S exually T ransmitted D iseases

1. Sexually Transmitted Diseases

2. This is an infection that can be transmitted through sexual contact with an infected individual. They are sometimes called sexually transmitted infections (STIs). • STDs can be transmitted many different ways, but most can be passed by: • Vaginal sex • Anal sex • Oral sex • Skin-to-skin contact • Infected Mother to child What is an STD?

3. Often no signs or symptoms People are unaware of infection, and don’t receive treatment. Long-term damage May have passed infection to others 20millionnew infections every year in the U.S. • More than 50%of all people will have an STD at some point in their lifetime Why Is This Important?

4. Impact on Youth 27% 23% N=9,081 N=21,752

5. You CANNOT get an STD from oral sex. Birth control protects against pregnancy and STDs. Once you’ve had an STD, you CANNOT get it again. Anal sex has a higher risk of spreading STDs than many other types of sexual activity. Only gay and bisexual men get STDs. You CANNOT get an STD if your partner is a virgin. Only promiscuous or “trashy” people get STDs. You CANNOT have two STDs at once You can get an STD from a toilet seat. Women are more likely to get tested for STDs. Lesbians CANNOT get STDs. If my partner has an STD, I’ll know/see it. Myth or Fact?

6. Chlamydia • Gonorrhea* • Syphilis • Trichomoniasis (parasitic protozoan) • HIV • Herpes • HPV • Hepatitis B Antibiotics can curebacterialSTDs, but cannot reverse the long-term damage Treatmentcanimprove the lives of many people living with viral STDs, (but there is NO CURE) Are STDs Curable?

7. Antibiotics can cure bacterial STDs…but not always the long-term damage.

8. In the U.S. • Most frequently reported STD • Estimated 1.71 million new cases in 2017 • Could fill the OU Football Stadium 20x! • How is it spread? • 1. Vaginal, anal, or oral sex with someone who has chlamydia. • 2. Infected pregnant women can pass it to their baby during pregnancy or childbirth. Chlamydia

9. The “Silent” Disease!!! • Possible symptoms include: • Abnormal vaginal/penile discharge • Burning sensation when urinating • Rectal pain, discharge, or bleeding • Pain/swelling in one or both testicles (less common) • Can lead to: • Sterility or infertility • Infection spreading to tube that carries sperm to/from the testicles (causing pain and/or fever) • Pelvic Inflammatory Disease (PID) • -Long-term abdominal/pelvic pain • -Scar tissue formation in fallopian tubes • -Ectopic pregnancy Chlamydia

10. ChlamydiaRates (Reported) by Age and Sex, U.S. in 2017

11. In the U.S. • 2ndmost common disease reported • Estimated 555,608 new cases in 2017 How’s It Spread? Gonorrhea Vaginal, anal, or oral sex with someone who has gonorrhea A pregnant woman infected with gonorrhea can give the infection to her baby during childbirth

12. Possible symptoms include: • Painful or burning sensation when urinating • Abnormal vaginal/penile discharge (white, yellow, or green) • Rectal discharge, itching, soreness, bleeding • Vaginal bleeding between periods • Painful or swollen testicles (less common) • Can lead to: • Sterility or infertility • Disseminated infection (rash, arthritis, fever, meningitis, etc.) • Painful infection of tubes attached to the testicles • Pelvic Inflammatory Disease (PID) • -Scar tissue formation in fallopian tubes • -Ectopic pregnancy • -Inability to get pregnant • -Long-term pelvic/abdominal pain Gonorrhea

13. Gonorrhea Rates (Reported) by Age and Sex, U.S. in 2017

14. A serious infection that affects a woman’s reproductive organs • Often caused by untreated STDs, like chlamydia and gonorrhea • May experience mild or no symptoms • Pain in your lower abdomen • Fever • An unusual discharge with a bad odor from your vagina • Pain and/or bleeding when you have sex • Burning sensation when you urinate • Bleeding between periods • Treatment can help if caught early but won’t undo any damage or complications to the reproductive system • Formation of scar tissue outside & inside the fallopian tubes (blockage) • Ectopic pregnancy • Infertility • Long-term pelvic/abdominal pain Pelvic Inflammatory Disease (PID)

15. “The Great Imitator” affected approximately 30,644 people in 2017 in the U.S. How is Syphilis Spread? • Direct contact with a syphilis sore (chancre) during vaginal, anal, or oral sex. • Can be spread from an infected mother to her unborn baby. Primary & Secondary Syphilis Primary Syphilis Tertiary/Late Syphilis Secondary Syphilis

16. Chancre- syphilis sore Firm, round, and painless Appears within 2-6 weeks after exposure (could take up to 3 months) Found on the part of the body exposed to the infection (penis, vagina, anus, lips, in rectum, or in mouth) Typically disappear after a few weeks without treatment (still progresses to next stage) Primary Syphilis

17. Appears about 4 weeks after chancre heals • Will go away without treatment, but infection will progress Condylomatalata or “fleshy warts” in anogenital region Secondary Syphilis Alopecia or patchy hair loss non-itchy RASHwith rough red or reddish brown spots Mucous Patches usually in the mouth, vagina, or anus

18. Primary and Secondary SyphilisRates (Reported) by Age and Sex, U.S. in 2017

19. The period when there are no signs/symptoms but syphilis is still present in the body If left untreated, you can continue to have syphilis in your body for years without any signs or symptoms. Latent Syphilis

20. Typically Occurs 10-30 years after infection begins! • Can damage almost any part of the body including the heart, brain, spinal cord, eyes and bones • Can result in mental illness, blindness, deafness, heart disease and death • Gumma: soft, gummy tumor Types • Cardiovascular Syphilis • Late Benign Syphilis • Neurosyphilis Syphilis Late (Tertiary) Syphilis

21. Usually occurs during late syphilis but can occur at anytime during the infection Symptoms: • Difficulty coordinating muscle movements • Paralysis (not able to move certain parts of your body) • Numbness • Blindness • Dementia (mental disorder) • Damage to internal organs • Can result in death More likely to occur early in the disease process if HIV infection is also present! Neurosyphilis Syphilis

22. 40% will be stillborn or die in the hospital Transmission can occur during any stage of syphilis and during any trimester of pregnancy Can cause: • Prematurity • Birth defects • Hutchinson’s teeth • Osteochondritis • Developmental delays Congenital Syphilis

23. Parasitepassed during vaginal sex • 70% of infected people have no signs/symptoms • Possible symptoms include: • Itching, burning, redness or soreness of the genitals • Burning with urination or ejaculation • Thin discharge: can be clear, white, yellowish, or greenish • - Can produce unusual or foul smell • Infection usually occurs: • Lower genital tract (vulva, vagina, penis or urethra) TrichomoniasisEstimated 3.7 million in 2016 Greatly increases the risk of getting/spreading other STIs!

24. How is it Spread? Vaginal, oral, or anal sex OR skin-to-skin contact with someone who has the virus • Symptoms: • One or more blisters on or around the genitals, rectum, or mouth • The blisters break &leave painful sores that take weeks to heal • These symptoms are sometimes called “having an outbreak” Genital Herpes (HSV-2) • Usually characterized by NO or very mild symptoms… NO CURE. • 1 in 8 people aged 14-49 have genital herpes. • Most people do not know it!

25. How is HPV transmitted? • Skin-to-Skin contact • Vaginal, Anal, and Oral sex • (Vaginal & anal most common) Human Papillomavirus (HPV) • HPV is VERY common! • Most sexually-active men and women will get at least one type of HPV at some point in their lives (estimated 80%).

26. Genital warts • Cervical pre-cancer • Other HPV-related cancers - #1 cause of cervical, anal, and penile cancers - Most people with HPV do not know they have it - There is no treatment for the virus itself, but there are treatments for health problems it can cause - In most cases, the immune system will overcome HPV on its own HPV-Related Health Problems

27. “inflammation of the liver” Hepatitis

28. HIV AIDS • Human • Immunodeficiency • Virus • HIV is spread through bodily fluids and affects specific cells of the immune system. • HIV attacks CD4 (T-cells) that help fight disease. • Without treatment, HIV will continue to replicate itself. Acquired Immune Deficiency Syndrome AIDS is a late stage of the HIV infection. Once diagnosed, the body has a hard time fighting disease and certain cancers. There is NO cure for AIDS, but there is treatment.

29. In the U.S. (2016 year-end) 38,739 people diagnosed with HIV 17,803 people diagnosed with AIDS Why is This Important?

30. from person to person through the exchange of bodily fluids 3 Main Ways: • Unprotected sex with people living with HIV (vaginal, oral, or anal) • Blood to blood contact • Exposure to HIV before or during birth or through breastfeeding How is HIV Spread?

31. What Fluids Transmit HIV? How Can HIV Enter the Body? • Blood Semen • Vaginal Fluids • Rectal Fluids • Breast Milk • Vagina • Penis • Anus • Broken Skin • Mouth • Nose • Eyes • Ears Can experience “flu-like” symptoms (if any) about 2-4 weeks after exposure: Fever, Enlarged lymph nodes, Sore throat, Rash HIV

32. BUT, medication can be: Expensive - $30,000 a year ($379,668 lifetime/2010) Complicated– many pills at specific times of day Toxic– side effects are common Ineffective – not all strains of HIV respond Treatment Extends Lives

33. Pre-Exposure Prophylaxis (PrEP): daily medicine that can stop HIV from replicating inside the body PrEPis only prescribed for HIV-negative individuals who are at ongoing substantial risk of getting HIV PrEP reduces the risk of getting HIV when taken consistently more than 90%from sexual contact more than 70%among IDUs PrEP as Prevention

34. NO Risk Abstinence (sex): not having oral, vaginal or anal sex Abstinence (drugs): not using drugs (HIV, HCV) No genital contact since some are spread by touch (HPV, HSV) Mutual monogamy between non-infected partners REDUCED Risk Protected Sex: “correct and consistent” use of condoms/barriers Fewer sexual partners Regular HIV/STD Testing: at least once a year Never sharing needles or “works” (HIV, Hepatitis) PrEP: daily preventative medication (HIV) Reducing the Risk of STDs

35. More than 98%effective when used correctly and consistently Latex (most common and effective) “Non-Latex”: Polyurethane, Polyisoprene Natural Membrane: Lambskin* Male Condoms

36. Male Condom Use Looks like a hat or sombrero or the top of a baby’s bottle

37. Do’s: • DO keep condoms in a cool, dry place • DO put the condom on an erect (hard) penis before any genital contact • DO hold the condom in place at the base of the penis before withdrawing (pulling out) after sex • DO throw the condom away after it’s been used • DO use water-based lubrication (vaginal sex) or silicone-based (anal sex) Don’ts: • DON’T use expired condoms • DON’T unroll the condom before putting it on the penis • DON’T leave condoms in hot places (wallet, car, etc.) • DON’T use oil-based products (baby or cooking oils, hand lotion, Vaseline, etc.) as lubricants with latex condoms • DON’T use your fingernails or teeth while opening the condom wrapper. • DON’T reuse a condom or use more than one condom at a time (‘double wrapping’) Male Condom Use

38. Female Condoms Dental Dams Thin, square pieces of latex Used for oral sex Could make your own dental dam (from a condom, latex glove, or non-microwavable plastic wrap) • Worn inside the vagina (or anus) • Thicker and more tear-resistant • Always latex-free • Wider opening covers more pelvic area More Protection

39. All sexually active people are at risk for STDs

40. HIV: --Everyone aged 15 through 64 should get tested at least once --People who have occasional exposure to HIV risks = at least once a year --People who are at high risk for HIV infection = 3-6 months • Syphilis: • --If you are pregnant • --Are a man who has sex with other men (MSM) • --Have sex for drugs or money • --Have HIV or another STD • --Had sex with someone who tested positive for syphilis Chlamydia & Gonorrhea: Age 24 or younger and having sex = once every year Age 25 or older = if you have had more than one sex partner or with a new sex partner Talk with a doctor about getting tested if you have had sex with someone who tested positive for chlamydia or gonorrhea! Get Yourself Tested!

41. https://gettested.cdc.gov www.stdcheck.com www.gytnow.org Community-Based Organizations Local Health Departments www.health.ok.gov Check out these Apps: “STD Info, Symptoms & Testing” “STD Testing Centers Locator” Where to Get Tested

42. www.cdc.gov www.health.ok.gov www.hiv.gov www.healthfinder.gov www.plannedparenthood.org www.sexetc.org www.gytnow.org www.stophiv.org www.ashasexualhealth.org www.iwannaknow.org www.nakedtruth.org www.rhtp.org Resources • OSDH-HIV/STD Service: 405-271-4636 • National HIV/AIDS Hotline: 800-535-2437