1. 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.

2. 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 XIIth
- 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.

3. 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

4. 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

5. 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.

6. 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 risks Possible
Performin
g oral sex
on a man
 Throat Chlamydia
 Throat
 Gonorrhea (25–
30%)
 Herpes (rare)
 HPV
 Syphilis (1%)
 Hepatitis
B (low risk)
 HIV (0.01%)
 Hepatitis
C (unknown
)
Performin
g oral sex
on a
woman
 Herpes
 HPV
 Throat
gonorrhea
 Throat
Chlamydia
Receiving
oral sex—
man
 Chlamydia
 Gonorrhea
 Herpes
 Syphilis (1%)
 HPV

7. Receiving
oral sex—
woman
 Herpes  HPV
 Bacterial
Vaginosis
 Gonorrhea
 Vaginal
sex—
man
 Chlamydia (30–
50%)
 Crabs
 Scabies
 Gonorrhea (22%)
 Hepatitis B
 Herpes (0.07%
for HSV-2)
 HIV (0.05%)
 HPV (high: around
40-50%)
 Syphilis
 Trichomoniasis
 Hepatitis C
Vaginal
sex—
woman
 Chlamydia (30–
50%)
 Crabs
 Scabies
 Gonorrhea (47%)
 Hepatitis B (50–
70%)
 Herpes
 HIV (0.1%)
 HPV (high; around
40-50%)
 Syphilis
 Hepatitis C

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

9. 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

10. 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.

11. 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

12. 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

13. 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.

14. 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

15. 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.

16.  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.

17. 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

18. 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.

19. Pathogenesis of AIDS

20. 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

21. 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.

22. 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.

23. 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.

24. 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

25. 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:

26. 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.

27. 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.

28. 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.

29. Bibliography
www.google.com
www.wikipedia.com
Ncert Biology textbook