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ACKNOWLEDGEMENT

“There are times when silence speaks so


much more loudly than words of praise to
only as good as belittle a person, whose
words do not express, but only put a
veneer over true feelings, which are
gratitude at this point of time”.
I would like to express our sincere
gratitude to our biology teacher Mr. Sunil
Goswami for his vital support, guidance
and encouragement- without which this
project would have come forth.
I would also like to express my gratitude to
the staff of the Department of Biology at
Kendriya Vidyalaya No. 1 AFS Jamnagar for
their support during the making of this
project.
This project was an amiable as well as
inspiring assignment to me for
achieving the success.
Anusha Kaushik
Roll no.

Certificate
This is to certify that Anusha
Kaushik student of class XII th- B;
Kendriya Vidyalaya No.1 AFS
Jamnagar has completed the project
titled “Study of Sexually
Transmitted Diseases” during the
academic year 2014-2015 towards
partial fulfillment of credit for the
Biology practical evaluation of
AISSCE 2014-2015, under the
supervision of Mr. Sunil Goswami.
Teacher In-charge
Examiner

Principal

Table of contents
1. Introduction
2. Cause
3. Main Types
4. Diagnosis
5. Study of HIV AIDS
6. Transmission of HIV
7. Types and Myths of HIV
8. Pathogenesis of HIV AIDS
9. Stages of HIV with their
symptoms
10. Diagnosis of HIV
11. Treatment
12. Prevention
13. Conclusion
14. Bibliography

Introduction
Sexually transmitted diseases (STD), also referred to as sexually
transmitted infections (STI) and venereal diseases (VD), are
infections that are commonly spread by sex, especially vaginal
intercourse, anal sex and oral sex. Most STDs initially do not cause
symptoms. This results in a greater risk of passing the disease on to
others.[2] Symptoms and signs of disease may include: vaginal
discharge, penile discharge, ulcers on or around the genitals,
and pelvic pain. STDs acquired before or during birth may
result in poor outcomes for the baby. Some STIs may cause
problems with the ability to get pregnant.
More than 30 different bacteria, viruses, and parasites can
cause STDs. Bacterial STDs include Chlamydia, gonorrhea, and
syphilis among others. Viral STDs include genital
herpes, HIV/AIDS, and genital warts among others. Parasitic STDs
include Trichomoniasis among others. While usually spread by
sex, some STDs can also be spread by non-sexual contact with
contaminated blood and tissues, breastfeeding, or during
childbirth. STD diagnostic tests are easily available in the
developed world, but this is often not the case in the developing
world.
The most effective way of preventing STDs is by not having
sex. Some vaccinations may also decrease the risk of certain
infections including hepatitis B and some types of HPV. Safer
sex practices such as use of condoms, having a smaller number of
sexual partners, and being in a relationship where each person
only has sex with the other also decreases the risk. Circumcision
in males may be effective to prevent some infections. Most STIs
are treatable or curable. Of the most common infections,
syphilis, gonorrhea, Chlamydia, Trichomoniasis are curable,
while herpes, hepatitis B, HIV/AIDS, and HPV are treatable but
not curable. Resistance to
certain antibiotics is developing among some organisms such
as gonorrhea.
Cause
Transmission
The risks and transmission probabilities of
sexually transmitted diseases are summarized by
act in the table:

Risk per unprotected sexual act with


an infected person
Known Possibl
risks e
Performin  Throat Chlamydia  Hepatitis
 Throat B (low risk)
g oral sex
on a man  Gonorrhea (25–  HIV (0.01%)
30%)  Hepatitis
 Herpes (rare) C (unknown
 HPV )
 Syphilis (1%)

Performin  Herpes  Throat


 HPV gonorrhea
g oral sex
 Throat
on a
woman Chlamydia

 Chlamydia  HP
Receiving  Gonorrhea
V
oral sex—
man  Herpes
 Syphilis (1%)
 Herpe  HPV
Receiving
 Bacterial
s
oral sex—
woman Vaginosis
 Gonorrhea

 Vaginal  Chlamydia (30–  Hepatitis C


sex— 50%)
man  Crabs
 Scabies
 Gonorrhea (22%)
 Hepatitis B
 Herpes (0.07%
for HSV-2)
 HIV (0.05%)
 HPV (high: around
40-50%)
 Syphilis
 Trichomoniasis

 Chlamydia (30–  Hepatitis C


Vaginal
sex 50%)
—  Crabs
woman
 Scabies
 Gonorrhea (47%)
 Hepatitis B (50–
70%)
 Herpes
 HIV (0.1%)
 HPV (high; around
40-50%)
 Syphilis
 Trichomoniasis

Anal sex—  Chlamydia  Hepatitis C


 Crabs
insertive
 Scabies (40%)
 Gonorrhea
 Hepatitis B
 Herpes
 HIV (0.62%)
 HPV
 Syphilis (14%)
Anal sex—  Chlamydia  Hepatitis C
 Crabs
receptive
 Scabies
 Gonorrhea
 Hepatitis B
 Herpes
 HIV (1.7%)
 HPV
 Syphilis (1.4%)
Anilingus  Amebiasis  HPV (1%)
 Cryptosporidiosis

(1%)
 Giardiasis
 Hepatitis A (1%)
 Shigellosis (1%)
Main types
Sexually transmitted infections include:

 Chlamydia is a sexually transmitted infection caused by the


bacterium Chlamydia trachomatis. In women, symptoms
may include abnormal vaginal discharge, burning during
urination, and bleeding in between periods, although most
women do not experience any symptoms. Symptoms in men
include pain when urinating, and abnormal discharge from
their penis. If left untreated in both men and women,
Chlamydia can infect the urinary tract and potentially lead
to pelvic inflammatory disease (PID). PID can cause serious
problems during pregnancy and even has the potential to
cause infertility. It can cause a woman to have a potentially
deadly ectopic pregnancy, in which the child is born outside
of the uterus. However, Chlamydia can be cured with
antibiotics.

 The two most common forms of herpes are caused by


infection with herpes simplex virus (HSV). HSV-1 is typically
acquired orally and causes cold sores, HSV-2 is usually
acquired during sexual contact and affects the genitals,
however either strain may affect either site.[31] Some people
are asymptomatic or have very mild symptoms. Those that do
experience symptoms usually notice them 2 to 20 days after
exposure which last 2 to 4 weeks. Symptoms can include
small fluid-filled blisters, headaches, backaches, itching or
tingling sensations in the genital or anal area, and pain
during urination, Flu like symptoms, swollen glands, or fever.
Herpes is spread through skin contact with a person infected
with the virus. The virus affects the areas where it entered the
body. This can occur through kissing, vaginal intercourse,
oral sex or anal sex. The virus is most infectious during times
when there are visible symptoms; however those who are
asymptomatic can still spread the virus through skin contact.
The primary attack is the most severe because the body does
not have any antibodies built up. After the primary attack,
one might have recurring attacks that are milder or might
not even have future attacks. There is no cure for the disease
but there are antiviral medications that treat its symptoms
and lower the risk of transmission (Valtrex). Although HSV-1
is typically the "oral" version of the virus and HSV-2 is
typically the "genital" version of the virus, a person with HSV-
1 orally CAN transmit that virus to their partner genitally.
The virus, either type, will settle into a nerve bundle either at
the top of the spine, producing the "oral" outbreak, or a
second nerve bundle at the base of the spine, producing the
genital outbreak.

 The human papillomavirus (HPV) is the most common STI


in the United States. There are more than 40 different
strands of HPV and many do not cause any health problems.
In 90% of cases the body’s immune system clears the
infection naturally within 2 years.[34] Some cases may not be
cleared and can lead to genital warts (bumps around the
genitals that can be small or large, raised or flat, or shaped
like cauliflower) or cervical cancer and other HPV related
cancers. Symptoms might not show up until advanced stages.
It is important for women to get pap smears in order to check
for and treat cancers. There are also two vaccines available
for women (Cervarix and Gardasil) that protect against the
types of HPV that cause cervical cancer. HPV can be passed
through genital-to-genital contact as well as during oral sex.
It is important to remember that the infected partner might
not have any symptoms.

 Gonorrhea is caused by bacterium that lives on moist mucous


membranes in the urethra, vagina, rectum, mouth, throat,
and eyes. The infection can spread through contact with the
penis, vagina, mouth or anus. Symptoms of Gonorrhea
usually appear 2 to 5 days after contact with an infected
partner however, some men might not notice symptoms for
up to a month. Symptoms in men include burning and pain
while urinating, increased urinary frequency, discharge from
the penis (white, green, or yellow in color), red or swollen
urethra, swollen or tender testicles, or sore throat. Symptoms
in women may include vaginal discharge, burning or itching
while urinating, painful sexual intercourse, severe pain in
lower abdomen (if infection spreads to fallopian tubes), or
fever (if infection spreads to fallopian tubes), however many
women do not show any symptoms. There are some antibiotic
resistant strains for Gonorrhea but most cases can be cured
with antibiotics

 Syphilis is an STI caused by a bacterium. If acquired, syphilis


needs to be treated adequately; otherwise it can cause long-
term complications and death. Clinical manifestations of
syphilis include the ulceration of the uro-genital tract, mouth
or rectum; if left untreated the symptoms worsen. In recent
years, the prevalence of syphilis has declined in Western
Europe, but it has increased in Eastern Europe (former Soviet
states). A high incidence of syphilis can be found in places
such as Cameroon, Cambodia, and Papua New Guinea.

 Trichomoniasis is a common STI that is caused by infection


with a protozoan parasite called Trichomonas vaginalis.
Trichomoniasis affects both women and men, but symptoms
are more common in women. Most patients are treated with
an antibiotic called metronidazole, which is very effective.
 HIV (human immunodeficiency virus) damages the body's
immune system which interferes with fighting off disease-
causing agents. The virus kills CD4 cells, which are white
blood cells that help fight off various infections. HIV is
carried in body fluids, and is spread by sexual activity. It can
also be spread by contact with infected blood, breast
feeding, childbirth, and from mother to child during
pregnancy. When HIV is at its most advanced stage, an
individual is said to have AIDS (acquired immunodeficiency
syndrome).

Diagnosis
Testing may be for a single infection, or consist of a number of
tests for a range of STIs, including tests
for syphilis, trichomonas, gonorrhea, Chlamydia, herpes, hepatitis
and HIV. No procedure tests for all infectious agents.
STI tests may be used for a number of reasons:

 as a diagnostic test to determine the cause of symptoms


or illness
 as a screening test to detect asymptomatic
or presymptomatic infections
 As a check that prospective sexual partners are free of disease
before they engage in sex without safer sex precautions (for
example, when starting a long term mutually monogamous
sexual relationship, in fluid bonding, or for procreation).
 as a check prior to or during pregnancy, to prevent harm to the
baby
 as a check after birth, to check that the baby has not caught an
STI from the mother
 to prevent the use of infected donated blood or organs
 as part of the process of contact tracing from a known
infected individual
 as part of mass epidemiological surveillance
Early identification and treatment results in less chance to spread
disease and for some conditions may improve the outcomes of
treatment. There is often a window period after initial infection
during which an STI test will be negative. During this period the
infection may be transmissible. The duration of this period varies
depending on the infection and the test. Diagnosis may also be
delayed by reluctance of the infected person to seek a medical
professional. One report indicated that people turn to the
Internet rather than to a medical professional for information on
STIs to a higher degree than for other sexual problems.
Study of HIV AIDS:-
HIV- (Human Immunodeficiency Virus) The
virus compromises the body’s ability to
handle disease and causes AIDS.

AIDS- (Acquired Immune Deficiency


Syndrome) it is related to HIV, but they are not
one in the same. A person has AIDS only in the
final stages of HIV, after the immune system
becomes unable to defend itself against foreign
invaders like bacteria, other viruses, and allows
the development of certain cancers. AIDS is
caused by the human immunodeficiency
virus (HIV). HIV destroys a type of defense
cell in the body called a CD4 helper
lymphocyte. 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
— that is, they become immune deficient.

How is HIV transmitted:-


 HIV is transmitted from an infected person to
another person through blood, semen, vaginal
fluids, and breast milk.
 Sexual intercourse (vaginal and anal): Anal and
vaginal intercourses are high-risk activities. In the
penis, vagina and anus, HIV may enter through cuts
and sores (many of which would be very small and
hard to notice), or directly through the mucus
membranes.
 Oral sex (mouth-penis, mouth-vagina): There are
cases where HIV was transmitted orally, so it's not
completely without risk to have HIV-infected semen,
vaginal fluid or blood in your mouth. However, oral
sex is considered a low risk practice. The virus can't
survive well in the mouth (in semen, vaginal fluid or
blood), so the risk of HIV transmission through the
throat, gums, and oral membranes is lower than
through vaginal or anal membranes.
 Sharing injection needles or works: Sharing needles or
other materials used for injecting is considered a
high-risk practice. Injection needles can pass blood
directly from one person to another if you share
them. If a person with HIV injects with a needle then
shares it with another person, the second person is at
very high risk for getting HIV.
 Mother to Child: Mother to child transmission is now
rare in the US and other developed countries because
pregnant women who are HIV-positive are normally
given medications to prevent the fetus from getting
infected. However, it is possible for an HIV-infected
mother to pass the virus directly before or during
birth, or through breast milk. Breast milk contains
HIV, and while small amounts of breast milk do not
pose significant threat of infection to adults, it is a
risk for infants.

There are two types of HIV i.e., HIV-1 and HIV-2.


Difference between HIV-1 & HIV-2:
₪ HIV-2 is lower transmissibility.
₪ HIV-2 develops more slowly.
₪ MTCT (mother to child transmission) is relatively
rare with HIV-2.
₪ HIV-2 is found primarily in West Africa.
₪ HIV-1 is more common worldwide.
Myths about HIV
YOU CAN GET HIV IF YOU HUG
SOMEONE WHO IS INFECTED

It is not possible to become infected with


HIV from everyday casual contact such
as sharing food, shaking hands or
touching the same objects.
MOSQUITOS CAN GIVE YOU HIV

Insects cannot transmit HIV. When taking


blood from someone mosquitoes do not
inject blood from any previous person.
The only thing that a mosquito injects is
saliva, which is used as a lubricant and
enables it to feed more efficiently.
YOU CAN GET HIV FROM
KISSING SOMEONE WHO IS
INFECTED
Saliva does contain HIV, but the virus is
only present in very small quantities and
as such
cannot cause HIV infection. Unless both
partners have large open sores in their
mouths, or severely bleeding gums, there
is no transmission risk from mouth-to-
mouth kissing.
Risk factors of HIV
₪ Have unprotected sex (do not use condoms).
₪ Is a man who has sex with other men.
₪ Have or have recently had a sexually
transmitted disease such as hepatitis
B&C.
₪ People who inject drugs or steroids,
especially if they share needles.
₪ Babies who are born to mothers who are
infected with HIV.
Pathogenesis of AIDS
Stages of HIV with its symptoms
Stage 1:
Primary HIV Infection
The first stage is called acute infection.
It is often accompanied by a short flu-like illness
It typically happens within 2 to 6 weeks
after exposure or becoming infected.
During this stage there is a large amount of HIV in
the peripheral blood and the immune system begins
to respond to the virus by producing HIV
antibodies. This process is known as
(seroconversion).
Symptoms
Extreme weakness or fatigue
Headaches, fevers
Stage 2:
Clinically Asymptomatic Stage
This stage lasts for an average of ten years
During this period without symptoms, HIV is slowly
killing the CD4 T-cells and destroying the immune system.
Blood tests during this time can reveal the number of
these CD4 T-cells. For an HIV-infected person, the
number of CD4 T-cells steadily drops.

No clear symptoms appear


Stage 3:
Symptomatic HIV Infection
AIDS (acquired immune deficiency
syndrome) is the advanced stage of HIV
infection. When the CD4 T-cell number drops
below 200, people are diagnosed with AIDS.
The symptoms of stage 3
Being tired all of the time.
Swollen lymph nodes in the neck.
Fever lasting for more than 10 days.
Night sweats.
Unexplained weight loss.
Purplish spots on the skin that don't go
away.
Shortness of breath.
Severe, long-lasting diarrhea.
Diagnosis
The HIV Test:
Enzyme-linked immunosorbent assay (ELISA).
This test is usually the first one used to detect infection
with HIV. If antibodies to HIV are presented (positive),
the test is usually repeated to confirm the diagnosis.

Western blot.
This test is more difficult than the ELISA to perform.
Polymerase chain reaction (PCR).
This test finds either the RNA of the HIV virus or the
HIV DNA in white blood cells infected with the
virus.

If you receive a diagnosis of HIV/AIDS, several types


of tests can help your doctor determine what stage of
the disease you have. These tests include:
CD4 count.
- CD4 cells are a type of white blood cell
that's specifically targeted and destroyed by
HIV.
- CD4 count vary from 500 to more than
1,000= healthy person.
- CD4 count becomes less than 200 =HIV
infection progresses to AIDS.
Viral load:
- This test measures the amount of virus in your blood.

Baby’s investigation of HIV after birth


Most HIV tests look for antibodies to HIV, not
the virus itself. But these tests aren’t very useful
for babies born to HIV-positive mothers.
WHY?
That’s because the mother’s HIV antibodies
get into the baby’s blood during pregnancy. If
the mother is HIV-positive, the regular HIV test
will show that the baby is HIV-positive,
even when that isn’t true.
Treatment
Anti-retroviral medicines work by
stopping the HIV from making copies
of itself.
- To strengthen the immune system.
- The amount of virus in your body
(viral load) is decreased.
- Allows your body to make more CD4 T cells.
Commonly three different types of
medicines are taken together. This is called
combination therapy. And that helps to
prevent the virus from becoming resistant to
the medicines. These medicines are usually
taken for life.

The classes of anti-HIV drugs include:


Non-nucleoside reverse
transcriptase inhibitors (NNRTIs).
It disables a protein needed by HIV to
make copies of itself.
Nucleoside reverse transcriptase inhibitors
(NRTIs).
They are faulty versions of building blocks
that HIV needs to make copies of itself.
Protease inhibitors (PIs).
It disables protease, another protein
that HIV needs to make copies of itself.
Entry or fusion inhibitors.
These drugs block HIV's entry into
CD4 cells.
Integrase inhibitors.
Raltegravir (Isentress) works by disabling
integrase, a protein that HIV uses to insert
its genetic material into CD4 cells.
Prevention
How to protect your baby from getting HIV:
Mother-to-child transmission of HIV can be
prevented by using antiretroviral drugs, which
reduce the chances of a child becoming infected
with HIV from 20% to less than 5%.
How to prevent men and women from getting HIV
Don't have sex with multiple partners.
Don't use drugs or alcohol with sex.
Use a condom.
If you inject drugs, use a new sterile needle
each time to significantly reduce the risk of
HIV transmission.
Conclusion
In general, the studies reported
similar low levels of knowledge and
awareness of sexually transmitted
diseases, with the exception of
HIV/AIDS.
Although, as shown by some of the
findings on condom use, knowledge
does not always translate into
behaviour change, adolescents' sex
education is important for STD
prevention, and the school setting
plays an important role. Beyond
HIV/AIDS, attention should be paid
to infections such as Chlamydia,
gonorrhea and syphilis.
Bibliography
www.google.com
www.wikipedia.com
Ncert Biology textbook

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