Sexual Health

1. Sexual Health

2. Teens & Birth Control: Excuses...Excuses...Excuses • “It was unromantic and planned” • “I Would feel guilty” • “It is against my religion” • “We used the withdrawal method” • “Doctor will blab to my mom” • “It won’t happen to me” • “Condoms break and don’t work”

3. Teens & Pregnancy • 1 million teens became pregnant in 2000 • 512,000 of these teens gave birth • 6 of 10 U.S. pregnancies are unplanned • Most teens do not plan to have sex the first time forget to use a birth control method

4. Sexually Transmitted Infections Basic but commonly misunderstood information

5. Sexually transmitted infections (STIs) are infections that are spread primarily through person-to-person sexual contact such as vaginal intercourse, oral and anal sex. There are more than 30 different sexually transmissible bacteria, viruses and parasites.

6. The 4 Most Common STIs in Canada Are: 1. Human papillomavirus (HPV) 2. Herpes Simplex Virus (HSV) 3 Chlamydia 4. Gonorrhea

7. How Common are STI in Canada? • HPV: At least 50% of sexually active males and females will have an HPV infection at some point in their lives. Up to 80% of women will have been infected by HPV by age 50. • HSV-2: About 25% of women and 13% of men have an HSV-2 infection. • Chlamydia: About 4% to 6% of women aged 15-24 have an active Chlamydia infection.

8. Most Cases of STI are Asymptomatic (no visible signs or symptoms) • HPV – 80%+ • HSV-2 – 60% • Chlamydia – men 50%, women 70%+

10. Chlamydia: Key Facts • Females are disproportionately infected and affected • Asymptomatic carriers are the main reservoir of transmission • It can affect the penis, cervix, fallopian tubes, anus, throat and - in rare cases - the eyes. • Chlamydia can cause serious health problems such as pelvic inflammatory disease and infertility if it is not treated. • Consistent condom use significantly reduces Chlamydia transmission

11. Chlamydia Statistics • In 2004 there were 31,109 positive Chlamydia tests for females aged 15-24 reported to the Public Health Agency of Canada. • Up to 50% of male and 70% of female cases are asymptomatic • In 10% - 40% of cases in females, Chlamydia results in Pelvic Inflammatory Disease (PID) • In 20% of cases, PID results in infertility • In 18% of cases, PID results in Chronic Pelvic Pain • PID is a leading cause of Ectopic pregnancy

12. SYMPTOMS: Symptoms for women include: • vaginal discharge • needing to urinate a lot • burning when you urinate • itchiness • bleeding and/or deep pain during sex • bleeding between periods • painful periods • high temperature • stomach pain Men with chlamydia might notice: • needing to urinate a lot • burning when you urinate • watery discharge from your penis • burning and itching around the hole of your penis • pain in your balls • swelling of your balls

13. How do you get it? • Chlamydia can be passed on through unprotected oral, vaginal or anal sex with an infected person. • A pregnant woman can also pass it on to her baby during childbirth. • Chlamydia can be easily treated with a course of antibiotic pills. • After you've had the antibiotics you will need to do a follow-up test to check that the infection is really gone. Treatment

14. SYPHILIS How do people get syphilis? • Direct contact with a syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth. • Transmission of the organism occurs during vaginal, anal, or oral sex. • Pregnant women with the disease can pass it to the babies they are carrying. • Syphilis cannotbe spread through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.

15. Syphilis Signs and symptoms Syphilis progresses in stages and can damage many parts of the body. Signs and symptoms Primary Stage: • The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre). • The chancre is usually firm, round, small, and painless. It appears at the spot where syphilis entered the body. • The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to the secondary stage.

16. Secondary stage: • Skin rash and mucous membrane lesions characterize the secondary stage. • This stage typically starts with the development of a rash on one or more areas of the body. • The rash usually does not cause itching. Rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed. In addition to rashes, symptoms of secondary syphilis may include: • Fever • sore throat • patchy hair loss The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent and possibly late stages of disease. • Headaches • weight loss • muscle aches • fatigue.

17. Late and Latent Stages Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. • This latent stage can last for years. • In the late stages of syphilis, the disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. • Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

18. How is syphilis diagnosed? • Examining material from a chancre (infectious sore) using a special microscope called a dark-field microscope. • A blood test is another way to determine whether someone has syphilis.

19. What is the treatment for syphilis? • A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. • Additional doses are needed to treat someone who has had syphilis for longer than a year. • Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. • Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

20. GONORRHOEA Gonorrhoea (also known as 'the clap') is a common sexually transmitted bacterial infection. It can affect the penis, cervix (inside the vagina), anus, throat or eyes. • Gonorrhoea is transmitted through unprotected sex (sex without a condom), this can be vaginal, anal or oral sex. • A pregnant woman with gonorrhoea can also pass it onto her baby during birth.

21. Symptoms If symptoms show, they appear within 2-7 days after contact, and can include: • an unusual discharge from your vagina (sometimes yellow or bloody) • an itchy, swollen or red vagina • pain in your stomach, when you urinate & during sex • Men can have a discharge from the penis that is thick, white and yellow, burning pain when they urinate, and swollen testicles. Both men and women can get a gonorrhoeal infection in their anus, and their symptoms might include: • Discharge & bleeding • Soreness & an itchy bum • Gonorrhoea can infect your throat too, via oral sex. It might give you a sore throat, but sometimes there are no symptoms.

22. How does the treatment work? • Once you've started taking antibiotics, the infection will clear up in about seven days • About a month later you'll need a check-up to make sure the infection is completely gone. • All your partners over the last three months should also be contacted and treated. This is called 'contact tracing'. The doctor or nurse will give you a letter to give to all your partners so they can go to a doctor for treatment. • After your treatment is finished, if you have unprotected sex with somebody that has the infection, you can catch gonorrhoea again.

24. HIV/AIDS in Canada (HIV/AIDS Epi Update; Public Health Agency of Canada) • As of the end of 2005, there were 58,000 people living with HIV in Canada. • Of these 58,000 HIV+ people, 15,800 (27%) were unaware of their infection. • An estimated 2,300 to 4,500 new infections occurred in 2005 compared to 2,100 to 4,000 in 2002. • Increasing proportions of HIV infections are among women (27.8% in 2006) and this proportion is growing. • Aboriginal people, especially women, are over-represented in the HIV epidemic in Canada.

25. How is HIV transmitted? • Unprotected sexual contact or sharing drug injecting equipment are the most common causes of HIV transmission. • In a some cases, HIV can be transmitted from pregnant mother to child. • Healthcare workers and emergency personnel are at low risk of acquiring HIV from workplace exposure to HIV • Blood products have been screened for HIV in Canada since 1985 • There is no transmission of HIV through ordinary social contact.

26. Stages of HIV infection Seroconversion and primary illness • People experience ‘Seroconversion’ illness between two and six weeks after becoming infected.  • The symptoms of this illness include • Tiredness • Fever • Diarrhoea • Rash • flu like symptoms

27. Treating HIV • Drug treatment for HIV is known as combined antiretroviral therapy (CAR) • Drug treatment does not prevent transmission of the virus but starting treatment early can lead to better outcomes for many HIV-infected people. • New drug treatmentsNew drugs and types of drugs are being developed all the time. Trials of these treatments are being conducted in specialist HIV/AIDS treatment and research centres. Alternative therapies include: • Vitamin and mineral supplements • Massage • Meditation • Herbal remedies • Traditional Chinese Medicine • Acupuncture.

28. HERPES SIMPLEX VIRUS • Type 1 typically infects the mouth and face producing cold sores. • Type 2 typically infects the genital area (genital herpes). • However, due to oral sex, type 1 can infect the genital area and type 2 can infect around the mouth.

29. How is Herpes caught? • The virus is spread through direct contact with blisters/ ulcers, mucus or vaginal secretions. • This includes vaginal, oral, anal sex or other intimate physical contact. • NOTE: the virus can be passed on by an infected person displaying NO symptoms of the infection i.e. no ulcers or blisters at the time. • Unfortunately, condoms only provides protection when covering or separating body parts infected with ulcers and blisters.

30. Short term effects of Herpes: • Itching and tingling in the genital area can cause discomfort. • Cold sores around the mouth and on the face can be annoying, inconvenient and embarrassing. • Typically clear up within 7 to 10 days.

31. How is Herpes treated? • There is NO cure for Herpes • Bathing the sores in warm salt water can aid the healing process and reduce inflammation. • Antiviral treatment is highly effective in decreasing the symptoms and preventing lapses. • The doctor may do a viral swab to confirm the presence of the virus.

32. HPV GENITAL WARTS • The human papilloma wart virus belongs to a large family of viruses with 100 members. • About 30 strains of these viruses tend to infect the genital areas, and may infect the vagina, penis, anus, cervix and the vulva. • Some viruses never produce any symptoms at all and only show up in routine pap smears.

33. How are Genital Warts caught? • Usually HPV is passed on during sexual activity either by direct skin – on – skin contact, or through the exchange of body fluids from genital to genital (especially if there is any broken skin). • HPV is invisible • Using a condom will provide SOME protection from HPV, however a condom does not cover all the areas of the skin that may be infected. • NOTE: the virus can also be passed on by an infected person displaying NO symptoms of the infection.

34. Symptoms of Genital Warts: • Some people never have any symptoms at all. • Usually don’t cause any discomfort, unless they rub against tight clothing. • Some people feel mild irritation and need to scratch, or the warts may be in an inconvenient position and interfere with sexual activity.

35. How are Genital Warts treated? • Genital warts can be removed by a doctor. • Can be frozen or treated with creams or chemical paints. • Regular and frequent pap smears for women.

36. HEPATITIS B • The term ‘hepatitis’ means inflammation of the liver. Hep B can be transmitted by: • Unprotected sex • Sharing needles and drug taking equipment • Non sterile piercing or tattooing. • A baby can become infected with the virus at birth from an infected mother. • Never share personal items such as tooth brushes or razors as they can harbour the virus in infected blood.

37. Symptoms of Hep B • Many people infected with Hepatitis B show no symptoms. Some experience shortly after contracting the infection: • Loss of appetite • Fever • Tiredness • Jaundice • Painful joints • Long term effects: • Most people recover from Hepatitis B. • Some people become chronic carriers (infectious for the rest of their lives). • Long term effect can be scarring of the liver , poor liver function and even liver cancer.

38. How is Hep B treated? • A vaccine is readily available which prevents people from contracting the disease. • Prevention is better than a cure. • If you do not know if you have had the vaccination, get a blood test at the doctors.

39. Hepatitis C • Hep C is a viral disease that leads to swelling (inflammation) of the liver. • Hep C can be caught via: • -blood-to- blood contact • Sharing needles • Razor blades • Unsterile tattooing • Body piercing equipment • Rarely acquired through unprotected sex

40. SYMPTOMS of HEP C: • Some people show no symptoms at first • Others can experience flu-like symptoms • Jaundice or a darkening of the urine • Fatigue Testing for Hep C involves a blood test. A test can give a negative result for several months after infection, so a second follow up test needs to be done.

41. How is Hep C treated? • Some Hep C strains are showing promising results with the use of anti-viral therapy. • As hepatitis affects the function of the liver, alcohol should be avoided.

43. Trichomoniasis Trichomoniasisis a sexually transmitted infection caused by the parasite Trichomonasvaginalis – also referred as “trich”

44. Symptoms of Trich Women: • Discomfort during intercourse • Itching of the inner thighs • Vaginal discharge (thin, greenish-yellow, frothy or foamy) • Vaginal itching • Vaginal odour (foul or strong smell) Men: • Burning after urination or ejaculation • Itching of urethra • Slight discharge from urethra

45. TREATMENT for TRICH: • Antibiotics are taken to cure the infection. • Avoid sexual intercourse until treatment has been completed. • Sexual partners should be treated at the same time, even if they have no symptoms.

46. PUBIC LICE • They are small, six-legged creatures that infect the pubic hair area and lay eggs. • These lice can also be found in armpit hair and eyebrows. • Causes: • Usually spreads during sexual activity. • Sometimes, pubic lice can spread through contact with objects such as toilet seats, sheets, blankets, or bathing suits at a store.

47. Symptoms & Treatments • Symptoms: • Itching in the area covered by pubic hair. This itching may start soon after getting infected with lice, or it may not start for up to 2 to 4 weeks after contact. • Skin reaction that is bluish-grey in colour. Sores (lesions) in the genital area due to bites and scratching • Treatment: • Inform your sexual Partners • Treatments for pubic lice are similar to those for head lice, and can be purchased from any pharmacy without a prescription. • Careful mechanical removal of eggs will be required, as the lice apply cement like substances when gluing the eggs to the hair and they are difficult to remove. • The infected person’s underwear and bed linen should be washed in hot water, followed by hot tumble drying to ensure all lice have been killed.

48. SCABIES • Scabies is an itchy, highly contagious skin condition caused by an infestation by the itch mite Sarcoptesscabiei. Mites are small eight-legged parasites. • They are tiny, just 1/3 millimeter long, and burrow into the skin to produce intense itching. • Signs & Symptoms: • Scabies produces a skin rash composed of small red bumps and blisters and affects specific areas of the body. • Textbook descriptions of scabies always mention "burrows" or "tunnels." • Scratching actually destroys burrows.

49. How can you get it? • Direct skin-to-skin contact is the mode of transmission. • They can only live off of a host body for 24-36 hours under most conditions. • It is hard, if not impossible, to catch scabies by shaking hands or sharing pyjamas with someone with Scabies. • Scabies are treated with prescription scabicide drugs. TREATING SCABIES:

50. Preventing STI’s & Pregnancy