1. Sexually Transmitted Diseases/Infections (STDs/STIs)
Infectious diseases spread from person to person through sexual contact

2. What is a Sexually Transmitted Disease?
Diseases you can get by having sex – vaginal, oral, or anal – with someone who is already infected.

3. STDs in the United States
An estimated 65 million people in the United States are living with an incurable STD
Every 8 seconds, a teenager gets a STD
1 in 10 teenagers is infected with a STD
Each year, more than 15 million Americans become infected with a STD.
¼ of these are teens
2/3 are under the age of 25

4. A Silent Epidemic
Epidemics – occurrences of diseases in which many people in the same place at the same time are affected
Why are they spreading so quickly?
Many STDs are asymptomatic – showing no signs/symptoms
Don’t get treatment because they don’t know they’re infected
Don’t like to talk about it
People are scared or embarrassed to get tested

5. STDs are a growing problem
Rates of STD’s have steadily increased
1960’s = 2 STD’s of major concern – syphilis and gonorrhea (both can be cured)
Today = more than 25 STD’s
1 in 4 sexually active adolescents will become infected before graduating high school

6. High-Risk Behaviors and STDs
Being sexually active with more than one person
Engaging in unprotected sex
Selecting high-risk partners
Using alcohol and other drugs

7. Teen are at a higher risk
Teenager’s bodies may not fight infections as well as the bodies of healthy adults
Their immune systems are still developing

8. How are STDs spread? ALL SEXUAL ACTIVITY
Any type of sexual activity that brings an uninfected person in contact with body fluids from an infected person
Any sexual activity that results in contact between one person’s genitals and another person’s skin or mucous membranes, in which one of the persons is already infected with an STD
Direct contact with open sores
A mother to her baby before birth, during birth, or during breast-feeding

9. Consequences of STDs Some STDs are incurable Can cause cancer
Can cause complications that affect the ability to reproduce
Some STDs can be passed from an infected female to her child before, during, or after birth

10. Importance of Abstinence
Only 100% way to prevent STDs!!!
A majority of teens (54.4%) in high school choose abstinence

11. Set your boundaries early!!!

12. PHYSICAL INTIMACY 9-12 = Sexual Activity Eye to body Eye to eye
Voice to voice
Hand to hand
Hand to shoulder
Hand to waist
Face to face
Hand to face
Hand to body (over clothes)
Touching above waist (under clothes)
Touching below waist (under clothes)
Intercourse – vaginal, oral, anal
9-12 = Sexual Activity

13. STDs caused by Bacteria
Chlamydia, Gonorrhea
Syphilis

14. Chlamydia Most common Bacterial STD Transmitted
2 million people currently infected
3 million more will acquire it this year
Transmitted
Through sexual activity
During childbirth

15. Symptoms of Chlamydia 85% of women and 40% of men have no symptoms
Vaginal or urethral discharge
Burning with urination
Pelvic Pain (women)
Swelling and tenderness of the scrotum (men)
Genital ulcers

16. Long-term effects of Chlamydia
Pelvic Inflammatory Disease (PID)
Can damage the fallopian tubes and result in tubal scarring and infertility
Causes 25% of the infertility in women pursuing in vitro fertilization in the US
Symptoms
Pelvic and abdominal pain
Fever
Abnormal vaginal bleeding
Ectopic (tubal) pregnancy
Infants
Illness
Blindness

17. Diagnosis and Treatment
Diagnosis – lab test (genital fluids or urine)
Treated easily IF caught early
Treatment
Oral antibiotics
Newborn infants routinely receive antibiotic eye drops/ointment to prevent eye infection

18. Gonorrhea – Skin Lesion

19. Gonorrhea – skin lesion on heel

20. Gonorrhea – in eye

21. Symptoms of Gonorrhea Discharge from vagina or urethra
Pain during urination
Abnormal vaginal bleeding (“spotting”) – women
Pain and swelling around the testicles – men
25-80% of women and a smaller percentage of men have no symptoms

22. Long-term effects of Gonorrhea
Pelvic Inflammatory Disease
Pregnant women
Spontaneous abortion
Premature rupture of membranes
Preterm birth
May infect amniotic fluid
Blindness
Joint infection
Life-threatening blood infections

23. Diagnosis and Treatment
Diagnosis – Body fluids will be examined and tested
Treatment
Oral or injectable antibiotics
After treatment, infected individuals should be re-examined and tested again

24. Syphilis Number of cases is again on the rise
Between 1940’s and 2000 – number of cases fell from approximately 100,000 to less than 6,000
Today, beginning to rise again (36,000)
Called “The Great Imitator”
Many of the signs/symptoms resemble other diseases
Transmitted
Sexual activity
Contact with syphilitic sores
Passed to infants during childbirth

27. Symptoms of Syphilis Primary Stage (10-90 days after infection)
Single sore (chancre)
Firm, round and painless
Occurs at spot where Syphilis entered body
Heals in 3-6 weeks if left untreated
Secondary Stage (2-8 weeks after infection)
Itch-less rash
Flu-like symptoms
Fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue

28. Secondary syphilis- rash on palms of hands

29. Symptoms (cont) Latent stage (2 or more years after)
Signs disappear and think cured
Attacks heart, blood vessels, and CNS
Late stage (10 to 30 years after)
Heart, skin, brain, spinal cord affected
Cannot be cured at this stage

30. Diagnosis and Treatment
Diagnosis – blood test
Treatment
Can be cured if caught early
Antibiotic
Will not repair or reverse the damage already caused by the disease
A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year.

31. STD’s caused by Viruses
HPV, Genital herpes, Hepatitis, HIV
CANNOT BE CURED!!!

32. Human Papilloma Virus (HPV)
More than 100 strains of HPV
40 cause genital infections
6.2 million Americans are infected with genital HPV each year
50% of sexually active Americans are or have been infected
20 million currently have the virus
Another 80 million have been infected some time in the past
In 90% of cases, the body’s immune system clears the HPV infection naturally within two years
By the age of 50, 80% of women will have acquired genital HPV
Transmission
Skin-to-skin contact
Contact with infected body fluids

33. Symptoms of HPV Most patients have no symptoms Genital and Anal Warts
7% of infected people

34. Long-term effects of HPV
Cervical Cancer – Women
Genital Cancers – Men

35. Diagnosis and Treatment
abnormalities detected on a Pap Smear – women
Most asymptomatic men do not know they are infected
Treatment
Topical medications applied to the wart
Decrease in size and disappear
Surgical removal (burning with a laser)
Freezing
Even with treatment, warts will often return

36. Genital Herpes Most common sexually transmitted viral infection in US
45 million people infected
1 in 5 American age 12 or over have genital herpes
2 types of herpes
HSV-1 and HSV-2
Most cases of genital herpes are HSV-2
HSV-1 can be transmitted to genitals via oral sex
Greatest risk factor is the total number sexual partners a person has had in their life

37. Transmission of Herpes
Skin to skin contact
Kissing with a sore
Touching a sore
Sexual activity
Exposure to infected body fluids
During childbirth

38. Symptoms of Herpes Initial infection Other symptoms
Fever, headache and muscle aches
Lesions appear in area of exposure
Blisters which break and become ulcers
About 8 days after exposure
Painful and often burn or itch
Other symptoms
Burning with urination, vaginal or urethral discharge, tender swollen lymph nodes
Recurrent outbreaks
Skin lesions

39. Long-term effects of Herpes
NO CURE!!!
Can transmit to others even at time when not experiencing symptoms
90% will experience at least one recurrence within 12 months of initial episode
Recurrences can occur for the remainder of the person’s life
Risk of spontaneous abortion and premature birth

40. Diagnosis and Treatment
Diagnosis – Viral cultures
As many as 90% do not know they are infected
Treatment
Anti-viral medications
Reduces the duration and intensity of symptoms

41. Trichomoniasis Caused by a Parasite
Most common curable STD in young, sexually active women 7.4 million new infections occur each year in the US
Increases the risk of contracting HIV
Transmission
Sexual contact

42. Symptoms of Trichomoniasis
50-80% of women and some men don’t know they are infected
Women
Vaginitis and/or Cervicitis
Vaginal discharge
Abnormal vaginal bleeding
Cervical irritation
Swelling and irritation of the genitals
Itching of the vulva
Abdominal pain
Men
Urethritis
Discharge from penis
Burning during urination

43. Long-term effects
Premature rupture of membranes
Preterm labor

44. Treatment
Oral medication (metronidazole)

45. Being Responsible About STDs
Seek medical help right away
Complete the full course of medications
Have follow up testing done
Avoid all sexual activity while being treated
Notify ALL sexual partners

46. Contraceptives Don’t Stop STDs

47. Safe Sex?
Safer… but not Safe Sex

48. Condoms
Thin sheath that is placed on an erect penis to catch semen when a male ejaculates.
Most effective kind of condom is a latex condom with a spermicide containing nonoxynol-9
Prevents pregnancy and HIV
Does not prevent ALL STDs! (HPV or Herpes)

49. With 100% Correct Condom Use
STD’s
Approx. risk reduction
Gonorrhea
50%
Chlamydia
Syphilis
30-50%
Trichomoniasis
No evidence
HPV
HIV
85%
Think about it.  A condom covers one specific part of the body, right?  Many sexually transmitted diseases are spread through skin-to-skin contact. 

50. Spermicide Chemical that kills sperm
Sold as jelly, foam, cream, film, or sponge
Spermicides are most effective when used along with other forms of contraception, such as a condom
Spermicides alone DO NOT protect against HIV or STDs.

51. Birth Control Pills
Female hormones that are taken orally every day to prevent ovulation or affect the lining of the uterus so that it cannot support and nourish a fertilized egg.
Does NOT protect from STDs or HIV.

52. Think about it…
Approximately 1 in every 5 people using condoms for pregnancy protection will get pregnant during the first year

53. 100% WAY TO AVOID GETTING ONE OF THOSE!!
ABSTINENCE
100% WAY TO AVOID GETTING ONE OF THOSE!!

54. HIV and AIDS
AIDS – Acquired Immune Deficiency Syndrome – a disease in which the immunes system of the patient is weakened
1982 – 1600 cases were reported…700 deaths resulted
2000 – AIDS was the 5th leading cause of death among adults from years
HIV – Human Immunodeficiency Virus – a virus that attacks the immune system
Causes AIDS

55. Teens at Risk
Teen have one of the fastest growing rates of HIV

56. How HIV Attacks Cells
Invades certain cells of the immune system – including T cells
HIV attaches to cell surface
Virus core enters cell and goes to nucleus
Virus makes a copy of its genetic material
New virus assembles at cell surface
New virus breaks away from host cell

57. HIV and the Human Body
As the number of viruses increase…the number of T cells decrease…the immune system is weakened
Opportunistic infections – infections that occur in individuals who do not have healthy immune systems
HIV is progressive
It destroys the cells of the immune system over many months or years
AIDS is the advanced stage of HIV

58. Transmission of HIV NOT transmitted by
Toilet seats
Telephones
Food
Being in the same area
Casual physical contact – shaking hands and hugging
Insect bites
Sweat
Sneezing
HIV lives inside cells and body fluids
Transmitted though…
Blood
Semen
Vaginal secretions
Breast milk

59. Transmission of HIV Sexual intercourse (any form of sex)
Secretions containing HIV can enter a partner’s blood through tiny cuts in the body
Increases with number of sexual partners
Increases by having another STD that causes sores
Chlamydia, herpes, gonorrhea, syphilis
Sharing needles
Mother to baby
Through the umbilical cord
During delivery
While nursing

60. Stages of HIV
A person in considered infectious immediately after contracting the virus
½ of infected people develop symptoms 3-6 weeks after becoming infected
Fever, rash, headache, body aches, and swollen glands
Symptoms tend to disappear within a week to a month – mistaken for another viral infection (flu)
Asymptomatic stage – a period of time during which a person infected with HIV has no symptoms
May last 6 months to 10+ years
Virus continues to grow
Can still be passed on to others
Immune system can keep up with the infection – produces billions of new cells

61. Stages of HIV Eventually, the immune system can’t keep up
Symptomatic stage – the stage in which a person infected with HIV has symptoms as a result of a severe drop in immune cells
Symptoms
Swollen glands, weight loss, and yeast infections
AIDS
Later stage where more serious symptoms appear
Presence of HIV infection
Severely damaged immune system
Measured by number of helper T cells – less than 200 per milliliter of blood
Appearance of one or more opportunistic infections

62. Detecting HIV
EIA test – a test that screens for the presence of HIV antibodies in the blood
May be inaccurate
Developing antibodies takes time
False negative – the test is negative, but the person is positive
Most people will test positive in the first 3-4 weeks…but some take up to 6 months
Certain health condition
Hemophilia, hepatitis, and pregnancy can lead to a false positive – the test is positive, but the person does not have the infection

63. Detecting HIV
If the EIA test is positive…person is tested again
If the repeat test is positive, another test is performed
Western Blot Test – WB – the most common confirmation test for HIV in the US
Tests for viral load in blood
If done properly, it has 100% accuracy
HIV positive = 2 EIA positive tests and positive Western Blot Test

64. Availability of Health Services
No cure for HIV/AIDS
Drugs treat HIV and treat and prevent the complications of opportunistic infections
Drugs and vaccines are being researched
To improve the quality of life
Hard to find a cure
HIV infects the cells that regulate the immune system
New strains of the virus have emerged
Treatment downfalls
Side effect so severe, many people can’t stand to take medicine
Expensive - $1000+ per month
Worldwide people don’t have access to treatment

65. History of HIV/AIDS
1981: Clusters of previously rare diseases noticed in both LA and NYC
1982: Collection of symptoms is named AIDS – 14 nations report cases of AIDS
1984: 7,000 Americans have AIDS
1986: AIDS-causing virus is named HIV; first drug treatment for AIDS developed
1988: December 1 is declared annual World AIDS day

66. History of HIV/AIDS
1989: Several new drugs available to treat opportunistic diseases; FDA approves first drug treatments for more than trial use
1990: Estimated number of AIDS cases worldwide = 1 million
1991: Red ribbon announced as international symbol of AIDS; scientists report that drugs have limited use because HIV develops resistance to them; 1 million cases of AIDS and 133,000 death from the disease reported worldwide since 1882
1992: First combination drug therapy approved

67. History of HIV/AIDS
1994: Studies show that drug treatment greatly reduces risk of HIV transmission from an infected mother to her baby
1998: First trial of an AIDS vaccine begun using 5,000 US volunteers; estimates are that 70% of all new infections and 80% of all AIDS deaths are occurring in sub-Saharan Africa
2002: The disease is the 4th leading cause of death in the world; an estimated 40 million people around the world are living with HIV/AIDS

68. A continuing problem
Number of reported AIDS cases in industrial world is decreasing
Availability of drug cocktails – combination of drugs – slow the progression of HIV
False security – research has identified new, drug-resistant strains
Pandemic – a global outbreak of infectious disease – 40 million people infected worldwide (2002)

69. Staying safe Knowledge is the best defense!
Abstinence from sexual activity or using drugs
Avoid pressure situations
Practice refusal skills
Choose relationships carefully