American College Health Association The Secret Epidemic: STIs on Campus A Presentation of the American College Health Association American College Health Association

 Sexually Transmissible Infections (STIs)  The Most Common STI among Teens and Young Adults  What to do if you think you have an STI  Nice people can get STDs!!! Discussion Points for Today

American College Health Association Infections—Generally Speaking  What are they? Overgrowths of bacteria, viruses, fungus (yeast), or protozoal pathogens  How are they spread? Inhalation of infected air, contact with infected body fluids, contact with infected skin (rashes, lesions)  How can they be prevented? Avoiding contact with infected air, fluids, and skin

American College Health Association Sexually Transmissible Infections (STIs)  Also known as Sexually Transmitted Diseases (STDs) Venereal Diseases What are your risks?  Sex without condoms  One night stands  Drugs or alcohol  Multiple partners

American College Health Association Sexually Transmissible Infections  Bacterial Infections Chlamydia Gonorrhea Non-specific urethritis Syphilis  Viral Infections Herpes Human papillomavirus (multiple strains - Pap smear changes, genital warts) Molluscum contagiosum Hepatitis B HIV

American College Health Association STI Prevention  Abstinence works best Avoid genital touching Many teens and young adults are now choosing abstinence Abstinence reflects feelings of self worth and self esteem Not everyone is “doing it” Sexual activity is NOT a requirement for friendship or social acceptance

American College Health Association “Risky Contact” for the Spread of STIs  You don’t have to have sexual intercourse to contract an STI Many STIs are spread by direct skin contact Everyone who has “risky contact” is at risk Teens and young adults are more “at risk” than other populations

American College Health Association “Risky Contact” for the Spread of STIs  Condoms do NOT completely protect from infections spread by skin contact, because they do not cover all infected areas of the skin Infection with these organisms does not require penetration during intercourse if there is other “risky contact.” HPV Herpes Molluscum

American College Health Association “Risky Contact” for the Spread of STIs  Avoid “risky contact,” which is any contact with skin or fluids that may contain the viruses and bacteria that cause STIs  Don’t share intimate apparel such as swimwear or underwear  Towels?????  Old myths - toilet seats, doorknobs, swimming pools…...

American College Health Association Review of male anatomy

American College Health Association Review of female anatomy

American College Health Association Who gets STIs?  Anyone who has “risky contact” with a person with an STI  One contact might be all it takes to get an STI  The more contacts, the greater the risk

American College Health Association Chlamydia and gonorrhea Chlamydia - most common  Women: infects urethra, cervix Often no symptoms Sometimes pain with urination or lower abdominal pain Infection can spread to tubes and ovaries Can cause infertility  Men: infects urethra, epididymis Can cause pain with urination Swelling and pain of the testicles  Gonorrhea - similar symptoms, may also affect joints  Non-specific urethritis - caused by bacteria that isn’t chlamydia, gc Spread by body fluids

American College Health Association Penile discharge - chlamydia, gonorrhea, NSU

American College Health Association Epididymitis due to Chlamydia - the swelling of this infection is seen above the right testicle

American College Health Association “Bull headed clap”

American College Health Association Cervicitis gonorrhea/chlamydia

American College Health Association Hydrosalpinx resulting from Chlamydia - closed, swollen and water-filled left tube in a young woman

American College Health Association Syphilus  Not very common  Important historically - said to have killed Christopher Columbus, Al Capone  Caused by bacteria  3 stages - primary (chancre), secondary, tertiary  Diagnosed by blood test  Treatable!

American College Health Association The Most Prevalent STIs Genital herpes  Men and women: genital skin Extremely painful lesions Often no symptoms  Women: cervix Abnormal vaginal discharge Often no symptoms May infect newborns during delivery Spread by skin contact Genital-Genital Hand-Genital Oral-Genital

American College Health Association Penis with vesicles (blisters) from genital herpes

American College Health Association Herpes

American College Health Association External genital skin of female with herpes ulcers

American College Health Association The Most Prevalent STIs  Molluscum Can appear anywhere on the skin Bumps that look like pimples Can become infected with bacteria Spread by body skin contact Genital-Genital Hand-Genital Oral-Genital

American College Health Association Molluscums of lower abdomen

American College Health Association External genital skin of female with huge molluscums

American College Health Association Human Papillomavirus (HPV)  Over 100 types of HPV More than 20 types of HPV can infect genital skin Men and women: genital and anal warts Women: lesions on the cervix and vagina Spread by skin contact Genital-Genital Hand-Genital Oral-Genital

American College Health Association Human Papillomavirus (HPV)  HPV: Genital Warts Men and women: external genital skin, anus, in urethra Women: cervix, vaginal walls Condoms offer some protection, but don’t cover all of the skin that can be infected

American College Health Association Genital warts

American College Health Association Genital warts of female

American College Health Association Flat genital warts of male

American College Health Association Papillary genital warts of male

American College Health Association Papillary genital warts of male

American College Health Association Papillary genital warts of male anus

American College Health Association HPV Treatments Treatments for External Genital Warts  Patient-applied prescription remedies Aldara™ (imiquimod) Cream, 5% Condylox™ gel 0.5% (podofilox)  Procedures performed in the doctor’s office Freezing–cryoprobe or liquid nitrogen Caustic chemicals–TCA, BCA, podophyllin Laser

American College Health Association HPV and Pre-Cancers  Cervix and anus: some HPV types cause lesions that can be pre-cancers If not treated, they can eventually become cancers  The Pap smear detects lesions on cervix Cells scraped from cervix are examined under a microscope If they have ever had sexual contact, women need yearly Paps

American College Health Association Genital warts on cervix of female

American College Health Association Pre-cancer changes on cervix

American College Health Association HPV—Treatments of the Cervix and Anus  Cervix: destruction of lesion by freezing, laser, loop excision These treatments are about 90% successful  Anus: similar to external genital warts Aldara™, Condylox™, freezing, caustic chemicals, laser

American College Health Association HPV Protection  Consistent condom use can cut down, but not eliminate, the transmission of HPV  Many HPV-associated lesions resolve spontaneously, but they may return  Warts can be treated and removed, but the virus may remain in latent form  See your health care provider for an accurate diagnosis and appropriate treatment

American College Health Association What about HIV/AIDS?  HIV usually leads to AIDS AIDS is fatal—newer treatments prolong life, but not to a full life expectancy Having an STI can increase the risk of acquiring HIV 2 in 1,000 young adults are HIV positive 92 in 1,000 young adults have chlamydia or HPV HIV is spread by body fluids Semen Vaginal Anal

American College Health Association Look-a-likes : gets everybody worried!!  Contact dermatitis (soaps, clothes)  Ingrown hairs  Abrasions  Etc.  Penile contact dermatitis from latex

American College Health Association If you think you have an STI  See a health care professional  Be honest about your sexual behavior  Ask for explanations  If you do have an STI, notify your partner

American College Health Association Testing for STIs  There is no single test that detects all STIs  No test is perfect (every test can fail to detect an infection)  IF YOU’VE EVER HAD UNPROTECTED SEX - GET TESTED!!  Screening tests (used when no symptoms are present) HPV (visual examination; Pap smear tests the cervix only) Chlamydia, gonorrhea (tests of genital secretions or urine) guys: “you’re going to put that WHERE?” HIV, syphilis (specific blood tests) There is no reliable test for herpes when symptoms are absent

American College Health Association STI Prevention  Alcohol and Drugs contribute to becoming infected with an STI  Combined with sexual activity, the use of alcohol and other drugs is strongly associated with: Sexual activity when you are not really ready The spread of STIs Unwanted/unplanned pregnancy Acquaintance/date rape

American College Health Association Remember: Abstinence works best  Avoid genital touching  Many teens and young adults are choosing abstinence for now (this does NOT mean life-long celibacy)  Abstinence reflects feelings of self worth and self esteem  Not everyone is “doing it”  Sexual activity is NOT a requirement for friendship or social acceptance

American College Health Association For more information about STIs, contact your health service or other health care professional. Visit the National HPV & Cervial Cancer Prevention Resource Center at or contact ACHA at (410)