ACKNOWLEDGEMENT

I would like to express our sincere gratitude to our biology

teacher ------------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 ---------------for their support
during the making of this project.

Certificate
 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. 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:
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 painduring 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 getserious
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 suchcannot 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