Contraception & Sexually Transmitted Infections

1. Contraception & Sexually Transmitted Infections A presentation to support the Grade 10 “Baby Project” Parklands CollegeEducators: Kim Schloms-Madlener & Desiree de Gouveia

2. Male Reproductive System

3. Female Reproductive System

4. Why use contraceptives? • To prevent unwanted pregnancies • To prevent Sexually Transmitted Infections & Diseases, including HIV • It is important to note that just because you are using a “contraceptive” does not mean you are protecting yourself against STI’s, including HIV. In other words “contraceptive” is a term that by definition only applies to preventing pregnancy.

5. Male Condom • Rubber sheath worn on erect penis that prevents semen from entering the partners body. • Prevents STI’s / HIV: Yes • Advantage: Low cost reliable, one of the only contraceptives that protect against both pregnancy and STI’s like AIDS. • Disadvantage: Not 100% safe if not used correctly and consistently.

6. Female Condom • “Polyurethane sheath worn inside the woman during sex. • Prevents STI’s / HIV: Yes • Advantage: Same as for male condom and gives women the chance to choose to be protected from STI’s. • Disadvantage: Same as for Male Condom.

7. The Pill • The contraceptive pill taken by women that prevents egg being fertilised by sperm. • Prevents STI’s / HIV: No • Advantage: If taken properly, the pill can be up to 99.5% effective against pregnancy. • Disadvantage: No protection from STI’s like AIDS. Some believe the pill makes people think they do not have to practice “safe sex” and protect themselves from HIV with a condom. • Illness / smoking / skin

8. IUD’s (Intra-Uterine Device) • Special type of plastic or copper device that is placed in the woman’s uterus to prevent pregnancy • Prevents STI’s / HIV: No • Advantage: IUD’s are an effective means of preventing pregnancy. • Disadvantage: Pain and increased risk of infection in the Fallopian Tubes. IUD’s provide no protection from HIV and are not recommended for woman under 25 who have not had children.

9. Injections & Implants • Chemical substances implanted/injected into a woman’s body to prevent pregnancy. • Prevents STI’s / HIV: No • Advantage: Effective means of contraception. • Disadvantage: No protection against STI’s, can cause a delay in the return of normal periods and fertility once you stop using them up to 18 months

10. Tubal Ligation or “Tube Tie” • Fallopian tubes are cut and sealed preventing eggs from reaching the uterus. • Prevents STI’s / HIV: No • Advantage: Permanent form of contraception (99% effective). Allows men to take responsibility for contraception. • Disadvantage: No protection from STI’s, and have a low success rate if they want to be reversed.

11. Vasectomy • Male sterilisation, carried out by means of a vasectomy, is a form of permanent birth control for men. • Prevents STI’s / HIV: No • Advantage: Permanent form of contraception (99% effective). • Disadvantage: No protection from STI’s, and have a low success rate if they want to be reversed.

12. Withdrawal • Man withdraws his penis and ejaculate outside of the vagina • Prevents STI’s / HIV: No • Advantage: Few advantages when used alone, but provides extra protection against pregnancy when used with a condom. • Disadvantage: Reduces sexual pleasure for both partners, is unreliable, mess, risks pregnancy and STI infection.

13. Rhythm Method • Women calculate days when they are most likely to get pregnant and abstain on those days. • Prevents STI’s / HIV: No • Advantage: Costs nothing and is easily accessible. • Disadvantage: Reduces sexual pleasure for both partners, is unreliable, mess, risks pregnancy and STI infection.

14. Abstinence or “non-penetrative sex” • Sexual stimulation without penetration (eg kissing, cuddling and mutual masturbation. • Prevents STI’s / HIV: Yes • Advantage: No cost, and provides 100% effectiveness against pregnancy and STI’s. • Disadvantage: Abstinence may cause stress or anxiety in a relationship if both partners are not in agreement.

15. Costs • The Pill can be purchased from any pharmacy or obtained from the free Clinics . Cost at the chemist ranges from R66 to over R250. • Tubal Ligation and Vasectomy involve being admitted to hospital for the day and these procedures could amount to in excess of R5 000. • Injection can be administered by a Gynaecologist’s nurse in his/her rooms or by a Clinic and this costs about R60 every 2 – 3 months. At a clinic it could be free. • IUD’s (Intra-Uterine Device)are inserted by a Gynaecologist in his/her rooms – cost not confirmed but could be as much as R3 000.

16. Sexually Transmitted Infections: Facts • Infertility if untreated • 2 million people in SA treated p/a • High risk = HIV • 25% females 15 – 25 y/o infected; males too • HIV is an STI • More easily transmitted male to female • Women physiologically susceptible to infection • Woman symptoms less

17. How do you know? • Change in smell / consitency / appearance vaginal discharge • Smell / discharge from penis • Pain / burn when urinating • Urinate more frequently • Sore / swollen genitals • Itching / rashes / lumps / blisters on genitals or anus • Dull ache or acute pain in lower stomach

18. Chlamydia • Infection of the genitals, anus or throat. • Usually no symptoms • Possibly change in vaginal secretions, lower abdominal pain, pain on passing urine or abnormal bleeding from the vagina. Men may have a discharge (extra fluid) from the tip of the penis, pain when passing urine or an irritation inside the penis. • Easily cured with antibiotics. • In women, Chlamydia may lead to inflammation of the cervix and womb = Pelvic Inflammatory Disease (PID). PID may cause the tubes to scar and block-up. Chlamydia is one of the commonest causes of infertility (being able to get pregnancy). • For men things are generally a little less complicated. They may develop chronic irritation in the penis or pain in the testicles.

19. Genital warts • Caused by Human Papilloma Virus (HPV). • Visible warts - which can be found anywhere on the genital or anal area. They tend to come in crops and their growth slows down with time. • Subclinical infection no warts are visible but microscopic changes show that the virus is present (usually on a Pap smear or biopsy). • Latent infection – virus can only be seen using laboratory techniques reserved for research purposes • Spread by direct contact with another person's skin in the area where the wart virus is. Symptoms: 3 weeks to 12 months • No cure or vaccination ; some treatments available. • Some types of the genital wart virus have been linked with abnormal cell changes on the cervix, vulva, penis or anus…cancerrisk.

20. Pelvic inflammatory disease - PID • Infection of the uterus and/or fallopian tubes. • Possible complications include: infertility, persistent pelvic pain. • Ectopic pregnancy • Treatment is with antibiotics. • Caused by a STI - Chlamydia / Gonorrhoea can also cause PID. • Pain in the lower abdomen (pelvic area) is the most common symptom.

21. Genital herpes • Caused by the Herpes Simplex Virus (HSV). There are two types of HSV: • Type 1 can be found around the lips and is then known as a cold sore • Type 2 is usually found around the genital or anal areas. • Close skin-to-skin contact with someone who has the infection - vaginal, anal or oral sex.If you have sex with someone with obvious herpes sores then you can easily become infected with the virus. • The first episode usually takes 2 to 20 days to occur after the initial contact, but may not occur until months or even years later. • Antiviral tablets for treatment • Drink lots of water and if you have difficulty passing urine you should contact a health service. • Can’t be cured, it can be controlled.

22. Pubic Lice (Crabs) • Crabs are tiny insects which can cause itching in the genitals / parts of the body. • Bed linen and clothing - washed in a hotcycle and dried in the sun or clothes dryer. • Crabs are caught by having close body contact with a person who is infested. • Possible to catch them by sharing towels, clothes or someones bed. • Apply head licelotion from hair to toes, leave on overnight, then wash off. • You will also need to change and wash any clothing and linen which has been in direct contact with the affected areas. • Itching may persist after treatment

23. Syphilis • Contracted during vaginal, anal or oral intercourse without a condom with someone who has the infection. • Also be transmitted during pregnancy • Chancre / Ulcer appears site of infection 10-90 days • Usually painless / unnoticed • Heals spontaneously within 2-6 weeks. • Secondary syphilis develops approximately 7-10 weeks • Flu-like symptoms / general rash which may include the palms of the hands, soles of the feet or face. • Symptoms usually mild and transitory • Latent - no physical symptoms / infection remain in this stage for years • 5-35 years Tertiary syphilis - damage to internal organs which may include the brain, spinal cord and heart • Antibiotic injections.

24. Preventing STI’s • Decide on your values about sex e.g. abstinence • Delay onset of sex as long as possible • Stick with one partner • Ask about partner’s sexual history • Use condoms…too risky not to! • Be critical of media • Learn about STI’s • If infected, notify your partner • Mostly curable – regular check-ups • Women – gynaecologist • Men – blood tests