WCHS 9th Grade 2016-2017 Sexually Transmitted Infections STI’s Debi Martin, RN

STI Facts STI’s primarily effect young people Health consequences last a life time 20 million NEW cases every year 50% of the new cases are diagnosed in young people age 15 – 24 years. 110 million infected people in the U.S. $16 billion in healthcare costs every year

There are over 50 different types with many more strains of each type STI Facts The only Reportable STD’s in Tennessee are: HIV Chlamydia Gonorrhea Syphilis There are over 50 different types with many more strains of each type

20 million NEW cases every year STI Number of new cases HIV Chlamydia Gonorrhea Syphilis HPV (Genital Warts) Herpes Hepatits B Trichomoniasis 41,400 2.86 million (1:15 females 14 – 19 yrs) 820,00 55,400 14,100,000 776,000 (HSV 2) 19,000 1,090,000

2 ways of Transmission Body Fluids Skin to Skin Condoms are effective Skin to Skin Nothing protects you Diseases that spread through body fluids Chlamydia Hepatitis B,C (on the rise) HIV Gonorrhea Syphilis Diseases that spread through skin contact HPV Herpes Syphilis If it starts with an H it’s a virus and there is no cure!

No Cure VIRAL INFECTIONS

HIV – no cure Human Immunodeficiency Virus The virus that causes AIDS (Acquired Immune Deficiency Syndrome) Destroys blood cells in the immune system, which results in the body losing the ability to fight infection Found in blood, body fluids (semen, vaginal secretions, breast milk).

HIV - transmission Intercourse (oral, anal or vaginal) with an infected person. Contact with secretions from an infected person. Sharing needles. Pregnant mom to baby. Blood transfusions (very rare). Accidental contact with infected blood (healthcare workers). Theoretically through prolonged “French” kissing if there are open, bleeding sores. NOT transmitted by saliva, tears, sweat, urine, feces, insect bites, the air, or environmental surfaces.

HIV - symptoms Mild flu-like symptoms (early); usually goes unnoticed. Person looks well and feels healthy for years, but is able to give HIV to others. Slow destruction of white blood cells. Eventually, the body is unable to fight infections (wt. loss, fever, diarrhea, night sweats). Average of about 10 years between infection and severe symptoms (pneumonia, cancer).

HIV infection - consequences When the white blood cell level is extremely low, or the person has been diagnosed with other infections, or conditions associated with a severely damaged immune system, the person is diagnosed as having AIDS. Persons with AIDS can live a long time, but people with AIDS die every day. HIV can be passed from an infected woman to her baby during pregnancy, child birth, or when breast feeding, causing to the baby’s immune system.

HIV – treatment/cure Can be treated, but not cured. Treatment is more effective if the infection is found and treatment begins immediately. Newer combination therapies can be highly effective in fighting opportunistic infections and reducing the amount of HIV in the body.

HIV - avoidance Abstinence from sexual intercourse. Abstinence from needle sharing. Use “universal precautions.” Treat everyone like they have something!

HIV – resources CDC INFO: 1-800-232-4636 CDC email: cdcinfo@cdc.gov Parent or trusted adult Family doctor Health Department: 473-8468 CDC – http://cdc.gov/ American Red Cross – www.redcross.org/services/hss/hivaids/

Genital Warts – HPV – no cure Over 100 different types of HPV HPV Types 6,11,16,&18 are protected by a vaccine Types 6 and 11 cause 90% of genital warts Types 16 and 18 cause 70% of cervical cancers Can also cause anal and throat cancer.

Genital Warts – no cure Flesh colored growths “cauliflower” appearance, on, around, or inside the genitals, rectum, or throat. HPV – Human Papillomavirus , or “venereal warts.”

HPV - transmission Skin to skin contact – oral, anal or vaginal sexual intercourse with an infected person. Hand or genital contact with the rash covered area, even if warts are not present. May take weeks or months for warts to appear. Very contagious – people can carry the virus without symptoms for a lifetime. Can give it to someone, even if warts are not visible.

Genital Warts - symptoms Visible and invisible flesh-colored warts on, around, and inside the genitals, rectum and anus, or throat. Rarely go away without treatment. May return after treatment.

Genital Warts - complications You have it for life and can spread it to others. May grow large enough to block the openings to the vagina, rectum or throat. They are uncomfortable and unsightly. May be passed from mother to baby. Cause the most cervical cancer in women. Warts and virus do not go away.

Genital Warts - avoidance Abstinence from sexual intercourse. A monogamous relationship (marriage).

Genital Warts – female/male

Genital Warts – treatment/cure NO CURE, can be treated. Removal of warts, but they may return. A three dose vaccine, which will prevent MOST cases of genital warts.

The only sure way to prevent HPV… is to avoid all sexual activity Choose Abstinence

Herpes – No cure Two types: HSV 1(oral) and HSV 2 (genital). 1 out of every 6 people in the U.S. have HSV 2 or 16.2 % of the U.S. population.

Herpes - transmission Kissing an infected person. Intimate sexual contact (oral, anal, vaginal sex) with an infected person. Skin to skin, touching the sore or area where sore will appear. Contact with the rash-covered, infected areas of the body, whether or not sores are visible. From infected mother to baby.

Herpes - symptoms May be none Itchy painful sores, small bumps or blisters. Blisters that weep, scab and last 1 – 3 weeks. Itching or burning before blisters appear. Flu-like feelings, especially when a person is first infected.

Herpes - complications Genital Herpes can cause painful genital sores in many adults and Can be severe in people with suppressed immune systems Spread skin to skin- outbreaks can occur in areas that are not covered by a condom

Herpes - consequences Infected babies may have central nervous system damage and painful blisters anywhere on their body. Blisters are painful and unsightly. You will always have it. Symptoms will return.

Herpes - treatment Medicine to reduce pain and blisters Medicine to reduce future outbreaks NO CURE!

Primary herpes, male and female Same patient 4 days later

Herpes - avoidance Abstinence from sexual intercourse. Monogamous relationship - marriage

Medication is available BACTERIAL INFECTIONS

Chlamydia The first time I had sex with my boyfriend, I got Chlamydia. So one week I was a virgin, and 2 weeks later, I had an STD that I didn’t know I had. 6 months later I started running a fever, I had very bad cramping, my stomach hurt just to touch it. I went to the doctor and I found out I was infertile. I will never be able to have a baby or family and I am just 16. Maybe adoption will be my answer?

Chlamydia - Silent Disease Most common STI. Most infections are in people 15 – 24 years of age. Caused by a bacteria

Chlamydia - transmission Sexual intercourse (oral, anal, vaginal) with an infected person. Contact with infected secretions (discharge). From mother to baby during birth.

Chlamydia - symptoms Usually NONE In women – discharge, pain in abdomen or with urination, bleeding. In men – burning or pain with urination, watery drip from penis, or pain in testicles.

Chlamydia - consequences Permanent and painful damage to reproductive and urinary organs. It’s the leading cause of pelvic inflammatory disease, which leads to infertility. Sterility – you can’t have children. If passed to the baby at birth, the baby could have eye problems or even die.

Chlamydia – treatment/cure Cured with proper treatment, but you can be re-infected. Antibiotics Treatment of both sexual partners.

Chlamydia - avoidance Abstinence Monogamous relationship Treatment of both partners

Gonorrhea Call clap, drip, GC, or “getting burned”. Caused by a bacteria. Can spread to other parts of the body and cause damage.

Gonorrhea - transmission Sexual intercourse (oral, anal, vaginal) with an infected person. Contact with infected discharge. Eyes can become infected if discharge is not washed off hands. From mother to baby.

Gonorrhea – symptoms May be NONE. In women – yellow or white discharge, painful urination, heavy painful periods/cramps, pain in lower abdomen. In men – yellow or white discharge, painful and frequent urination. Reddened, sore throat, white patches in the throat. Rectal pain and blood or pus in bowel movements. Unusual redness and burning in the eyes; may lead to blindness.

Gonorrhea - consequences Damage to reproductive or urinary organs. Infertility/sterility If untreated, pain in joints, heart problems, skin infections, blindness, death. Baby may have eye problems, blindness, or pneumonia.

Gonococcal opthalmia Gonorrhea, skin lesions

Gonorrhea - avoidance Abstinence Monogamous relationship Treatment of both partners Antibiotic resistance is emerging Could be untreatable in the future

Syphilis Called syph, the pox, lues (Loo-eez), or bad blood. Caused by a bacteria Can spread to other organs of the body and cause serious damage to vital organs. There has been a resurgence in recent years.

Syphilis - transmission Sexual intercourse (oral, anal, or vaginal intercourse) with an infected person. Hands or genitals in contact with open sores, rashes, or lesions. From mother to baby.

Syphilis - symptoms Early symptoms may be missed. 3 stages: 1st Chancre, a painless sore that goes away after a few weeks (the person is still infected) 2nd Rash, sore throat, hair loss – symptoms go away after a few weeks, but the person is still infected. 3rd May have no visible symptoms- but there may be irreversible damage to major organs heart, brain, spinal cord, blindness; brain damage; death.

Primary syphilis chancre

Secondary syphilis rash

Secondary syphilis, alopecia (hair loss)

Syphilis – consequences If untreated, symptoms disappear but damage to organs increases. Pregnant woman – miscarriage or still birth. May be passed to baby, causing damage to the baby’s eyes, skin, teeth, liver, and bones.

Syphilis – treatment/cure Can be cured with antibiotics, but re-infection can occur. Treat both sexual partners. There is no cure for irreversible organ damage. Major increase seen in young men

Late syphilis - ulcerating gumma

Syphilis – avoidance Abstinence from sexual intercourse (oral, anal, and vaginal intercourse.) Monogamous relationship (marriage).

Trichomoniasis Call “trich” Caused by a parasite Trichomoniasis is considered the most common curable STD. In the United States, an estimated 3.7 million people have the infection, but only about 30% develop any symptoms of trichomoniasis.

Trichomoniasis – transmission Sexual intercourse (oral, anal, vaginal intercourse). The parasite doesn’t usually infect the hands, mouth or anus.

Trichomoniasis – symptoms 70% of people with Trichomoniasis do not know they are infected Symptoms can come and go If symptoms are present, they may include: In women: itching, burning, pain with urination, discharge that may be clear, white, yellowish, or greenish, and many times a strong odor In men: itching or irritation inside the penis, burning after urination, or discharge.

Trichomoniasis – consequences Increases the risk of getting HIV May cause premature birth May cause the baby to be born small (less than 5.5 pounds).

Trichomoniasis – treatment/cure Can be cured with antibiotics, but re-infection can occur. Treat both sexual partners.

Trichomoniasis – avoidance Abstinence from sexual intercourse (oral, anal, and vaginal intercourse.) Monogamous relationship (marriage).

Change in Teen Pregnancy Rate Among Girls Age 15-19, 1988-2008 (Percent)

Resources for more information on HIV or any STI CDC INFO: 1-800-232-4636 CDC email: cdcinfo@cdc.gov Parent or trusted adult Family doctor Health Department: 473-8468 CDC – http://cdc.gov/ American Red Cross – www.redcross.org/services/hss/hivaids/

Resources for more information on HIV or any STI Websites that ending with .edu or .gov CDC.gov is the primary reference in this presentation. Michigan Model is the curriculum that is used by the Warren Co. School system and has been approved by the local school board.