SEXUALLY TRANSMITTED INFECTIONS

1. Abstaining from sex is the only way to be 100 percent confident of avoiding STI infection. ABSTINANCE! SEXUALLY TRANSMITTED INFECTIONS (S T I’s)

2. Fact and Answers about STI’s • The estimated total number of people living in the US with an incurable STD is over 65 million. Every year, there are approximately 15 million new cases of STDs, a few of which are curable. • Two-thirds of all STDs occur in people 25 years of age or younger. • One in four new STD infections occur in teenagers. • Cervical cancer in women is linked to high-risk types of HPV • Of the STDs that are diagnosed, only four--gonorrhea, syphilis, chlamydia and hepatitis B--are required to be reported to state health departments and the CDC for statistical purposes. Hepatitis B is recent addition to that list. • Hepatitis B is 100 times more infectious than HIV • STDs, other than HIV, cost more than $8 billion each year to diagnose and treat, both the disease and their complications. • It is estimated that as many as one in four Americans have genital herpes, yet at least 80 percent of those with herpes are unaware they have it

3. Fact and Answers about STI’s • At least one in four Americans will contract an STD at some point in their lives. • Overall, herpes is the most common STD in the United States, with more than 45 million individuals having this lifelong (but harmless) virus. In a given year, however, it is estimated that more people will become infected with HPV than with herpes. More than 1 million people acquire herpes each year and over 5 million people acquire HPV each year. Some researchers believe that HPV infections may self-resolve and may not be lifelong like herpes. • Less than half of adults ages 18 to 44 have ever been tested for an STD other than HIV / AIDS. • At least 15 percent of all infertile American women are infertile because of tubal damage caused by pelvic inflammatory disease (PID), the result of an untreated STD. • Approximately two-thirds of Hepatitis B (HBV) infections are transmitted sexually, HBV is linked to chronic liver disease, including cirrhosis and liver cancer.

4. History of STI’s • Pre 1960's:Syphilis and Gonorrhea were the only major STDs • 1976:Chlamydia first recognized • 1980-present:8 NEW diseases identified • 1981:AIDS identified • 1982:Herpes became very prevalent • 1992:PID or Pelvic Inflammatory Disease recognized • 1996:HPV or Human Papilloma Virus recognized as the cause of 90% of all cervical cancer, and is the reason for yearly PAP smears.

5. Gonorrhea Genital Herpes The 8 Most Common Sexually Transmitted Diseases HIV/AIDS Pelvic Inflammatory Disease Human Papilloma Virus Syphilis Chlamydia Hepatitis B

6. Common Signs/Symptoms of STDs • Itching around the vagina and/or discharge from the vagina for women • Discharge from the penis for men • Pain during sex, when urinating and/or in the pelvic area • Sore throats in people who have oral sex • Pain in the anus for people who have anal sex • Chancre sores (painless red sores) on the genital area, anus, tongue and/or throat • A scaly rash on the palms of your hands and the soles of your feet • Dark urine, loose, light-colored stools, and yellow eyes and skin • Small blisters that turn into scabs on the genital area • Swollen glands, fever and body aches • Unusual infections, unexplained fatigue, night sweats and weight loss • Soft, flesh-colored warts around the genital area

7. National Center for Health Statistics

8. SYMPTOMS For women: Usually none. May experience vaginal discharge, burning with urination, lower abdominal pain, low back pain, nausea, fever, pain during intercourse & bleeding between menstrual periods. For men: Usually none. May experience discharge from the penis, burning with urination, burning or itching around the opening to the penis or pain & swelling of the testicles. burning or itching around the opening to the penis or pain & swelling of the testicles. DAMAGE In women: Considered to be the most common cause of sterility. Advanced stages may require removal of uterus, ovaries, and fallopian tubes. May cause chronic pelvic pain and/or fatal ectopic pregnancies. * If left untreated in women, Chlamydia can lead to pelvic inflammatory disease (PID) - see below. In men: Urethral infection and/or sterility NUMBERS 3 million new cases reported annually. 3/4 of women and 1/2 of men infected may be have no symptoms and therefore not seek help until it has caused major damage. By age 30, 50% of sexually active women have evidence that they have had Chlamydia at some time during their lives. 1 in 10 adolescent girls tested is infected. Chlamydia

9. SYMPTOMS For women: Yellow or bloody vaginal discharge. Burning with urination. For men: Yellowish white discharged from penis. Burning with urination. Swollen or painful testicles DAMAGE In women: Sterility. May require surgery in severe cases. Can lead to pelvic inflammatory disease (PID) - see below. In men: Sterility. Scarring of urethra and urinary tract problems. NUMBERS 650,000 people are infected annually. 75% of all reported gonorrhea is found in persons aged 15- 29 years. Highest rates of infection are found in 15-19 yr. old women and 20-24 yr. old men. Gonorrhea

10. SYMPTOMS For women: First stage includes swollen, non-painful sores (called chancres) where the infection entered the body. The ulcers may go unnoticed if they are inside her body. Second stage includes rash, fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and tiredness. Third stage includes loss of coordination, paralysis, numbness, gradual blindness, dementia, and possible death. For men: First, second and third stages are the same as women. DAMAGE In women: Mental handicaps, heart disease, blindness, dementia and death. Can cause birth defects or death in infant if mother is infected. In men: Same as women. NUMBERS 35,600 new cases were reported in 1999, including 6,650 cases of primary & secondary syphilis. In 1999, syphilis occurred primarily in persons aged 20- 39. Reported rates of syphilis were 1.5 times greater in men than women in 1999. The racial or ethnic distribution of syphilis in 1999 was: African Americans 78%, Whites 16%, Hispanics 8%, and others 1%. Syphilis

11. SYMPTOMS For women: Fever, sore throat, fatigue, swollen lymph glands. For men: Same as women. DAMAGE In women: Immune system breaks down. Death. May infect unborn children. In men: Same as women. NUMBERS Approximately 800,000-900,000 people are infected with HIV (including people who have AIDS and those who do not yet know that they are infected). HIV / AIDS

12. SYMPTOMS For women: Painful ulcers appear at site of infection. Periodic eruptions of these ulcers anywhere on the body. Pain during sex. Fever and swollen glands. Initial outbreak considered to be extremely painful. For men: Same as women. DAMAGE In women: Continuous outbreaks. Lifelong treatment required. Causes potentially fatal infections in infants if mother is shedding virus at the time of delivery. In men: Same as women. NUMBERS 45 million currently infected. 20% of the sexually active population has this disease. Genital Herpes is more common in women (approximately one out of four women) than in men (almost one out of five). Genital Herpes

13. SYMPTOMS For women: Genital warts that sometimes form cauliflower shape. Many do not experience noticeable symptoms. May have vulvar itching and pain. Usually detected through abnormal Pap smears. For men: Genital warts similar to those in women. DAMAGE In women: Requires painful and expensive treatment to remove pre-cancerous warts. In men: Cancer of penis and anus. NUMBERS Approximately 20 million people are currently infected. 50-75% of sexually active men and women acquire genital HPV at some point in their lives. About 5.5 million Americans get a new genital HPV infection each year. 90% of cervical cancer cases began with HPV. Human Papilloma Virus (HPV)

14. SYMPTOMS For women: Often none. May Experience jaundice (skin turns yellow), fatigue, dark urine, gray-colored stools, abdominal pain, loss of appetite, nausea, vomiting, And/or joint pain. For men: Same as women. DAMAGE In women: Severe liver damage. May lead to cancer of liver and cirrhosis. In men: Same as women. NUMBERS 80,000 new infections were reported in 1999 The highest rate of disease occurs in 20-49 year olds. Approximately 1.25 million chronically infected Americans. Hepatitis B

15. SYMPTOMS For women: Lower abdominal pain that is often mistaken for menstrual cramps. Fever, unusual vaginal discharge, painful intercourse, painful urination & irregular menstrual bleeding. For men: None. This disease only affects women but may be caused by infections carried by men DAMAGE For women: Ectopic (tubal) pregnancy. Infertility. Cancer. Can be life-threatening. For men: None. NUMBERS 1 million new cases reported annually. More than 100,000 women become infertile each year as a result of PID. About 1/5 of women with PID become infertile. 10-80% of women with either Chlamydia or gonorrhea develop PID as a result. PID goes unrecognized by both women and their health care providers 2/3 of the time. Pelvic Inflammatory Disease (PID)

17. Bacterial Vaginosis Chancroid Chlamydia Condylomata Acuminata Cytomegalovirus (CMV Genital Warts Gonorrhea Granuloma Inguinale Hepatitis B Virus (HBV) Herpes (Progenitalis Human Immunodeficiency Virus (HIV) Human Papilloma Virus Lymphogranuloma Venereum (LGV) Molluscum Nonspecific Urethritis (NSU) Pelvic Inflammatory Disease (PID) Pubic Lice Reiter’s Syndrome Scabies Syphilis Trichomoniasis Urinary Tract Infectin Vaginitis Common Sexually Transmitted Infections