1. STI/ STD Don’t Let it Happen to You By: Andrea Abrams Linda Dhennin Reshma Prasad Rachael Walker Sharon Wang

2. What is a STI/ STD? Stands for… SEXUALLY TRANSMITTED INFECTION or DISEASE Infection contracted by intimate contact as well as sexual contact between individuals. Infection can be viral, bacterial, fungal, parasitic, or protozoal. Most infections can be treated but viral infections can not be cured.

3. Risk factors for STI/ STD Transient or urban residence Any sexual activity Early onset of sexual activity Multiple sexual partners Drug use Previous infection Treatment Medications Topical ointments Surgery Time Signs, symptoms and secondary complications Genital discharge Rash or lesions Discharge from the eye Oral lesions and sores Fever, chills, malaise Chronic infection Cancer Death

4. Healthy People 2020 Goals Increase the proportion of sexually active persons aged 15 to 19 years who use condoms to both prevent pregnancy and provide barrier protection against disease. Increase the proportion of sexually active males aged 15 to 19 years who use a condom at first intercourse. Baseline is 79.6, goal is 87.6. Increase the proportion of sexually active females aged 15 to 19 years who use a condom at first intercourse. Baseline is 68.0, goal is 74.8 Increase the proportion of male adolescents who received formal instruction on sexually transmitted diseases before they were 18 years old. The baseline in 91.8, goal is 93.8. Increase the proportion of female adolescents who received formal instruction on sexually transmitted diseases before they were 18 years old Baseline is 93.8, goal is 95

5. Healthy People 2020 (cont.) Goals Increase the proportion of male adolescents who received formal instruction on HIV/AIDS prevention before they were 18 years old. Baseline is 87.9, goal is 96.7. Increase the proportion of female adolescents who received formal instruction on HIV/AIDS prevention before they were 18 years old. Baseline is 89.3, goal is 98.2 Why is it important? The Centers for Disease Control and Prevention (CDC) estimates that there are approximately 19 million new STD infections each year—almost half of them among young people ages 15 to 24 The cost of STDs to the U.S. health care system is estimated to be as much as $15.9 billion annually. Untreated STDs can lead to serious long-term health consequences, especially for adolescent girls and young women

6. Gonorrhea Syphilis Chlamydia Chancroid Bacterial Vaginosis Genital Herpes STI/ STD’s

7. Human Papillomavirus Trichomoniasis Scabies Pediculosis Pubis (Crabs) HIV STI/ STD’s cont.

8. Prevention Abstinence Safe protected sex Limit sexual partners Get screened Have your partner get screened

9. Prevalence in Riverside County How Data is collected The STD surveillance systems operated by state and local STD control programs are the sources of California data. Case reports are submitted to local health jurisdiction in the form of laboratory reports and Confidential Morbidity Reports (CMRs). The local health jurisdictions then submit the data to the California Department of Public Health (CDPH).

10. Total Cases In the Riverside County in 2014 Female Ages 10-14 -Chlamydia: 20 -Gonorrhea: 5 - P&S/Syphilis: 0 Female Ages 15-19 -Chlamydia: 1582 -Gonorrhea: 123 - P&S/Syphilis: 1 Male Ages 10-14 -Chlamydia: 3 -Gonorrhea: 2 - P&S/Syphilis: 0 Male Ages 15-19 -Chlamydia: 393 -Gonorrhea: 107 - P&S/Syphilis: 7

12. CDC Screening Guidelines Annual chlamydia and gonorrhea screening of all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection Syphilis, HIV, chlamydia, and hepatitis B screening for all pregnant women, and gonorrhea screening for at-risk pregnant women starting early in pregnancy, with repeat testing as needed, to protect the health of mothers and their infants. Screening at least once a year for syphilis, chlamydia, and gonorrhea for all sexually active gay, bisexual, and other men who have sex with men (MSM). MSM who have multiple or anonymous partners should be screened more frequently for STDs (i.e., at 3-to-6 month intervals).

13. CDC screening guidelines cont. Anyone who has unsafe sex or shares injection drug equipment should get tested for HIV at least once a year. Sexually active gay and bisexual men may benefit from more frequent testing (e.g., every 3 to 6 months). Routine screening for C. trachomatis on an annual basis is recommended for all sexually active females aged <25 years

14. The routine screening of adolescents who are asymptomatic for certain STDs (e.g., syphilis, trichomoniasis, BV, HSV, HPV, HAV, and HBV) is not generally recommended. However, YMSM and pregnant adolescent females should be screened for syphilis Guidelines from USPSTF, ACOG, and ACS recommend that cervical cancer screening begin at age 21 years Screening Guidelines cont.

15. Teen Source Organizations http://www.teensource.org/std?gclid=CIu5q832jswCFZRahgodgAsA xw Planned Parenthood Free screenings and information Kids Health http://kidshealth.org/en/teens/std.html Obria Medical Clinics https://www.obria.org/?gclid=CJuWnKz4jswCFdgBgQoddUkGHA Telephone applications CDC National Resources for Adolescents

16. Local Resources for Adolescents http://www.saferstdtesting.com/free-std-testing/free-std-testing- riverside-ca or call 1-888-380-5571 for additional counseling OR https://samedaystdtesting.com or call 1-877-669-8413 to speak with a patient liason Anonymous Assistance

17. Quiz

18. Can STD’s lead to death if left untreated?  A. TRUE  B.False

19. What are signs and symptoms associated with STD’s?  A. Genital discharge  B. Rash or lesions  C. Fever/Chills  D. Oral lesions or sores  E. All of the above

20. What is one way you can prevent STD’s?  A. Medications  B. Exercise  C. Abstinence  D. Have numerous sex partners

21. References http://pediatrics.aappublications.org/content/134/1/e302 CDC. (2015, April). Center for Disease Control. Retrieved April 10, 2016, from Center for disease control : http://www.cdc.gov/std/tg2015/screening-recommendations.htm http://www.cdc.gov/std/tg2015/screening-recommendations.htm Healthy People 2020. (2016). https://www.healthypeople.gov/node/3521/objectives#4462 US Preventive Task Force. (2015, April 00). Retrieved April 12, 2016, from US Preventive Services Task Force: http://www.uspreventiveservicestaskforce.org/Page/Document/Upd ateSummaryFinal/sexually-transmitted-infections-behavioral- counseling1?ds=1&s=sexually%20transmitted http://www.uspreventiveservicestaskforce.org/Page/Document/Upd ateSummaryFinal/sexually-transmitted-infections-behavioral- counseling1?ds=1&s=sexually%20transmitted