Sexually Transmitted Infections

1. Sexually Transmitted Infections Are You Putting Yourself At Risk?

2. Simple Facts about STI's • Did you know that you can have an STI and not even know it? • Some STI’s are easily cured and some have no cure • In Canada, the highest rates and increases in STI’s are in young people aged 15 to 24 • Know your partners’ sexual history and how to protect yourself • Frequent STI testing is another choice when protecting yourself

3. Chlamydia • Bacterial Infection • The Most frequently reported sexually transmitted infection • Can spread during oral, vaginal or anal sex Best Defenses • Always use condoms properly • Limit the number of sexual partners • Know your partner’s sexual history • Have frequent STI testing! (urine test is easy!) • Always use dental dams and condoms for oral sex

4. A watery or milky drip from the penis Itchy feeling inside the penis Burning when urinating Swelling or pain in the testicles Sometimes NO SYMPTOMS at all !!! (IN 60-70 % of cases) Yellow or green discharge from the vagina Burning when urinating Bleeding between periods Pain in your lower stomach Pain during intercourse Sometimes NO SYMPTOMS at all !!! (IN 60-70% of cases) Signs and SymptomsMale Female

5. Good News!! Chlamydia is curable! It is treated easily with antibiotics! However, if not treated properly, or at all, the infected person can continue to spread it to others and may experience fertility challenges later on (when they are trying to have a baby).

6. Chlamydia

7. LGV

8. Lymphogranuloma Venereum (LGV) • Subtype of chlamydia (bacterial) • Prior to 2004 found in Africa, Asia, South America, and the Caribbean • More invasive than chlamydia • Unprotected oral, vaginal, and anal sex • Risk of infection can be decreased by using condoms or other barrier methods

9. LGV – continued • After exposure: symptoms can start between 3 to 30 days • Painless sore or lump may appear where bacteria entered body. (infected person may not know they are infectious • Most commonly found in the anus, may experience bloody or pussy discharge • Rare cases – meningoencephalitis and hepatitis • Testing – swabs

10. LGV – continued • Additionally: HIV, syphilis, herpes, gonorrhea, hepatitis B & C (co-infection is common!) • Treatment – 3-week course of antibiotics (sexual partners [60 days] need to be notified)

11. Gonorrhea • Bacterial Infection • Can spread during oral, vaginal or anal sex • Can cause long lasting health problems such as Pelvic Inflammatory Disease and infertility if not treated early Best Defenses • Always use condoms properly • Limit the number of sexual partners • Know your partner’s sexual history • Have frequent STI testing! (urine test is easy!) • Always use dental dams and condoms for oral sex

12. Thick yellow-green discharge from penis Burning/itching at end of the penis Burning when urinating Swelling or pain in the testicles Sometimes NO SYMPTOMS !!! Green discharge from the vagina Burning when urinating Pain in lower stomach Pain during sex Abnormal periods Sometimes NO SYMPTOMS !!! Signs and SymptomsMale Female

13. Urine Luck! • Antibiotics can cure Gonorrhea! • Once someone has been treated with antibiotics, they need to be tested afterwards to make sure the cure was effective (test of cure)

14. Gonorrhea

15. Syphilis • Caused by a bacteria • Often called the “Great Imitator” because symptoms can baffle health professionals • Can be spread during unprotected oral, vaginal or anal sex • Can also be spread by skin to skin contact with an open, or active syphilis rash

16. First Stage: Painless sore on the penis, inside the mouth or near the anus Chills, fever, tiredness like the “flu” Second Stage: Rash on the palms of hands, soles of feet or the whole body First Stage: Painless sore around or in the vagina Chills, fever, tiredness like the “flu” Second Stage: Rash on the palms of hands, soles of feet or the whole body Signs and SymptomsMale Female

17. Testing and Treatment Syphilis can be detected with a simple blood test! Syphilis is curable with antibiotics if treated in the first or second stage!

18. Syphilis

19. Genital Herpes • Caused by a virus - two different viruses: Herpes Simplex Virus (HSV) 1 and HSV 2 • Cold sores on the mouth are caused by HSV type 1 • Genital herpes most often caused by HSV type 2 • You can get Type 1, as well as Type 2 in the genital area • Herpes is spread during oral, vaginal or anal sex

20. Signs and SymptomsMale and Female • Sores/blisters/pimples on the penis, around the testicles, near the anus, and on thighs and buttocks • Tender lumps in the groin • Itching, burning or tingling in the genital area • Fever and/or chills like the “flu”

21. HSV 1 and 2 are incurable • Once you have HSV, you have it for life - there is antiviral medication however, that reduces transmission and outbreaks by 48% • With any intimate skin to skin contact, there is a risk of becoming infected with or transmitting HSV to others • Condoms/Dental Dams help reduce to risk of transmission to others Is It Curable???

22. Genital Herpes

23. Human Papillomavirus(Genital Warts) • Caused by a virus –(HPV)- over 100 Types of this virus • Most common STI – 550 000 Canadians annually • Can spread even when there are no visible warts • 75% of sexually active young adults will have HPV in their lifetime • Spread by oral, vaginal or anal sex, or possibly during foreplay (any sort of skin-to-skin contact) • If not detected and treated, it can lead to cervical, anal or penile cancer

24. Signs and Symptoms • Genital warts are unsightly cauliflower-like growths • In women, genital warts can appear on the vulva, urethra, cervix, vagina, anus or thighs • In men, warts can appear on the penis, scrotum, anus or thighs • Genital and anal warts are very contagious and are spread during oral, vaginal or anal sex with an infected partner

25. Human Papillomavirus is caused by a virus that is not curable • Genital and anal warts sometimes disappear without treatment however, sometimes genital warts last for years • There are treatments available. On average it takes about 8 months or longer to get rid of existing warts Is It Curable?

26. Is It Preventable? • Gardasil is a newly available vaccine which can prevent 4 types of HPV (2 of these strains are cancer causing) • Regular Pap Tests can detect HPV in females • Know your sexual partner’s sexual history • Using condoms always reduces the risk

27. Gardasil • 98% immune response • Protects against most common HPV types – 6, 11, 16, and 18 • Low risk types – 6 and 11 (90% external genital warts, causes discomfort, ulceration, and scarring, will usually resolve within 24 months with repetitive treatments) • High risk types – 16, 18, 31, 33, and 45 (associated with low-grade dysplasia, high risk dysplasia, cervical CA, vulvar/vaginal CA, and anal CA)

28. Interesting or NOT So Interesting Findings: • 80-90% anal CA is HPV related (73% is type HPV#16) • Studies show that anal CA is on the rise in females (not just a male CA anymore) • There is no screening/testing to detect anal CA • Tonsilar CA – 68% HPV related • Sino-nasal – 22% HPV related (84% is type HPV#16)

29. Risk for Persistence of HPV in following groups: • Over age 30 • Smokers • Persons with multiple infections • Persons with immunosuppression

30. Human Papillomavirus(Genital Warts)

31. Human Immunodeficiency Virus(HIV) • Caused by a virus • HIV attacks the body’s immune system, which is the primary defense against infections- will eventually lead to AIDS • Can spread by oral, vaginal or anal sex • It can not be transmitted through saliva, sweat, tears, urine or feces of an infected person unless there is blood present • Can also be spread by sharing needles or crack pipes

32. Signs and SymptomsMale and Female • You may not feel or look sick for years • Symptoms may include - constant weight loss, fatigue, night sweats, loss of appetite, joint or muscle pain, sore throat - very vague - sometimes misdiagnosed • If you have have unprotected intercourse or shared needles, YOU NEED to get TESTED !!! - (14 week window) • HIV will become AIDS once the immune system can no longer help the body fight off infections, diseases and viruses that can lead to death • HIV is always eventually fatal, but antiviral medications can help those infected live longer, and in better health, than they would otherwise experience without any medication

33. Is It Curable? HIV is incurable! HIV is FATAL! A person infected with HIV can continue to spread it! Protect yourself, always use a condom properly, from start to finish! Get STI testing regularly

34. Hepatitis B and C • Viral infection that attacks the liver • Acquired through vaginal, oral or anal intercourse, needle sharing, saliva, razors and tooth brushes • Can be passed during child birth and breastfeeding if infant is not immediately vaccinated for Hep B • Blood transfusions- in 3rd world countries • Tattoos, piercing- non- sterile needle equipment • Transmission is through blood to blood contact, however, excessive exposure to some body fluids can transmit virus as well

35. Signs and SymptomsMale and Female • Fever, Malaise, flu-like symptoms, nausea, vomiting, joint pain, rash • Jaundice- rare, abdominal pain • All symptoms may last up to 6 months - infection > 6 months – Chronic Hepatitis • 90% of adults recover as immune system fights off the virus • A Hep B immune person cannot transmit the virus to others

36. Is It Curable? • Hep B is preventable - Get Vaccinated! • Hep C - no vaccine as of yet - however, research is ongoing and researchers are on the brink of a possible cure! - Hep C clients should get Hep B and A vaccine • High risk people can get Hep A & B Vaccine from Health Clinics • Know your sexual partners’ history • Use condoms & do not share needles • Investigate Tattoo and Piercing Parlors for safe practice

38. Viral/ Parasitic Infections

39. Viral/ Parasitic Infections Scabies Crabs/ Pubic Lice Molluscum Contagiosum

40. Infections Not Necessarily Sexually Transmitted

41. STI’ s are NOT always visible

42. www.sexualityandu.ca

43. General Tips  • The only 100% sure way to prevent a sexually transmitted infection is Abstinence- no oral, anal or vaginal intercourse, no intimate touching at all! • Know your sexual partner’s history and get tested prior to having sex with a new partner • If you think you might have an sexually transmitted infection (STI), contact your local Sexual Health Clinic or your family doctor • Diagnosis of an STI puts a person at risk for other more serious STI’s • Use condoms and dental dams 100% of the time!