Psychology 2075 Chapter Notes - Chapter 8: Unit, Pubic Hair, Liver Disease

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The term STI (sexually transmitted infection) is preferred over STD (sexually transmitted disease) as it is more
oSTD refers only to infections causing symptoms
oSTI includes infections for which people have symptoms as well as those for which they have no
symptoms (asymptomatic)
The STI epidemic in Canada disproportionately affects teens and young adults (ages 15 – 24)
oThree main infections that account for a majority of cases in this age group – human papillomavirus,
trichomoniasis, and chlamydia
STI-related stigma – an individual’s awareness that people will judge them negatively for having an STI
STI-related shame – negative feelings people have about themselves when they receive an STI diagnosis
People with higher STI-related stigma and shame are less likely to be tested or screen for STIs
Some STIs are caused by bacteria, some are caused by viruses, and a few are caused by other organisms
oBacterial infections (such as chlamydia, gonorrhea, and syphilis) can be cured using antibiotics,
whereas viral infections (such as HIV/AIDS, herpes, HPV and hepatitis B) cannot be cured but they can
be treated to reduce symptoms
Chlamydia trachomatis – bacterium that is spread by sexual contact and infects the genital organs of both males
and females
Most prevalent bacterial STI in Canada
Rate of chlamydia has been rising steadily since 1997, and adolescent girls have a particularly high rate of
infection with more than five times the national rate of 249 cases per 100,000
oMen – thin, usually clear discharge and mild discomfort on urination appearing 7 to 21 days after
infection; 50% of cases are asymptomatic
Symptoms are similar to symptoms of gonorrhea in men, however, gonorrhea produces more
painful urination and more profuse, pus-like discharge
oWomen – 75% of cases are asymptomatic
oTreated with azithromycin or one of the tetracyclines, does not respond to penicillin
oPoorly treated or undiagnosed cases may lead to a number of complications – urethral damage,
epididymitis (infection of the epididymis), Reiter’s syndrome, and proctitis in men who have anal
oWomen with untreated/undiagnosed chlamydia may experience serious complications if not treated –
pelvic inflammatory disease (PID) and possibly infertility due to scarring of the fallopian tube
Pelvic inflammatory disease (PID) – an infection and inflammation of the pelvic organs, such
as the fallopian tubes and the uterus, in women
oUntil a vaccine is available, screening is one of the most effective tools for prevention in addition to safer
oIn screening programs, asymptomatic carriers are identified, treated and cured so that they do not
continue to spread the disease
HPV – human papillomavirus
More than 40 different types of HPV exist
oSome types cause genital warts and are called low risk because they do not cause cancer
oOther types cause cervical cancer and are called high risk types
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oSome types have no symptoms at all, majority of those infected with HPV are asymptomatic
Highly infectious disease and although condoms reduce the risk of infection, they do not eliminate it
Transmitted through skin-to-skin contract most often from contact with the penis, scrotum, vagina, vulva, or anus
of the infected person
Genital warts – warts which appear on the genitals, usually around the urethral opening of the penis, the shaft
of the penis, or the scrotum in the male, and on the vulva, walls of the vagina, or the cervix in the female
oTypically appear 3-8 months after intercourse with an infected person
HPV causes almost all cases of cervical cancer
oHPV 16 and 18 account for 70% of the cases of cervical cancer
oHPV is also associated with cancer of the penis and anus
oInspection of the warts, due to distinctive appearance
o“Silent infection” because many individuals with HPV show no obvious signs of infection
oFor many women, first indication of HPV is abnormal cells on a Pap test
oChemicals such as podophyllin (Podofilm) or trichloroacetic acid can be applied directly to the warts,
Aldara can also be used
These treatments have to be repeated several times and the warts then fall off
oCryotherapy – warts are frozen off, often using liquid nitrogen
oGardasil – protects against four HPV types that between them cause 70% of cervical cancers and 0% of
genital warts, must be administered in three shots over a 6-month period
Use of the vaccine does not affect existing infections, therefore, it is recommended that girls
between the ages of 9 and 13 (before they engage in sexual intercourse) are administered the
vaccine; as well as women between the ages of 14 and 25 who have not had an HPV infection
or abnormalities on their Pap tests
Protects against HPV 16 and 18, the ones associated with cervical cancer, as well as two other
types that cause most causes of genital warts
oCervarix – newer vaccine that protects against two HPV types that cause 70% of cervical cancers
Genital Herpes
Disease of the genital organs caused by the herpes simplex virus (HSV)
Transmitted by sexual intercourse and by oral-genital sex
Two strains of HSV – HSV-1 and HSV-2, both of which can either cause genital herpes
It is estimated that more than 20% of Canadian adults are infected, and research shows that infection rates are
higher among individuals who have had more sexual partners
Majority of people with HSV are asymptomatic and are not aware that they are infected, thus transmitting the
disease to others unknowingly
oGenital herpes caused by HSV-2 – small, painful bumps or blisters on the genitals which appear within
two to three weeks of infection
oIn women, they are usually found on the vaginal lips; in men, they usually occur on the penis
oThe blisters heal on their own in about three weeks in the first episode of infection, but the virus
continues to live in the body and may remain dormant for the rest of the person’s life. The symptoms
may recur unpredictably, so that the person repeatedly undergoes 7- to 14-day periods of sores
oHSV-1 infection tends to be less severe
oNot yet any known drug that kills the virus
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oThe drug acyclovir (Zovirax) prevents or reduces the recurring symptoms, although it does not actually
“cure” the disease
oValacyclovir (Valtrex) and famciclovir (Famvir) are newer drugs that are even more effective at
shortening outbreaks and suppressing recurrences
Long-term consequences
oMen or women with recurrent herpes may develop complications such as meningitis or narrowing of the
urethra due to scarring, leading to difficulties with urination
oSerious risks
Having a herpes infection also increases one’s risk of becoming infected with HIV
Virus may transfer from mother to infant in childbirth, which in some cases leads to serious
illness or death in the baby
Psychological aspects – coping with herpes
oWide range of psychological responses
At one end, persons with asymptomatic herpes, who are not aware that they have the disease
and are happily sexually active (and possibly unknowingly spreading the disease to others)
At the other end, persons who experience frequent, severe, painful recurrences
These difficulties are aggravated by the fact that outbreaks are often unpredictable, and
current scientific evidence indicates that people are at least somewhat infectious even
when they are not having an active outbreak
oInfections on the genitals are more likely to be stigmatized than a similar infection elsewhere on the
body, such as a cold sore, likely because they are sexually transmitted
HIV Infection and AIDS
AIDS (acquired immune deficiency syndrome) – a sexually transmitted disease that destroys the body’s natural
immunity to infection so that the person is susceptible to and may die from a disease such as pneumonia or
HIV (human immune deficiency virus) – the virus that causes AIDS, destroys the body’s natural system of
immunity to diseases
oHIV-1 accounts for almost all infections in North America
oHIV-2 has been identified, found almost exclusively in Africa
It is estimated that 33 million people worldwide are infected with HIV, although the majority of them show no
symptoms yet and are unaware that they are infected
The hardest-hit part of the world is sub-Saharan Africa, accounting for 71% of all new HIV infections
In 2008 alone, HIV infection caused approximately 2 million deaths worldwide – thus, it has been described as a
global epidemic and pandemic
Although the number of people with HIV worldwide continues to grow, the number of new infections each year
has decreased which suggests that HIV prevention efforts are working in at least some countries
oHIV is transmitted by an exchange of body fluids (semen, blood, and possibly secretions of the cervix
and vagina)
oHIV is spread in four ways:
1. By sexual intercourse (either penile-vaginal or anal intercourse)
2. By contaminated blood (a risk for people who receive a blood transfusion if the blood has
not been screened)
3. By contaminated hypodermic needles (a risk for those who inject drugs or healthcare
workers who receive accidental sticks)
4. From an infected woman to her baby during pregnancy or childbirth
oStatistics indicate that Canadians who have been diagnosed with HIV/AIDS are from the following
exposure categories:
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