoniasis?
sexual activity
Trichomonas vaginalis may persist for months to years in the genital
tract
Q. What can happen to a person with
trichomoniasis?
no symptoms (common in women and men)
women
“frothy” gray or yellow-green vaginal
discharge
itching
increased risk of getting HIV infection
men
urethritis
prostatitis
epididymitis
Q. What can happen to babies born to
infected moms?
premature rupture of membranes
preterm birth increased by 30%
low birthweight infants
neonatal trichomoniasis (uncommon)
Q. How can a person be tested for
trichomoniasis?
microscope exam
culture
antigen test
DNA test
Q. How is trichomoniasis treated?
antibiotics
ectoparasitic
infections
pubic lice (“crabs”) --------
Phthirus pubis
-------- insect
scabies
-------- Sarcoptes scabiei --------
mite
Q. What organism causes pediculosis
pubis (pubic lice)?
pubic lice (“crabs”) --------
Phthirus pubis
-------- insect
adult size: 1.1-1.8 mm long
female louse lives for 3-4 weeks
female lays approximately 30 eggs
eggs hatch after 1 week
Q. How common is pediculosis pubis
(pubic lice)?
about 3 million people / year in the
U.S. get infected
Q. How does someone get pubic lice?
sexual contact (common)
close personal contact (occasionally)
contact with clothing, bed linens,
towels used by an infected person
(occasionally)
Q. What can happen to a person with
pubic lice?
itching
(which can lead to scratching and
bacterial infections)
Q. What can happen to babies born to
infected moms?
certain chemicals (Lindane) used to
treat pubic lice are not safe for use in pregnant or breastfeeding women
Q. How can a person be tested for pubic
lice?
visible lice or eggs (magnifying lens
helps)
Q. How is pubic lice treated?
apply lotion or mousse
remove eggs from hair using fingernails
or fine-toothed comb
launder clothing, bedding, towels using
hot water and hot dryer cycle (or seal in plastic bag for 2 weeks)
Permethrin
disrupts neuron function of lice and
scabies
found in lotions and creams used to
treat lice and scabies infections
Q. How long can pubic lice survive?
on the human body adult lice live 3-4
weeks
if a louse falls off a person it can
only live for 24-48 hours
Q. What organism causes scabies?
The human itch mite (Sarcoptes
scabiei var. hominis)
females are 0.30-0.45mm long
females lengthen their burrows and lay
2-3 eggs/day for 1-2 months
egg à
adult = 10-20 days
typical infection = 10-15 females
Q. How common is scabies?
about 1 million people / year
in the U.S.
Q. How does someone get scabies?
close body and skin contact
sexual contact
crowded conditions with frequent skin
and body contact such as:
nursing
homes
extended
care facilities
prisons
child
care facilities
Q. What can happen to a person with
scabies?
itching
scratching
skin sores
infection of sores with bacteria on the
skin (such as Staphylococcus aureus)
allergic reaction to mites and mite
feces
Q. How can a person be tested for
scabies?
rash and burrows consistent scabies
removing a mite from a burrow with a
needle
finding mites, eggs, or mite fecal
matter (scybala) in a skin scraping
Q. How is scabies treated?
prescription lotions or creams
decontamination of bedding, clothing and
towels by washing in hot water and drying at high heat
or sealing in a plastic
bag for at least 72 hours
simultaneous treatment of all contact
persons
Q. How long can scabies mites survive?
scabies mites generally do not survive
more than 2-3 days away from human skin
Q. What organism causes HIV/AIDS?
AIDS = Acquired Immunodeficiency
Syndrome
is caused by
HIV = Human Immunodeficiency Virus
Q. How common is HIV?
Florida 2017:
22.9/100,000 people diagnosed with HIV
Q. How does someone get HIV?
sexual activity
injection into bloodstream by contaminated needles or syringes
infected body fluids making
contact with
mucous membranes or damaged
tissues
fluids = blood, semen
(cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, breast milk
mucous membranes = inside rectum, vagina, penis, mouth
Q. What can happen to a person with HIV?
stage 1: acute HIV infection
flu-like illness 2-4 weeks after
infection
fevers, muscle aches, skin rashes,
loss of appetite, swollen lymph glands
Q. What can happen to a person with HIV?
stage 2: clinical latency
(asymptomatic HIV infection)
virus reproduces slowly, person feels
fine
may last for about 10 years without
treatment
may last several decades with treatment
Q. What can happen to a person with HIV?
stage 3: Acquired ImmunoDeficiency
Syndrome (AIDS)
badly damaged immune system
CD4 cell count below 200 cells/ml
severe illnesses (infections and
cancers), chills, fevers, sweats, swollen lymph glands, weakness, weight loss
without treatment 3 year survival
serious, severe complications of AIDS
infections
pneumocystic
carinii pneumonia
pneumonia
shingles,
cytomegalovirus, encephalitis
fungal
meningitis, tuberculosis
salmonella,
toxoplasmosis
cancers
lymphomas
cervical
cancer
Kaposi’s
sarcoma
(the
most common cancer in AIDS)
incubation time for AIDS in adults
time between HIV infection
and onset of one or more severe,
debilitating diseases associated with extreme impairment of the immune system
typically ranges - 8 to 11 years or
more
median duration - about 10 years
HIV is a retrovirus
targets & destroys CD4 lymphocytes
(T-helper cells/helper T-4 cells)
CD4 cells coordinate response to
infections and cancers
CD4 count <200 cells/cc = AIDS
Q. What can happen to babies born to
infected moms?
if pregnant women
get
tested for HIV
take
antiretroviral drugs if HIV positive
get
C-sections when indicated
avoid
breast feeding if HIV positive
then
less
than 2% of HIV positive moms
will
pass the infection to their babies
Q. How can a person be tested for HIV?
tests of
plasma or whole blood or oral fluids
tests for viral RNA, viral proteins
(p24),
and/or antiviral antibodies (IgM, IgG
Q. How soon can an HIV infection be
detected?
(10-35 days depending on the type of
test)
within a few months of being infected
with HIV
most people develop antibodies to the
virus
(a process called seroconversion)
seropositive - blood contains antibodies to HIV
seronegative - blood does not contain antibodies to HIV
(but
may be in early stages of HIV infection before the body has had a chance to
make antibodies)
Q. How is HIV/AIDS treated?
ART = AntiRetroviral Treatment
consisting of multiple drugs – at least
3 different ones
earliest available classes of HIV
medications:
reverse transcriptase inhibitors (1987)
zidovudine
and lamivudine
protease inhibitors (1996)
indinavir
and ritaniver
PrEP = Pre-exposure Prophylaxis
(prevention for people who are at
high risk)
2 antiretroviral drugs every day
example: Truvada = tenofovir +
emtricitabine
risk of getting HIV infection
is up to 92% lower
for participants who take medicines
consistently
compared to those not taking medicines
PEP = Post-exposure Prophylaxis
(prevention after a particular
incident)
antiretroviral medicines for 28 days
starting as soon as possible (every hour
counts)
and definitely within 72 hours (3
days)
after potential exposure to HIV
more drugs
and higher dosages
than in PrEP
Q. What groups of people are at higher
risk of getting HIV/AIDS?
2017 – New HIV diagnoses
9,807
Black, Male-to-Male Sexual Contact
7,436
Hispanic/Latino, Male-to-Male Sexual Contact
6.982
White, Male-to-Male Sexual Contact
4,008
Black Women, Heterosexual Contact
1,717
Black Men, Heterosexual Contact
1,058
Hispanic/Latina Women, Heterosexual Contact
999
White Women, Heterosexual Contact
semen contains more HIV virus than
vaginal fluids
vaginal mucosa is exposed to HIV fluids
longer than penis
vagina more likely to experience trauma
than penis
contact of infected semen with rectal mucosa is very dangerous
Q. How good are condoms at preventing
HIV transmission?
with consistent use per self report:
80% risk reduction - heterosexual M and
W (Weller 2002)
72-91% risk reduction - MSM, receptive
anal sex (Smith 2015, Johnson 2018)
63% risk reduction - MSM, insertive anal
sex (Smith 2015)
preventing
sexually transmitted diseases
assess your and your partner’s risk
status
obtain prior medical examinations
use condoms and spermicides
avoid sexual activity with multiple partners
inspect your partner’s genitals
wash your--and your partner’s--genitals
before
and after sexual contact
obtain routine medical evaluations
inform your partner(s) if you have an
STD
J