1. Ms. Markowski Texas Woman’s University
STDs & STIs
Ms. Markowski
Texas Woman’s University

2. What do you know? What is a STI? List any STIs you can think of:
What symptoms do people with STIs have?
How do people get a STI?
Who gets a STI?
How can people know if they have a STI?
How can people avoid or prevent STIs?

5. Teen STI Statistics
STIs and STDs are used interchangeably (I = infection, D = disease)
Teens and young adults (14-25) are more likely than other age groups to have multiple sex partners and to engage in unprotected sex.
Therefore, this age group has the HIGHEST rate of STIs (SIECUS, 2005).
Most won’t know they have an STI because the most common symptom of STIs is having NO SYMPTOMS at all & most don’t get tested 
but it doesn’t mean you aren’t sick; you just can’t see or feel it always
Rate of new infections for Herpes & HPV is highest during the late teens and early twenties
50% of young people will become infected with an STI by age 25.
65-75% of ALL sexually active men and women will get either herpes or HPV infections in their lifetime

6. Fluids & Behaviors that Transmit STIs
Contact with of blood, semen, vaginal fluid & with HIV, Breast milk
Behaviors:
Unprotected oral, anal or vaginal sex
Blood to blood contact (fighting, accidents, needles)

7. How can we PREVENT STIs? Abstinence Get Tested (how often?)
Be monogamous (one partner at a time; easier to keep track & most people like it that way  )
Use Condoms (barrier) EVERY TIME & EVERY ORIFICE!

8. Bacterial v. Viral STIs Bacterial: Virus: Living organism
ANTIBIOTICS treat it once infected
Examples
Chlamydia
Gonorrhea
Syphilis
Bacterial Vaginosis
Pelvic Inflammatory Disease (PID)
Virus:
Non-living, need a host (our bodies are the host)
NO CURE, but vaccines for HPV & Hepatitis to prevent
Examples:
HPV (genital warts)
HIV (AIDS)
Herpes
Hepatitis B & C

9. Chlamydia Most common Bacterial STI
Bacterial, so re-infection is likely if untreated and
Person has more unprotected sex
Symptoms:
few, commonly no symptoms
burning sensation with urination (men)
Whitish discharge from vagina/penis
All these vague symptoms are ignored by some or thought to be temporary issues not related to STIs
Long Term Effects:
(Women) Pelvic Inflammatory Disease (PID), ectopic (tubal) pregnancy, and infertility
(Men): swelling and pain in testes, infertility
Transmission:
Contact with semen, vaginal fluid, anus or mouth; rarely through vaginal childbirth which would be serious eye or lung infections for newborn
Treatment:
Antibiotics as soon as possible

10. Chlamydia discharge (looks very similar to pre ejaculate fluid, but comes out when not erect)

11. Gonorrhea (aka “the clap”)
Common Bacterial STI
Re-infection is likely if untreated and infected
person has more unprotected sex
Symptoms:
few, commonly no symptoms
Frequent, persistent sore throat
Burning sensation with urination (men)
Green discharge from vagina/penis
Long Term Effects:
(Women) Pelvic Inflammatory Disease (PID), ectopic preg., and infertility
(Men): swelling and pain in testes, infertility
Transmission:
Contact with semen, vaginal fluid, anus or mouth; rarely through vaginal childbirth which would be serious eye or lung infections for newborn
Treatment:
Antibiotics as soon as possible

12. Gonorrhea (greenish discharge coming out of urethra of penis)
Drips
Gonorrhea (greenish discharge coming out of urethra of penis)
Source: Florida STD/HIV Prevention Training Center

13. Syphilis
Bacterial Infection that has 3 distinct stages
Symptoms:
Primary Stage: Chancre at entry site
Secondary Stage: Skin rash up to 180 days
after chancre disappears
Latent Stage: “Hidden Stage” when there are
symptoms but the bacteria is doing
internal damage
4. Late stage: Rash/chancre disappear then it can cause
severe brain/joint disease
Long Term Effects:
Blindness, brain & heart damage, psychosis or death
Transmission:
Contact with semen, vaginal fluid, anus or mouth; rarely through vaginal childbirth & to cause blindness, meningitis or death in infant
Treatment: Antibiotics as soon as possible

14. Syphilis (1st stage chancre)

15. Bacterial Vaginosis (aka BV)
Bacterial STI involving an imbalance of the natural bacteria in the vagina
by not using condoms during sex or new or multiple partners
Symptoms: (obviously only in women)
few, commonly no symptoms
Thin, off-white discharge from vagina which may have a foul odor (less thick discharge than a yeast infection)
Long Term Effects:
Increases risk of getting other STIs
Transmission:
Contact with semen, vaginal fluid, anus or mouth; rarely through vaginal childbirth which would be serious eye or lung infections for newborn
Treatment:
Antibiotics as soon as possible

16. Yeast infections Treatment: Symptoms: (obviously only in women)
Fungal infection involving the overgrowth of yeast normally living in mouth, vagina, scrotum & feet.
Symptoms: (obviously only in women)
Redness, burning, Itching, thick whitish or yellowish discharge, sore/itchy around area of infection
Also known as jock itch, athletes foot, thrush and yeast infection
Transmission & Causes:
Contact with infected genitals or fluids
Caused usually by STRESS, antibiotics without taking acidophillis. sweaty workout wear, damp bathing suit, scented pads, or rarely, sex with certain partners
Treatment:
Antifungal medications
(see next slide for examples)

17. Yeast infection treatments (active ingredient same for all 3 but price differs)

18. Pubic Lice (aka “crabs”)
Parasitic infection
Found on any pubic hair, including legs,
armpit, moustache, beard, or eyebrows
Symptoms:
itching, redness, visible lice
Transmission:
Any Contact with other’s pubic hair or
Contact with infected bedding/ towels, or clothes
Treatment:
Lice-killing shampoo, shave hair if possible
wash all clothes, bedding, towels

19. Human Papilloma Virus (HPV) (genital warts)
Most common Viral STI in America, even in teens
Symptoms:
Generally no early symptoms
1-8 months later, warts appear in contact area of
infection usually on mouth, throat, genitals or anus
Long Term Effects:
Warts, most common cause of Cancer of throat, anus, cervix, penis
Usually burning or itching near the warts
Transmission:
Contact with penis, vagina, anus, or mouth (either the fluid or the wart itself)
Treatment:
Try to lazer or freeze (cryotherapy) visible warts (they usually reappear)
**Guardasil is a vaccine to prevent but not treat HPV

20. HPV VACCINE (Gardasil)
The vaccine Gardasil®, protects against 4 HPV types, which together cause 70% of cervical cancers & 90% of genital warts.
The FDA licensed this vaccine for use in girls/women, ages It is also recommended by for boys at age years old. The vaccination of boys is also likely to benefit girls by reducing the spread of HPV viruses.
The vaccine is given in a series of three shots over a six month period.

21. HPV Penile Warts HPV and Cervical Cancer
Source: Cincinnati STD/HIV Prevention Training Center

22. HPV Cervical Warts & Thigh
Source: Cincinnati STD/HIV Prevention Training Center

23. Genital Herpes
Viral infection caused by herpes simplex I or II infections
Symptoms:
sores or blisters on or around genitals/rectum, mouth or eye (wherever the virus entered the body)
Flu-like symptoms, fever, swollen glands
Sores come and go for the rest of your life, especially with stress and last from 2 days to 4 weeks
Long Term Consequences:
Reoccurring infections (painful), infants born to infected moms can lead to encephalitis, jaundice, or other infections
Transmission:
Contact with semen, vaginal fluid, anus or active viruses in mouth/saliva
Can spread without visible sore and transmits oral to genital and vice versa
Treatment: (no cure)
Anti-viral Rx meds, or over the counter (OTC) medicines lik eLysine, Abreva, Novitra, Herpacin, all help symptoms

24. Herpes

25. Genital Herpes Simplex in Females
Sores
Source: Centers for Disease Control and Prevention

26. Pelvic Inflammatory Disease (PID)
Infection of a woman's pelvic organs including uterus, fallopian tubes and cervix
Symptoms: none, mild to severe pain in abdomen, pain with sex, fever, irregular periods
Transmission: Caused from Bacteria found in two common (STIs) gonorrhea and chlamydia
Long term issues: Commonly causes sterility if left untreated!
Risk factors:
Have had an STI (especially if left untreated for 3+ months)
Being under 25 and having sex
Having more than one sex partner
Using douches can push bacteria into the uterus, ovaries, and tubes, causing infection.

27. PID Healthy

28. HIV & AIDS How it works: Transmitted through 4 fluids & methods 
Human Immunodeficiency Virus
Acquired Immuno-Deficiency Syndrome
Transmitted through 4 fluids & methods 
vaginal secretions,
semen
blood
breast milk
Does NOT transmit through air or surfaces
How it works:
HIV targets T helper cells of the Immune System
T-helpers Recognize diseases (virus, bacteria, fungus, parasite, etc) and initiate an immune attack
Destruction of T-cells will make an immune response less and less effective and increase vulnerability to sickness over time

29. Get tested for HIV!!!
Symptoms:
Most people have none right away, some people get flu- like symptoms that eventually go away for years until HIV becomes AIDS
If you have ever come into contact with someone else’s blood, semen, vaginal fluid or breast milk, GET TESTED for HIV
You must ask specifically for an HIV test
Most accurate tests are about 3 months after suspected exposure for accuracy
it takes time to HIV to target, reproduce and kill enough T helper cells to show up in blood work
3 out of 4 people who are HIV positive DO NOT TELL their partners
because they have no idea they have the virus!

30. When does HIV become AIDS?
1. When T Helper Cell count lowers to below 200, a person is considered to have AIDS. (normal: 1,000)‏ OR
2. Having 1 or more opportunistic infections
- such as pneumonia, flu, cold, cancer
Time for transition to AIDS diagnosis varies by person and access to Rx drugs:
5%: die after 3 yrs
20%: 5 years
40%: 10 or more years
35%: 20 years or more (this is as much as we know since mid-80s)
GET TESTED with each new exposure to these fluids!!

31. Treatment for HIV Rx Anti-retroviral drugs
Recommend 3 or more meds from at least 2 different classes to interrupt virus replication
That’s at least 6 medication a day, multiple times a day for the rest of your life!
If don’t stick to the meds, it will cause HIV resistance, which makes it more lethal
Identification: oral swab, takes 20 minutes
4 classes of drugs to treat the disease
If don’t stick to them, will cause resistance
Post Exposure Prophylaxis (PEP_: highly effective anti retroviral drugs
Up to 72 hours post exposure, really toxic to body, but can prevent infection

32. Historical Perspective
: HIV spreads from monkeys to humans through eating monkey meat (similar to how we eat deer)
In 1981, cases of a rare cancer began affecting young healthy gay men in NY and San Francisco (700 deaths in first year)‏
1982: GRID immerges as name; then later changed to “4H label”
1987: 150,000 cases of HIV worldwide (40,000 deaths)
1990: 1 million living with HIV/AIDS worldwide
2000: 21 million have died, 30 million currently living with virus
To Date: At least 30 million people have died of AIDS
40 million living with the virus
16,000 new infections every day
110 new infections in US every day
8,000 deaths a day worldwide

33. Specific ways to prevent ANY STD/STI
Abstinence from oral, vaginal and anal sex
Using a condom EVERY TIME during any sex type
any exchange of bodily fluids (semen, vaginal secretions, blood) transmits infections
Get Yourself Tested (GYT) and your partner too
How often: every new partner or new fluid exchange!
As always, avoid Alcohol and other Drugs
Making sexual decisions is hard enough without the influence of mind-altering drugs

34. Adolescent Condom Use
According to the Youth Risk Behavior Surveillance (2014):
Among currently sexually active students, 57.9% reported using condoms during last intercourse
73% reported having had intercourse at least once without a condom
Very few use a condom with oral sex, which explains the increase in mouth cancer

35. Protect yourself! Remember: you only have ONE body and ONE life
Use condoms EVERY time and get TESTED
Every time you switch partners!
Be safe, be smart, be healthy!

36. Resources:
C.D.C., (2005). Human Papillomavirus (HPV) and Cervical Cancer: An Update on Prevention Strategies Script. Retrieved October 6, 2005 from
Grunbaum, J., Kann, L., Kinchen, S., Williams, B., Gross, J., Lowry, R., & Kolbe, L. (2002). Youth Risk Behavior Surveillance (YRBS)-United States, 2001, Morbidity and Mortality Weekly Report, 51, 1-64.
SIECUS., (2005). The truth about STDs. Retrieved October 5, 2005 from
SIECUS., (2005). The truth about adolescent sexuality. Retrieved October 5, 2005 from