Reproductive Health and Safety Education

1. Reproductive Health and Safety Education Lesson 3: Sexually Transmitted Infections (STIs)

2. Lesson Objectives Students will Understand the meaning of abstinence Recognizing common methods of transmitting STIs Differentiate between STIs and STD’s Identify signs and symptoms of STIs Obtain knowledge of local resources for STI testing and counseling

3. Ground Rules • Only one person speaks at a time • Be respectful of peers and teacher • We are free to express our opinion or to participate in activities without being subjected to judgment or criticism • While participation is encouraged, each person has the right to pass • We do not share personal information or ask that of others • Each person comes prepared to each class

4. Question Box

5. Let’s Review List the components of yesterday’s decision making acronym H.E.L.P. Evaluate a poor decision you or someone you know made that impacted their health & well-being negatively. What would you suggest to yourself or someone you know if faced with the same situation again?

6. Let’s Review • Why do you think abstinence is the only way to 100% prevent unintended pregnancy and is the superior method preventing STI/STD’s? • If your friends abstain from risky behaviors, how is that connected to your behavior and future? • If your friends engage in risky behaviors, how are their choices connected to you? • Can you think of an example when a non-risk taking person was impacted by a risk taking person? • What conclusions can you draw from this example?

7. What do you think this is? According to the journal Science the human epidermis (skin) colonizes 1,000 species of bacteria. here _______

8. Terminology Sexually Transmitted Disease vs. Sexually Transmitted Infection http://www.ashastd.org/learn/learn_overview.cfm Wake County Public School System 8 Reproductive Health & Safety

9. STI/STD are infections and/or diseases that pass from person to person through sexual contact. STI/STD’s have three basic categories Viral, Bacterial & Parasitic Sexually Transmitted Infections • It only takes ONE incident of sexual contact with someone infected with a STI/STD to become infected too.

10. Viral Herpes Simplex Virus Human Papillomavirus (HPV) Human Immunodeficiency Virus (HIV) / Acquired Immune Deficiency Syndrome (AIDS) Viral Hepatitis Bacterial Bacterial Vaginosis Chlamydia Gonorrhea Syphilis The three major types of STIs • Parasitic • Trichomoniasis • Scabies • Pubic Lice (Crabs)

11. BACTERIAL Sexually Transmitted Infections

12. Transmission Can be transmitted during vaginal, anal, or oral sex. Can be passed from infected mother to her baby during child birth Younger women have an increased risk of infection Signs/Symptoms “silent” infection ¾ women have no symptoms ½ men have no symptoms Abnormal discharge Burning sensation when urinating May develop abdominal pain, low back pain, nausea, fever, and/or bleeding between menstrual cycles Effects on the body Women First infects urethra then moves to fallopian tubes Can cause pelvic inflammatory disease (PID) Happens in 10 - 15% of untreated Chlamydia Men May get Non-Specific Urethritis (NSU) Treatment Antibiotics Statistics Most frequently reported bacterial STI Chlamydia Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? Yes

13. Transmission Spread through physical contact with infected person The bacteria can grow in mouth, throat, eyes, and/or anus Signs/Symptoms Men can be asymptomatic (may have no signs or symptoms)or they may experience: burning when urinating, white, green or yellowish discharge, painful or swollen testicles Women often have mild symptoms burning when urinating, increased vaginal discharge or abnormal bleeding Effects on the body Women ~ Can cause Pelvic Inflammatory Disease (PID) Men ~ Can cause epididymitis (painful conditions of the ducts attached to the testicles) also may cause infertility Treatment Antibiotics, though gonorrhea is becoming drug resistant Statistics Of patients ages 10 – 19 years of age 27% of STI cases reported in NC are Gonorrhea (2008NCDHHS Division of Public Health) Gonorrhea Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? Yes

14. Transmission Common and serious side effect of some STIs, (Mainly untreated cases of Chlamydia and/or Gonorrhea) Occurs because of bacteria moving up reproductive organs Signs/Symptoms Can be asymptomatic (having no symptoms) Most common symptom is lower abdominal pain Other symptoms include: Discharge, foul odor, painful urination, irregular menstrual cycle Effects on the body Can cause permanent damage to the fallopian tubes, uterus, and surrounding tissue Damage can lead to chronic pelvic pain, infertility, and potential fatal ectopic pregnancy (pregnancy outside the uterus) Increases the risk of contracting HIV if exposed Treatment Antibiotics can help limit PID, but can’t reverse the damage done Statistics PID goes unrecognized by women and their health care provider about 2/3 of the time. Pelvic Inflammatory Disease Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? Depends

15. Transmission Not fully understood Potential for increasing risk New or multiple partner intercourse Douching Doesn’t increase risk Toilet bowls seats, Bedding Swimming pools, Signs/Symptoms Abnormal vaginal discharge with unpleasant odor (usually gray or white) May experience burning with urination or itching around the vagina Effects on the body Increases risk of contracting HIV if exposed Increases risk of contracting other STIs May cause complications during childbirth Statistics (CDC 2000) Most common vaginal infection in women of childbearing age. In the United States, BV is common in pregnant women. Treatment Antibiotics BV can reoccur Bacterial Vaginosis (BV) Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? Yes

16. Transmission Direct contact with Syphilis sore Typically found; external genitals, lips, mouth Signs/Symptoms Most asymptomatic (show no symptoms) Treatment Antibiotics Penicillin if caught in first year Additional dosages needed if found later Statistics (CDC) In 2008 the CDC reported 46,277 cases of syphilis Effects on the body Primary Stage Usually a single sore Lasts 3 to 6 weeks Secondary Stage Skin rash – reddish brown rash on bottoms of hands and feet Fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue Late and Latent Stages Called the “Hidden” stage if remains untreated Damage occurs to internal organs (brain, nerves, eyes, heart, blood vessels, liver, bones, joints) and may cause death Syphilis Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? Depends

17. VIRAL Sexually Transmitted Infections

18. Transmission Two Types HSV-1 and HSV-2 HSV-2 is more common Can be transmitted with or without visual blister/sores Signs/Symptoms No or minimal signs or symptoms Sores, flu like symptoms Sores show as one or more blisters Effects on the body Genital sores Can be severe in people with suppressed immune systems Psychological distress Fatal infections in babies Treatment Antiviral medication Daily suppressive medicine Statistic (CDC) 1 out of 5 adolescents and adults have had HSV Herpes Simplex Virus Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? NO

19. Transmission Typically via genital contact But can be passed to the mouth or throat as well Signs/Symptoms Can be asymptomatic (most people don’t develop symptoms) In 90% of cases, the body’s immune system clears HPV naturally within two years. In certain strands of HPV, genital warts will occur Effects on the body Can infect genitals, mouth, throat Certain HPV types cause Genital warts Certain HPV types cause Cancer (typically cervical) or Sterility The types of HPV that can cause genital warts are not the same as the types that can cause cancer. Human Papillomavirus (HPV) Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? No

20. Treatment Preventative Vaccine that prevents four types of HPV (most types that are cancer causing and/or genital wart causing) Cervarix and Gardasil Is there a Cure? Vaccines to prevent getting HPV! If a person has HPV, no treatment for virus itself. A healthy immune system tends to fight it off, Statistics (CDC) HPV is so common that at least 50% of sexually active men and women get it at some point in their lives. Human Papillomavirus (HPV) Information pulled from CDC Fact Sheet To see more Click Here

21. Transmission Primarily unprotected intercourse Sharing needles From infected mother during pregnancy, birth or breast-feeding Signs/Symptoms Can be asymptomatic (no symptoms) Can have flu-like symptoms May not know until doctor visit (could be years) Effects on the body Attacks and Lowers T-Cell count Body loses ability to fight off common cold/other infections Progresses into Acquired Immune Deficiency Syndrome (AIDS) Treatment AZT: Gets into the T-cell and prevents the infecting virus from making DNA. DDI: Stops virus reproduction. Statistics (CDC) More than 1.1 million Americans are HIV positive, with 21 percent unaware of their status. Human Immunodeficiency Virus Information pulled from CDC HIV Basic Web Page To see more Click Here Is there a cure? NO

22. Transmission Later stages of HIV infection Signs/Symptoms Immune system is severely diminished You can see any sign or symptom that deals with illnesses Effects on the body Decrease immune system Low T-cell count Treatment Medications to hinder the progression of HIV to AIDS Statistics (2008) Wake County has about 15 AIDS patients for every 100,000 people NCDHHS Division of Public Health Acquired Immune Deficiency Syndrome Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? NO

23. Transmission Hepatitis A Ingesting fecal matter Hepatitis B + C Body fluids Signs/Symptoms Can Include; Fever, Fatigue, Loss of Appetite Nausea, Vomiting, Abdominal pain Dark Urine, Joint Pain, Jaundice Clay-colored bowel movements Treatment A our immune system B, C None Effects on the body Affects the liver Leading cause of liver cancer Most common types Hepatitis A, B, C Uncommon in USA Hepatitis D, E Statistics In the United States, an estimated 3.2 million Americans are living with chronic Hepatitis C. (Most common blood borne STI) Viral Hepatitis Information pulled from CDC overview To see more Click Here Is there a cure? NO

24. Hepatitis Differences Information pulled from CDC overview To see more Click Here

25. PARASITIC Sexually Transmitted Infections

26. Transmission Commonly found in the vagina (women) or urethra (men) Transmitted via sexual contact Signs/Symptoms May be asymptomatic (not have any symptoms) Men ~ irritation inside the penis, mild discharge, or slight burning while urinating Women ~ frothy, yellow-green vaginal discharge with strong odor, discomfort during urination, as well as irritation and itching Effects on the body Genital inflammation Can increase women’s susceptibility to HIV if exposed to the virus Treatment Single dose drug Metronidazole or Tinidazole Statistics (CDC) An estimated 7.4 million new cases each year Trichomoniasis Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? Depends

27. Transmission Spread through contact of infected area Occasionally through clothing and bed linens or towels Signs/Symptoms Itching in genital area Visible Nits (eggs) Treatment Lotions or shampoos can be used to treat the infected area Effects on the body Parasitic insects found primarily on pubic or genital areas of humans Three forms Egg (nit) Nymph Adult Pubic lice do not transmit disease; however, secondary bacterial infection can occur from scratching of the skin Pubic Lice (Crabs) Information pulled from CDC Fact Sheet To see more Click Here Is there a cure? Yes

28. Transmission Infestation of the skin by the human itch mite. The adult female scabies mites burrow into the upper layer of the skin where they live and deposit their eggs. Scabies can be passed easily by an infested person to his or her household members and sexual partners. Scabies in adults frequently is sexually acquired. Signs/Symptoms Asymptomatic (2-6 weeks) Itching Skin Rash Treatment Scabicides used to treat human scabies are available only with a doctor’s prescription. No “over-the-counter” (non-prescription) products have been tested and approved to treat scabies. Effects on the body Skin sores from itching Sores can cause bacterial skin infection This can cause inflammation of the kidneys Scabies Is there a cure? Yes

29. Jeopardy Quiz Every student is going to answer individually on a piece of paper Total your own score for a self assessment of sexually transmitted infections For every correct answer you will get the point/s that the question was worth. For every wrong answer there is no penalty. Name that STI Activity

30. CURABLE Chlamydia Gonorrhea Pelvic Inflammatory Disease Bacterial Vaginosis Syphilis Most cases of Human Papillomavirus Trichomoniasis Pubic Lice Scabies NOT CUREABLE Effects of Pelvic Inflammatory Disease Herpes Simplex Virus HIV/AIDS Viral Hepatitis B Viral Hepatitis C Which STIs are curable and which STIs will a person have forever

31. Predict possible outcomes if someone you know chose to have sexual contact. What is the likelihood that they will contract a STI? What is the likelihood that they would contract a STI that is not curable? What alternatives would you suggest to someone thinking about having sexual relations? If 5/13 STIs don’t have a cure…

32. Use the Wake Resources hand out As well as http://www.hivtest.org/std_testing.cfm (A website that is a part of the CDC) STI Testing Sites

33. Abstinenceis the BEST decision to AVOID all of the risks associated with sexual activity!! By choosingabstinenceyou know that you are100%free of disease and the risk of an unintended pregnancy! REMEMBER

34. Think-Tac-Toe • Lotus Diagram • FQR Chart • Venn Diagram • Force Field Analysis

35. With your family member/s, identify 2 things you pledge to abstain from. Write them down, explain how abstaining from them will protect your health and the health of others. Have your family member/s write down why it is important to them that you abstain from the chosen items too. Be sure you and your family member/s sign and date the pledge HOMEWORK

36. Find out Tomorrow… Have you seen this before?What is it?