Sexually Transmitted Infections

1. Sexually Transmitted Infections

2. Group Agreements • Respect • Knowledge does not equal experience • Maintain appropriate boundaries • Ask Questions

3. Anonymous Questions??? • MATURE in nature • I will not address anything that is inappropriate

4. Why Sexually Transmitted Infection versus disease? -More medically accurate term Transmitted through oral, anal, vaginal contact. Epidemic: Over 15 million new cases of STIs reported every year. Sexually Transmitted Infections

5. Every 97 seconds a teenager in California is infected with an STI • 37 teens an hour • 891 teens every day

6. Why is the rate so high among teens? • Access to services • Low rates of testing • Don’t have information about STIs • Teens don’t think they will be infected • Drug and alcohol use • Older partners

7. Immature cells on the cervix of younger women • Immature (columnar) cells make it easier for STI agents infect • Cells mature by age 25

8. Chlamydia Gonorrhea Syphilis Trichomoniasis HIV/AIDS Genital Herpes Human Papilloma Virus (HPV) Genital Warts Cervical Cancer Hepatitis B 8 Most Common S.T.I.s Others: Hepatitis C,Pubic Lice, Pelvic Inflammatory Disease

9. Other Infections • Bacterial Vaginosis • Yeast Infection • Not considered STIs • Symptoms like burning during urination, itching, or discharge may mimic STIs • Usually, no symptoms

10. Risk Factors of Other STIs • Bacterial Vaginosis • New or multiple sex partners • douching • Yeast Infection • Antibiotics, normal hormonal changes (women) • Although not contagious, contact with a partner may stimulate overgrowth

11. How does someone get an STI? • Having sex without a condom • Vaginal Sex • Oral Sex • Anal Sex • Direct skin to skin contact • Sharing needles for tattooing, piercing, steroids, IV drug use, etc.

12. Transmission: Skin-to-Skin Contact - Direct contact with an STI lesion, sore, or infected tissue - Oral, anal, vaginal sex and other intimate contact

13. Do condoms protect against skin-to-skin contact infections? • Condoms only protect the area that they cover. • If the infection is covered by the condom, risk is reduced.

14. What body fluids can contain an STI? Blood Semen Vaginal fluids Breast Milk Body fluids that do not: Saliva, urine, sweat, tears Transmission: Body Fluids

15. Transmission Where can an STI enter the body? Vagina Cuts Penis (opening) Scrapes Mouth Sores Anus Microtears Eyes Nose STI organisms can be passed even when there are no signs or symptoms present

16. Do condoms protect against the exchange of body fluid? • Yes! 98% effectivnbe when used correctly, consistently and cooperatively.

17. How can someone reduce the risk of getting an STI? • Abstinence • Condoms, Condoms, Condoms • Male and female condoms • Dental dams • Get tested • Get vaccinated (Hepatitis A, B and HPV) • Limit # of partners • Communication • No alcohol/drug use

18. New HPV Vaccine • Gardasil protects against 4 HPV types that cause about 70% of cervical cancer and 90% of genital warts • Recommended for girls 11 – 12 years (approved for up to 26 & as young as 9) • Best if given before first sexual intercourse

19. Communication • What would someone ask their partner before becoming sexually involved? • Have you had sexual partners in the past? • Have you been tested? When? • Have you had unprotected sex since the test? • Do you have an STI? • Do you always use protection? • Do you currently have any other sexual partners?

20. What is the most common symptom of an STI? NOTHING

21. “Nothing” is most common symptom of an STI • 80% of women, 50% of men show no early symptoms of Chlamydia and Gonorrhea • On average an HIV+ person will have no obvious changes in their body for up to 10 years • Many people don’t have or don’t notice 1st and 2nd phases of syphilis • Many people go years without herpes or warts outbreaks. Warts are painless and can go unnoticed. • Most people may not get warts at all.

22. Possible Early Signs & Symptoms • Bumps • Sores • Rash • Abnormal Discharge • Painful urination • Lower abdominal pain • Itching • Swelling • Ongoing flu-like feelings, fatigue

23. Females Pelvic Exam: pap smear testing of discharge Visual exam Urine sample (not always required) Blood draw Males Urine sample Visual exam Testing of discharge (if symptomatic) Blood draw Testing

24. Treatment • Bacterial Infections • Can be cured with antibiotics. • Treatable, but repeatable • Viral Infections • Various drugs are used to slow down the progress of the virus and reduce or remove symptoms • There is no cure, only treatment • Some like HPV self-resolve.

25. Why would a person choose to not get tested? • Fear • Shame • Denial • No symptoms • Lack of education • $$$ • Don’t know where to go

26. What happens if STIs are not treated? • Can be spread to sexual partners • Can cause reproductive damage (PID) • Can cause complications with pregnancy

27. S.T.I. Without treatment Chlamydia • Infertility • Pelvic Inflammatory Disease Increases risk of HIV transmission by 3 – 5 times. Gonorrhea PInfertility PPelvic Inflammatory Disease PHeart disease PBlindness Increases risk of HIV transmission by 3 – 5 times.

28. S.T.I. Without treatment üHeart disease, paralysis, brain damage, dementia, blindness, death  Increases risk of HIV transmission by 2-4 times. Hepatitis B PCirrhosis PCancer PDeath HIV/AIDS üDestroys immune system, causing severe illness and/or death Syphilis

29. S.T.I. Without treatment • Low birth weight and pre term births for newborns. • Increases risk of HIV transmission by 2-4 times Increase risk of Cervical Cancers Genital Herpes PFrequent, painful outbreaks of blisters and sores increases risk of HIV transmission by 3 – 6 times. Trichominiasis HPV: Genital Warts P • Can grow and become harder to remove

30. Treatment Options • Antibiotics for bacterial infections. • Medications that can treat but not cure viral infections • Some topical medications can treat and remove genital warts

31. Summary • Abstinence is 100%!! • But if someone is sexually active: Love Responsibly • Condoms, Condoms, Condoms! • Get tested!! • Communicate!!!

32. CONDOMS!!

33. Let’s talk about “the period”… • 28 day cycle • Day one of the cycle is the first day of the period • Ovulation occurs around day 11-14 • Woman is MOST fertile days 6-20 because sperm can live up to 5 days in the vagina!