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Peer Challenge
Cape May County, NJ
Atlantic County, NJ
Cumberland County, NJ
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Risk #1: More Information on Sexually Transmitted Infections

HPV (human papillomavirus) is the most common STI occurring in 38 percent of sexually active teens.  A recent study indicated that a surprising 60% of the females attending Rutgers University who went to the STI clinic tested positive for HPV.  There are approximately 130 strains of this highly infectious virus and about 40 strains are transmitted through sexual contact.  Strains 6, 11, 42, 43, 44, and 55 are responsible for causing Genital Warts, small painless cauliflower-like growths in the genital area.  More serious than genital warts, are the strains of HPV which causes genital cancer in both men and women (strains 16, 18, 31, 33, 35, 39, 45, and 51). Although genital cancer in men is not that common, cervical cancer kills about 5,000 women every year and HPV is responsible for over 99% of the cases of cervical cancer.  More women die every year from cervical cancer than from AIDS yet we are much more informed about HIV than HPV.  Pap tests reveal the presence of precancerous cells resulting from the presence of HPV. Most of the time cervical cancer does not show up until the female is about 35-40 years old, but since the cells surrounding the cervix of a teenage girl are much more immature than they are in older females, the cancer can grow much more rapidly. Since HPV is a viral STI there is no cure, however, most HPV infections resolve spontaneously.  HPV can spread even when warts are not visible. Treatment includes removing the warts by freezing, surgery, cautery, and acids, but unfortunately even after their removal they can grow back because the virus can still remain in the body. Treatments often have to be repeated and can become expensive. HPV can pass from mother to child during delivery causing polyps to grow on the baby’s vocal cords.  Fortunately, a vaccine has been developed to prevent HPV.  However, the vaccine, Gardasil, only prevents 70% of the strains of HPV which can cause cervical cancer (strains 16 and 18) and genital warts (strains 6 and 11).

Herpes is known as “the gift that keeps on giving” since it is viral STI (herpes simplex I) and remains incurable.  It is detectable in over 20% of the population. 1-2 weeks after exposure painful blisters appear in the genital area.  In a couple of weeks it cleans up but the virus migrates to the spinal nerves where it remains dormant until a future outbreak.  Outbreaks can occur several times a year, but their cause remains unknown with diet, stress, and hormones as possible triggers. Cold sores are caused by herpes simplex II so oral sex can transmit the virus from the mouth to the genital area and vice versa.  The virus can pass from mother to child and can be deadly or cause severe nervous system damage so a caesarian is often performed. Drugs like valtrex can reduce the number of outbreaks and the risk of transmitting the virus.  However, since the drugs do not cure herpes, the virus can still be transmitted and the drugs are expensive and must be taken every since day.

Hepatitis B is one of the most common, highly contagious viral diseases infecting 400 million people globally and 1 million Americans.  15-20% of college students are infected with hepatitis B (HBV), the most serious of the 5 strains of hepatitis (A, B, C, D, E). HBV is one of the leading causes of liver cancer and is responsible for an annual death toll of one million people worldwide and 5,000 Americans.  Since it is found in all body fluids, its main modes of transmission are through blood transfusions and intravenous drug use, sexual contact, and from infected mother to child. 70-90% of the infected newborns become chronic carriers and risk developing long-term liver complications.
Although many of those infected with HBV never show any noticeable symptoms, most will experience jaundice (a yellowing of the skin) and flu-like symptoms including mild fever, tiredness, loss of appetite, nausea and vomiting. As a viral STI it is incurable, but 90% of those infected develop antibodies against the disease and will totally clear the virus from their bodies. The remaining 10% will become lifelong chronic HBV carriers increasing their risk of developing liver disease including cirrhosis and liver cancer.  Thanks to the development of a safe and effective vaccine, HBV can be prevented, but for those already infected there is no cure.  The Centers for Disease Control recommends vaccinations for all newborns, children and teens so most daycare centers, schools and colleges now require the 3 shot HBV vaccination prior to their entrance. Treatments include steroids, interferon, and lamivudine that slow down the rate of the virus’ reproduction and reduce liver inflammation.

HIV is found in about 1-2 million Americans and 16,000 teens become infected every year.  1 out 100 Texas University students tested positive for HIV. New Jersey has a higher average of HIV cases (75/100,000) than the nation’s average (52/100,000).  HIV is a lenti retrovirus that mutates rapidly so the development of a cure or vaccine is highly unlikely.  It suppresses the immune system by infecting the T-4 cells and often takes 7-10 years for the onset of symptoms.  Since it is a viral STI there is no cure, but new drugs can slow the replication of the virus. It is 100% fatal with many victims dying of opportunistic diseases like cancer and pneumonia.

Chlamydia has risen to become the most common bacterial STI infecting about 30-40 percent of sexually active teens. The vast majority of females, 85 percent, do not show any symptoms and often do not know that they are infected until they try to get pregnant or develop Pelvic Inflammatory Disease (PID), which causes abdominal pain, fever, and permanently damages the reproductive tract.  The resulting fallopian tube scarring can cause infertility and increases the risks for tubal pregnancies.  A single episode of PID from a chlamydia infection causes a 25 percent chance of sterility and a second episode increases sterility chances to 50 percent.  Left untreated the resulting pelvic infection could require the removal of the reproductive organs and even cause death. Chlamydia can pass from the mother to child during the time of delivery causing corneal scarring and pneumonia. In males chlamydia can cause infertile sperm, but this condition is usually reversible with antibiotics. About 60 percent of males will experience symptoms including a discharge from the penis, a burning sensation while urinating, and tenderness and pain in the testicles so they can get the antibiotic treatment before any permanent damage occurs. Although chlamydia is curable with antibiotics like tetracycline, the resultant reproductive tract scarring is permanent. Female teenagers have the highest risks of infection because their cervical cells are immature and they do not respond as well as adults to the antibiotic treatment for PID.  Studies have connected chlamydia to cancer, arthritis, and arteriosclerosis.

Gonorrhea like chlamydia is a highly contagious pus making bacteria causing similar symptoms in males and like chlamydia 80% of females have no early symptoms. Untreated it can develop into PID and lead to sterility. PID from gonorrhea can lead to a 12% sterility in women and a second episode can cause a 25% sterility rate.  Antibiotics will usually cure gonorrhea, but 20% are antibiotic resistant making treatment more difficult and expensive. 

Syphilis is a bacterial STI curable with penicillin.  Prior to 1963 there were only 2 STIs: gonorrhea and syphilis and both are curable.  After the sexual revolution there are now more than 25 serious STI and the viral STI are incurable and several are deadly.  Syphilis has 3 stages: primary syphilis begins with a painless sore known as a chancre.  Secondary syphilis appears several months later with flu-like symptoms and a rash that clears up in about 3 weeks.  Tertiary syphilis causes severe brain, heart valve, blood vessel, bone, and skin damage and eventually leads to death. Syphilis increases the chances of contacting HIV and can be passed to infants where it can and cause fatal and irreversible health problems.

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