OVERVIEW of basics for HIV, common STIs and HPV

HIV (Human Immunodeficiency Virus)

1. What is HIV?
   • A virus that attacks the body’s immune system, specifically the CD4 cells (T cells), which help the immune system fight infections. Over time, untreated HIV can lead to AIDS (Acquired Immunodeficiency Syndrome).
2. Transmission:
   • Primarily spread through contact with infected bodily fluids like blood, semen, vaginal fluids, and breast milk. Common ways include unprotected sex, sharing needles, and, less commonly, mother-to-child transmission during childbirth or breastfeeding.
3. Symptoms:
   • Initial symptoms might resemble the flu (fever, fatigue, sore throat), but some people remain asymptomatic for years.
   • As the virus progresses, it weakens the immune system, making individuals more vulnerable to infections and certain cancers.
4. Treatment and Management:
   • There’s no cure, but antiretroviral therapy (ART) helps control the virus, allowing individuals to live healthy lives.
   • Regular testing and early treatment are crucial to maintaining a low viral load and preventing transmission.

Common STIs (Sexually Transmitted Infections)

1. Chlamydia
   • Cause: Bacterial infection (Chlamydia trachomatis).
   • Symptoms: Often asymptomatic but can cause genital pain and discharge in both men and women.
   • Treatment: Easily treated with antibiotics if detected early.
   • Impact: Untreated chlamydia can lead to complications, including infertility and increased risk of HIV.
2. Gonorrhea
   • Cause: Bacterial infection (Neisseria gonorrhoeae).
   • Symptoms: Many are asymptomatic; symptoms may include painful urination, discharge, or testicular pain.
   • Treatment: Treated with antibiotics, though some strains have become resistant, making treatment more challenging.
   • Impact: Can cause severe reproductive and health issues if untreated, such as pelvic inflammatory disease (PID) and infertility.
3. Syphilis
   • Cause: Bacterial infection (Treponema pallidum).
   • Symptoms: Presents in stages; early signs include sores, rash, and flu-like symptoms, progressing to severe internal organ damage if untreated.
   • Treatment: Treatable with antibiotics, particularly in the early stages.
   • Impact: Can cause serious long-term complications, including neurological damage and increased HIV risk.
4. Genital Herpes
   • Cause: Viral infection (Herpes Simplex Virus, HSV-1 and HSV-2).
   • Symptoms: Painful blisters or sores on the genitals, but often asymptomatic.
   • Treatment: No cure; antiviral medications help manage outbreaks and reduce transmission.
   • Impact: Lifelong infection that can cause social stigma and, in rare cases, complications during pregnancy.
5. Human Papillomavirus (HPV)
   • Cause: Viral infection, with over 100 types; some strains cause genital warts, others are associated with cancers.
   • Symptoms: Often asymptomatic; certain strains cause warts, while high-risk strains can lead to cancers (throat, anal, penile, cervical).
   • Treatment: No cure, but vaccination and screening can prevent high-risk infections and related cancers.
   • Impact: Persistent HPV infection with high-risk types can lead to various cancers, which is why vaccination and regular screenings are essential.

HPV and Its Connection to Cancer

1. What is HPV?
   • The most common STI globally, caused by the human papillomavirus, which includes over 100 strains.
   • HPV often clears on its own, but some high-risk strains can lead to cancer if they persist.
2. Cancer Risks:
   • Throat Cancer: Linked to HPV strains that infect the mouth and throat through oral contact.
   • Anal Cancer: More common among individuals with HIV due to immune suppression.
   • Penile Cancer: Rare, but certain HPV strains increase risk, especially in immunocompromised individuals.
   • Cervical Cancer: One of the most well-known cancers associated with HPV in individuals assigned female at birth.
3. Prevention:
   • Vaccination: The HPV vaccine can protect against the most common cancer-causing strains.
   • Screening: Regular screenings (like Pap smears and HPV tests) can detect early signs of cancer, allowing for prompt treatment.

OVERVIEW of basics for HPV and cancer risks, specifically covering throat, anal, and penile cancers, along with data insights for both national and Cuyahoga County trends where available.

HPV and Cancer Risks: What You Need to Know

1. How HPV Leads to Cancer

• HPV and Cancer Mechanism: HPV, especially high-risk types like HPV-16 and HPV-18, can cause abnormal cell changes. If the virus is not cleared by the immune system, these abnormal cells can become precancerous or develop into cancer over time.
• Cancers Linked to HPV:
  • Oropharyngeal (Throat) Cancer: Linked to HPV strains that infect the mouth and throat, often through oral transmission.
  • Anal Cancer: More prevalent in immunocompromised individuals (e.g., those with HIV) due to decreased immune response.
  • Penile Cancer: Rare but associated with persistent HPV infection, especially in uncircumcised individuals or those with compromised immunity.

2. Data Points: HPV-Related Cancer Trends Nationally vs. Cuyahoga County

• National Data:
  • Throat Cancer: Rates have increased in recent years, with HPV as a leading cause. About 70% of oropharyngeal cancers in the U.S. are HPV-related, primarily affecting men aged 50-60.
  • Anal Cancer: National rates are higher in individuals with HIV, especially men who have sex with men (MSM). Women are also at increased risk compared to men.
  • Penile Cancer: Less common but predominantly affects men over 50 and those with compromised immune systems.
• Cuyahoga County Trends:
  • HPV-Related Cancers: Data on HPV-linked cancers in Cuyahoga County follows similar trends to national data, with a noted increase in throat cancer cases among men. Local healthcare institutions have noted that HPV is a major factor, particularly among younger populations engaging in high-risk behaviors.
  • Demographic Insights: Throat and anal cancers are seen more frequently in MSM and individuals with weakened immune systems in Cuyahoga County. Penile cancer remains rare but is more likely in older men, particularly those without regular healthcare access.

3. Demographic Breakdown: Age, Gender, and Risk Factors

• Age:
  • Most HPV-related cancers develop years after the initial infection, with cases commonly appearing in individuals over 40.
• Gender:
  • Throat cancer: More common in men, likely due to higher exposure to HPV via oral transmission.
  • Anal cancer: Found more frequently in women and MSM.
  • Penile cancer: Primarily affects older men, particularly those with limited healthcare access and preventive measures.
• Risk Factors:
  • Multiple sexual partners: Increases risk of HPV exposure.
  • HIV or other immune-suppressing conditions: Heightens risk of persistent HPV infection.
  • Lack of HPV Vaccination: Increases susceptibility to high-risk HPV strains.
  • Lifestyle Factors: Tobacco and alcohol use can compound risk, especially for throat cancers.

4. Importance of Early Detection and Routine Screenings

• Vaccination: The HPV vaccine is highly effective in preventing the most dangerous strains, reducing cancer risk significantly. It’s recommended for both males and females starting as early as age 9.
• Screenings:
  • For Anal Cancer: Anal Pap tests are available and especially recommended for high-risk groups, such as MSM and people with HIV.
  • For Throat Cancer: While there’s no routine screening, awareness of early symptoms (persistent sore throat, hoarseness, lumps) is critical.
  • For Penile Cancer: Regular exams and awareness of any unusual symptoms (sores, lumps) are essential for early detection.
• Outcomes of Early Detection:
  • Increases the chance of successful treatment.
  • Allows for targeted interventions to prevent cancer progression.
  • Reduces healthcare costs and improves quality of life for individuals by catching cancers early.

Prevention and Care Strategies for HPV, HIV, and STI-Related Cancer Risks

1. Vaccination

• HPV Vaccine:
  • The HPV vaccine is highly effective in preventing infection with the high-risk HPV types most commonly linked to cancers (like HPV-16 and HPV-18).
  • Recommended for everyone starting at ages 9-12, with catch-up vaccinations available for people up to 26 years (and in some cases, up to age 45).
  • Benefit: Reduces the risk of HPV-related cancers by up to 90% when administered before HPV exposure.

2. Regular Screening and Early Detection

• Anal Pap Tests: Especially for people with higher risk (e.g., MSM, individuals with HIV), anal Pap tests can detect abnormal cells early, allowing for monitoring and intervention before cancer develops.
• Routine Oral Health Checks: For those at risk of throat cancer, regular dental visits can help catch early signs. Oral exams by healthcare providers can be helpful, especially if symptoms like persistent sore throat or hoarseness occur.
• Penile Exams: Self-checks for unusual symptoms (sores, lumps, unusual discharge) and regular medical checkups can aid in early detection.

3. Safe Sexual Practices

• Use of Condoms and Dental Dams: Consistent condom and dental dam use can reduce the transmission of HPV, HIV, and other STIs.
• Limiting Partners: Reducing the number of sexual partners can lower exposure risk, especially for HPV, which is highly transmissible.
• Open Communication: Encouraging conversations about STIs and testing with partners can foster a healthier and safer sexual environment.

4. Smoking and Alcohol Reduction

• Quit Smoking: Tobacco use is a known risk factor that exacerbates the progression of HPV-related throat and other cancers. Reducing or quitting smoking can significantly lower cancer risk.
• Moderate Alcohol Consumption: Heavy alcohol use can irritate mucous membranes and, when combined with HPV infection, can increase cancer risk. Moderation is recommended, especially for those at risk of throat cancer.

5. Education and Awareness

• Understanding Risk Factors: Knowledge about HPV, HIV, and STI risks can empower individuals to take preventive actions and encourage regular health checks.
• Community Programs and Resources: Provide information about local clinics in Cuyahoga County that offer STI testing, HPV vaccines, and educational resources.
• Combatting Stigma: Reducing stigma around HPV and other STIs can encourage more people to get vaccinated, tested, and treated without fear of judgment.

6. Treatment and Ongoing Care for At-Risk Populations

• Antiretroviral Therapy (ART) for HIV: Effective HIV management with ART reduces immunosuppression, lowering susceptibility to HPV-related cancers.
• Follow-Up for Abnormal Test Results: If screening reveals abnormal cells, regular follow-up with healthcare providers can prevent progression to cancer through early intervention.

7. Promote Self-Care and Health Advocacy

• Self-Exams: Encourage people to become familiar with their bodies and conduct self-checks for any unusual symptoms.
• Advocating for Routine Checkups: Routine physicals and checkups that include STI testing and discussion of symptoms can catch issues early.
• Empowerment through Knowledge: Reinforce the importance of understanding one’s health history and advocating for oneself in healthcare settings to ensure appropriate screenings and vaccinations.

KAHOOT TO END SESSION – Note to self.

• What’s one thing that you learned today that you didn’t know before attending?