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2013 World AIDS

Day
Global Theme:
Getting to Zero

FACTS and STATISTICS
World AIDS Day is held on December 1st each year.
According to the Foundation of AIDS Research, at the end
of calendar year 2012,
more than 35 million people were living with
HIV/AIDS,
3.3 million of them were under the age of 15 and since
the beginning of the epidemic,
more than 75 million people have contracted HIV; and
nearly 36 million have died of HIV-related causes.

SEXUALLY
TRANSMITTED
DISEASES
-AIDS-
HIV (Human Immunodeficiency Virus) is
a virus that attacks the immune system,
the bodys natural defense system
AIDS (Acquired Immune Deficiency
Syndrome)
Sexual transmission

Unprotected relations

Infected sexual secretions

Genital, oral, rectal mucous membranes

Infected person
Cont
Blood or blood product

Infected blood / blood transfusion
Open wound
Receive tatoo,piercings and scarification
procedure
Infected person

Cont
Mother to child

Virus from mother to child

in utero, intrapartum or via

Absence of treatment

Infected baby
Progresses in 3 stages :
Initial stage (Acute Retroviral Syndrome)
Abdominal cramps, nausea or vomiting
Diarrhea
Fever
Headache
Skin rash
Weight loss

Cont
Chronic stage
Confusion
Dry cough
Fatigue
Shortness of breath
Personality changes
Odynophagia (pain during swallowing)
Mouth sores
Late stage

Testing positive for HIV infection
Complete Blood Count (CBC)- to identify the
number and type of cell in blood
A chemistry screen- measure the blood levels and
evaluate liver and kidney function
Syphilis testing
Screening for hepatitis A, hepatitis B and
hepatitis C
Tuberculosis (TB) screening


Antiretroviral Therapy :
- tenofovir, abacavir
- nevirapine, etravirine
- tipranavir, indinavir
- maraviroc, enfurvitide
- raltegravir (insentress)

Cont

Antibiotics and prednisone
for complication of pneumonia
Amphotericin B with flucytosine :
for complication of meningitis
Clotrimazole
for complication of oral candidiasis
The virus that causes HIV has become
resistant. The medication no longer
effectively controls virus multiplication nor
protects immune system
Didnt take medication as prescribed
Medical history ;
Eg. Have you ever had symptoms that
might indicate illness ( fever, weight loss,
shortness of breath,or diarrhea? )
Physical examination ;
Temperature
Weight
Eyes cytomegalovirus (CMV) retinitis
Gynecologic
Cont
Mouth oral yeast infections (thrust),
mouth sores
Lymph nodes - lymphadenopathy
Abdomen hepatomegaly, splenomegaly
Skin Seborrheic dermatitis, Kaposis
sarcoma

SYSTEMIC
GONORRHEA
DEFINITION
Gonorrhea is a sexually transmitted diseases
(STD). Gonorrhea is caused by Neisseria
Gonorrheae, a bacterium that can grow and
multiply easily in the warm, moist areas of
the reproductive tract, including the cervix
(opening to the womb), uterus (womb), and
fallopian tubes (egg canals) in women, and
in the urethra (urine canal) in women and
men. The bacterium can also grow in the
mouth, throat, eyes and anus.
RISK FACTORS
Sexually active persons :
Teenagers
Young adults
Africans Americans

SIGN AND SYMPTOMS
For men :
Burning sensation when urinating
White, yellow, or green discharge from
penis
Painful or swollen testicles
For women :
painful or burning sensation when urinating
Increased vaginal discharge
Vaginal bleeding between period
CONT..
For both :
Rectal infection like :
Discharge
Anal itching
Soreness
Bleeding
Painful bowel movements
Infections in throat :
Sore throat

HOW DOES GONORRHEA AFFECT
A PREGNANT WOMAN AND HER
BABY?
Pregnant woman who has gonorrhea may
give the infections to her baby as the baby
passes through the birth canal during
delivery. This can cause :
Blindness
Joint infections
Life threatening blood infections

DIAGNOSTIC PROCEDURES
Urine test for UFEME (urine for
examination & microscopic examination)
Gram stain (sample from a urethra or a
cervix)
gram stain of
urethral
discharge
TREATMENTS
Medication like antibiotics :
fluoroquinolones
cephalosporins
ceftriaxone
CONT..
Oinment :
Erythromycin
(prevent blindness)

amoxicillin
cefixime
Spectinomycin


Gonococcal
ophthalmia
COMPLICATIONS
For women :
Pelvic Inflammatory Diseases (PID)
Infertility
Ectopic pregnancy
Perihepatitis

Gonococcal cervicitis
Bartholins abscess
CONT..
For men :
Epididymitis
Infertility
Prostatitis
urethritis
Gonococcal urethritis
Disseminated
gonorrhea
(skin lesion)
SYPHILIS
SYPHILIS
DEFINITION
Is a sexually transmitted diseases (STD)
caused by the bacterium treponema
pallidum. It has often been called the
great imitator because so many of the
sign & symptoms are indistinguishable
from these of other disease.

PATHOPHYSIOLOGY
Break in the skin or mucous membrane

Vulnerable to invasion by the spirochete

Enter the system and spread through the blood
and lymphatic system

Congenital syphilis is transfered to the fetus

Through the placenta circulation

SIGN AND SYMPTOMS
Primary syphilis :
Usually occurs 10 days to 3 month after exposure
Sore on the penis (men)
Sore around inside the vagina (women)
Secondary syphilis :
Rash reddish brown occur anywhere on body
Fever
Swollen lymph glands
Body aches
Sore in mouth
fatigue
CONT..
Tertiary syphilis :
effect brain & spinal cord
damage heart & other organs
Late syphilis :
Jerky or uncoordinated muscle
movement
Paralysis
Numbness
Gradual blindness
Dementia

DIAGNOSTIC TEST
Dark ground examination
DFA- TP (direct fluorescent antibody)
FTA (fluorescent treponemal antibody
absorption)
S. VDRL (venereal disease research laboratary)
TPHA (treponema pallidum haemagglutination
assay test
CXR (Chest X-ray)
Lumbar puncture
Serum FTA

TREATMENT
Primary & secondary
1. Procaine penicillin G 600 000 units IM daily for
10 days.
2. Benzathine penicillin 2.4 million units IM weekly
for 2 weeks.
- If allergic to penicillin
1. Doxycycline 100mg oral TID for21 days
2. Tetracycline 500mg oral 6 hourly for 21
days
3. Erthromycin 500mg oral 6 hourly for 21
days
cont
Late stage
1. Benzathine penicillin 2.4 million units
I M weekly for 3 weeks
- I f allergic to penicillin
1. Doxycycline 100mg for 30 days or tetracycline.

HEALTH EDUCATION
FOR SEXUALLY TRANSMITTED
DISEASE (STD)
Practice safe sex to prevent HIV. Always
use a condom during sexual activity, unless
in a relationship with one partner who does
not have HIV or other sex partners
Reduce number of sex partners, preferably
to one partner
Do regularly tested for HIV

Cont
Coping and support to patient and family
HIV / AIDS clinics that may help :
Learn all about HIV / AIDS
Be proactive
Maintain a strong support system
Keep all appointments and take medications
exactly as directed

Cont
Talk to sex partner about their sexual
history and find out whether has engaged in
high-risk behaviors
Avoid alcohol and drugs, which can impair
both judgement and immune system.
Tell sex partners about behavior and
whether has HIV-Positive
Do not donate blood, plasma, semen, body
organs or body tissues

Cont
Avoid breast feeding their infant.
Wear mask, glove, protective eyewear or
shields, gowns and apron to prevent
exposure of the skin or mucus membranes
to bloodborne pathogens
Do not share IV needles, syringes, cookers,
cotton, cocaine spoon or eyedroppers with
others.