Public Health-Seattle & King County Teaching About STDS HIV/AIDS Program Public Health-Seattle & King County hivstd.info@metrokc.gov http://www.metrokc.gov/health/apu 206/205-STDS (7837)

Elements of effective programs: tailoring to the age and experience of the audience; focus on risky sexual behavior; sound theoretical foundation; provision of basic facts about avoiding risks of unprotected sex; acknowledgement of social pressures to have sex; and practice in communication, negotiation and refusal skills.

Key Teaching Points Youth are at risk for STDS. STDS are preventable. STDS are transmitted by unprotected anal, oral or vaginal sex. Sexually active youth should be tested and treated for STDS.

Youth are at risk for STDS People < 25 account for 66% of new STD infections. The Seattle Public Schools 1999 Teen Health Risk Survey showed that 40% of high school students had had sex. Of students who reported having had sex, 20% said they had experienced forced intercourse. 55% of high school students who had sex in the last 3 months used a condom the last time they had sex. In King County, the 1997 gonorrhea rate per 100,000 was 351.5 for 18-19 year olds compared to 142.1 for 30-34 year olds.

Key Teaching Points Youth are at risk for STDS. STDS are preventable. STDS are transmitted by unprotected anal, oral or vaginal sex. Sexually active youth should be tested and treated for STDS.

Prevention Abstinence Mutual monogamy with uninfected partner Limited sexual contact (non-penetrative) Condoms - correct and consistent use Reduce number of sexual partners Talk with new partners about risk reduction Tx of curable STDs, regular PAP test, vaccinate Avoid sex if you have symptoms of an STD Notify recent partners if you have an STD

WARNING: Condoms may not fully protect you or your partner from getting herpes or HPV. Condoms are not as effective at preventing herpes or HPV transmission as they are at preventing the transmission of other sexually transmitted diseases. You may have sores or viral shedding in the genital region which may not be covered by or protected by condoms (e.g., labia, the scrotum). Prevention Abstinence Mutual monogamy with uninfected partner Limited sexual contact (non-penetrative) Condoms - correct and consistent use Reduce number of sexual partners Talk with new partners about risk reduction Tx of curable STDs, regular PAP test, vaccinate Avoid sex if you have symptoms of an STD Notify recent partners if you have an STD

Condom Effectiveness Intact latex condoms do NOT allow air, water, viruses, or other organisms such as bacteria to pass through. Prevent pregnancy up to 98 percent of the time. In studies, among 124 discordant couples who used condoms consistently over 2 years, none of the uninfected partners became infected with HIV.

Key Teaching Points Youth are at risk for STDS. STDS are preventable. STDS are transmitted by unprotected anal, oral or vaginal sex. Sexually active youth should be tested and treated for STDS.

Two Kinds of Sexual Transmission M-C Two Kinds of Sexual Transmission S-S 1) Skin to Skin 2) Body Fluid N B-F

STD Transmission B-F S-S Genital Herpes Genital Warts (HPV) Syphilis Pubic Lice Scabies Chlamydia Gonorrhea HIV Hepatitis A Hepatitis B Hepatitis C

HIV and other STDs are connected. same behaviors increased transmission feelings of susceptibility and personal concern

Key Teaching Points Youth are at risk for STDS. STDS are preventable. STDS are transmitted by unprotected anal, oral or vaginal sex. Sexually active youth should be tested and treated for STDS.

Sexually active youth should be tested and treated for STDS. Many STDS do not have symptoms. Untreated STDS can have serious consequences. Where can your students get tested?

Bacterial STDs: Chlamydia, Gonorrhea and Syphilis

Pelvic Inflammatory Disease Epididymitis Symptoms: fever, chills, pain Complications: sterility Treatment: antibiotics Pelvic Inflammatory Disease Symptoms: pain, fever, chills Complications: Ectopic pregnancy, maternal death, sterility Treatment: antibiotics

Other symptoms appear-- Syphilis Primary Chancre appears at site of infection Transmission: contact with rash or chancre Symptoms: (at left) Time to onset: 10-90 days Pregnancy: perinatal infection may cause blindness or infant death Diagnosis: blood tests Treatment: antibiotics very effective Secondary Other symptoms appear-- rashes, fever, fatigue Latent Phase No Symptoms Late Phase Damage to nervous system and death

Viral STDs: Genital herpes, Genital warts, Hepatitis A, B and C, and HIV.

Herpes (HSV) HSV-1 HSV-2 Cold sores Oral-genital frequent Genital lesions Genital-oral infrequent

Genital Herpes (HSV) Transmission: skin to skin Symptoms: Prodrome--tingling in legs, buttocks or groin Lesion--itching, blister at infection site; Recurrences vary in frequency and severity Time to onset: 2-20 days Pregnancy: 5% transmission when lesions present Diagnosis: culture, antibody test Treatment: symptom relief; antivirals effective

HPV (Human Papilloma Virus) “Genital Warts” About 30 Types of Genital HPV 4 types related to cervical/anal Cancer Genital Warts

HPV (Human Papilloma Virus) “Genital Warts” Transmission: skin to skin contact; not dependent on visible warts Symptoms: fleshy “warts” on genitals, perineum, anus; some strains cause no visible symptoms Time to onset: 1-20 months Pregnancy: perinatal infection possible Diagnosis: observation, PAP detects dysplasia Treatment: remove visible warts

Vaginitis “vaginal infection” Trichomonas Bacterial vaginosis (BV) Yeast infections Diagnosis of all vaginitis confirmed by microscopic examination

Trichomonas, aka “Trich” (parasite) Transmission: sexual contact, shared clothes Symptoms: -women: itching, burning, “fishy” discharge -men: usually asymptomatic, but can transmit Treatment: oral medication

Vaginosis (bacteria) Caused by overgrowth of normal bacteria Symptoms: itching, burning, frothy discharge Time to Onset: varies Treatment: antibiotics or vaginal cream

Yeast infection (fungi) Caused by overgrowth of common vaginal fungi Symptoms: itching, burning, “cottage cheese” discharge Treatment: vaginal cream or oral medication

Scabies (parasite) Transmission: sexual contact, clothes, touching Symptoms: itchy rash, especially at night Time to onset: 2-6 weeks from first exposure Diagnosis: microscopic examination of skin scrapings Treatment: creams and lotions

Pubic Lice, aka “Crabs” (parasite) Transmission: sexual contact, clothes, sheets Symptoms: redness and itching in hairy areas Diagnosis: seen easily by naked eye Treatment: lotion, clothes/sheets washed in hot water

HIV/STD Hotline (206) 205-7837 Last Questions http://www.metrokc.gov/health/apu hivstd.info@metrokc.gov HIV/STD Hotline (206) 205-7837