1. STDs: What Teens Need To Know
High School Lesson 4A
STDs: What Teens Need To Know
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

2. Teens & Sexually Transmitted Diseases (STDs)
TEACHER SCRIPT:
Did you know that over 50% of sexually active adolescents will get an STD by age 24 through some form of sexual activity? That’s staggering. Most people who are sexually active do not realize that STDs are this common.
Infections spread by sexual contact are called sexually transmitted diseases (STDs). There are over 20 kinds of STDs. Remember that not only vaginal sex but also anal sex, oral sex, and genital to genital contact can spread STDs. Today, we will focus on the most common kinds of STDs.
More than half of sexually active people will have an STD by age 24!
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

3. Sexually Transmitted Diseases . . .
STDs are infections caused by viruses, bacteria, or protozoa and are spread by sexual activity.
A virus causes an infection that usually cannot be cured. Medicines can slow down the multiplication of the virus but do not kill them.
Bacteria and protozoa cause infections but can usually be killed with antibiotics.
TEACHER SCRIPT:
Infections are usually caused by germs or microorganisms that are so small they can only be seen with a microscope. Infections are caused by viruses, bacteria, or protozoa. Many viruses cannot be cured because we do not have medicines that kill viruses. Bacteria and protozoa can usually be treated with antibiotics. Infections can spread from one person to another in different ways. Colds or the flu are often spread from one person to another by coughing or sneezing. STDs are spread through sexual contact or sexual activity.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

4. Sexually Transmitted Diseases (STDs)
Are You Aware
of These FACTS?
TEACHER SCRIPT:
Many people are not aware of the FACTS about STDs. Are you?
NOTE: Sometimes the term sexually transmitted infections (STIs) is used rather than sexually transmitted diseases (STDs). As most often used in healthcare publications, we have elected to use the term STD in this presentation. All STDs are caused by STIs.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

5. FACTS About STDs
STDs are one of the most common types of infections in the U.S. today
You can get an STD the first time you have sex
Some STDs have no cure
TEACHER SCRIPT:
STDs are one of the most common types of infections in the U.S. today. Almost 19 million new cases of STDs are estimated to occur in the U.S. each year. You can even get an STD the first time you have sex! You can’t tell if someone has an STD just by looking at them. Most people with STDs are unaware of their infection and go unrecognized and untreated. And to make matters even worse, some STDs have no cure. Sadly, most infections are in teens and young adults who have become sexually active without knowing the facts about STDs.
Centers for Disease Control and Prevention. Summary of Notifiable Diseases—United States, MMWR. 2010;57(54).
American Social Health Association/Kaiser Family Foundation. Sexually Transmitted Diseases in America: How Many Cases and at What Cost? Menlo Park, CA: Kaiser Family Foundation; 1998.
Weinstock, H., Berman, S., Cates, W. Sexually transmitted diseases among American youth: Incidence and prevalence estimates, Perspectives on Sexual and Reproductive Health ; 36(1): 6-10.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

6. FACTS About STDs Most infected with an STD don’t know it
Most people get an STD from someone who does not know they are infected
TEACHER SCRIPT:
Most people who have an STD don’t even know they are infected. The sexually transmitted organisms are in their bodies but they don’t have any signs or symptoms: no sores, blisters, discharge, or pain. We say they are “asymptomatic.” They have no symptoms. However, they can still spread the infections to their sexual partners.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

7. STDs can cause serious HEALTH problems
FACTS About STDs
Cancer
Death
STDs can cause serious HEALTH problems
Pain
TEACHER SCRIPT:
STDs are not just nuisance problems. They can cause serious health problems. If you get an STD, there is no way to predict if you will have serious health problems and/or suffer severe lifetime consequences. As we will discuss, there are STDs that can cause severe pain in the genital area. Two common STDs can cause infertility (can’t get pregnant) in females. A viral STD is now known to cause some types of cancer. In the U.S., thousands of people die every year from serious health problems caused by STDs.
Infertility
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

8. Relationship strain & disruption
FACTS About STDs
Stress
Depression
STDs can cause
EMOTIONAL problems
Anxiety
TEACHER SCRIPT:
STDs can also cause emotional problems.
Relationship strain & disruption
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

9. FACTS About STDs Teens are at greater risk of getting STDs
It is easier to get HIV if you are already infected with another STD
Many STDs can be transmitted to a baby during pregnancy or birth
STDs cost billions of dollars
TEACHER SCRIPT:
Teens are at greater risk of getting STDs primarily because over time they have sex with many different partners. Also, the adolescent cervix, the bottom part of the uterus, has not matured and is more easily infected with some STDs than the cervix of an older woman. We also know that if you have certain STDs, it is easier to become infected with HIV. Many STDs cause damage to the genital skin allowing HIV easier access into the blood stream. Even babies can be born with an STD if their mothers are infected during the pregnancy. All of these factors have contributed to STDs costing billions of dollars in the United States.
CDC STD data.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

10. Sexually Transmitted Diseases . . .
STDs are spread by sexual activity.
What is sexual activity?
Sexual Activity is any contact with genitals, buttocks, or breasts for the purpose of sexual stimulation.
TEACHER SCRIPT:
STDs are infections spread specifically through sexual activity. Sexual activity is any contact with the genitals, buttocks, or breasts for the purpose of sexual stimulation. Sexual activity by law includes other activities beside vaginal sexual intercourse.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

11. any contact includes…
Vaginal Sex - penis in vagina, usually called sexual intercourse
Oral Sex - oral (mouth) contact with genitals
Anal Sex - a man’s penis placed into the anus
Outercourse - genital-to-genital contact without penetration of the vagina by the penis
TEACHER SCRIPT:
When people talk about sex, they are usually referring to sexual (vaginal) intercourse where the penis is placed inside the vagina. Oral sex is when the mouth of one person touches the genitals of another person. Anal sex is when a penis is placed inside the anus (rectum). Outercourse is genital-to-genital contact without penetration of the vagina by the penis, with ejaculation near the outside of the vagina. As you can see, the term “sex” includes much more than just vaginal sexual intercourse. Teens need to understand that whether it’s oral, anal, or vaginal, it’s all sex. Abstinence is the healthiest choice for unmarried teens.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

12. Sexually Transmitted Diseases in Adolescents
According to the CDC, adolescents are at higher risk for acquiring STDs than adults:
multiple sexual partners
high risk partners
more susceptible to infection
TEACHER SCRIPT:
Adolescents are at higher risk for STDs because they frequently have unprotected intercourse, are biologically more susceptible to infection, are frequently engaged in sexual partnerships of limited duration, and face multiple obstacles to using health care.1 In general, the younger a person begins to have sex, the greater the number of lifetime sexual partners they will have. The greater the number of sexual partners, the greater the risk of acquiring one or more STDs. Often, girls who begin having sex at a young age are dating older, sexually-experienced males who may already have an STD. Estimates suggest that teens and young adults (15 to 24 year olds) represent only 25% of the ever sexually active population but acquire nearly one-half of all new STDs.2 Adolescent females are also more susceptible to infection due to the immaturity of the reproductive tract, particularly the cervix which comprises the bottom of the uterus.
1CDC. Sexually Transmitted Disease Treatment Guidelines, Atlanta, GA:U.S. Department of Health and Human Services, August 4, 2006;55(RR11);11.
2Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: Incidence and prevalence estimates, Perspectives on Sexual and Reproductive Health. 2004;36(1):6-10.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

13. Sexually Transmitted Diseases
Of all infections that are reported to the CDC, the most common types are STDs
18.9 million new cases of STDs per year
Over 9 million STDs in 15 to 24 year olds
TEACHER SCRIPT:
Of all infections that are reported to the Centers for Disease Control (CDC), the most common are sexually transmitted diseases.1 Of the more than 18.9 million new cases of STDs each year, almost half, or an estimated 9.1 million, occur in year olds.2
If STDs are so common, why don’t we hear more about them? (Allow time for student responses.) People just don’t talk about STDs. It’s embarrassing. Another reason is that many people who have STDs don’t know it. They aren’t having any symptoms, but they are passing on the STD to their next partner(s).
Let’s look at diagrams of the male and female genital systems to see how STDs can infect the various parts.
1Centers for Disease Control and Prevention. Summary of Notifiable Diseases— United States, MMWR. 2007;54(53).
2Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: Incidence and prevalence estimates, Perspectives on Sexual and Reproductive Health. 2004;36(1):6-10.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

14. STDs Can Involve the Entire Male Reproductive System
Vas Deferens
Prostate Gland
Scrotum
Penis
TEACHER SCRIPT:
Some STDs can affect the inside of the urethra in the penis and travel to the prostate gland. Rarely, they can also travel through the vas deferens to the epididymis and testicles. STDs can also infect the skin of the penis and scrotum.
Testicle
Urethra
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

15. STDs Can Involve the Entire Female Reproductive System
TEACHER SCRIPT:
STDs can obstruct or block the fallopian tubes preventing fertilization or causing scarring which can “trap” a fertilized egg causing a tubal pregnancy—this can be a life-threatening situation if not diagnosed and treated promptly. Many women also suffer from pelvic pain as a result of the damage to their reproductive tract caused by an STD.
STDs can also infect the cervix, vagina, and the outside skin folds (labia or vulva).
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

16. Herpes HPV HIV Some Common STDs Are . . . Chlamydia Gonorrhea Syphilis
Trichomonas
Bacteria
Protozoa
Chlamydia
Gonorrhea
Syphilis
TEACHER SCRIPT:
This slide lists only a few of the most common STDs. There are many more. Which ones are curable with antibiotics? (bacteria and protozoa) Which ones cannot be cured with medicine? (viruses)
Let’s discuss a few important facts about each STD.
Viruses
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

17. Gonorrhea & Chlamydia STDs caused by bacteria Organisms
Neisseria gonorrhoeae
Chlamydia trachomatis
Location: vagina and cervix in women and the urethra (urine canal) in women and men
TEACHER SCRIPT:
Gonorrhea is caused by Neisseria gonorrhoeae. Chlamydia is caused by Chlamydia trachomatis. They can infect the reproductive tract, primarily the cervix (opening to the uterus) in women, and in the urethra (urine canal) in women and men. Gonorrhea and chlamydia can be located in secretions in the vagina, and travel through the opening of the cervix and infect the inside lining of the uterus and fallopian tubes. These bacterium can also grow in the mouth, throat, and anus.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

18. Gonorrhea & Chlamydia
Most infected don’t know it & can pass it to other sexual partners
In males – infects urethra, can cause pus (yellow drips from penis), burning with urination
In females – infects cervix – could infect uterus, fallopian tubes, ovaries causing pelvic inflammatory disease (PID)
TEACHER SCRIPT:
These infections can be treated with medicines called antibiotics but only if the sexually active person goes to a clinic to be tested and is found to be infected. Most people infected with these bacteria do not know it (they don’t have any symptoms) and can pass chlamydia and gonorrhea to others during sex. If a male has symptoms, he may have yellow pus coming from his penis and burning when he urinates. In women, chlamydia and gonorrhea usually infect the cervix (the bottom of the uterus) but can cause a severe infection called pelvic inflammatory disease (PID) if they travel through the narrow opening in the cervix to the uterus, fallopian tubes, and ovaries.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

19. Are Gonorrhea & Chlamydia Serious Problems?
Can cause pelvic inflammatory disease (PID) – a severe infection of the uterus, fallopian tubes, and ovaries
PID can lead to:
infertility (can’t get pregnant)
pregnancy in the fallopian tubes
pelvic pain
Easier to get HIV if infected with gonorrhea or chlamydia
TEACHER SCRIPT:
Untreated gonorrhea or chlamydia can cause serious problems. In women, gonorrhea and chlamydia are the common causes of pelvic inflammatory disease (PID). About 1 million women each year in the U.S. develop PID. Women with PID do not necessarily have signs or symptoms. PID can lead to internal abscesses (pus pockets that are hard to cure), long-lasting pelvic pain, and infertility. The bacteria can damage the fallopian tubes enough to increase the risk of ectopic pregnancy (a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube). When a woman becomes pregnant, the fertilized egg must travel from the fallopian tube to the uterus. The baby can only develop and grow normally in the uterus. If the fertilized egg gets stuck in the fallopian tube because of damage and scarring possibly caused by gonorrhea or chlamydia, the pregnancy cannot develop normally and the fetus will die.
Just like with many of the other STDs, a person with gonorrhea or chlamydia can more easily get HIV if they have sex with someone who has HIV.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

20. Pelvic Inflammatory Disease (PID)
Normal
Infected
Uterus
Uterus
TEACHER SCRIPT:
If the chlamydia and gonorrhea bacteria travel from the vagina through the cervix into the uterus and fallopian tubes, they can cause pelvic inflammatory disease (PID). Girls who have PID may have mild to severe lower abdominal pain with fever. The infection may be so severe that the fallopian tubes are filled with pus. It is often necessary for girls with PID to be admitted to the hospital and given intravenous antibiotics (IVs). If the fallopian tubes get infected, the infection can be treated, but the tubes may be permanently damaged with scar tissue. The tubes can be partially blocked causing a fertilized egg to get stuck in the tube, resulting in an ectopic (tubal) pregnancy. The tubes are not meant to hold a growing baby. When the pregnancy gets too big, the tube can rupture, causing pain and bleeding. Surgery may be necessary to remove the tubal pregnancy and stop the bleeding.
In some cases, the fallopian tubes may be completely blocked by PID, preventing the egg and sperm from ever meeting. This inability to become pregnant is called tubal infertility. A woman who is wanting to have a baby may not be able to get pregnant if she developed PID that caused scar tissue blocking the fallopian tubes. In some women, PID causes chronic pelvic pain for many years. In summary, pelvic inflammatory disease caused by chlamydia and gonorrhea can be a very serious disease in females leading to tubal pregnancy, pelvic pain, and infertility.
Fallopian Tube
Damaged Fallopian Tubes
Ovary
Cervix
Can cause tubal pregnancy or infertility
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

21. Treatment of Gonorrhea & Chlamydia
Antibiotics by mouth or injection
Sexual partners must also be treated
If PID has developed, antibiotics cannot reverse the tissue damage caused by PID
TEACHER SCRIPT:
Many of the currently used antibiotics can successfully cure gonorrhea and chlamydia. Gonorrhea is usually treated by giving a single injection (shot) of antibiotics in the arm or buttocks. Because many people with gonorrhea also have chlamydia, antibiotics for both infections are usually given together. Chlamydia us usually treated with a one-tome large dose of an oral antibiotic. If you have gonorrhea or chlamydia, you should also be tested for other STDs. Sexual partner(s) must also be tested and treated for the infection.
Although medication will stop the infection, it will not repair any permanent damage (scar tissue) done by the disease, especially in females who have developed PID. Even if you have been treated for gonorrhea or chlamydia, you can get the disease again if you have sex with an infected person.
CDC. Sexually Transmitted Diseases Treatment Guidelines, MMWR December 17, ; 59(RR11).
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

22. Can Gonorrhea & Chlamydia Be Prevented? Yes!!
Condoms can reduce but do not entirely eliminate the risk of gonorrhea or chlamydia
Abstinence is 100% effective
TEACHER SCRIPT:
Gonorrhea and chlamydia can only be prevented 100% of the time by abstinence from all types of sexual activities (anal, oral, and vaginal sex, and outercourse). While condoms can decrease your chances of getting gonorrhea or chlamydia if used perfectly (correctly, every time), only abstinence provides complete protection.
Homes K, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization. June 2004; 82(6):
National Institutes of Health, Workshop Summary, July 20,
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

23. If you don’t have sex, you don’t have to worry about getting gonorrhea or chlamydia!
TEACHER SCRIPT:
If you are having sex, you should see a healthcare professional, such as a doctor or a nurse, to get tested for gonorrhea and chlamydia. You could be infected and NOT know it. As we will discuss, condoms decrease, but do not eliminate your chance of getting gonorrhea and chlamydia. Abstinence from sexual activity is the only 100% effective way to prevent gonorrhea and chlamydia.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

24. Syphilis STD caused by a bacteria Organism: Treponema pallidum
Location:
chancre (painless sore) usually on the genital area
rash on the hands/feet and other areas of the body
TEACHER SCRIPT:
Syphilis is a complex STD caused by the bacterium Treponema pallidum. In it’s early stage, syphilis causes a painless sore on the male or female genitals or other areas of the body. Later stages involve a rash on the hands, feet, or other areas of the body and infection of other body organs (nervous system, heart).
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

25. Syphilis Starts as a painless sore on the genitals
If not treated, can spread and cause serious health problems to heart or nervous systems
Can be transmitted to an unborn baby if the mother is infected
Treated with antibiotics
TEACHER SCRIPT:
If syphilis is not treated in its early stages with antibiotics, it can cause serious health problems such as damage to the nervous system (brain, spinal cord) and heart. Most infections are found early, before serious problems can occur. Blood tests are used to detect this STD. If a pregnant woman has syphilis, it can be transmitted to her unborn baby, causing serious physical and mental handicaps. It is very important for a pregnant woman infected with syphilis to be treated to prevent these problems in the baby.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

26. Is Syphilis a Serious Problem?
If not treated, infection can spread to brain, heart, spinal cord, eyes, and other areas
Can be spread to the baby during pregnancy causing severe brain and growth abnormalities
TEACHER SCRIPT:
While the health problems caused by syphilis in adults and newborns are serious in their own right, it is now known that the genital sores caused by syphilis also make it easier to transmit and acquire HIV infection through sexual activity.
CDC Fact Sheet: Syphilis
Genital sores of syphilis make it
easier to get HIV infection
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

27. Can Syphilis be Prevented? Yes!!
Condoms may reduce your risk of syphilis but they do not cover all the areas infected
TEACHER SCRIPT:
The CDC has reviewed data regarding condom use and STD transmission. They have concluded that for STDs spread by sores rather than fluids, “condoms may offer less protection because areas of skin not covered by the condom may be vulnerable to infection.” Prevention of one case of an STD can result in the prevention of many cases. “The surest way to avoid STDs, including syphilis, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is know to be uninfected.”
Homes K, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization. June 2004; 82(6):
CDC. Condoms for the Prevention of Sexually Transmitted Diseases. MMWR. 1988; 37(9):
CDC Fact Sheet: Syphilis
Abstinence is 100% effective
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

28. If you don’t have sex, you don’t have to worry about getting syphilis!
TEACHER SCRIPT:
Anyone who is sexually active and has a sore or blister on their genital area, whether it is painful or not, should see a healthcare professional and be tested for STDs. As we will discuss, condoms decrease but do not eliminate your risk of getting syphilis. Because syphilis is transmitted through all forms of sexual activity, abstinence from all forms of sex will ensure you will not get syphilis.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

29. Trichomonas STD caused by a Protozoa Organism: Trichomonas vaginalis
Location:
-vagina and cervix in women -urethra in men and women
TEACHER SCRIPT:
Trichomonas vaginalis is a microscopic parasite. Infections of the vagina caused by this protozoa is one of the most common causes of a vaginal discharge in women. Trichomonas can also be located in the urethra in men and women.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

30. Trichomonas Can cause a heavy discharge from the vagina
Usually no symptoms in males
Millions infected each year
Treated with antibiotics
TEACHER SCRIPT:
An infection of the vagina caused by trichomonas is one of the most common causes of a vaginal discharge in women. Males infected with trichomonas usually do not know they are infected because they do not have a discharge or any other symptoms and unknowingly spread it to females during sex.
When a female is found to have a vaginal infection caused by trichomonas, it is important also to treat the male sexual partner to prevent re-infection. Women who have trichomonas may be at increased risk for pelvic inflammatory disease which can lead to serious health problems as discussed earlier.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

31. Is Trichomonas Infection a Serious Problem?
Females may have a frothy, yellow/green vaginal discharge with a foul odor
In pregnant women, it can cause premature (early) delivery
Increases the risk of getting HIV infection
TEACHER SCRIPT:
In pregnant women, trichomonas has been associated with premature delivery.
This infection has also been associated with an increased risk of getting HIV.
CDC Fact Sheet: Trichomoniasis
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

32. Can Trichomonas Infection be Prevented?
Condoms can reduce but do not entirely eliminate the risk of trichomonas
TEACHER SCRIPT:
The only way to ensure prevention of trichomonas is through abstinence. Condoms have been shown to reduce your chance of infection but not 100%.
Homes K, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization. June 2004; 82(6):
National Institutes of Health, Workshop Summary, July 20,
Abstinence is 100% effective
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

33. If you don’t have sex, you don’t have to worry about getting trichomonas!
TEACHER SCRIPT:
If you are sexually active and have a heavy discharge from the vagina, you should see a healthcare provider and be tested for STDs. As with other STDs, condoms decrease your chance of getting trichomonas. Abstinence provides 100% protection from trichomonas.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

34. Genital Herpes STD caused by a virus
Organism: herpes simplex virus (HSV)
Type I (HSV-1)
Usually mouth/lips; also in genital area
Type 2 (HSV-2)
Usually genital area; also in the mouth
Location: lives in the nerves in these areas
TEACHER SCRIPT:
Genital herpes is an STD caused by a virus called herpes simplex virus (HSV). HSV type 1 usually occurs in the mouth or on the lips but can occur on the genital area. HSV type 2 occurs primarily on the genitals but can also occur in the mouth. The virus lives in the nerves in these areas but periodically travels down the nerves onto the skin causing sores and blisters to form.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

35. Genital Herpes Simplex Virus (HSV)
Can cause painful recurring blisters and sores on the genital area
Most infected don’t even know it
Most people get herpes from someone who has no sores or blisters and don’t even know they are infected
NO CURE: INFECTED FOR LIFE!
TEACHER SCRIPT:
In some people herpes causes painful blisters and sores on the genital area. Most people who get the sores and blisters will get them again and again because the virus stays in their bodies for the rest of their lives. While there are no medicines to get rid of the herpes virus, medications are available that can prevent the sores from coming back, but you have to take the pills every day. If you stop taking the medicine, the sores can reappear. Most people who get herpes will get it from someone who has no sores or blisters. In fact, most people infected with herpes don’t even realize they have the virus. Once a person has herpes, the person can pass it to someone else during sex even when sores are not present.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

36. Herpes Simplex Virus Type-2 (HSV-2)
Usually lives in the genital area
Most people who have herpes sores/blisters caused by HSV-2 will have them come back again and again
HSV-2 is usually spread through genital sexual activity
TEACHER SCRIPT:
There are 2 types of HSV: type 1 and type 2. HSV-2 prefers to live in the nerves and skin of the genital area, while HSV-1 prefers the nerves and mucous membranes inside the lips/mouth. Most people who breakout with sores/blisters in the genital area caused by HSV-2 will do so again and again because the virus stays in the nerves of the genital area and occasionally causes recurring outbreaks. Some people with genital HSV-2 have sores that keep coming back on their genital areas for years and possible a lifetime.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

37. Herpes Simplex Virus Type-1 (HSV-1)
HSV-1 commonly causes infection of the mouth and lips (“cold sores” or “fever blisters”)
Can get HSV-1 of the mouth by coming into contact with the saliva (spit) of an infected person (ex. kissing)
HSV-1 in the mouth can be spread to the genitals by oral sex
TEACHER SCRIPT:
HSV type 1 commonly causes oral (mouth) herpes manifested by cold sores and fever blisters. A person can get this virus through contact with saliva of an infected person such as by kissing. Millions of people have cold sores or fever blisters in the mouth or on their lips. These sores come and go and, while they may be painful, do not cause serious health problems. Most people will acquire HSV-1 infection of the mouth sometime during their lifetime. This is normal because we come in contact with so many people during our lifetime. Often, the infection is transmitted by family members (kissing, sharing food, etc.)
Unfortunately, herpes infections in the mouth can be spread to the genitals of another person during oral sex. In other words, if a person has herpes type 1 in their mouth and performs oral sex on the genital area of another person, that person may get herpes type 1 infection in their genital area.
Roberts C, Pfister J, Spear S. Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sexually Transmitted Diseases 2003; 30:
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

38. Is Genital Herpes a Serious Problem?
Can cause recurrent painful genital sores
Frequently causes emotional distress
Can be transmitted to a baby during pregnancy or birth
If exposed to HIV, increased risk for acquiring HIV if you have genital herpes
TEACHER SCRIPT:
Herpes can cause recurrent painful genital sores. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected. The infected person may be frustrated with the recurrent sores on the genital area. They have to deal with the fact that they can pass the herpes infection to others during sexual activity.
If a woman has herpes and becomes pregnant, she must notify her healthcare provider. Herpes can cause serious life threatening health problems in infants if the baby is infected during pregnancy or birth. Medications can be given to decrease the chance of the baby becoming infected, so it is very important to tell your doctor if you have herpes.
In the United States, genital herpes may play a major role in the sexual spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection because it is easier for the HIV to enter the body through damaged skin (sores/blisters). In other words, if a person has genital herpes, it is easier for that person to get infected with HIV if they has sex with a person who has HIV.
Corey L., Handsfield, H.H. Genital herpes and public health: Addressing a global problem. JAMA. 2000;283:  
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

39. Can Genital Herpes Be Prevented? Yes!!
Condoms can reduce your risk of getting genital herpes if used the right way every single time you have sex. A condom only protects the area of the body that it covers. Areas the condom doesn’t cover can become infected.
TEACHER SCRIPT:
Condoms may reduce the risk of herpes but can fail in preventing the spread of herpes because they do not cover all of the areas infected by the virus and are often not used correctly and consistently.
Abstinence from sexual activity (oral, anal, and vaginal sex and outercourse) is the only certain way to avoid getting genital herpes.
Homes K, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization. June 2004; 82(6):
National Institutes of Health, Workshop Summary, July 20, Available at::
Abstinence is 100% effective
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

40. If you don’t have sex, you don’t have to worry about getting genital herpes!
TEACHER SCRIPT:
If you are sexually active and have sores, blisters, or any type of genital irritation that comes and goes several times a year, you should see a healthcare professional for STD testing. As with other STDs, condoms decrease, but do not eliminate your change of getting herpes. Again, if you abstain from sexual activity, you will not have to worry about getting genital herpes.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

41. Genital Human Papillomavirus (HPV)
STD caused by a virus
Organism: human papillomavirus
Location: skin of genital area
Penis
Scrotum
Anus
Vulva (labia)
Vagina
Cervix
TEACHER SCRIPT:
Genital HPV infection is an STD that is caused by human papillomavirus. HPV is sexually transmitted and can infect the genital area: the skin of the penis, scrotum, vulva (labia), anus, vagina, or cervix (lower part of the uterus).
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

42. Genital Human Papillomavirus (HPV)
Can cause genital warts on the vulva, vagina, cervix, penis, scrotum, and anus
Can cause cancer of the cervix, vagina, vulva, anus, penis, mouth, and throat
Treated by freezing, burning, lasers, chemicals, and surgery
TEACHER SCRIPT:
Genital human papillomavirus (HPV) is the most common STD today. HPV can cause warts on the genital area (vulva, vagina, cervix, penis, scrotum, and anus). The virus can also cause abnormal, precancerous cells on the labia, cervix, and anus which can lead to vulvar, cervical, and anal cancer. HPV is also the cause of some cases of cancer of the mouth and throat. HPV in the genital area can be transmitted to the mouth and throat through oral sex. Warts on the other areas of the body, such as the hands and feet, are not spread by sex.
ADDITIONAL INFORMATION:
90% of HPV-infected individuals who are otherwise healthy are able to clear the virus; however, the 10% that do not clear the virus can suffer serious problems. In women who can’t get rid of the HPV, it can infect (attack) the cervix and cause abnormal cells that can lead to cancer later in life (detected by a Pap smear). The abnormal cells on the cervix can be treated by freezing, burning, or surgery to remove a small part of the cervix. This can prevent the abnormal cells from turning into cancer. If the abnormal cells have turned into cancer, the woman will usually have a hysterectomy (removal of her uterus) and she will not be able to have children. Almost all cases of cancer of the cervix are caused by HPV. A few thousand women die every year in the U.S. because they had cancer of the cervix that could not be successfully treated. New evidence has shown that HPV can also cause cancer of the anus and mouth/throat in both males and females.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

43. How is Genital HPV Spread?
Sexual activity, primarily vaginal & anal intercourse
Can also be spread with outercourse (skin-to-skin contact)
Usually get it from someone who does not have warts and does not know they are infected
Can be spread from the genital area to the mouth/throat through oral sex
TEACHER SCRIPT:
The types of HPV that infect the genital area are spread by skin-to-skin contact primarily through sexual contact. This includes vaginal and anal sex, as well as outercourse. HPV can be transmitted to the mouth by performing oral sex on someone who has HPV on their genital area. Most HPV infections have no signs or symptoms; therefore, most infected persons are completely unaware they are infected, yet they can transmit the virus to a sex partner.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

44. Is Genital HPV a Serious Problem?
Can cause warts on the genital area and in the mouth/throat
Can lead to precancerous cells especially on the cervix (abnormal Pap smears)
Can cause cancer of cervix, penis, labia (vulva), anus, mouth, and throat
TEACHER SCRIPT:
Millions of people have HPV. For some, HPV can have serious complications. In women, HPV can infect the cervix and cause abnormal cells that can lead to cancer later in life. These abnormal cells can be detected during a pelvic exam by a healthcare professional performing a Pap smear (placing a speculum in the vagina and scraping some of the cells from the cervix and placing them in a liquid to be sent to a lab for examination). Women at highest risk for developing cervical cancer are those who become sexually active in the mid-adolescent years and have multiple sexual partners. Studies have confirmed that HPV is the cause of cervical cancer. It is estimated that 12,710 women in the United States in 2011 will be diagnosed with cancer of the cervix and 4,290 will die as a result of it.
HPV can also cause cancer of the labia, penis, and anus. Risk factors for anal cancer include having anal sex. Anal cancer is treated with surgery and/or radiation therapy. Cancer of the penis is very rare. Although you may get HPV as a teenager, the cancer does not develop until adulthood.
American Cancer Society. Cancer Facts & Figures
National Institutes of Health, Workshop Summary, July 20, Available at:
Bohmer G, van den Brule AJ, Brummer O, Meijer CL, Petry KU. No confirmed case of human papillomavirus DNA-negative cervical intrepithelial neoplasia grade 3 or invasive primary cancer of the uterine cervix among 511 patients. Am J Obstet Gynecol, 2003;189(1)
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

45. Genital Human Papillomavirus (HPV)
2 vaccines are approved by the Food & Drug Administration (FDA) to decrease your chances of contracting HPV
Reduce the risk of warts and cancers caused by HPV
Both approved for females, one for males
TEACHER SCRIPT:
The HPV vaccines are most effective if administered prior to any sexual contact. Most insurance companies pay for the 3 injections for those who are between the ages of 9 and 26.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

46. Can Genital HPV Be Prevented? Yes!!
Condoms can reduce your risk of getting genital HPV if used the right way every single time you have sex. A condom only protects the area of the body that it covers. Areas the condom doesn’t cover can become infected.
Vaccines are available
TEACHER SCRIPT:
Condoms are somewhat effective in preventing the transmission of HPV but not entirely because they do not cover all of the genital areas infected by the virus. The NIH stated that preventing HPV infection would require “encouraging delayed onset of sexual intercourse.” Abstinence is the most effective strategy to prevent HPV infection.
Two vaccines are approved by the FDA.
Cervical Cancer. NIH Consensus Statement. 1996;14(1)1-38.
Abstinence is 100% effective
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

47. If you don’t have sex, you don’t have to worry about getting genital HPV!
TEACHER SCRIPT:
Like the previous diseases we have discussed, if you do not engage in sexual activity, you do not have to worry about getting genital HPV.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

48. Human Immunodeficiency Virus (HIV)
The
virus
that
causes
Acquired Immunodeficiency
Syndrome (AIDS)
TEACHER SCRIPT:
Many people have heard of the terms “HIV” and “AIDS” but may not know what these abbreviations mean. HIV is Human Immunodeficiency Virus, the virus that causes Acquired Immunodeficiency Syndrome, or AIDS.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

49. HIV Infection/AIDS
Virus that infects and attacks your immune system, specifically the CD4+ cells, causing AIDS
Organism: Human Immunodeficiency Virus
Location: blood, semen, vaginal fluid, and breast milk of those infected
TEACHER SCRIPT:
HIV infects and attacks CD4+ cells in the immune system often leading to AIDS. HIV can be found in blood, semen, vaginal fluid, and breast milk of those who have been infected.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

50. HIV vs. AIDS AIDS HIV Infection
the virus has attacked the immune system
can become
very sick (infection/cancer)
can die
HIV Infection
the virus is in
the body
may not know it because you
feel fine
can pass to others during sex
TEACHER SCRIPT:
When people get infected with HIV, it usually does not cause them any problems for months or even years. They may look healthy, are infected with the virus and probably do not know it, but can pass it on to someone during sex. HIV slowly attacks the body’s immune system. The immune system fights infections that can make us sick. If a person’s immune system is not working properly, the body cannot fight off even a simple infection caused by bacteria and viruses such as the flu, a cold, or an ear infection. Most people who have HIV do not develop AIDS for years. The average time between getting the virus and developing AIDS is about 10 years but can be as short as a few months or as long as 20 years or more. Individuals may get HIV as a teenager, not know it because they feel fine, become sick as an adult, and find out that they have AIDS. There is no cure for HIV infection and AIDS. There are medications that can slow down the effects of the virus, but the medications cannot rid the body of the virus. Remember, many people infected with HIV don’t know it, but pass it to others during sex.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

51. How Does Someone Get HIV
Men having sex with men (MSM)
High risk heterosexual intercourse (male/female where one of the partners is infected or at high-risk for HIV)
Shared needles with infected drug user
NOTE: HIV infection from blood transfusions has essentially been eliminated with thorough testing of donated blood. Transmission from HIV infected mother to newborn has been dramatically reduced with treatment during pregnancy.
TEACHER SCRIPT:
The most common way to acquire HIV is by having anal and/or vaginal sexual intercourse with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, anus/rectum, or mouth during sex.1 In the United States, HIV is most commonly transmitted through men having sex with men (MSM). The second most common way it is spread is when men and women have intercourse and one of them is infected. People who use illegal IV drugs (injecting drugs into a vein) and share needles can spread the virus in the blood on the needle, even if the blood is not visible.
If a pregnant woman has HIV, she can pass the virus to her baby before or during birth or while breastfeeding. Because of diagnosis and treatment during pregnancy, the number of HIV infected newborns has been dramatically reduced.2
Because blood donors are continually screened for HIV, it is very rare today to contract HIV from a blood transfusion. Nearly all people infected with HIV through blood transfusions received those transfusions before 1985, the year HIV testing began for all donated blood.
1National Institute of Allergy and Infectious Diseases. Understanding HIV/AIDS.
2 Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, Vol. 19. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention;
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

52. Is HIV/AIDS a Serious Problem?
Worldwide Statistics
2.6 million newly infected
33.3 million living with HIV
1.8 million deaths
As of 2009, nearly 30 million have died
Teacher Script:
Based on the UNAIDS 2010 report, there were 2.6 million newly infected persons in 2009 with 33.3 million estimated to living with HIV. Approximately 1.8 million deaths related to HIV/AIDs occurred in 2009.
UNAIDS. AIDS Epidemic Update 2010
2010 UNAIDS Report on the Global AIDS Epidemic.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

53. Is HIV/AIDS a Serious Problem?
United States Statistics
34,247 new cases of AIDS in 2009
479,868 persons living with AIDS in 2008
As of 2008, over 594,496 have died of AIDS
Teacher Script:
According to the CDC’s HIV/AIDS Surveillance Report for 2009, there were 34,247 reported new cases of AIDS in the United States.
Note: The HIV data reported by the CDC only includes 40 states.
Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, Vol. 21. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention;
1HIV/AIDS Surveillance Report, 2009; (21), June 2011.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

54. Treatment of HIV/AIDS
Medications can slow down the virus, but currently cannot eliminate it from the body
There is no vaccine for HIV/AIDS
HIV/AIDS patients must take their medications exactly as directed, for life
These medications have many side effects
TEACHER SCRIPT:
There are medicines that can slow down the virus, but they cannot eliminate it from the body. There are other treatments that can prevent or treat some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. As with other diseases, early detection offers more options for treatment and preventative health care. There is no vaccine to prevent HIV/AIDS. Once a person begins to develop immune deficiency and is started on antiviral medications, they must take them for their entire life. The medicines are very costly, have numerous side effects, and must be taken exactly as prescribed since the HIV can become resistant to the drugs (i.e. the medicines won’t slow the virus down). The World Health Organization (WHO) recommends antiviral medications be started when the CD4+ cell count is ≤350 or when symptoms are evident.
World Health Organization. RAPID ADVICE Antiretroviral therapy for HIV infection in adults and adolescents. Nov
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

55. Can HIV Be Prevented? Yes!!
Do not use IV drugs
Condoms used correctly, every time have been shown to reduce your chance of getting HIV by about %
TEACHER SCRIPT:
You can protect yourself by not getting involved in illegal drug use.
Studies have confirmed that condoms do greatly reduce the risk of HIV by approximately 80%, but only if used correctly and consistently with every sexual intercourse. However, consistent and correct condom use is not the norm despite years of condom awareness and education. Abstinence from sexual intercourse (oral, anal, and vaginal) and I.V. drugs are the only methods that are 100% effective in preventing HIV.
If you are having sex, you must use a condom correctly every time you have sex.
National Institutes of Health, Workshop Summary, July 20, Available at::
Centers for Disease Control and Prevention. Condoms for the prevention of sexually transmitted diseases. MMWR ;37(9):
Abstinence from IV drugs and
sexual activity is 100% effective
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

56. If you don’t have sex or use IV drugs, you don’t have to worry about getting HIV!
TEACHER SCRIPT:
As the slide says, if you don’t have sex or use illegal I.V. drugs, you don’t have to worry about getting HIV. You will not get HIV by donating blood. When you give blood at a blood center, clean disposable needles are used and never are re-used.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

57. Facts To Remember About STDs
STDs can cause serious health problems (sores, warts, pain, infertility, cancer, and even death).
A person can have an STD, not know it, but pass it on to someone during sex.
You can get an STD the 1st time you have sex.
If you have had sex, you need to see a healthcare professional to be tested for STDs & be treated if infected.
TEACHER SCRIPT:
There are four major concepts to remember about STDs. First, STDs can cause serious health problems. Second, most people who have STDs don’t know it and can pass them to their partner(s) during sexual activity. Third, you can get an STD the first time you have sex. Fourth, if you have had sex, you should see a healthcare professional. If you are unsure where to go, talk to the school nurse or counselor.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

58. How can STDs be Prevented?
Abstinence – not having sex, is % effective if used consistently & correctly
Condoms – reduce the risk of getting an STD if used consistently & correctly
There are vaccines that prevent infection from the common types of HPV
TEACHER SCRIPT:
Read the slide.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

59. Did You Know?
Most women ovulate (release an egg from the ovary) about once a month and can only get pregnant the few days around ovulation.
But, you can get an STD any day of the month!
TEACHER SCRIPT:
In order to get pregnant, intercourse with ejaculation must take place within a day or two of the female ovulating. The egg that is released can only be fertilized within a day or two after ovulation. STDs can be transmitted by an infected person any day of the month.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

60. Did You Know? 1 in 6 couples using a condom get pregnant each year.
If condoms can fail in preventing pregnancy, they can fail at preventing STDs.
It’s easier to get an STD than to get pregnant!
Both are prevented by not having sex!
TEACHER SCRIPT:
Since one in six couples gets pregnant during their first year of condom use, it is obvious that condoms can fail when it comes to preventing pregnancy – particularly when only a small window of opportunity exists to get pregnant. Considering this, how effective can condoms be in preventing STDs which you can get any day of the month? Not having sex is the only 100% way to prevent the transmission of STDs or getting pregnant. If you are having sex, you must use a condom every time you have sex.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

61. Condom Facts You Need To Know
Condoms do greatly reduce the risks of pregnancy and HIV but only if used consistently and correctly with every act of intercourse
TEACHER SCRIPT:
Condoms do greatly reduce the risk of pregnancy and HIV if used consistently and correctly. It must be understood that this protection is not 100%. If adolescents choose to become sexually active, they must understand that consistent and correct condom use is essential and critical to reduce, but will not eliminate, their risk of pregnancy, HIV, and other STDs.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

62. Condom Facts You Need To Know
Condoms have a higher pregnancy failure rate than hormonal methods of birth control.
**To reduce the risk of a pregnancy, a condom plus another method of birth control is recommended if you are sexually active (ex. the pill, injection, etc).
TEACHER SCRIPT:
Condoms have the highest failure rate of the popular methods of birth control. To reduce the risk of pregnancy, it is best to use condoms PLUS a hormonal method of birth control.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

63. Condom Facts You Need To Know
Condoms reduce, but do not eliminate the risk of STDs including HIV (must have regular check ups for STD screening)
TEACHER SCRIPT:
Although condoms are not 100% effective, partial protection can substantially reduce the spread of STDs, especially HIV. Sexually active teens must have regular check-ups to test for STDs (CDC recommends at least every year). Most people with STDs do not have symptoms and are not aware they are infected. The only way to know if you have an STD is to be tested.
National Institutes of Health, Workshop Summary, July 20, Available:
Homes K, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization. June 2004; 82(6):
Hatcher RA, et al. Contraceptive Technology. 19th Revised ed. New York, NY: Ardent Media,
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

64. If you are having sex, you MUST use a condom, consistently and correctly every time!!!!
TEACHER SCRIPT:
Read the slide.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

65. The Good News
Fewer teenagers today are having sexual intercourse compared to years ago1
Teens having babies in the US have decreased greatly over the last 20 years!2
The number of teens having abortions has also decreased.3
TEACHER SCRIPT:
Despite the fact that you are constantly bombarded with sexual messages on TV, in the movies, in music, and in magazines, the number of teens having sexual intercourse is decreasing and the teen pregnancy rate has been declining. “Not everyone is doing it,” regardless of what it seems. Teens who have never had intercourse are now a majority in U.S. high schools.
1Youth Risk Behavior Surveillance, United States, MMWR. 2010:55(SS-05), J June 9.
2Hamilton BE, Martin JA, & Ventura, SJ. Births: Preliminary data for National vital statistics reports; vol 59 no 3. Hyattsville, MD: National Center for Health Statistics, 2010.
3Abortion Surveillance, United States, MMWR. 2011:60(1), February 25.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

66. Facts To Remember about Sex
Sex is an adult activity with adult responsibilities and consequences.
Sex is NOT an adolescent recreational activity.
TEACHER SCRIPT:
Sex is not bad. It is, however, an adult activity with adult responsibilities and consequences. Those consequences include physical, legal, and emotional troubles.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

67. Facts To Remember about Sex
Abstinence is a decision not to have sex until you’re in a committed adult relationship (example: marriage).
Renewed abstinence is when someone decides to become abstinent after they’ve had sex.
TEACHER SCRIPT:
Abstinence means choosing not to have sex. Abstinence is the healthiest choice you can make as a teenager because you will not have to worry about STDs or pregnancy. If you have been sexually active in the past, it is never too late to stop and be abstinent from this day forward. This is known as renewed abstinence. It’s never too late to make the choice to wait!
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

68. If You Have Had Sex, See a Healthcare Professional.
You could have an STD & not know it.
If you have an STD and it is not treated, you could pass it to someone else and/or develop serious health problems.
You can change your behavior and choose Renewed Abstinence!
TEACHER SCRIPT:
If you have had sex, you should see a healthcare professional. Most people with STDs don’t know they are infected with an STD, and they need special tests done to find out if they are infected. If you are unsure about where to go, your school nurse or counselor may be able to recommend where you can go or whom you can call to schedule an appointment. Remember, it is never too late to choose to change your behavior and be abstinent from sexual activity. Start today!
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

69. How do You Test for STDs in Males?
Physical exam
Urine
chlamydia
gonorrhea
Swab of the lesion
herpes
Blood test
HIV / AIDS
syphilis
TEACHER SCRIPT:
Read the slide.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

70. How do You Test for STDs in Females?
Physical exam
Urine
chlamydia
gonorrhea
Cervical sample
HPV
chlamydia/gonorrhea
Swab of the lesion
herpes
Blood test
HIV / AIDS
syphilis
TEACHER SCRIPT:
Read the slide.
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

71. Making the Abstinence Choice!
Talk
Encourage
Set Expectations
Set Limits
Question
Listen
TEACHER SCRIPT:
Teens who choose abstinence can set a great example for others. As a teen, you can talk to other teens and encourage them to be abstinent. You need to set expectations and limits for yourself before it becomes an issue. Make sure you voice those limits to friends and dates.
Observe
Be An Example
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

72. What Teens Say . . .
60% of teens who have had sex wish they had waited.
TEACHER SCRIPT:
A survey of teenagers revealed that nearly 60% of teens who have had sex wish they had waited. The survey also showed that there are more virgins than non-virgins in high schools today. Many teens are beginning to realize that all the problems that come with being sexually active are not worth it. Choosing to abstain from sexual activity means teens can focus on friends, doing well in school, participating in sports, and just growing up rather than worrying about suffering the legal and health consequences related to sex.
National Campaign to Prevent Teen and Unplanned Pregnancy <
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011

73. You are . . . Stop Think Do the Right Thing for You. Worth the Wait
TEACHER SCRIPT:
Everyone wants to be loved and have good relationships. By choosing abstinence, you are giving yourself the best chance possible to achieve this goal! Don’t settle for less--You are worth the wait!
Worth the Wait
Scott & White Worth the Wait®
High School—Lesson 4
4th Edition, September 2011