REAL LIFE. REAL TALK Leigh Anne Woods

1. REAL LIFE. REAL TALKLeigh Anne Woods

3. Teenage mothers are: • More likely to have other children within shorter periods, resulting in larger families. • Less likely to graduate from high school or to pursue postsecondary education. • More likely to live in poverty and require welfare assistance than their non-pregnant peers. Children born to teen parents are: • more likely to be born prematurely and 50% more likely to be low-birth weight babies (less than five and a half pounds). • less likely to graduate from high school than children of older parents. • more likely to be abused, abandoned or neglected and end up in foster care • 10 times more likely to live in poverty than those born to married women over the age of 20.

5. Safest, simplest, most effective, easiest-to-get method to avoid pregnancy and STIs. 100% effective Risks & disadvantages: No health risks Some risk that a partner will not agree that abstinence is the best choice. Can be difficult to say no

6. Decide WHY you want to abstain. Why might a person choose to abstain? Communication is key! How will you say “NO”? SAY NO Repeat the refusal Suggest an alternative Use body language that says no Build the relationship

7. Wait! Is that legal?

8. Virginia Law What does consent mean? • To give approval or permission having a full understanding of the possible consequences. Any form of sexual relations under the age of 13 is statutory rape.

9. Virginia Law Alcohol & Drugs • A person under the influence of alcohol or drugs CANNOT give legal consent (permission) to sexual activity.

10. Sexting: What is it? Sending or forwarding nude, sexually suggestive, or explicit pics on your cell or online. For some people, it's no big deal. But real problems can emerge when the parties involved are under 18, when people get pressured into sexting, and when sexts go viral.

11. Purchasing Contraception • You do not need parental consent to do the following: Buy condoms Get tested or treated for STI’s Buy a pregnancy test Begin birth control.

13. Reproductive Health 101 • Why is reproductive health important? • STIs—the things you may not know • Contraceptives Knowledge is Power!!

14. Know Your Body!

15. not an STI, but an imbalance in “harmful” vs “good” bacteria in the vagina the most common vaginal infection in women of childbearing age What tips the balance? douching new/multiple sex partners Complications Increased risk for HIV, herpes, gonorrhea, chlamydia Pelvic inflammatory disease premature baby Symptoms none white or gray vaginal discharge with an unpleasant, fish-like odor, especially after intercourse. Bacterial vaginosis Women only! • Treatment: antibiotics

16. Why is Reproductive Health Important? • Annual, well-woman exams: • Pap test for cervical cancer screening • Clinical breast exam to detect anything abnormal • STI and HIV testing • Birth control discussion if needed

17. Why is Reproductive Health Important? • Consequences: • Untreated cervical problems can lead to infertility and/or cancer • Undetected breast abnormalities can lead to breast cancer • Untreated STIs and/or HIV can lead to infertility, transmission to others and/or death • Unprotected sex can also lead to unintended pregnancy

18. Why is Reproductive Health Important? • Men need annual exams too! • Testicular check for anything abnormal • STI and HIV testing—treatment for a positive test • Consequences could also include infertility, cancer, transmission to others, death

19. Symptoms • 50-75%: NONE! • Vaginal/penile discharge • Burning upon urination • Back/abdominal pain • Painful intercourse Treatment: antibiotics Prevention: condoms • Complications • Increased risk of HIV • Premature delivery with complications to baby • Pelvic inflammatory disease: 40% of untreated infections! • Chronic pain • Ectopic pregnancy • Infertility Recommendations: yearly chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women.

20. Gonorrhea • the second most common sexually transmitted bacterial infection: 700,000 new cases each year • transmitted during vaginal, anal, and oral sex (performing or receiving). Ejaculation not required. • highest reported rates of infection are among sexually active teenagers, young adults, and African Americans • Symptoms • NONE! • Painful urination • Penile/vaginal discharge • Anal itching/pain/discharge • Complications • Increased risk of HIV • Pelvic inflammatory disease • Infertility – male and female • Treatment: antibiotics • Prevention: condoms

21. Syphilis • The great “imitator-” almost eliminated, but making a comeback! • the highest rates of syphilis are among African-American men • Spread by vaginal, anal, or oral sex • Primary, secondary, late stages • Symptoms • NONE! • Primary: Sores or chancres; can last 3-6 wk. • Secondary: rash (hands, feet, body) • Late: paralysis, numbness, blindness, dementia, death; occurs in 15%, 10-20 yr after infection • Complications • Increased risk of HIV • Late stage • Treatment: antibiotics • Prevention: condoms

22. Trichomoniasis • the most common curable STI in young, sexually active women • transmitted by penis-to-vagina intercourse or vulva-to-vulva contact • Women can acquire the disease from infected men or women, but men usually contract it only from infected women. • Symptoms Women • frothy, yellow-green vaginal discharge with a strong odor • pain during urination or intercourse Men • NO symptoms! • Slight irritation, burning • Complications • Increased risk of HIV • Premature, low birth weight babies • Treatment: prescription drugs • Prevention: condoms

23. So…some infections can be short term IF: • You recognize symptoms • Get tested early • Follow treatment recommendations Better yet – prevent!

24. Herpes simplex virus • 1 of 5 adolescents and adults have genital herpes • HSV 1 and 2 – both cause genital herpes! • transmitted by SKIN TO SKIN CONTACT! NO CURE! • can re-occur at any time • Symptoms • blister-like lesions or red bumps on vulva, penis, anus, or mouth • pain, itching, fever • Complications • fatal for babies if infected at birth • Treatment: NONE; prescription drugs can reduce symptoms slightly (Valtrex) • Prevention: condoms

25. Risk factors include: other STI, multiple sex partners, sex with trauma, men having sex with men Transmission by: IV drug use, vaginal or anal intercourse, body art or piercing from non-licensed studio Chronic infections (always infectious!) Symptoms NONE! yellow eyes, skin tea-colored urine fatigue, lack of appetite, nausea Complications liver disease liver cancer transmission to baby Hepatitis B and C • Treatment: no guaranteed effective treatments • Prevention: Hepatitis B vaccine – get it!!!

26. Human papillomavirus- HPV • The most common sexually transmitted infection– at least half of all sexually active men and women acquire genital HPV • transmitted by skin-to-skin contact • many different types: over 130 strains with 40 being sexually transmitted. • Can linger for years! • Symptoms • NONE! • low risk: genital warts (1% of sexually active adults) • flat or cauliflower-like lesions on vulva • may re-occur • not easily detectable in men • High risk types: cancer (cervical, vulvar, anal, penile, oral)

27. Prevention Gardasil® vaccine: four HPV types: HPV 16 and 18 (cause 75% of cervical cancers) + HPV 6 and 11 (cause 95% of genital warts). The FDA has expanded the approved uses of Gardasil to include prevention of anal cancer and precancerous lesions. for cervical cancer: Pap smears -annual screening for ages 21–30 yrs; every 2–3 yrs for ages ≥30 if 3 consecutive annual Pap tests are negative. three-dose vaccine given over 6 months. recommended for both females and males ages 11 -26 Human papillomavirus

28. Annual Well Woman Exam

29. NORMAL AND HEALTHY CERVICAL DISPLASIA

30. CERVICAL CANCER

31. 1 in 5 people do not know they are HIV+ In 2007, 35,962 cases of AIDS were diagnosed and 14,110 deaths among people living with HIV were reported in the United States. Eastern Virginia, which ranges from Richmond to the coast of Virginia Beach, has one of the highest percentages of HIV and AIDS in all of Virginia. Human Immunodeficiency virus (HIV)

32. Virus is transmitted in blood, semen and vaginal fluids, also breast milk. Risk factors Other STI Multiple partners Risk behaviors Unprotected vaginal and anal intercourse (heterosexuals, bisexuals, gay and lesbian) IV drug use Symptoms of HIV infection – NONE or mild flu-like symptoms Symptoms of AIDS: Swollen glands, fatigue, diarrhea, night sweats, infections, tumors HIV and AIDS

33. Get tested!!! You can live with the results. Tests look for HIV antibodies Antibodies develop 14 days-6 months (average is 25 days) after initial exposure Rapid tests available with results in 20-30 min Treatment no cure! drugs reduce virus growth and prolong life, but with major side effects and expense! Prevention: condoms HIV

34. Getting & Using Contraception

35. Know Your Method! • Birth control is NOT one size fits all! A method that’s perfect for one woman may not be right for another. Talk to your partner about contraception, but it is up to you (female) as to what type of birth control to take. Be honest with yourself about your level of responsibility! • Ask yourself: • Will I remember to take a pill everyday? • Am I afraid of needles? • Is my partner willing to wear condoms? • How much can I afford to pay for birth control? • Does this method best fit my lifestyle? • Do I want my monthly cycle to be affected?

36. Does that work? NO! Withdrawal - Pre-ejaculation fluid can contain sperm. Douching- Sperm travels quickly and can enter the cervix before being washed out of the vagina. Hoping– Some people think that if they had sex once and didn’t get pregnant, that they can’t get pregnant. Fertility Awareness Method (Rhythm)– Keeping track of your menstrual cycle to figure out the “safe” days to have sex.

37. Emergency Contraception Available over the counter. Works up to three (3) days after contraception failure or unprotected sex. http://www.yorku.ca • Works by preventing ovulation and • preventing fertilization • 2. Is NOT an abortion pill! • 3. Now available over-the-counter • 4. 89% effective. www.rhedi.org

38. Emergency Contraception:Ella A new prescription only birth control option. Works up to five (5) days after contraception failure or unprotected sex. Works by delaying ovulation Is NOT an abortion pill! Not to be used in place of birth control. 90-95% effective.

39. Extended-Cycle Oral Contraceptives With “old fashion” pills, the active pill with hormones was taken for 21 days, followed by 7 days of a placebo or “sugar pill” www.walgreens.com • Newer forms of oral contraceptives have the active pills that contain hormones taken for 24 days. • This causes periods to be both shorter and lighter • Have less side effects • Still maintains a monthly period www.pharmacynortheast.com

40. Extended-Use Contraceptives It is very safe to not have a period at all as long as this is due to birth control. www.sundaypaper.com • Seasonale/Seasonique are pills taken for three months consecutively. • This means women who use this only have a period once every three months. big5.xinhuanet.com Lybrel is a brand of pills in which the active hormone pills are taken continuously daily throughout the year.

41. Depo Provera (the shot) • The shot is an injectableprogestin • The shot can prevent pregnancy for 12 weeks and is given every three months • Appropriate for women who: • Want effective, long-lasting contraception • Cannot take estrogen • Don’t want to worry about taking daily, weekly or monthly birth control

42. Transdermal Birth Control www.knol.google.com www.ehow.com • Ortho-Evra is a patch worn on the skin. • It contains similar hormones to the birth control pill, but they are absorbed through the skin instead of the digestive system. • Instead of taking a pill each day, the patch is changed only once a week. • Women using the patch still have a period each month.

43. Nuvaring www.soc.ucsb.edu http://moosesp.files.wordpress.com • Nuvaring is a monthly form of birth control. • It also has the same types of hormones that are in the pill, but the hormones are absorbed through the vagina. • The ring is very easy to insert and remove. • It is ok to continue with normal daily activities while using the ring. • Women will still have a period each month.

44. Subdermal Implantable Contraception Implanon is a form of birth control that lasts up to three (3) years. • The device is a small rod that is about the size of a tooth pick. • It is placed under the biceps muscle in the arm. This is done in the doctor’s office. • It is completely reversible and can be taken out whenever you want before it expires in three years. Implanon www.uptodate.com Implanon has low side effects and there is little pain to place it.

45. Intrauterine Devices (IUDs) • They are placed by a clinician in the doctor’s office. • New IUDs are very safe and have low side effects. • Can be removed at any time prior to expiration. • Both are estrogen free! Paragard- approved up to 10 years. Mirena- approved up to five (5) years www.utdol.com

46. Condoms At A Glance: Store in cool, dry place! Do not carry in wallet, pockets, purse or book bag.

47. Novelty Condoms:

48. The Condom Line Up • Talk to your partner • Condoms w/ a reservoir tip and a WATER based lubricant ! • Check package for expiration date and holes • Man gets an erection • Open package carefully • Pinch tip of condom to remove air • Unroll condom down to base of penis • Have safe sex • Man ejaculates • Hold base of condom when pulling an erect penis out of vagina • Remove condom carefully (away from vagina) to keep contents from spilling • Throw away used condom in the garbage • MAKE SURE YOU WASH YOUR HANDS!!!