STDs 08

Mathilde, Layla, Eléonore, Aurélie

What is an STD?

Definition of an STD

A sexually transmitted disease or venereal disease is an illness that is transmitted between humans by sexual contact, including vaginal intercourse, oral sex, and anal sex. The causes of STD's are bacterias, parasites and viruses. There are more than 25 diseases that are transmitted through sexual activity. Some STD's can have severe consequences, especially for women, if they are not treated correctly and rapidly.

How do we get STD's?

We get them from having non-protected sexual relations with someone who is already contaminated.
An STD can pass from one person to another with different contacts:

• The contact of the vagina's skin and the penis'skin (for Herpes for example)
  
• The contact of both women and men's sexual fluids
  
• The contact of blood with blood or sexual fluid.
  

Someone can also be contaminated without a sexual contact, just by seating on dirty toilets, or touching himself with dirty hands.

How do we know we have an STD?

A lot of STD's can exist within a person without showing any initial symptoms. Because a person doesn't see any symptoms, he/she may not be aware they are carrying an STD and as they have sexual relations with other people, they spread the STD to that person. That's why it is very important to get an STD test. If all the results are negative then you can be a little more secure in knowing you don't have one. If any come back positive then you can get proper treatment before the STD gets worse. Some STD's may not show any symptoms until they've gone through several phases in your body and are the most damaging to your system. This is why a regular gynecological visit is useful.

What are the different STD's?

There are multiple STDs, with different symptoms and consequences.

• AIDS, due to HIV infection:

AIDS is one of the most serious, deadly disease in human. There are about 42 million people living with HIV or AIDS around the world, and more than 3 million die every year from illnesses related to AIDS. AIDS is caused by the human immunodeficiency virus (HIV). HIV destroys defense cells in the body called CD4 helper lymphocytes. These lymphocytes are part of the body's immune system, the defense system that fights infectious diseases. But as HIV destroys these lymphocytes, people with the virus begin to get serious infections that they normally wouldn't. They become immune deficient. As the medical community learns more about how HIV works, they've been able to develop drugs to inhibit it (meaning they interfere with its growth). These drugs work in slowing the progress of the disease and people with the disease now live much longer. But there is still no cure for HIV and AIDS.
HIV can be transmitted from an infected person to another person through blood, semen (the fluid released from the penis when a male ejaculates), vaginal fluids, and breast milk. The virus is spread through high-risk behaviors including unprotected oral, vaginal, or anal sexual intercourse and sharing needles, such as needles used to inject drugs and those used for tattooing. If a woman with HIV is pregnant, her newborn baby can catch the virus from her before birth or from breastfeeding.
A healthy body is equipped with CD4 helper lymphocyte cells. These cells help the immune system function normally and fight off certain kinds of infections. They do this by acting as messengers to other types of immune system cells, telling them to become active and fight against an invading germ. HIV attaches to these CD4 cells, infects them, and uses them as a place to multiply. Then, the virus destroys the ability of the infected cells to do their job in the immune system. The body loses the ability to fight many infections. Because their immune systems are weaker, people who have AIDS are unable to fight off many infections, particularly tuberculosis. People who have AIDS tend to keep getting sicker, especially if they are not taking antiviral medications properly. AIDS can affect everybody. Because AIDS is fatal, it's important that doctors detect HIV infection as early as possible so a person can take medication to delay the onset of AIDS. Once a person's blood lacks the number of CD4 cells required to fight infections, or the person has signs of specific illnesses or diseases that occur in people with HIV infection, doctors make a diagnosis of AIDS. The amount of time it takes for symptoms of AIDS to appear varies from person to person. Some people may feel and look healthy for years while they are infected with HIV. It is still possible to infect others with HIV, even if the person with the virus has absolutely no symptoms. You cannot tell simply by looking at someone if he or she is infected. One of the reasons that HIV is so dangerous is that a person can have the virus for a long time without knowing it. That person can spread the virus to others through high-risk behaviors. HIV transmission can be prevented by:
1) abstaining from sex (not having oral, vaginal, or anal sex
2) always using latex condoms for all types of sexual intercourse
3) avoiding contact with the bodily fluids through which HIV is transmitted
4) never sharing needles.
If you think that you may have HIV or AIDS or if you have had a partner who may have HIV or AIDS, see your family doctor, adolescent doctor, or gynecologist. He or she will talk with you and make some tests. Clinics offer both anonymous (meaning the clinic doesn't know a person's name) and confidential (meaning they know who a person is but keep it private) testing. Most AIDS testing centers will ask you to follow up for counseling to get your results and to know if the test is either negative or positive.

• Human Papillomavirus (HPV):

Genital HPV is the most common sexually transmitted infection. In some rare cases, the virus is transmitted from a mother to her baby during childbirth. You can't catch it from a towel, doorknob, or toilet seat. The virus infects the skin and mucous membranes. There are more than 40 HPV types that can infect the genital areas of men and women, including the skin of the penis, vulva and anus, and the linings of the vagina, cervix, and rectum. You cannot see HPV. Most people who become infected with HPV do not even know they have it. Most people with HPV don't develop symptoms or health problems. But sometimes, certain types of HPV can cause genital warts in men and women. Other HPV types can cause cervical cancer and other less common cancers, such as cancers of the vulva, vagina, anus, and penis. Genital HPV is passed on through genital contact, most often during vaginal and anal sex. HPV can cause normal cells on infected skin or mucous membranes to turn abnormal. Most of the time, you can't see or feel these cell changes. In most cases, the body fights off HPV naturally and the infected cells then go back to normal. A vaccine can now protect females from the four types of HPV that cause most cervical cancers and genital warts. The vaccine is recommended for 11 and 12 year-old girls. It is also recommended for girls and women age 13 through 26 who have not yet been vaccinated or completed the vaccine series. For those who choose to be sexually active, condoms may lower the risk of HPV, if used all the time and the right way. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer.

• Hepatitis:

Hepatitis is an inflammation of the liver, and it can be caused by many things, including a bacterial infection, liver injury caused by a toxin, and even an attack on the liver by the body's immune system. Even if there are several forms of hepatitis, the condition is usually caused by one of three viruses: hepatitis A, hepatitis B, or hepatitis C virus. Some hepatitis viruses can mutate, which means they can change over time and can be difficult for the body to fight. In some cases, hepatitis B or C can destroy the liver. The patient then will need a transplanted liver to survive, which is not always successful.
The hepatitis A virus is transmitted through the feces of infected individuals. People usually get hepatitis A by eating food or drinking water that has been contaminated with feces. Once a person has recovered from a hepatitis A infection, that person has immunity to the virus, meaning that he or she will probably never get it again. People are also protected against hepatitis A if they've been vaccinated for it.
Hepatitis B is a more serious infection. It may lead to a condition called cirrhosis or liver cancer, both of which cause severe illness and even death. Hepatitis B is transmitted from person to person through blood or other body fluids. The most common way people get infected with hepatitis B is through unprotected sex with a person who has the disease. There's no effective cure for hepatitis B. In most cases, a teen who gets hepatitis B will recover from the disease. But some people will have the condition forever. Medications can help some people with hepatitis B to get rid of it.
Like hepatitis B, hepatitis C can lead to cirrhosis or liver cancer. Also like hepatitis B, hepatitis C is transmitted from person to person through blood or other body fluids. Hepatitis C is the most serious type of hepatitis, it's one of the most common reasons for liver transplants in adults. Every year, thousands of people die from the virus. And there's no cure and no vaccine. The most common way people become infected is through sharing drug paraphernalia such as needles and straws. People also get hepatitis C after having unprotected sex with an infected partner. The medications that are usually used to treat hepatitis C manage to control the disease in some people. However, hepatitis C treatments are not very easy to take, especially because some of them require frequent injections. Hepatitis infection causes inflammation of the liver, which means that the liver becomes swollen and damaged and begins losing its ability to function.
People with hepatitis often get symptoms similar to those caused by other virus infections, such as weakness, tiredness, and nausea. Because the symptoms of hepatitis are similar to other conditions, it's easy for a person who has it to confuse it with another illness. A blood test is usually needed to determine if a person has hepatitis. There are vaccines available to protect people against hepatitis A and hepatitis B. In addition to the vaccinations against hepatitis A and B, there are other steps for protecting yourself against hepatitis virus infection as having protected sexual intercourse.

• Gonorrhea:

Gonorrhea is a sexually transmitted disease which is caused by a bacterium. Gonorrhea is transmitted through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted. Any sexually active person can be infected. Symptoms and signs include a burning sensation when urinating. Sometimes men with gonorrhea get painful or swollen testicles. If not treated, gonorrhea can cause serious and permanent health problems. The surest way to avoid transmission of STDs is to abstain from sexual intercourse, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Latex condoms can reduce the risk of transmission of gonorrhea.

• Chlamydia:

Chlamydia is a common sexually transmitted disease caused by a bacterium, which can damage reproductive organs, including infertility. Chlamydia can be transmitted during vaginal, anal, or oral sex. Any sexually active person can be infected with chlamydia. Chlamydia is known as a "silent" disease because about three quarters of infected women and about half of infected men have no symptoms. There are laboratory tests to diagnose chlamydia. Chlamydia can be easily treated and cured with antibiotics but if untreated. The surest way to avoid transmission of STDs is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia.

• Trichomoniasis:

Trichomoniasis is a common sexually transmitted disease. Trichomoniasis is the most common curable STD in young, sexually active women. Trichomoniasis is caused by the single-celled protozoan parasite. The parasite is sexually transmitted through contact with an infected partner. Some men may temporarily have an irritation inside the penis or slight burning after urination or ejaculation. Some women have signs or symptoms of infection which include a yellow-green vaginal discharge with a strong odor. A health care provider must perform a physical examination and laboratory test to diagnose trichomoniasis. Trichomoniasis can usually be cured with prescription drugs. The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of trichomoniasis.

• Genital Herpes:

Genital herpes is a sexually transmitted disease caused by the herpes simplex viruses. Most individuals have no or only minimal signs or symptoms from this infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. Generally, a person can only get the infection during sexual contact with someone who already has it. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected. There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication. Correct and consistent use of latex condoms can reduce the risk of genital herpes.

• Syphilis:

Syphilis is caused by a bacterial infection and is transmitted by sexual intercourse. A painful sore or ulcer usually appears at the infection site. The best is to see your health care provider for laboratory diagnosis. The treatment includes antibiotic medications. In order to prevent Syphilis, the solution is to avoid having sex until all symptoms are resolved and medications are completed. If the STD is untreated, serious complications may occur.

• Crabs:

Crabs, also called pubic lice, are small, wingless insects that infest pubic hair. Everybody can get them, men and women. Crabs are usually spread through sexual contact BUT can also be spread through contaminated clothing and bedding. Itching is one of the main symptom. Medicated creams and shampoos can cure them. To avoid them, latex condoms may be helpful, but only when the infestation is covered or protected by the condom.

What can we do to protect ourselves from an STD?

Condoms

Why should I use it:
First, the condoms are widely recommended for the prevention of sexually transmitted diseases and secondely, they are also used to prevent pregnancy. There are then considered as a very efficient contraceptive method when it's used correctly.
By blocking the exchange of body fluids that might contain infectious agents, latex condoms provide the best protection available against STDs. In fact, the condom has multiple roles:

• It avoids the sperm cells to enter in the vagina and then in the uterus so that they can't fertilize the oocyte.
  
• It also avoids the contact between the genital skin, eventually blood and sexual fluids.
  

But, we have to be careful and use it corretly. It isn't 100% efficient; it can break for example.

• for more information on condoms: Male_Contraceptives_08

Vaccination against the cancer of the uterus

The human papillomavirus divides into two families: those who affect the skin (warts) and those who affect the sexual mucous membranes. In their life, 70% of women are once affected by the papillomavirus.

• Advantages:

This vaccine protects young girls and women against the papillomavirus wich affects their uterus. It is advised that the vaccin should be done before their first sexual relationship. Three injections must be done to be sure that they are working correctly.

• Disadvantages:

This vaccine has had major advertising and it actually doesn't protect against all the papillomavirus (there are more than a hundred). Some doctors are saying that this vaccine is useless and that there is bigger danger to catch some other papillomavirus by getting this vaccine. It has been tested for only three years and secondary effects have been neglected...

• Other factors can be the cause of a cancer of the uterus:

Early sexual relationships; Many partners; The pill; Smoking

For more information:

• http://www.who.int/bulletin/volumes/85/2/07-020207/en/
• http://www.paho.org/English/DD/PIN/ptoday03_jul08.htm

What are the different prevention programs against STD's?

• " Stop Sida" is a french non looking for benefit organisation that is dedicated to the fight against AIDS. It

1. helps in any medical research on infectious diseases, particularly on AIDS.
2. gives support to families with infected member.
3. trains doctors and health researchers.

For more information: http://www.stopsida.asso.fr/

• "HPV-HUG" :
  

During one year, the Geneva Hospital sponsers the vaccination for the HPV. Girls aged between 11 and 19 years old can be vaccinated for free against this virus which causes the uterus'cancer.
New vaccines are available, efficient for 99% against the cells responsible for 70% of “col de l’utérus” cancers. These vaccines protect by injecting neutralizing antibodies: the vaccinations is fully effective before or at the beginning of sexual life of young girls.
For more information : https://www.hpv-hug.ch/

• "WHO" : "Uniting the world against AIDS"

SDI is an external programme of diagnostic development for sexually transmitted infections. It is currently housed within the Product Research and Development unit of TDR. The placement of SDI in the Product Research and Development group of TDR allows the initiative to benefit from the considerable expertise in product development, evaluation and implementation in the group and to exploit synergies in the development of diagnostics for other communicable diseases.

References

STD's and condoms:
http://www.cdc.gov/condomeffectiveness/latex.htm
http://www.mayoclinic.com/health/condoms/HQ00463
http://www.who.int/std_diagnostics/news/history.htm
http://www.hug-ge.ch/hug_cite/action_prevention.html#5

Different STD's:
http://www.epigee.org/guide/stds.html
http://kidshealth.org/teen/infections/stds/hepatitis.html
http://www.netdoctor.co.uk/health_advice/facts/venerealdiseases.htm
http://www.nlm.nih.gov/medlineplus/sexuallytransmitteddiseases.html
http://www.ucsfhealth.org/adult/medical_services/womens_health/gynecology/conditions/std/signs.html
http://www.nyc.gov/html/doh/html/std/stdc3.shtml

http://www.unityhealthcare.org/Eastern/std_definitions.htm

http://www.cdc.gov/std/default.htm

How do we know we have an STD?: http://www.onlinedatingmagazine.com/STDs/STDadvice/stdknow.html

Programs against STD's: http://www.popline.org/docs/1365/155823.html

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