STD 101 Unlocking Good Health with Prevention and Control

1. STD 101Unlocking Good Health with Prevention and Control Miami-Dade STD Program Florida Department of Health A presentation for our senior high schools

2. “1 in 4 Teenage Girls”(Play DVD)

3. “Early knowledge of STD infection is a critical component in preventing & controlling the spread of STDs, including HIV.”

4. Who Are We?

5. STD Clinic offers: • Four convenient sites • Routine voluntary HIV test with STD exam • Multilingual & culturally competent trained staff • Private Setting • Client Confidentiality • Community & Case Specific Screenings • Educational Presentations

6. Comprehensive Exam & Screening for common STDs Chlamydia Gonorrhea Syphilis Herpes BV Trichomoniasis Genital Warts HIV Testing Blood Orasure Rapid Test Treatment available for common STDs Hepatitis A & B & C Testing Hepatitis A vaccination for eligible clients Hepatitis B vaccination available Pap Smear Testing Start-up Birth Control for STD Clients Pregnancy Testing for STD Clients Types of STD Clinical Services NEW

7. Disease Intervention & Prevention Services • General & Specific Patient Education & Counseling • HIV Counseling & Testing in Field Setting • Confidential • Anonymous • Risk & Harm Reduction Counseling • HIV Post Test Counseling • Negative • Positive • Indeterminate • Disease Intervention Interviews • Partner Counseling & Referral Services (PCRS) • Community Awareness & Sexual Health Promotion • Referrals • Other STD Testing in Field Setting

8. How We Work?

9. STD Prevention & ControlAt-A-Glance Goes to Doctor for Exam DIS locates & refers client for RX, evaluation, interview, & PCRS Gets STD Test Does Not Get Treated Residents & Visitors Send Lab Report to STD Gets Treated Surveillance Verifies Treatment/PTC Doctor &/Lab reports to MDCHD

10. What’s A STD?

11. Sexually Transmitted Disease (STD)? A sexually transmitted disease is a broad term that refers to as many as 20 different infections, all of them transmitted by sex. STDs are serious, sometimes painful and can cause a lot of damage in your body. Some STDs infect your reproductive and sexual organs. Others (HIV, hepatitis B, and syphilis) cause general body infections.

12. How are STDs spread? • Through the exchange of body fluids such as semen, vaginal fluid, and blood with someone who is infected. • Through vaginal, anal and oral sex. • STDs can be given by mothers to their babies • You can get some STDs, such as herpes, by kissing and caressing or close contact with infected areas—not just intercourse.

13. Asymptomatic Vs Symptomatic disease Asymptomatic – Sometimes a person can have an STD with no signs or symptoms. Symptomatic – Other times, a person will have symptoms that go away on their own. Either way, the person will still have the STD until he/she gets treated. A few STDs can not be cured. But most can be cured with treatment.

14. How common are STDs? STDs are increasingly common in the United States today. That’s distressing news, because STDs are also easy to prevent.

15. STD FACT SHEET According to CDC, each year • An estimated 19 million new infections occur, almost half of them among young people ages 15 to 24 An estimated 2.8 million new cases of chlamydia occur in the United States • Gonorrhea is the second most commonly reported infectious disease in the U.S.

16. Types of Organisms responsible for STDs • Bacteria • Viruses • Fungi • Protozoa • Metazoa

17. Bacteria (including mycoplasmas and chlamydiae) Types of Bacteria that affects humans • Spirilla-syphilis, yaws • Cocci-gonorrhea, meningitis • Bacilli-typhoid fever, tetanus • Mycoplasmas-nongonococcal urethritis (NGU), pneumonia • Chlamydia trachomatis-chlamydial urethritis, mucopurulent cervicitis (MPC)

18. Viruses A few of the significant viral STDs are • hepatitis B • genital herpes • condylomata acuminata (genital warts) • acquired immunodeficiency syndrome (AIDS)

19. Fungi Fungi causes • Candidiasis • Other vaginal yeast infections • Lung diseases • Ring worm

20. Protozoa Protozoa are responsible for • Trichomoniasis • Malaria

21. Metazoa • Metazoa causes many diseases and infestations • Scabies • Guinea worm infection • Pediculosis pubis

22. Common STDs • Bacterial Vaginosis (BV) • Chlamydia • Gonorrhea (Clap, Drip, Burns) • Genital Warts • Herpes (HSV types I and II) • Hepatitis B (Hep B) • Human Immunodeficiency Virus (HIV) • Lice & Scabies • Syphilis • Trichomoniasis (Trich)

23. What’s HappeningLocally?

24. Chlamydia, Gonorrhea, and Primary & Secondary Syphilis Infection Among Adolescents & Young Adults (Age 10-24) in Miami-Dade County, Florida 2005-2007

25. Chlamydia • Chlamydia is a sexually transmitted disease that is caused by the bacterium Chlamydia trachomatis. Signs and Symptoms • Pain and burning when urinating, discharge. 75% of women and 50% of men have no signs or symptoms. Diagnosis • Lab exam of fluid from the infected area Treatable? • Yes Therapy • Antibiotic pills that kill bacteria Result if Left Untreated • Pelvic infections such as Pelvic Inflammatory Disease (PID).

26. Chlamydia • Chlamydia trachomatis in a Thin Prep PAP Test Because chlamydia is most common among young women, CDC recommends annual chlamydia screening for all sexually active women under age 26, as well as for older women with risk factors such as new or multiple sex partners

27. Chlamydia • Chlamydia urethritis, penile • Chlamydia Trachomatis in a Thin Prep PAP Test

28. Gonorrhea • Gonorrhea is a sexually transmitted disease that is caused by the bacterium Neisseria gonorrhoeae. Signs and Symptoms • Pain or burning when urinating, yellow discharge Diagnosis • Lab exam of fluid from the infected area Treatable? • Yes Therapy • Antibiotic pills that kill bacteria Results if Left Untreated • Pelvic Infections, PID, and Sterility

29. Gonorrhea Studies suggest that the presence of gonorrhea infection makes an individual three to five times more likely to acquire HIV, if exposed Positive Gram Stain from Urethral Discharge Gonoccocal Urethritis Gonoccocal Cervicitis

30. Gonorrhea Bartholin’s abscess Gonococcal ophthalmia • Bartholin’s abscess

31. Gonorrhea Disseminated gonorrhea – skin lesion • Disseminated gonorrhea – skin lesion

32. Genital Warts • Genital warts is a sexually transmitted disease that is caused by the virus Human Papilloma. Signs and Symptoms • Bumpy warts on/near genitals Diagnosis • Visual Treatable? • Yes (but can’t be cured) Therapy • Burning or liquid removal of warts Result if Left Untreated • May lead to some cancers

33. Genital Warts • Condyloma acuminata, vaginal wall

34. Genital WartsCondyloma Acuminata Vulva Anal Meatus Meatus

35. Herpes • Herpes is a sexually transmitted disease caused by the herpes simplexvirus (HSV). Signs and Symptoms • HSV-type 1 (oral herpes) commonly causes fever blisters on the mouth or face • HSV-type 2 (genital herpes) typically affects the genital area causing red bumps/blisters. However, both viral types can cause either genital or oral infections. Diagnosis • Lab exam of fluid from the sore Treatable? • Yes (but can’t be cured) Therapy • Pills and ointment Results if Left Untreated • Prolonged and more severe symptoms

36. Herpes Primary Same Patient, 4 Days Later Vulva Cervicitis

37. Herpes Primary Recurring

38. Lice and Scabies • Lice (Crabs) is a sexually transmitted diseases caused by the metazoa Pediculosis Pubis. You get crabs by having sex, sharing clothes, bed sheets, or towels with someone who is infected. Scabies is a contagious skin disease caused by the metazoa Sarcoptes scabiei, a very small mite. Signs and Symptoms • Severe itching, rashes Diagnosis • Visual Treatable? • Yes Therapy • Over-the-counter or prescription lotion Results if Left Untreated • Continuing symptoms

39. Lice Female Crab Louse Lice in the pubic area Scabies Scabies Scabies Mite Eczema

40. Syphilis • Syphilis has been called “the great imitator” because so many of the signs and symptoms are indistinguishable from those caused by other diseases.

41. Syphilis • Syphilis is a sexually transmitted disease caused by the bacterium Treponema Pallidum. Signs and Symptoms • Chancre sore, rash, genital ulcers Diagnosis • Lab exam of tissue, fluids/blood test Treatable? • Yes Therapy • Penicillin shots to kill bacteria or antibiotic pills Results if Left Untreated • Blindness, Heart disease, Brain damage

42. Syphilis Treponema Pallidum Stages: • Primary • Secondary • Latent • Late Latent

43. Primary Stage The most infectious stage of the disease.

44. Primary Syphilis Chancres Vaginal Penile Anal Vaginal Chin

45. Secondary Stage Lesions of the mouth, throat, and cervix (mucous patches) frequently occur during this stage.

46. Secondary Syphilis Papulo-pustular rash Condyloma Lata Palmer Rash Nickel and Dime Lesion Alopecia

47. The stage in which no clinical signs or symptoms are present to suggest infection and serologic tests for syphilis are reactive. An early latent stage of syphilis can appear between the primary and secondary stages; between secondary relapses; and after the secondary stage, continuing to the late latent stage, late syphilis, or cure. Untreated late syphilis may present a wide range of signs and symptoms, varying from none which are apparent to those which indicate severe damage to one or more body systems. Late syphilis is classified as neurosyphilis, cardiovascular syphilis, and late benign syphilis. Latent Syphilis Late Syphilis

48. Congenital syphilis Through the 18th week of gestation the Langhan’s cell layer of the early placenta may help in restricting the treponema from crossing the placenta to infect the fetus. Thus, pregnancy while the mother is in the primary or secondary stages of infection frequently terminate in a stillbirth, whereas pregnancy occurring during the later stages of syphilis may result in a clinical spectrum from a fulminating fatal congenital syphilis

49. Congenital Syphilis IS Preventable

50. Congenital Syphilis • Primary chancre of syphilis that appeared at the age of 4 wks