Sexually Transmitted Diseases

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Sexually transmitted diseases are infectious diseases that can be spread by sexual contact. Some can also be transmitted by nonsexual ways, but these make up a minority of the total number of cases. An estimated ten to twelve million Americans have sexually transmitted diseases. Sexually transmitted diseases in the United States affect both sexes, all races, and every economic stature. STDs come from different sources. Some are epidemic like gonorrhea, infections of the urethra, genital herpes, and genital warts. Some diseases are caused by a bacterium such as Chlamydia, and others are from protozoan or yeast. Many of these infections are transmitted largely by sexual contact with an infected person. The practice of anal and oral sex also lead to cases of anal and oral infections. Gonorrhea, syphilis, and chlamydial infections can also be transmitted from a pregnant woman to her infant, either in the uterus or during birth. Sexually transmitted diseases are very hard to control. Some public officials attribute the increase in many of these diseases to increasing sexual activity. Others say the replacement of the condom with birth control pills and diaphragms might also increase the risk of STDs. "Many STDs are transmitted more efficiently from men to women than the reverse, perhaps because the vagina serves as a reservoir that prolongs exposure to infectious secretion (Handsfield 2)" The physical examination of patients with STD or at risk is a simple procedure. All patients require inspection of the entire skin surface. At a minimum they carefully inspect all skin surfaces that are uncovered or exposed during genital examination. This includes the face, head, hands, lower arms, lower trunk, pubic area, thighs, mouth and throat. Also checked in men are the genitals and the pubic and inguinal regions, the penis, urethra, urethral bulb, and the scrotum are checked for tenderness and other abnormalities. "For homosexually active men, the anus and perineum are carefully inspected. The examination of women includes inspection of the pubis area, the external genitals, perineum and anus, speculum examination of the vaginal mucosa and cervix, and a bimanual pelvic examination (Handsfield 4)." A way to avoid STDs and unwanted pregnancies is to use a condom. "A condom is a sheath worn over the penis during oral, anal, and vaginal sexual contact (Virginia Tech Health Services)." Condoms can be made of latex rubber or animal membrane. Animal membrane condoms prevent pregnancy but have large enough pores for tiny HIV viruses to pass through. Latex condoms are much better in forming a barrier against HIV. Polyurethane condoms haven't been fully tested, so people should avoid using them. Do not use novelty condoms like the ones that glow in the dark, these are not FDA approved. Always check the expiration date. Never use a condom after the date stamped on the wrapper or on the seal. Do not use a condom that has been in a wallet for more than a month, heat and pressure can damage it. Also, stay away from oil-based lubricants, like Vaseline, which can eat through the latex. And finally, do not open the packet with scissors or your teeth, the condom could rip. Nudge the condom away from the edge and gently tear the packet open. Next to abstinence, which is having no sexual relations at all, condoms are the best protection against STDs. When a condom is used correctly, they are about 90 percent effective in preventing pregnancy, and 95 percent effective when used with spermicide. Spermicide, also called Nonoxynol 9, has been found to be effective in killing the HIV virus in laboratory experiments when used at 5 percent strength. Spermicide immobilizes and kills sperm. It comes in jellies, creams, foams, suppositories, film, and as a coating on condoms. STDs can also be avoided by remaining monogamous. This means only having sex with one person who only has sex with you. If you know that you are clean of all STDs and that your partner is also clean, then you both can avoid STDs by only being with each other. Chlamydia is a STD caused by the bacterium Chlamydia trachomatis. The bacterium is found in infected body fluids from the penis or vagina and it spreads through direct sexual contact and from mother to baby. Chlamydia is the most prevalent bacterial STD, about four million people will become infected with Chlamydia this year. Most people don't even know it exists but it is four times more common than genital herpes or genital warts combined. Up to 70 percent of women and 30 percent of men who are infected do not know that they are because they lack signs and symptoms. There are no symptoms for this disease so people are not aware that they have a problem until they develop complications. In women this includes pelvic inflammatory disease (PID), infertility, and dangerous complications during pregnancy and birth. In men the testicles become inflamed. Some signs of chlamydia for men and women are a discharge from the penis, vagina, or rectum, cramps in the lower abdomen, burning or itching around the opening of the penis, pain in the testicles, pain when urinating, unusual vaginal bleeding, and bleeding after sex. If a woman with chlamydia is pregnant and she is not treated, her baby has a 50-50 chance of developing conjunctivitis, which is an inflammation of the eyes that threatens eyesight, and a 20 percent chance of pneumonia. Chlamydia can also lead to premature birth or low birth weight. Chlamydia is the easiest STD to treat. Doctors can prescribe a single dose of an antibiotic called Azithromycin, or they can prescribe Doxycycline for 7 days. Either of these antibiotics will cure this disease within a week. Every year up to one million Americans develop genital warts, and as many as 50 percent of all men and women are now infected. Human Papilloma Virus (HPV) is the virus that causes genital warts. These warts grow on the genitals, in the urethra, in the anus, and rarely in the throat. They are soft to the touch and may look like miniature cauliflower florets. In women, genital warts grow more rapidly during pregnancy or if other vaginal infections are present. "They often itch and if they are allowed to grow, in severe cases they can block the openings of the vagina, anus, or throat and become quite uncomfortable (Handsfield 4)" HPV infection is spread from person to person through direct skin contact during vaginal, anal, or oral sex with someone who has genital warts. Babies can get the virus if their mothers have genital warts at the time of delivery. Signs of genital warts occur six weeks to eight months after contact with someone with HPV. Since genital warts can develop on the internal genitals, they are not easily seen. Sometimes the infection doesn't cause any warts and many people with HPV do not know that they have it. Freezing the warts with liquid nitrogen, applying certain chemicals, using laser therapy, and using electrical heat can easily treat genital warts. Even though the warts will be removed, some of the virus may still stay alive in the skin and cause more warts. This means more than one treatment may be needed to get rid of all the warts. The one thing not to do is use over the counter treatments for warts on sensitive genital skin. Genital warts can be avoided by being monogamous, by always using condoms, and by knowing the signs of HPV infection. Acquired Immune Deficiency Syndrome (AIDS) is the destruction of the immune system resulting from infection with the Human immunodficiency virus (HIV). AIDS is a gradual weakening of the immune system, which allows severe infections and cancers to grow. It eventually leads to death from one of these illnesses. It may take six to ten years until the HIV infection becomes AIDS. This disease attacks the CD4 T-cell count, these are the major type of white blood cell lost during the HIV infection. The lower the person's CD4 T-cell count, the more advanced the person is into the disease. Within one to three weeks after infection with HIV, most people experience general flulike symptoms like fever, headache, skin rash, tender lymph nodes, and malaise. These symptoms last for about one to two weeks. During this time HIV reproduces to very high concentrations, it circulates through the blood, and creates infections all throughout the body, especially in the lymph nodes. The infected person's CD4 T-cell count falls briefly but then returns close to normal and the person's immune system responds to the infection and limits the spread of HIV. The next phase can last for up to ten years. The person stays healthy and his or her CD4 T cell level is between low and normal, which is 500 to 700 cells per mm3. HIV continues to spread and reproduce causing more destruction to the immune system. Eventually the immune system declines and the person's T cell level drops dramatically from about 500 to 200 cells per mm3. Infections then spread but they are not yet life threatening. Within the next couple of months or years the immune system is destroyed and serious illnesses set in. The infected person may have CD4 T-cell levels below 200 per mm3. Next comes a stage of ongoing weight loss and fatigue. The immune system fails and the T-cell count is below 50 per mm3, and death occurs within one to two years. HIV is most commonly spread by sexual contact with an infected person. The virus is present in the sexual secretions of men and women. HIV goes into the bloodstream of the uninfected person by getting into small abrasions or by sexual intercourse. Sharing needles or syringes that contain the blood of an infected individual also spreads HIV. Transmission through blood transfusions is now very rare and it occurs in less than one person in every 100,000. HIV can be transmitted from an infected mother to her baby, either before or during childbirth or through breast-feeding. Only about 30 percent of babies born to HIV-infected mothers actually become infected. "The three anti-HIV drugs currently licensed by the U.S. Food and Drug Administration (FDA) are all RT inhibitors: AZT, ddl, and ddC. These drugs work as DNA-chain terminators. Because the drug appears to be a normal nucleotide base (the building block for DNA), the RT enzyme mistakenly inserts the drug into the growing viral DNA chain. Once the drug is inserted, no additional DNA bases can be added (Encarta)." These drugs are not a cure for the HIV infection, scientists originally wanted them to slow the progression of AIDS, and they have extended the life of the infected individual by about six months. Syphilis is an infection that can be life threatening if it is not treated. It is caused by a bacterium called Treponema pallidum. This bacterium is found in sores and rashes that occur anywhere on the skin or inside the mouth or genitals. Syphilis is spread by sexual contact and from mother to baby during pregnancy. Without treatment the infection can lead to heart disease, nerve disorders, brain damage, mental disorders, blindness, and death. There are six symptoms that an infected person with syphilis may have. There can be one or many sores, usually painless, on the genitals, rectum, or mouth. Rashes anywhere on the body are another symptom. The rashes can be flat, scaly, round, or crater like. One may also develop headaches, sore throats, swollen glands, and hair will fall out in big patches. There are four stages of syphilis. First, there is a development of a red, painless sore. Within one to six weeks it will go away on its own. Second, development of the rash and flu-like symptoms. These symptoms can be mild and come and go for over two years. Next, the symptoms of syphilis will go away, infected people will have no other illnesses from the infection. Stage four is late stage syphilis. The infection begins to damage the heart, brain nerves, bones and other parts of the body. Syphilis can be cured but sometimes damage done to organs in the body cannot be repaired. Syphilis can be treated with antibiotics, mainly with penicillin. Other antibiotics can be prescribed if one is allergic to penicillin. This antibiotic kills the bacteria causing the infection. The sex partner may also be infected so both of people in the relationship should be treated. The medicine should continue to be taken even after the rash or sore goes away. Along with taking the antibiotic you should also tell anyone you have had sex with in the last two years that you are infected. Do not have sex again until your doctor gives an okay. You should get rechecked to make sure you are cured and also get checked for HIV. Gonorrhea is a disease caused by a bacterium called Neiserria gonorrhoeae. The bacteria that cause gonorrhea are found in the vagina, penis, throat, rectum, and in the semen or vaginal fluids. Gonorrhea is spread through sexual contact and from mother to baby during delivery. It is the most commonly reported sexually trans

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