1. Presented By Dominique Guinn-Allen Disease Intervention Specialist Supervisor Arkansas Department of Health Central Region HIV/STD Update

2. What STDs have you heard about?

3. WHERE DOES ARKANSAS RANK? AIDS33 rd AIDS33 rd P & S Syphilis18 th P & S Syphilis18 th Gonorrhea12 th Gonorrhea12 th Chlamydia31 th Chlamydia31 th Congenital Syphilis 2 nd Congenital Syphilis 2 nd

4. Arkansas 2007 STD Statistics 9964 cases of Chlamydia 9964 cases of Chlamydia 4172 cases of Gonorrhea 4172 cases of Gonorrhea 239 cases of Early Syphilis 239 cases of Early Syphilis 352 cases of HIV 352 cases of HIV 195 cases of AIDS 195 cases of AIDS

5. 3 of every 5 gonorrhea and chlamydia cases in Arkansas are Among 15 – 24 year olds.

6. The United States has the highest rate of curable STDs in the developed world It is estimated that 15 million cases of STDs are acquired annually Of these, youth under age 20 experience 4 million infections annually Cost approximately $17 billion a year

22. TELEVISION 99% of American families have TV sets, with the average family owning 2.75 sets. American children, ages 2-17, watch television on average almost 25 hours per week or 3 ½ hours a day. Almost one in five watch more than 44 hours of TV each week. Television is the top after school activity chosen by children ages 6 to 17. http://www.mediafamily.org/

23. TELEVISION By the time a child is eighteen years old, he or she will witness on television (with average viewing time) 200,000 acts of violence including 40,000 murders. Children, ages 8 to 18, spend more time (44.5 hours per week- 61/2 hours daily) in front of computer, television, and game screens than any other activity in their lives except sleeping. http://www.mediafamily.org/

24. MUSIC TELEVISION In one study 75% of concept music videos (those that told a story) involve sexual imagery and more than half involve violence - usually against women. One-fourth of all MTV videos contain alcohol or tobacco use. A longitudinal study found a positive correlation between TV and music video viewing and alcohol consumption among teens. http://www.mediafamily.org/

25. MUSIC TELEVISION In one study 75% of concept music videos (those that told a story) involve sexual imagery and more than half involve violence - usually against women. One-fourth of all MTV videos contain alcohol or tobacco use. A longitudinal study found a positive correlation between TV and music video viewing and alcohol consumption among teens. http://www.mediafamily.org/

26. THE INTERNET The Internet provides access to websites which enable people of all ages, genders and ethnic groups to access social networks, engage in their culture, develop friendships, explore their sexuality, their sexual fantasies, talk about sex and arrange to meet for sex.

27. Gender Differences Teens (59%) and adults (74%) also believe that teen girls often receive the message that “attracting boys and looking sexy is one of the most important things they can do.” http://www.thenationalcampaign.org/

28. What myth or piece of misinformation about sexuality (puberty, sex, pregnancy, STDs) do you recall learning as you were growing up?

29. The Major STDs Treatable…but repeatable SyphilisChlamydiaGonorrheaTrichomoniasis Crabs (pubic lice) Crabs (pubic lice) Not curable...some life-long HSV ( Herpes Simplex Virus ) HPVs ( Human Papilloma viruses ) HIV (Human Immunodeficiency Virus) HBV ( Hepatitis B Virus )

30. AIDS AIDS HIV HIV Reportable Sexually Transmitted Diseases Reportable Sexually Transmitted Diseases Syphilis Chlamydia Gonorrhea

31. How are STDs transmitted?

32. STD Transmission Direct contact with an STD lesion, sore, or infected tissue through oral, anal, vaginal sex…and other intimate sexual contact Transfer of STD-infected semen & vaginal fluids, discharge, or blood through oral, anal, vaginal sex STD organisms can be passed even when there are no signs or symptoms present!

33. 33 Most common bacterial STD in the US More than 3 million infected each year Most common in person under age 25 One of the most under-reported infections Can lead to PID, ectopic pregnancy And infertility

34. 34 Also known as the: Clap Drip Dose Each year in the US an estimated 700,000 infections Antimicrobial resistance Number of infections on the rise in US Can lead to PID, ectopic pregnancy And infertility

35. About 4 of 5 females with Gonorrhea or Chlamydia will NOT have any signs or symptoms. Caution…

36. There are 2 types of HSV: HSV-1 and HSV-2. – –HSV-2 causes most genital infections. – –HSV-1 causes oral infections (cold sores, fever blisters) and some genital infections VERY common infection – –One million new cases annually of HSV-2 – –22% of the US population over the age of 11 are infected…and most do not know it. 36

37. Over 40 types of sexually transmitted Human Papillomavirus (HPV)—some cause warts Can cause cervical cancer – –HPV vaccine prevents the two types of virus that cause 70% of cervical cancer cases It is EXTREMELY common – –An estimated 6.2 million new infections annually 37 HPV

38. Bacterium Treponema pallidum So many of the signs and symptoms are indistinguishable from those of other diseases. Less common than other STDs, but still more than 35,000 new cases each year And it is on the rise—especially in the South 38 Syphilis

39. AIDS was first noticed in the 1980s and has grown to be a world-wide epidemic 39.5 million people world-wide are living with HIV Over million people in the U.S. are estimated to be infected with HIV In the US, half of all new HIV infections occur in people under age 25 Probably more—most have not been tested

41. Percent of newly reported HIV/AIDS cases by risk factor in the past 10 years, Arkansas

42. ACT 614 of 1989 Established that any person who has tested HIV positive and who exposes another person to the virus through parenteral transfer of blood or blood products or who engages in sexual penetration with another person without first having informed that person of the presence of HIV shall have committed a Class A felony. Additionally, the act allows judges to order HIV testing, based upon reasonable cause, for persons charged with certain sexual offenses. The act also required physicians to report to the Department of Health all patients determined to have AIDS or to have tested HIV-positive. Established confidentiality restrictions on the Department for all information and reports made in connection with persons determined to have AIDS or to be HIV-positive.

43. Minor Consent for STD Care Arkansas Code 20-16-508 (Act 100 of 1969) states that minors can consent for STD medical services. Arkansas Code 20-9-602 ( Act 328 of 1973) gives general consent rules for medical treatment. It allows minors to consent for their medical and surgical treatment if they have sufficient intelligence to understand their proposed treatment or procedure. Healthcare providers cannot notify Healthcare providers cannot notify parents or guardians when minors get parents or guardians when minors get tested or treated for STDs. tested or treated for STDs.

44. Body image Mood swings Am I normal Everyone is watching me Peer relationships Fantasizing Fads Experimentation-testing boundaries Concrete thinking No consequences

45. Early, clear parent-child communication regarding values and expectations Parents are in a unique position to engage their children in ongoing, timely conversations about sex, HIV, STDs and teen pregnancy This is a valuable step in helping delay sexual initiation and make responsible decisions about sexual behaviors

46. Most children and adolescents are enrolled in school Schools can reach youth before the onset of sexual activity Research shows that well-designed, well- implemented, school-based prevention programs can promote healthy behaviors

47. Any questions?

48. THANK YOU

49. A BIG Thank You to the many people who contributed to the creation of this slide presentation: Paul Gibson Paul Gibson Binu Jacob Binu Jacob Swiche Swiche Kathleen Courtney Kathleen Courtney