1 Sexually Transmissible Infections2017 Please note: This presentation includes a broad range of slides on sexually transmissible infections (STIs). Please select the particular slides that best suit your needs. The data used throughout the presentation had been sourced from the Department of Health’s surveillance data of notifiable diseases in Victoria.
2 Key Messages Sex should be a positive experience.STIs are a possibility when engaging in sexual activity. STIs can be spread via: Skin to skin contact Oral, anal or vaginal sex Sharing of sex toys. STIs are often asymptomatic. Regular testing is recommended. Condoms offer some protections against STIs. Discuss the following: Learning about safer sex is much more important than knowing all of the STIs by name, treatment and symptoms. Sexually Transmitted Infections © Family Planning Victoria 2017
3 STIs – what are they? STI stands for Sexually Transmitted (or Transmissible) Infections. STIs are caused by some viruses (e.g. herpes, human papilloma virus), some bacteria (e.g. chlamydia, gonorrhoea, syphilis), and some parasites (e.g. scabies, pubic lice). Discuss the following: STIs are no longer referred to as sexually transmitted diseases (STDs). Disease is a term that is used to refer to chronic medical conditions that cannot be cured. As some infections such as chlamydia can be cured, the word infection has now replaced disease. Sexually Transmitted Infections © Family Planning Victoria 2017
4 STIs – who is at risk? Can affect anybody who has any type of sex.They are passed from one infected person to another uninfected person, regardless of gender, through sexual activity. Young people are vulnerable to STIs experimental time where risky behaviours are common higher number of sexual partners. Discuss the following: Risk-taking is a normal part of developing one’s identity. The brain (cognitive development) does not finish developing until about the age of Most teenagers have not developed thorough problem solving or decision-making skills. Inexperience, embarrassment and lack of confidence can prevent forethought and the planning of safer sex. Sexually Transmitted Infections © Family Planning Victoria 2017
5 STIs – how are they transmitted?STIs can be spread via: skin to skin contact oral, anal or vaginal sex sharing of sex toys. This includes all forms of penetrative sex (oral, vaginal and anal) as well as some forms of foreplay such as genital skin to skin touching. Oral sex has a lower risk of transmission (chlamydia, gonorrhea, syphilis and herpes) STIs can also be sometimes passed on through fluid from an infected area by fingers or sharing sex toys. Also vertical transmission from a mother to a baby can also occur Some STIs can be passed through skin-to-skin contact; others require contact with infected body fluids such as semen, rectal mucous or cervical/vaginal secretions. BBV stands for Blood Borne Viruses. These include Hepatitis B, Hepatitis C and HIV. These viruses are transmitted from one infected person to another uninfected person through the exchange of blood or other infected bodily fluids. Infected blood or body fluid needs to enter the bloodstream of the uninfected person for transmission to occur. Blood to blood contact can happen through unsafe (unsterile) tattooing practices or body piercings, the sharing of drug injecting and other equipment or unsterile surgical operations or procedures. Sometimes small amounts of blood are passed from one person to another person through sexual activity (if there is blood present at the time of the sexual activity (e.g. during rough sex). Sexually Transmitted Infections © Family Planning Victoria 2017
6 STIs – what are the symptoms?Many STIs have no symptoms at all - so its important to have regular testing. Sometimes symptoms will be present, and if they are a check-up with a doctor/nurse is recommended. Discharge Rash Itch or irritation Pus or pain Sores or smell Asymptomatic means without symptoms. Please note: The ‘DRIPS’ acronym is useful to teach, as these symptoms do indicate the presence of an infection. However, students need to understand that checking for symptoms should never be relied on, as most STIs do not have symptoms. Some STIs are known as the "Silent Infections." This is because you may be infected but not have any symptoms. So you may not know whether you or your partner has an STI – this is why it is important to use a condom correctly every time you have sex and to have regular checkups. If left untreated STIs can cause other health problems or complications. Getting regular checkups can minimize the risk of transmitting an infection or developing other health problems or complications. Sexually Transmitted Infections © Family Planning Victoria 2017
7 STI notifications in Victoria* Indicates that no stats are available 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Hep B (newly acquires) 83 92 88 70 67 59 37 54 28 58 Chlamydia 11208 12380 13903 16541 19238 19737 19614 19921 * Gonorrhoea 1007 922 1480 1758 1863 2444 2992 3271 4936 5509 Syphilis (infectious) 422 378 392 290 320 470 660 797 727 799 HIV/AIDS (newly acquired) 263 261 262 233 280 307 163 144 128 Discuss the following: It is difficult to source current figures. The Department of Health takes up to 12 months to collate and release data. Surveillance of Notifiable Diseases in Victoria 2017 Department of Health State Government Victoria Sexually Transmitted Infections © Family Planning Victoria 2017
8 STIs – how can they be prevented?Safer sex practices help prevent STI transmission using condoms and oral dams limiting partners getting immunised (hepatitis B and HPV) having regular STI check ups. Sexually Transmitted Infections © Family Planning Victoria 2017
9 STIs – should I get checked?STI checks should be considered after unprotected sex. If you are under 30 once a year to be safe, even if you use condoms 100% of the time. If you are a male who has sex with other males, every 3 months, depending on your risk. If you have any symptoms. Testing can include urine tests, swabs and blood tests. Often you collect your samples yourself. Please note: Keeping the messages simple and proactive (safer sex) is more effective in changing behaviour. Discuss the following: A Pap test checks for cell changes that may indicate cancer. Sometimes a doctor or nurse may detect an STI when conducting a Pap test (e.g. because of symptoms), but they are not looking for STIs. Sexually Transmitted Infections © Family Planning Victoria 2017
10 STIs – what else do I need to know?Know that you cannot tell if someone has an STI just by looking at them. Be prepared for safer sex by carrying condoms and knowing how to use them correctly. Be mature about STIs and reassure yourself and your partner that an STI is not a moral judgment of character, but an infection like any other. Sexually Transmitted Infections © Family Planning Victoria 2017
11 Sexually Transmitted InfectionsChlamydia
12 Chlamydia Chlamydia is the most commonly reported STI in Australia.Young people under the age of 30 are at greatest risk. Most people have no obvious symptoms. If there are symptoms, you may notice: a change in vaginal discharge (sticky fluid that comes from the vagina) irregular bleeding from the vagina (especially after sex) stinging or burning when passing urine redness at the opening of the penis a clear or slightly cloudy discharge from the penis pelvic (tummy) pain, including during sex a fever Chlamydia can also infect the rectum (anal passage) and cause discharge and pain. Sexually Transmitted Infections © Family Planning Victoria 2017
13 Chlamydia Testing simple and easy to test and treat usually freeyou can self collect swabs/pee in a pot. Treatment antibiotics no sex for 7 days after treatment has started. Notifications it is recommended that you tell everyone you have had sex with in the last 6 months so they can be tested and offered treatment. Sexually Transmitted Infections © Family Planning Victoria 2017
14 Chlamydia notifications in VictoriaNote that this STI is on the increase Surveillance of Notifiable Diseases in Victoria 2014 Department of Health State Government Victoria Sexually Transmitted Infections © Family Planning Victoria 2017
15 Chlamydia notifications in Victoria by age groupMore females than males – why? More females visit their GP for routine checkups, that is why we see higher numbers of females reporting Around 80% within age group 15-29 A trend which has been consistent in the last 10 years Surveillance of Notifiable Diseases in Victoria 2014 Department of Health State Government Victoria Sexually Transmitted Infections © Family Planning Victoria 2017
16 Sexually Transmitted InfectionsHerpes Simplex Virus
17 Herpes Simplex Virus It is caused by either Herpes Simplex Virus type 1 or 2. Herpes type 1 usually infects both the mouth and genitals. Herpes type 2 usually infects the genitals but can infect the mouth. Many people have the Herpes virus but are unaware. Discuss the following: HSV oral infections are almost exclusively type 1. Up to 50% of genital infections in young people are type 1. It is also known as the cold sore virus. Sexually Transmitted Infections © Family Planning Victoria 2017
18 Herpes Simplex Virus Most people have no obvious symptoms.If there are symptoms, you may notice: redness or irritation of the skin itching, tingling or soreness difficulty or pain passing urine blisters or painful ulcers in the genital area pain enlarged glands in the genital area feeling generally unwell (muscular aches, headache and fever). Discuss the following: The virus stays in the body permanently. Antiviral medication decreases transmission and can be taken continuously or as soon as symptoms develop. For those who have more than one partner during their lifetime, herpes is a part of life. It is not fatal and can be managed. Some people become aware that they have herpes when they have their first major outbreak. Subsequent outbreaks usually becomes less severe and further apart. Some people become aware that they have the infection when their partner is diagnosed with herpes. Sexually Transmitted Infections © Family Planning Victoria 2017
19 Herpes Simplex Virus Testingif you have blisters, sores, irritation or soreness of your genital skin, see a doctor a swab test (cotton bud rolled over the affected skin) will be performed in the early stages of symptoms. Treatment anti-viral tablets. Recommendations avoid sex when you have symptoms of herpes condoms decrease the risk of passing on the infection. Sexually Transmitted Infections © Family Planning Victoria 2017
20 Sexually Transmitted InfectionsHuman Papilloma Virus (HPV)
21 Human Papilloma Virus (HPV)An estimated 90% of sexually active people will have been exposed to HPV during their lifetime Most young people are now vaccinated against HPV (Gardasil) Most people have no obvious symptoms If there are symptoms, you may notice: Warts Cell changes to the cervix (identified through cervical screening). Discuss the following: Gardasil is the vaccine that is given to all year 7 students. It immunises against the types of HPV that are associated with cervical cancer in Australia. It requires a series of thee injections. It does not prevent other STIs. The Gardasil immunisation program is considered to be a success. The incidence of genital warts, as seen in clinics and health services around Australia, has been reduced since the introduction of the vaccine. Women still need to have cervical screening once they become sexually active, even if they have had the full course of injections. Sexually Transmitted Infections © Family Planning Victoria 2017
22 Human Papilloma Virus (HPV)Treatment warts can be removed (creams/paints, freezing, excision), other treatments available for changes to cells in the cervix. Complications HPV is found to be the cause of almost all cervical cancers. Recommendations condoms help to reduce the risk of contracting HPV. Sexually Transmitted Infections © Family Planning Victoria 2017
23 Sexually Transmitted InfectionsOthers Hepatitis (A & B) HIV/AIDS Gonorrhoea Mycoplasma Genitalium (MG) Syphilis Trichomoniasis Pubic Lice Scabies
24 Gonorrhoea notifications in VictoriaNote that Gonorrhoea is on the rise across Victoria Surveillance of Notifiable Diseases in Victoria 2017 Department of Health State Government Victoria Sexually Transmitted Infections © Family Planning Victoria 2017
25 Syphilis notifications in VictoriaNote that Syphilis is on the rise across Victoria Surveillance of Notifiable Diseases in Victoria 2017 Department of Health State Government Victoria Sexually Transmitted Infections © Family Planning Victoria 2017
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