CHAPTER
13 Protecting Your Sexual Health
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Did You Know That…
Over 22 million people have died from AIDS. 63% of youth aged 14 to 21 are sexually active. There are 2.5 million cases of sexually transmitted diseases among female teenagers annually and 1 million pregnancies. Drug users who inject their drugs account for 20 percent of cases of AIDS among men. Over 19 million women are living with HIV/AIDS. More than 1 million women annually suffer a bout of pelvic inflammatory disease. Antibiotics can not kill viruses. Herpes is incurable. You can teach a bacterium not to eat an antibiotic.
After reading this chapter you should be able to answer the following questions What is Aids? What is herpes? What is trichomoniasis? What is syphilis? What is gonorrhea? What is chlamydia? What are pubic lice? What are venereal warts? What is candidiasis? How does the immune system work? How does an antibiotic work? How does Aids compromise the immune system?
Key Terms Macrophages AIDS Polymorphonuclear leukocycte Herpes T cells Syphilis Helper T Gonorrhea Suppressor T Chlamydia Killer T Pubic lice B-cell Trichomoniasis Antibody Hepatitis B Complement Venereal wart Lymphocyte Candidiasis Leukocycte Condoms Antigen Viruses Bacterium Parasite
Pyrogen Antibiotic
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Introduction _______________________________________________
It has been said that when you go to bed with someone, you are going to bed with everyone that person has been to bed with for the last four years and everyone their partners have been to bed with for the last four years. With some people that is like going to bed with everyone in American and most of the people in the Eastern Bloc countries. It is a scary thought, especially when you consider that there are life threatening diseases out there, and the ones that are not life threatening, can be life altering. You would think with all the risks that having premarital sex brings, most people would think twice before jumping in bed with someone…WRONG! Statistics indicate that 63% of youth aged 14 to 21 are sexually active. Worse yet, according to a recent report by the University of North Carolina at Chapel Hill, one out of every two sexually active teenagers can expect to become infected with a sexually transmitted disease by age 25. Do you know why? Well, we will tell you. Only 45 percent of these people report using a condom consistently. Hello! Not surprisingly, sexually active teenagers have the highest STDs of any age group of the general population. It is not just males who are having all that sex either. Premarital sexual activity among adolescent women has accelerated significantly over the last two decades despite an increase in sex education and AIDS prevention programs. Fifty one percent of women ages 15 to 19 said they had engaged in premarital sex by their late teens according to a recent survey conducted by the Centers for Disease Control. The consequence of early sexual activity is especially harmful for teenage girls, particularly since they have higher rates of sexually transmitted diseases than older people. There are 2.5 million cases of sexually transmitted diseases among female teenagers annually and 1 million pregnancies. It should be noted that an adolescent woman who gets an STD suffers the worst consequences because they are the ones who develop the unwanted complications such as pelvic inflammatory disease (PID), which can lead to sterility and ectopic pregnancy. In case you didn‟t know, ectopic pregnancy can be fatal. More than 1 million women annually suffer a bout of pelvic inflammatory disease. It is estimate that between 16 to 20% of those PID episodes are occurring among teenagers. Here is something else that may blow your mind. Of the adolescents who had sexual intercourse earlier in life reported greater numbers of sex partners. Among 15 to 24 year olds who initiated sexual intercourse before age 18, seventy five percent reported having had two or more partners and 45% reported having had four or more partners, according to the CDC. It goes without saying that the more partners you have, the greater the risk of contracting an STD. Now, we are not saying that sex is bad. What we are saying though, is that sex can bring about some not so good consequences. Let‟s take a look.
AIDS _________________________________
Do you like statistics? Try these on for size. Over 22 million people have died from AIDS. Over 42 million people are living with HIV/AIDS and 74 percent of these infected people live in sub-Saharan Africa. Over 19 million women are living with HIV/AIDS. By the year 2010, five countries (Ethiopia, Nigeria, China, India and Russia) with 40 percent of the world‟s population will add 50 to 75 million infected people to the worldwide pool of HIV disease. There are 14,000 new infections every day (95 percent in developing countries). HIV/AIDS is a “disease of young people” with half of the 5 million new infections each year occurring among people ages 15 to 24. The United Nations (UN) estimates that currently there are 14 million AIDS orphans and that by 2010 there will be 25 million. We know what you are thinking, “These are worldwide statistics and they don‟t reflect what is going on in American.” Really…well, how about these little stats. An estimated one million people are currently living with HIV in the United States, with approximately 40,000 new infections occurring each year. Seventy percent of these new infections occur in men and 30 percent occur in women. By race, 54 percent of the new infections in the United States occur among African Americans and 64 percent of the new
Chapter 13 - Protecting Your Sexual Health _______________________________________________________________
infections in women occur in African American women. Seventy five percent of the new infections in women are heterosexually transmitted. Half of all new infections in the United States occur in people 25 years of age or younger. Now, if that doesn‟t give you reason for alarm, nothing will. So let‟s look at this bad boy a little closer. The spread of the HTLV-III virus is by direct human contact. The most likely form of transmission of AIDS is through sexual intercourse, most often through homosexual unions, particularly anal intercourse. Sexual union between a man and a woman, including oral sex, can also bring about the transmission of AIDS. Even kissing, which probes the mouth with the tongue where there is a cut or broken skin on the lips, gums, or mouth, can be a potential source for the transmission of the virus. The virus can also be transmitted by infected needles and by blood transfusions when the transfused blood contains this virus. In fact, behavior associated with drug abuse is now the single largest factor in the spread of HIV infection in the United States. Since the epidemic began, intravenous drug use has directly and indirectly accounted for more than 36 percent of AIDS cases in the United States. Amazingly, drug users who inject their drugs account for 20 percent of cases among men, 50 percent of cases among women and about 55 percent of pediatric cases…children of mothers who are injecting drug abusers or mothers who have sex with male injecting drug abusers. It might seem like it is very easy to contract the Aids virus. Wrong! Actually, it is really not as easy to contract the virus as you might expect. Present studies show that Aids virus, virulent and deadly as it is, is also highly sensitive and cannot survive 15 minutes outside of body fluids. It is not transmitted on utensils, in food, by food handlers, dishwashers and not by touching hand to hand. Still, since AIDS is a major STD threatening our sexual health and life, we are going to give it a little extra special attention here.
The Immune System ______________________________________________________________
In order to understand the influence that AIDS has on your immune system, it‟s imperative that you have a basic understanding of how the immune system functions. Now, I know what you‟re thinking, “Dear God, not the immune system…it‟s harder to understand than Tommy Hearns after a 12-round fight.” Well, don‟t panic. The way I explain the immune system even Jessica Simpson could understand it. Not only am I going to make it simple, I am going to make it fun and exciting. I am not just blowing smoke here either, so stay tuned. Perhaps the best way to look at this is a war between your body and invading antigens…viruses, bacteria, parasites and other foreign substances. Your body‟s first line of defense against the aforementioned invaders is your skin. The skin is a security blanket that is roughly 1 yard wide, 2 yards long and is less than a quarter inch thick. This tough barrier with its acid coated surface prevents most invaders from penetrating the body and reaching its interior. Although some chemicals can be absorbed directly through the skin, no virus, bacterium or other microbial organism can penetrate a healthy skin. The acidity on the surface of the skin acts as a chemical weapon which destroys most germs and viruses before they can mount a formidable attack on the body. If the skin is healthy or free of injury, disease can only enter the body through the
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natural openings…eyes, ears, nose, mouth, anus, vagina or urethra. These entrances to the body are also protected by chemical secretions. For instance tears, nasal secretions and saliva all contain enzymes that can destroy foreign invaders. Furthermore, if an organism is swallowed, it will be confronted by the hydrochloric acid in the stomach and the bile in the small intestines…two chemical compounds which are lethal to most intruders. Despite these safeguards, there are times when an invading array of antigens gain entry into the body. Such an invasion usually occurs because of injury or disease to the skin. However, there are times when antigens do pass through the body‟s openings. When these invaders penetrate the first line of defense, they are immediately engaged by a macrophage, a large white blood cell that stands guard at the front line of defense. These guys are like the body‟s infantry. They are pretty good fighters, but they are not exactly the Delta Force. Macrophages are phagocytic in nature, meaning that they surround and engulf foreign invaders. If the macrophages cannot destroy or absorb the attacking invaders, they will send a chemical (pyrogen) message to the hypothalamus to turn up the hypothalamic thermostat a few degrees in order to turn the heat up on the invading antigen. It should be noted that most antigens cannot tolerate elevated temperatures. The way the macrophages achieve this increased body temperature is by releasing pyrogen, a chemical, which is in direct communication with the hypothalamus. Next, the macrophages send out an S.O.S. by chemical electrical means to the stem cells which are located in the yellow bone marrow in the breast bone, ribs, crest of the hips and the long upper bones of the arms and legs. In turn, the stem cells start producing another white blood called the lymphocyte. The lymphocytes in turn start their own more specialized brand of war. It is these lymphocytes that are considered to be the principle fighting division of the immune system. This is where the war really begins. Once produced, the lymphocytes go to the thymus, a training camp if you will that is located in the breastbone. On an as needed basis, the lymphocytes are processed and converted into T cells. The T cells are so named because they are developed in the thymus. These cells are an entirely different type of soldier…a more sophisticated fighter. They are the gladiators of defense. The T cells are subdivided into three distinct forms, each assigned a specialized role in protection: helper T cells, suppressor T cells and killer T cells. The killer T cells engage the enemy. These “bad boys” are specialized killers which seek out the enemy and destroy them. The killer T cells are real ass kickers. You might say they are like the Green Berets of the immune system. Helper Ts and suppressor Ts are more like military commanders or generals. Together they form a council which determines how many killer T cells are required to defeat the invading antigens. You might want to envision them sitting up on a mountain watching the battle. If more killer T cells are needed, the helper T cells will stimulate their production and send them to the battle front. On the other hand, if the killer Ts are kicking ass and doing “just fine thank you,” the suppressor cells will call a halt to the slaughter by restricting the number of killer Ts being sent to the battle front. This is important because you don‟t want to create any more damage than necessary. Any time you have a war, there is going to be damage. Remember, this war is being fought on our territory. Therefore, you want to keep the damage to a minimum. Put another way, you don‟t need an atomic fly swatter to kill a little fly. Why? Simple…you don‟t want to blow your entire house up to kill a fly. Along this line of thinking, you don‟t want to destroy a lot of body tissue to kill an antigen that is easily destroyed. If the killer Ts cannot conquer the invading enemy by themselves, the T cell commanders (you know, the helper Ts and suppressor Ts) will call for reinforcements. What they do is send a chemical electrical message to the stem cells to produce more lymphocytes. Some of the lymphocytes are sent back to the
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thymus to be converted to killer Ts, but others are sent to the bursa, an area in the intestines. You might look at the bursa as a specialized training facility for military elite. The soldiers trained in the bursa are the ultimate ass kickers, the Delta Force if you will. When the lymphocytes pass through the bursa, they come out as B cells. The B cells in turn become plasma cells…a cheap trick done with smoke and mirrors. Next, these plasma cells manufacture molecules of protein called antibodies, the warriors for the second division of the immune system referred to as humoral immunity. These antibodies are the real ass kickers of your immune system. If they were a bomb, they would have “nuclear” written all over them. Antibodies are Y shaped protein molecules which are engineered to target and destroy specific invaders. They resemble a lobster with two claw like arms, the ends of which contain receptacles specific to an antigen. It is interesting to note that one antibody is needed for every two antigens because an antibody can fix one arm or receptacle to one antigen while using the other to twist and attach itself to a second antigen. If you‟re an invading antigen, these antibodies will scare the DNA right out of you. These molecular rockets race through the blood and lymph vessels looking for the invaders. Once they find them, they lock onto them and call for backup from another chemical component of the immune system called complement. Once summoned, complement races to the antibody that has locked onto the invader, surrounds the enemy and like Alka-Seltzer in water, dissolves the invader. As soon as the invaders are killed, the antibody will call in macrophages and other white blood cells called polys (short for polymorphonuclear leukocyte) to clean up what‟s left of the mutilated invaders. When all of the invaders have been completely conquered, the T cell council, more specifically the suppressor cells, will call a halt to the action. Memory T cells and B cells remain in the blood and lymphatic system to patrol the body. If the same invader once again attempts to do the body harm, the memory cells will attack and destroy it. Pretty amazing, isn‟t it?