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Melanie J. Davis, EdD, CSE The Hows and Whys of STIs.

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Presentation on theme: "Melanie J. Davis, EdD, CSE The Hows and Whys of STIs."— Presentation transcript:

1 Melanie J. Davis, EdD, CSE The Hows and Whys of STIs

2 About the Author Melanie Davis, EdD, CSE is a sexuality education consultant and trainer. She teaches lifespan sexuality education programs, presents on college campuses, and works with healthcare providers and their patients. Phone Free resources & blogs (c) 2010 Honest Exchange LLC. All Rights Reserved.

3 How STIs Reach the Body Bacteria Can be cured by antibiotics Bacterial Vaginosis Chlamydia Chancroid Gonorrhea Syphilis Fungus Curable with antifungals Candida This is not a complete list of STIs. Virus No cure, but symptoms can be treated Genital Herpes Hepatitis B HIV – AIDs Human Papilloma Virus (HPV) Parasites Curable with antimicrobials Scabies Lice Trichomoniasis (c) 2010 Honest Exchange LLC. All Rights Reserved.

4 The Interrelationship Between HIV and Other STIs Increased infectiousness People with HIV or other STIs are more likely to transmit their infection through sexual contact Increased susceptibility People with STI are 2-3x more susceptible to HIV through sexual contact due to genital ulcers and increased concentrations of CD4+ cells in genital secretions The good news STI testing and treatment can help prevent the spread of HIV Treatment for other STIs reduces HIV shed and frequency of shed STI treatment reduces spread of HIV in communities. Education helps people reduce risky behaviors (c) 2010 Honest Exchange LLC. All Rights Reserved.

5 Behaviors Behaviors and life circumstances can increase or reduce the risk of transmission. Behaviors are affected by cultural, social, and religious values, personal experience, and education. Increased risk:Reduced risk: Multiple partners Limited or no partners Unprotected sex Correct use of barriers High-risk partners Outercourse & other low-risk activity Lack of knowledge Increased age upon initiation of sex Poverty Knowledge about safer sex Sexual coercion Consensual activities Having STIs Regular STI tests Being STI free (c) 2010 Honest Exchange LLC. All Rights Reserved.

6 Barriers Male condoms Female condoms Dental dams Gloves Clothing Barriers can be used during sexual activity to reduce the transmission of STIs. They restrict access to blood, semen, and vaginal fluids. Protection is limited to the area of the body that is covered by the barrier. (c) 2010 Honest Exchange LLC. All Rights Reserved.

7 Chlamydia Organism: Bacteria Signs: May be no symptoms. Abnormal discharge from penis or vagina, burning or pain during urination, anal irritation, Itching at urethral opening (male), bleeding between periods (female), painful intercourse and lower abdominal or back pain (female) Transmission: Unprotected oral, anal, or vaginal sex; from mother to infant during birth Cure? Yes, with antibiotics. Partners must be notified and treated. If ignored: risk of HIV infection, PID, Infertility, ectopic pregnancy, chronic pelvic pain Risk reduction: Avoid sexual contact while until treated and re-checked Be tested for this and other STIs at least annually. Take all medications as prescribed The CDC estimates there are about 2.8 million new cases of chlamydia in the United States each year. (c) 2010 Honest Exchange LLC. All Rights Reserved.

8 Genital Herpes Organism: Virus Signs: Symptoms are rare or mild. Blisters on or near genitals or anus; painful or difficult urination, genital or anal itching or irritation, swelling or soreness or cuts or sores in groin area, fever blisters of the mouth or lips, flu-like symptoms. Transmission: Unprotected oral, anal, or vaginal sex. Mother-to-child transmission during vaginal delivery. Can be transmitted even when symptoms are absent. Cure? No, but anti-viral medication can prevent and shorten outbreaks. Some medications may lower risk of transmission to another person. Arginine increases risk of herpes breakout; lysine minimizes outbreak. Eating a lot of nuts, sweet potatoes, chocolate, and coconut may lead to an outbreak. Diet can influence your herpes diagnosis by keeping lesions hidden. If ignored: HIV infection, recurrent painful genital sores, fatal infections in newborns if untreated during pregnancy. Risk reduction: Abstain from oral, anal and vaginal sex Consistent, correct use of Latex or polyurethane barriers during sex Mutually monogamous relationships with an uninfected partner Regular pelvic exams (women) and STI tests If having sex with an infected partner, discuss outbreaks and treatment (c) 2010 Honest Exchange LLC. All Rights Reserved.

9 Gonorrhea Organism: Bacteria Signs: Symptoms may not be present. Abnormal discharge from penis or vagina; burning or pain during urination, frequent urination, irritation around anus, bleeding, or painful elimination; males: itching around urethral meatus, soreness or swelling around top of penis, painful or swollen testicles; women: bleeding between periods, painful intercourse. Transmission: Unprotected oral, anal, or vaginal sex. Mother-to-child transmission during vaginal delivery. Cure? Yes, with prescription antibiotics and medications. If ignored: HIV infection; infertility; women: PID, chronic pelvic pain, ectopic pregnancy. Can cause premature delivery, blindness or life-threatening infection in newborns. Risk reduction: Abstain from oral, anal and vaginal sex Consistent, correct use of Latex or polyurethane barriers during sex Mutually monogamous relationships with an uninfected partner Early treatment for you and partner (notify other partners) Regular PAP tests and pelvic exams (women) Regular health exams and STI tests (men and women) (c) 2010 Honest Exchange LLC. All Rights Reserved.

10 Hepatitis B Organism: Virus attacks the liver. Signs: About 30% of persons have no signs or symptoms. Symptoms may include jaundice, fatigue, abdominal pain, loss of appetite, nausea, vomiting, and joint pain. Transmission: Occurs when blood from an infected person enters the body of an uninfected person. Unprotected sex with an infected person Sharing drugs, needles, or "works" when injecting drugs Needle sticks or sharps exposures on the job From mother to child during birth Cure? No, but some cases clear up on their own. Chronic Hepatitis B can be treated with Adefovir dipivoxil, interferon alfa-2b, pegylated interferon alfa-2a, lamivudine, entecavir, and telbivudine. If ignored: Can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Risk reduction: Hepatitis B vaccine Abstain from unprotected oral, anal and vaginal sex Avoid shared needles and exposure to potentially infected blood Avoid shared razors, toothbrushes, etc. that may have been contaminated by blood. (c) 2010 Honest Exchange LLC. All Rights Reserved.

11 HIV – Human Immunodeficiency Virus Organism: Virus targets CD4+ cells Signs: In first few weeks after HIV infection, acute retroviral syndrome causes fever, malaise, lymphadenopathy, skin rash. Can occur without symptoms. Transmission: Exchange of blood, semen and vaginal secretions during unprotected sex; mother-to-child transmission during pregnancy and breast feeding; exposure to infected blood during needle sharing or accidental exposure. Cure? No, but early treatment can delay (often for years) the development of opportunistic infections and AIDS. If ignored: opportunistic infections, susceptibility to other STIs, and eventual death related to complications of AIDS Risk reduction: Abstain from unprotected oral, anal and vaginal sex Consistent, correct use of Latex or polyurethane barriers during sex Regular tests for STIs and HIV, regular health exams Avoid shared needles and exposure to potentially infected blood and fluids (c) 2010 Honest Exchange LLC. All Rights Reserved.

12 HPV – Human Papillomavirus Organism: Virus Signs: Symptoms are rare for most strains; others cause genital warts that appear as small bumps, swellings or cauliflower-like growths on or near genitals, anus or upper thigh. Transmission: Unprotected oral, anal, or vaginal sex. Mother-to-child transmission during vaginal delivery. Can be transmitted even when symptoms are absent. Cure? No, but warts can be removed, and medications and minor surgery can be used in cases of pre-cancerous cell changes. Some strains of HPV resolve on their own. The HPV vaccine protects against four HPV types that cause most cervical cancers and genital warts. The vaccine is recommended for females ages 9-26 years. If ignored: Abnormal PAP tests; risk for cervical or penile cancer; HIV infection Risk reduction: Abstain from oral, anal and vaginal sex Consistent, correct use of Latex or polyurethane barriers during sex Regular PAP tests and pelvic exams (women) Regular health exams and STI tests (men and women) (c) 2010 Honest Exchange LLC. All Rights Reserved.

13 Syphilis Organism: Bacteria Signs: May be no symptoms or easily misdiagnosed symptoms. Painless chancre (sore) on genitals, rectum or mouth lasting up to several weeks; skin rash (usually rough reddish spots on palms and soles of feet and trunk, flu-like symptoms Transmission: Unprotected oral, anal, or vaginal sex; mother-to-child during birth Cure? Yes, with antibiotics. Partners must be notified and treated. If ignored: risk of HIV infection; damage to major organs, blood vessels, bones, eyes, joints; paralysis, blindness, dementia; death Risk reduction: Abstain from oral, anal and vaginal sex Mutually monogamous relationships with an uninfected partner Consistent, correct use of Latex or polyurethane barriers during sex Avoid sexual contact with an infected partner until treatment is complete (c) 2010 Honest Exchange LLC. All Rights Reserved.

14 Trichomoniasis Organism: Parasite Signs: Most men have no symptoms. Women may have yellow-green discharge with strong odor; discomfort during urination; uncomfortable intercourse; irritation or itching around genitals; lower abdominal pain (rare) Transmission: Unprotected oral, anal, or vaginal sex Cure? Yes, with antibiotics. Partners must be notified and treated. If ignored: risk of HIV infection; risk of passing HIV to a partner if you have HIV+ Risk reduction: Abstain from unprotected oral, anal and vaginal sex Consistent, correct use of Latex or polyurethane barriers during sex Avoid sexual contact with an infected partner until treatment is complete (c) 2010 Honest Exchange LLC. All Rights Reserved.

15 Risk Factors for STIs – According to the CDC High risk for HIV transmission: Vaginal or anal intercourse without condoms Intravenous drug use with shared needles (and being a partner of an IV drug user) Men who have sex with men High risk for other STIs: Vaginal, anal or oral intercourse without condoms Young age upon initiation of sex Multiple sex partners Sex partners with multiple partners Alcohol and drug use that impairs judgment Having sex for money (c) 2010 Honest Exchange LLC. All Rights Reserved.

16 5 Categories of STI Risk Factors -- CDC Behavior: unprotected sex, multiple partners, substance use. Demographics: age, sex, ethnicity, marital/relationship status, education, income. Psychosocial factors: low self esteem, low self efficacy, perceptions of personal risk, future orientation, hopelessness. Context: sex with partners of unknown status, safer sex negotiation, domestic violence. Sociocultural factors: social norms, religious beliefs, gender role norms, marginalization, unemployment, poverty, sexism, racism, homophobia, availability of public health care, and political, economic, and health policy; (c) 2010 Honest Exchange LLC. All Rights Reserved.

17 Safer sex isnt just about condoms. Its about partners feeling safe with each other emotionally, too. Can you be trusted not to pressure anyone into unsafe or uncomfortable behaviors ? Can you trust your partner(s) not to pressure you? (c) 2010 Honest Exchange LLC. All Rights Reserved.


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