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Sexually Transmitted Infections - myths and reality

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1 Sexually Transmitted Infections - myths and reality
Hello and welcome We are going to do a session on STIs , look at some myths and reality and give some key messages. Sexually Transmitted Infections - myths and reality

2 SEAN SARAH Doesn’t feel comfortable With her body Doesn’t know how
to use a condom Communication About sex difficult Friends say using a Condom makes sex Less enjoyable Doesn’t know how To use a condom Nowhere to have sex Drinks a lot which Affects his ability To practice safer sex Her friends hate Sean Thinks “other people” Get sexually transmitted infections Scared Sean will end The relationship if she Refuses to have sex Don’t have practical Knowledge to make safer Sex easy Friends all brag about Their exploits Doesn’t feel good about Herself. Lacks confidence, Embarrassed to talk to Sean about sex Unprepared for sex Don’t have any Condoms Doesn’t think ahead. Wants a good time Family are Catholic. Pressures on Sarah not To have sex Outside marriage

3 What I’ll be talking about
Who I am and what I do What are sexually transmitted infections (STIs)? Why are STIs important? Who gets STIs? How can you avoid getting an STI? Myths about STIs Introduce yourself and your role READ slide what the session may include : Also if time there will be an interactive workshop on transmission and some simple quizzes and case studies

4 Like to start and finish with the same slide
We are not mystic – we don’t know if someone has an STI by looking at them – we don’t always know if we have an STI ourselves. In new sexual relationships we should always use condoms – if want to stop using them -both get tested for STIs – remain monogamous.

5 What are STIs? Germs (bacteria, protozoans and viruses) spread by ‘sexual contact’. Name some STIs are Germs – bacteria, protozoans (beasties) and viruses. Get the audience to shout out Chlamydia, Genital Herpes, Genital Warts, Gonorrhoea, Syphilis, HIV, Hepatitis B, Hepatitis C, NSU (non specific urethritis), Pubic Lice, Trichomoniasis or Trich (another beastie). Thrush can be transmitted sexually but you can also get Thrush from wearing tight underwear , washing with perfumed products, change of climate or due to pregnancy for examples. So Thrush is not a true STI. List them all if the audience don’t get them all Make the point that there are lots of STIs

6 What does sexual contact mean?
Increasing chance of catching an infection Anal sex Vaginal sex Oral sex Touching someone elses genitals with your genitals. Mutual masturbation Sexual Contact is not only about penetrative sex Oral sex and close sexual contact and masturbation can also be risky especially if sexual fluids are involved.

7 Why are STIs important? The majority of people who have an STI will have no symptoms Left untreated STIs may cause problems with your reproductive systems and stop you having children. The Key Message here is: You can have absolutely NO Symptoms from an STI STIs left untreated - and in the long term – may cause infertility in both males and females

8 Some symptoms of STIs Name some?
No symptoms Discharge from the penis or vagina Genital ulceration Bleeding between periods Abdominal pain Testicular pain Lumps appearing on the skin However if you are LUCKY enough to get a symptom or symptoms that may make you go to a doctor – What could they be? Get the audience to shout out some symptoms Then flash up the most common symptoms Some symptoms may go away – but the STI will not have gone away! Repeat the key message that there can be NO symptoms from an STI

9 Why are STIs important? They are getting more common

10 3 Most Common STIs Chlamydia Genital Herpes Genital Warts

11 Explain that this slide is from ARI labs.
All the STI tests in Grampian go through the ARI Laboratories. This just shows that Chlamydia is really common compared to HIV, Syphilis, Gonorrhoea and Trich. With up to 2,000 new cases of Chlamydia every year. Before next slide ask the audience – Who is at most risk of Chlamydia? Is it Injecting Drug Users, Sex Industry Workers, Homeless People, etc? Wait for answer – then CLICK on next slide

12 The younger you start to have sex the more likely you are to catch an infection
The high risk group for Chlamydia are the age 15 – 24 year olds. This is because this group is more sexually active , have more sexual partners and also they do not have the knowledge and skills to protect themselves. The younger you start to have sex the more likely you are to catch an infection. Girls tend to go to health services more than boys – that’s why more girls positive – key point - Chlamydia is not a female only infection.

13 Hepatitis C infection in Grampian – not commonly spread sexually – most common amongst Injecting Drug Users – about 130 cases per year Hepatitis B infection – a sexually transmitted infection- about 60 new cases in 2009 HIV – a sexually transmitted infection- about 39 – 45 cases per year All of these bloodborne viruses are on the increase

14 Scotland – 6,534 Grampian - 459 (December 2010) 740 000 1.7 million
Adults and Children Estimated to be Living with HIV 2010 – 33 million (WHO) Eastern Europe & Central Asia 1.7 million Western Europe North America 1.4 East Asia & Pacific North Africa & Middle East Caribbean South & South-East Asia 7.8 million Sub-Saharan Africa 24.7 million Latin America 1.7million Australia & New Zealand 81 000 Discuss HIV as a world wide problem Some parts of Africa have as many as 16,000 new cases per day – 1,600 are children born with HIV every day Scotland has a total of 6,534 that we know of Grampian has a cumulative total of 459 cases up to December 2010 Scotland – 6,534 Grampian (December 2010)

15 How is HIV passed on-Unprotected Sex
Risk - High This is the most common way it is passed on in Grampian Unprotected sex between heterosexual couples is the most common way it is passed on Risk oral sex low Barrier methods of contraceptive necessary

16 Who gets STIs? Anyone who is sexually active can get an STI if they do not protect themselves carefully ASK – who gets STIs? Then click as key message

17 How to catch and spread an STI
Have sex with lots of people Don’t use a condom Ignore symptoms Don’t get a check-up READ slide And say if you are doing any of the above then you have put yourself at risk of catching and spreading an STI

18 HOW MANY PEOPLE DID YOU SAY YOU’D SLEPT WITH?
ASK – the audience – does the lady at the bottom who has just slept with Johnny need an STI test?? Yes she does as Johnny and her have been having unprotected sex and Johnny has had lots of previous partners. She may have any number of STIs that anyone on that slide has ! WHY, JUST THE ONE!!

19 No such thing as SAFE sex so we tend to talk about SAFER sex.
Only way to be completely safe is to completely abstain from sex altogether or lock yourself in a cupboard and throw the key away! So we will look at how to make it SAFER

20 How not to catch or spread an STI
Decide if you really want to have sex with this person. (and don’t get so drunk that you can’t decide!). You’ll have a better time if you’ve no regrets the next day If you have sex, consider lower-risk sexual contact - eg masturbation. If you’re going to have vaginal, oral or anal sex use a condom/dental dam. (and learn how to use one first!) If you’re going to stop using condoms get an STI screen first. If you don’t know what you did last night – then you really don’t know what you did !! It’s not good to regret things and you can’t just stick you head in the sand and try to forget regretful things Take responsibility for your actions and get emergency contraception and an STI test. Masturbation is less risky than unprotected penetrative sex and remember to wash your hands of sexual fluids Use condoms and dental dams always If you want to stop using condoms in your relationship – then both of you get an STI screen – get treated if you have an STI – then remain monogamous.

21 Where to get free condoms
Family planning clinic Genitourinary medicine clinic GPs Pharmacies Healthpoints Other community agencies ?Employer ASK where can you get condoms FREE? Trainer to be knowledgeable of the local agencies/areas that provide the free condom distribution service

22 Confidentiality Testing Where can you go for an STI test?
The trainer to be knowledgeable of the local testing sites

23 Where to get STI tests Your GP Hospital GUM clinic
rapid access if symptoms Family planning clinics Trainer to know the local testing sites

24 What does a test for STIs involve?
Men - a very small swab from the end of the penis. (or a urine specimen if just having a chlamydia test) Women – lower vaginal swabs (self taken if just having a chlamydia test) Both - a blood specimen (if having tests for syphilis or HIV, HBV or HCV) Take along and show the lower vaginal swabs that are used in clinics HIV, Hepatitis |B and Syphilis are viruses that will require a blood test for diagnosis

25 STI myths You’d know if you had one.
You could tell if someone else had one Lets look at some Myths and reality! ASK TRUE or FALSE?

26 90% of women and 70% of men with Chlamydia have no symptoms
Myth – False Most men and most women will have no symptoms of Chlamydia

27 STI myths Does a test for STIs hurt? YES or NO?

28 Reality A test for chlamydia can be as easy as peeing into a bottle

29 STI myths If I leave it alone it will go away? Yes or NO?

30 Reality Most STIs need treatment to be cured
Usually treatment is simple (and treatment is free at a GUM clinic) Treatments for most STIs are usually antibiotics. Wart creams for warts Hepatitis treatments can help stabilise your liver HIV treatments needs to be taken for life but can stabilise your immune system

31 STI myths If I go for tests everyone will know? Will they?

32 Reality It’s always good to let your partner know if you have symptoms
Tests at a GUM clinic are confidential and your GP, 3rd cousin twice removed will not be told. Your sexual partner(s) may be need to be notified so that you don’t become re-infected.

33 STI myths Condoms don’t work - they have holes in them that viruses can go through

34 Reality Condoms only have one hole!
Condoms are very effective in preventing you from getting - HIV, gonorrhoea, chlamydia Condoms are less good at preventing you from getting warts or herpes. (infection doesn’t come out of the end of the penis) Condoms only have one hole and that is where you put your penis! Close sexual contact can cause warts and herpes from skin shedding!

35 Caroline She’s had a few boyfriends in the past. On the pill, ‘often’ uses condoms. She meets… Case Study 1

36 Rak He has just finished with a woman he was going out with for 1yr.
They start going out, start having sex with condoms. He wants to stop using condoms.

37 What would you do if you were them?

38 Both should get a check up at their GP or GUM.
Then they can stop using condoms.

39 Rachel What would you do?
She’s 16. She was at a party on Sunday, drank 9 Bacardis and had sex with erm Fraser? Not on the pill. Doesn’t think he used a condom. Now regrets the whole thing What would you do? Case Study 2

40 For now - she will probably need emergency contraception
Get from GP, family planning, GUM, pharmacies Will need to consider longer-term contraception too. She should get tests for STIs She should drink less in the future - stay in control - do what she wants and have no regrets. Has she regretted sex before? She should insist on condom use - no condom, no sex.

41 What will you do? Pie him!

42 Summary STIs are v common
some of you will have one now and not know it condoms prevent transmission of most STIs Key messages

43 To contact any Grampian Sexual Health Services phone:0845 337 9900

44 Text sexinfo to 80182 SEXINFO
For nearest Emergency Contraception service For nearest Long term Contraception service For nearest STI testing Service

45 Questions often asked Will I know if I am infected with HIV or any STI? Where can I get a test? Will anyone know if I go for a test? What will they do at the clinic? Where can I get more information and advice?

46 Any other questions?

47 STI and Glove Game

48 STI Quizzes Competition Discussion

49 Condoms Quiz Race Demos

50 The Condom 1350BC sheaths as protection
against infection, injury and insect bites The condom offer the most reliable protection against infection during intercourse and also effective form of contraception Condoms have been around since at least 1350BC when ancient Egyptian tribesmen used sheaths as protection against infection, injury and insect bites The first evidence of the condom in Europe was in cave paintings dating back to 100Ad In the 16C an Italian claimed to have made a linen condom to protect against Syphilis in the 1700’s condom shops appeared made for animal gut evidence that Casanova used these to prevent pregnancy Rubber was latter discovered to work and followed by latex in the 1930’s and started being produced commercially in the 1950’s Now can for latex allergies polyurethan male condoms these are also thinner therefore increase sensation also can use oil based lub on them 100AD Europe

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64 flared, straight, plain, contoured
Male Condom strengths flavours colour size textures The male condom was 1st on the scene advanced from these days The male condom certainly is not boring different colours sizes shapes textures when you get free condoms these ones are the regular alternatives Samples have a look applicator / types / lub flavors pina colada although different sizes these will hold textures ribbed Shapes: flared, straight, plain, contoured

65 Condom Types Male condom Dental dams Femidom
Nowadays many different types the most common is the male condom but also on the seen are Dental Dams are for oral sex Female condom the Femidom – less than 1% of the population use them as not so effective as male condom Femidom

66 Some handy hints when dealing with condoms
Both partners should learn how to put on and take off a condom properly

67 Don’t blow, stretch or unroll the condom before use

68 It may burst, tear or slip off, so take care

69 Be careful not to damage the rubber with fingernails or jewelry
Use water based lubricants

70 Only the CE Kitemark guarantees satisfactory safety standards
This is now changing and going to have the same mark throughout Europe Only the CE Kitemark guarantees satisfactory safety standards

71 The rule is use a new condom every time

72 Keep in a cool place avoid heat or direct sunlight

73 Using Condoms read instructions
beware of sharp nails puncturing condoms take care not to damage on opening apply when penis is erect, before contact do not pull on roll back foreskin pinch end and hold onto rim after use, hold rim during removal twist and dispose use water based lubricants 98% effective if used correctly many reasons for it not There are two reasons for condoms failing:I have an applicator if you want to try it out product failure poor quality condoms or condoms which are damaged user failure not following the instructions unfamiliarity and poor technique Read and follow the instructions beware of sharp fingernails and jewelry puncturing condoms be careful not to damage the condom when opening the wrapper always put the condom on as soon as the penis is erect but before there is any contact with the genital area make sure air is squeezed out of its top before rolling the condom on do not put it on like a sock if the user is uncut/uncircumcised roll back foreskin prior to putting on it is advisable to hold onto the rim of the condom when entering after the user has ejaculated but before erection is completely lost hold the condom rim firmly around the penis while it is withdrawn twist the condom and dispose of appropriately - use only water based lubricants such as KY Jelly, others may damage the rubber

74 SEAN SARAH Doesn’t feel comfortable With her body Doesn’t know how
to use a condom Communication About sex difficult Friends say using a Condom makes sex Less enjoyable Doesn’t know how To use a condom Nowhere to have sex Drinks a lot which Affects his ability To practice safer sex Her friends hate Sean Thinks “other people” Get sexually transmitted infections Scared Sean will end The relationship if she Refuses to have sex Don’t have practical Knowledge to make safer Sex easy Friends all brag about Their exploits Doesn’t feel good about Herself. Lacks confidence, Embarrassed to talk to Sean about sex Unprepared for sex Don’t have any Condoms Doesn’t think ahead. Wants a good time Family are Catholic. Pressures on Sarah not To have sex Outside marriage

75 Like to start and finish with the same slide
We are not mystic – we don’t know if someone has an STI by looking at them – we don’t always know if we have an STI ourselves. In new sexual relationships we should always use condoms – if want to stop using them -both get tested for STIs – remain monogamous.


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