1. Teens and STI’s
(What’s Up Down There!)

2. What Is
Sex ? ?

3. What are STI’s?
Sexually transmitted infections are infections that are passed from an infected person through sexual activity that involves contact with the genitals or anus.

4. How Common are STI’s?
Almost 4 million teenagers get some type of STI each year.
That’s roughly 8,000 every day, and 6 every minute.
The U.S. has the highest STD rate of any industrialized country.
One out of two sexually active youth will acquire an STD by age 25.
Teens who have had sex have the highest STD rates of any age group in this country. The highest rates of gonorrhea and chlamydia are among 15 to 19 year old females.

5. How are STI’s Spread?
Exchange of body fluids (blood, semen, vaginal secretions) from sexual partner to partner during vaginal, anal, or oral sex.
Skin-to-skin contact when rubbing genitals or when one person touches another person’s genitals and then touches his/her own.
Sometimes kissing or sharing inanimate sexual objects.

6. Risk Factors
Multiple lifetime sexual partners- the more partners  RISK
Length of relationship- the less you know about a sexual partner  RISK
Substance use- mixing use of drugs and alcohol with sexual decision making  RISK
Netherlands and France
• Adults see intimate sexual relationships as normal and natural for older adolescents, a positive component of emotionally healthy maturation. At the same time, young people believe it is “stupid and irresponsible” to have sex without protection and use the maxim, “safer sex or no sex.”
• Public health policies are based on scientific research. Political and religious interest groups have little influence on public health policy.
• A national desire to reduce the number of abortions and to prevent sexually transmitted infections, including HIV, provides the major impetus in each country for unimpeded access to contraception, including condoms, consistent sexuality education, and widespread public education campaigns.
• Governments support massive, consistent, long-term public education campaigns utilizing the Internet, television, films, radio, billboards, discos, pharmacies, and health care providers.
Media is a partner, not a problem, in these campaigns. Campaigns are far more direct and humorous than in the U.S. and focus on safety.
• Youth have convenient access to free or low-cost contraception through national health insurance.
• Sexuality education is not necessarily a separate curriculum and may be integrated across school subjects and at all grade levels. Educators provide accurate and complete information in response to students’ questions.
You might think that young people living in these countries would have sex at younger ages. But not so, in the U.S., young people typically initiate sexual intercourse at the same age or even earlier compared to young people in the Netherlands and France.

7. Common STI’s Chlamydia Gonorrhea Syphilis HPV Genital Herpes
Pubic Lice
Hepatitis B
Trichomoniasis

8. Most Common STI’s in Teens
Human Papilloma Virus Chlamydia Trichomoniasis Genital Herpes

9. Common Symptoms D R I P S
Discharge – unusual color, texture, amount, odor
Rashes or redness – in genital area or on torso/soles of feet/palms of hands
Itching and irritation in the genital area
Pain – burning with urination, pain with intercourse, pelvic/scrotal pain
Sores, bumps, blisters, warts

10. HPV

11. Human Papilloma Virus
HPV is by far the most common viral STD. HPV lives in/on the skin and the mucus membranes.
There are an estimated 6.2 million new cases of genital HPV every year – 4.6 million of these are among youth under 25.
At any given time, there are approximately 20 million people (6.5%of the population) infected with HPV in the United States.

12. It is estimated that at least 50% of people will have some type of HPV at some point in their lives.
HPV is a group of well over 100 different wart viruses. About 40 of them are sexually transmitted.
Some are considered low risk – these types can cause genital warts.
Some are considered high risk – these can cause abnormal cellular changes that can lead to cervical cancer, and cancers of the throat, penis, vulva, vagina, and anus.

13. Most people who have HPV have no signs or symptoms and don’t know they have it. However, they are still capable of transmitting it to others.
Most people fight off and clear the virus on their own (without treatment) within a few years.
However, some people get persistent infections that do not go away. These persistent infections can cause:
Genital warts that can multiply and recur after treatment
Cervical cancer and other cancers

14. How do you get HPV Infection?
Through all types of sex (vaginal, anal, and oral)
Intimate touching (hands, rubbing genitals)
Sharing inanimate sexual objects

15. How Do You Know if You Have It?
Unfortunately, there is currently no screening test for HPV. However, HPV can be diagnosed when…
A physical examination shows presence of visual genital warts – this is the only way to diagnose HPV in men.
A woman’s pap test comes back abnormal.

16. Genital Warts Look Like…

17. What is Gardasil?
Gardasil is the HPV vaccine that protects against the four most common types of HPV. These types cause 70% of all cervical cancer cases and 90% of genital warts.
It has been approved for boys and girls 9-26 years of age. It is specifically recommended to be given to boys and girls years old, before they engage in sexual activity.
It is given in a series of three injections with the second and third injections given 2 and 6 months after the first.

18. Okay, let’s all take a break and look at something soothing.

19. CHLAMYDIA

20. The Facts About Chlamydia
Chlamydia is caused by a bacterium
Symptoms can appear 21 days after infection
75% of women and 50% of men infected with Chlamydia have no symptoms--they may not know they have it
Infection can be cured with antibiotics, but any damage to the body is permanent
Statistic from CDC, Tracking the Hidden Epidemics—Trends in STDs in the U.S. (2000)

21. How Common is It? 3 million cases occur each year
40% of all Chlamydia infections occur in teens, aged 15-19
Statistic from CDC, Tracking the Hidden Epidemics—Trends in STDs in the U.S. (2000)

22. Through vaginal, anal and oral sex.
How is It Spread?
Through vaginal, anal and oral sex.

23. Abnormal vaginal discharge
Symptoms in Women
Abnormal vaginal discharge
Image courtesy of the Seattle STD / HIV Prevention Training Center at the University of Washington, Source: Claire E. Stevens and Ronald E. Roddy.

24. Symptoms in Women, cont’d
Ladies, this is your cervix…
Left image courtesy of the Seattle STD / HIV Prevention Training Center at the University of Washington, Source: Claire E. Stevens. Right image courtesy of CDC, Source: St. Louis STD/HIV PTC.
… and this is your cervix on Chlamydia.

25. Symptoms in Men Discharge from the penis (may be runny and whitish)
Burning on urination
(No pictures)

26. If Left Untreated…
In Women: In Men:
Can cause Pelvic Inflammatory Disease (PID) which can lead to sterility
Can cause sterility
Can cause testicles to become swollen and tender
(no pictures)

27. Deep breaths, people.

28. GONORRHEA

29. The Facts About Gonorrhea
Also called the “clap”
Caused by a bacterium
Symptoms can appear in 1-13 days after contact
Infection can be cured with antibiotics, but any damage to the body is permanent

30. How Common is Gonorrhea?

31. How Do You Get Gonorrhea?
Through vaginal, anal and oral sex.

32. Symptoms of Gonorrhea Women Men Greenish, yellowish vaginal discharge
Painful urination
Abnormal vaginal bleeding
Men
Discharge from penis
Painful urination

33. If Left Untreated…
In Women: In Men:
Can cause Pelvic Inflammatory Disease (PID) which can lead to sterility
Can cause testicles to become swollen and tender
(no pictures)

34. GENITAL HERPES

35. The Facts About Genital Herpes
There are two types of the Herpes simplex virus: HSV-1 and HSV-2
HSV-1 causes oral infections like cold sores
HSV-2 causes genital infections
Herpes symptoms can be treated, but the virus has no known cure and can stay in the body for life

36. How Do You Get Genital Herpes?
Through all types of sex (vaginal, anal, and oral)
Intimate touching (hands, rubbing genitals)
Sharing inanimate sexual objects

37. Symptoms of Genital Herpes
Painful or itchy/tingling sores on the vagina, penis, mouth, anus, or the eyes
Sores can last from 4-21 days
Herpes is MOST contagious during an outbreak of sores, but the virus can still be passed from person to person when no sores are present.
Most infections occur when there are no symptoms.

38. Genital Herpes Looks Like…

39. Ahhhhh.

40. PUBIC LICE

41. The Facts About Pubic Lice
Also called “crabs”
Pubic lice are parasitic insects found in the genital area, living on pubic hair
After hatching, lice feed on human blood
Infestation can be treated with a medical shampoo

42. Symptoms of Pubic Lice
Itching in the genital area or anus--depending on the area of contact--begins about 5 days after infestation
May be able to see eggs, or crawling grayish-white lice

43. Pubic Lice Look Like…

44. Whew.

45. HIV

46. The Facts About HIV
Human immunodeficiency virus (HIV) attacks the immune system, and causes AIDS
Symptoms may not appear for up to 10 years
While there are medicines to help manage HIV infection, there is no known cure and no vaccine for HIV/AIDS

47. How Do You Get HIV?
Through blood, semen, vaginal fluids and breast milk.
This means that HIV is spread by sharing contaminated needles, from mother to child, vaginal and anal sex.

48. How Do You Get HIV? cont’d
People who already have an STI are more likely to contract HIV:
Women with Chlamydia are 3-5 times more likely to contract HIV if exposed
People with Syphilitic sores are 2-5 times more likely to contract HIV if exposed
Gonorrhea and Herpes may also make it easier to contract HIV
Statistics from CDC: Tracking the Hidden Epidemics—Trends in STDs in the U.S. (2000).

49. The last stage of HIV disease is AIDS which is fatal.
Symptoms of HIV
There may be no symptoms for 10 years, or more--many people who are HIV+ do not know they are infected.
When symptoms occur, they may include weight loss, diarrhea, fatigue.
The last stage of HIV disease is AIDS which is fatal.

50. How Common is HIV?
Almost 1 million Americans are living with HIV/AIDS--over 30,000 are aged 13-24
Total number of Americans living with HIV/AIDS taken from Kaiser Family Foundation’s HIV/AIDS Fact Sheet (March 2004). Estimation of number infected ages taken from CDC Fact Sheet: Young People at Risk: HIV/AIDS Among America’s Youth. Number of newly reported infections for youth under age 25 taken from Kaiser Family Foundation: HIV/AIDS Policy Fact Sheet (March 2004). “one dies every day,” taken from Children’s Defense Fund: Moments in America for Children (March 2002).

51. In General, STI’s…
Can be passed from pregnant woman to fetus/infant through the placenta (syphilis, HIV), during childbirth, or in some cases, after delivery during breastfeeding (HIV). In the newborn, STIs can cause many different problems from being born too early to brain damage to death.
Can come back after treatment if you are re-exposed.
stillbirth, low birth weight, eye infections, neonatal sepsis (infection in the baby’s blood stream), brain damage, blindness, deafness, respiratory problems, and/or liver problems.
Can be life-changing. If you are diagnosed with an incurable STI like HIV or Genital Herpes, you have the responsibility to inform any potential sexual partners before you have sex.

52. Prevention/Risk Reduction
Practice sexual abstinence – avoid all genital contact with a partner.
Engage in alternative ways to release sexual tension.
Limit or reduce your number of sexual partners.
Use condoms for all sexual acts.
Get vaccinated!