1 STDs: Just the Facts  Human Relations Media ISBN 978-1-55548-789-8Welcome to STDs: Just the Facts: Please review this presentation before using it with your students. Click “View” on the menu bar, then “Note Page” to review the note pages. If there are slides that you would like to omit, you can use the HIDE feature to skip those slides. (Select “Slide Show” on the menu bar, select the sides you want to hide in the slide thumbnails or in the slide sorter view, then click “Hide.” To unhide the slides, click “Hide” again on the menu.) If you would like to get more information on specific STDs, the first slide on each disease offers web links to articles from the CDC and WebMD. Starter activity idea: Have students brainstorm what they know about STDs. Make a master list and review it after the presentation making corrections as necessary. A word about statistics: We have made every attempt to provide accurate, up-to-date statistics using information from the CDC. Statistics specifically on teen STDs can be difficult to extract because teens are often included in the wider age group. Each year, new studies are done and new figures become available. We encourage you to update the figures in this presentation as you see new studies, and to include local STD data if available. * * * * end of notes * * * *  Human Relations Media ISBN

2 Worried about STDs? You might not be concerned about STDs, but…Millions of teens get infected every year. Some STDs can be cured; others are yours for life. Being infected with one STD increases your risk of getting other STDs. Let’s check it out…

3 What is an STD? STD = sexually transmitted diseaseAlso called sexually transmitted infection (STI). Infection is transmitted by sexual contact.

4 Yes or No? You can get an STD from: shaking hands sitting on a toiletdrinking from a water fountain sharing food or utensils being bitten by an insect being sneezed or coughed on touching a person’s sweat or tears You can use this slide as the starting point for a class activity, letting students respond before you click to display each answer. Ask students to suggest other actions that will NOT transmit an STD. (i.e. hugging, touching a doorknob). * * * * end of notes * * * *

5 through sexual contact.Yes or No? You can get an STD through sexual contact.

6 Click above to play video.What is Sexual Contact? Sexual contact means any intimate contact (not just intercourse) with another person’s: lips mouth penis vagina anus Graphics surrounded by a yellow border are video clips – double click to play. This clip is from Straight Talk About STDs by Human Relations Media. Remind students that ‘fooling around’—even if there is no intercourse—can lead to STD infection in some cases. Certain STDs can be spread by intimate skin-to-skin contact or by sharing a toothbrush, a razor, clothes, bedding or towels. (This will be discussed later in the presentation.) * * * * end of notes * * * * Click above to play video.

7 A Word about AbstinenceAbstinence = not having sex 100% effective in preventing STDs. Lots of teens use this method. As part of the discussion of this slide, you might want to have students identify various activities that a couple can do together while being abstinent. * * * * end of notes * * * *

8 The Hidden Epidemic Each year:Almost 20 million new cases of STDs among all sexually active people. Teens account for more than 3 million STD infections.

9 Risk Factors for STDs being a sexually active teenhaving more than one sex partner not using latex condoms using alcohol or drugs Young people are at high risk of STD infection because they are sexually inexperienced (i.e., not accustomed to using condoms properly, less sure about negotiating safer sex practices). Having multiple sex partners increases the risk of having sex with someone who has an STD. Alcohol or drugs are risk factors because these substances lower inhibitions and increase the chance of having sex and/or having sex without a condom. Remind students that there is no way to tell if someone is “clean” just by how the person looks. Some infected people do not tell their partners about their STD status. * * * * end of notes * * * *

10 Risk Factors for STDs Females under the age of 25 have special risk factors: They have higher rates of STDs than young males. They are less likely to experience symptoms, and may not know they are infected. Young women have higher rates of STDs than young males because: Their partners tend to be older, therefore more likely to be infected. Their bodies are more vulnerable to STD infection. Their cervixes are not fully mature yet. Viruses and bacteria live longer in their reproductive systems. CDC Press Release about Teen Females and STDs, March 2008 Teen men have lower STD rates that teen women because they typically choose sex partners who are younger or the same age as they are. When teen men do get an STD, they are more likely than teen women to have symptoms—and thus they are more likely to get treated. * * * * end of notes * * * *

11 Risk Factors for STDs Young women risk permanent fertility problems from untreated STDs.

12 How Will I Know? If you’re sexually active and have symptoms like…abdominal pain painful urination pain during sex unusual discharge from penis or vagina genital soreness, burning or itching … you may have an STD.

13 Click above to play video.What Should I Do? Seek medical care. A doctor or nurse will: take a sexual and health history do a physical exam take samples (urine, blood and/or fluid from sores) interpret test results make a diagnosis treat as needed Graphics surrounded by a yellow border are video clips – double click to play. This clip is from Straight Talk About STDs by Human Relations Media. Reproductive health care is important! Remind your students that many neighborhood and health department clinics will provide STD treatment without charge, or will charge fees based upon a person’s ability to pay. * * * * end of notes * * * * Click above to play video.

14 Get Regular Checkups Sexually active teens should go for a physical checkup once a year. Tell the doctor that you’re having sex. Ask for STD tests if they aren’t offered. Young women should have a yearly pelvic exam and Pap smear. Ask students where they would go for a checkup. Answers should include: family doctor neighborhood clinic health department clinic By law, all teens are entitled to get reproductive health care without permission from their parents. Tell students: Don’t underestimate your parents; they want you to be healthy. * * * * end of notes * * * *

15 What Causes STDs? bacteria viruses protozoans parasitic insectscomputer rendering of AIDS virus bacteria viruses protozoans parasitic insects bacteria viewed under electron micrograph Scabies are parasitic mites that burrow into the skin. They are not included on this list because, while they can be transmitted sexually, they are most often transmitted by non-sexual means. * * * * end of notes * * * *

16 Bacterial STDs Common bacterial STDs: chlamydia gonorrhea syphiliscomputer rendering of chlamydia bacteria Chlamydia, gonorrhea and syphilis are reportable to the Centers for Disease Control and Prevention (CDC). Current statistics can be found in the end pages of the Morbidity and Mortality Weekly Report (MMWR) here: For cumulative yearly statistics, look under Weekly Report, Past Volumes, and select “Week 52” from the year of interest. * * * * end of notes * * * *

17 Chlamydia 75% of women have no symptoms.Symptoms may appear in 1-3 weeks: yellow discharge from penis or vagina painful urination lower abdominal pain (women) painful intercourse (women) swollen testicles (men) 75% of women have no symptoms. chlamydia In addition to these symptoms, women may also experience spotting between periods, nausea and fever. * * * * end of notes * * * *

18 Gonorrhea More than 300,000 cases reported yearly.Highest rates are among 15- to 19-year-old females. If untreated, is a leading cause of pelvic inflammatory disease (PID). gonorrhea The CDC estimates that there are about 700,000 cases of gonorrhea each year, even though only 300,000 – 350,000 cases are reported. Since many people with gonorrhea are diagnosed with chlamydia at the same time, clinics often treat these two STDs together. For more detailed information: CDC: WebMD: * * * * end of notes * * * *

19 Pelvic Inflammatory DiseasePID = pelvic inflammatory disease Chronic painful infection of the female reproductive tract. Results from untreated chlamydia or gonorrhea. Treated with antibiotics. 1 million women affected each year. PID is not an STD; it is usually a result of being infected with chlamydia or gonorrhea that goes untreated. PID increases the risk of fertility problems—including ectopic pregnancy (fetal development in a fallopian tube). PID causes sterility in 100,000 women each year. For more detailed information: CDC: * * * * end of notes * * * *

20 Syphilis About 10,000 cases yearly.If untreated, can lead to paralysis, blindness and death. For more detailed information: CDC: WebMD: Syphilis is one of the oldest recognized STDs. It may have originated in the New World and been unleashed on Europe by Columbus and his crew. Many notables have had syphilis including painter Edouard Manet, poet Charles Baudelaire, composer Franz Schubert and the American gangster Al Capone. Students may raise the question of the Tuskegee Study ( ) in which poor African-American men with syphilis were followed medically to describe the life history of the disease when it was untreated. Recently, the U.S. Public Health Service apologized for this study. A web search will provide many links for additional information, but you might start with the CDC’s site: * * * * end of notes * * * * syphilis

22 Syphilis If untreated, becomes tertiary syphilis (after 10- to 20-year dormancy): organ damage blindness paralysis death

23 Bacterial STDs Can be cured with antibiotics.Can be acquired again and again. Both partners must be treated at the same time to prevent reinfection. Diagnosing chlamydia and gonorrhea: urine test and swab of discharge from vagina or penis. The swab is used to make slides for microscopic examination or to grow cultures of the bacteria. Diagnosing syphilis: blood test Treatment is especially important in pregnant women. If untreated, chlamydia may cause premature delivery. Babies of infected mothers can be born with eye infections and respiratory problems. Women infected with gonorrhea can have babies born with the STD. Blindness, joint infections, and life-threatening blood infections can also occur in the baby. Babies born to mothers with syphilis can have seizures, be developmentally delayed or even die. * * * * end of notes * * * *

25 Viral STDs Cannot be cured; you’re infected for life.Common viral STDs: HIV genital herpes genital warts (HPV) hepatitis B May be controlled by anti-viral meds. HIV = human immunodeficiency virus HPV = humanpapilloma virus, also known as genital warts * * * * end of notes * * * *

26 human immunodeficiency virusHIV HIV = human immunodeficiency virus About 56,000 new cases each year. More than 500,000 people are living with HIV, including almost 7,000 children under 13. Half of all new cases are people under age 25. For more detailed information: CDC: WebMD: * * * * end of notes * * * * human immunodeficiency virus

27 HIV viewed under electron micrographFlu-like symptoms appear a few weeks after infection. HIV and the immune system remain in a stand-off battle for years. An estimated 56,000 new infections each year, half of which are in people younger than 25. CDC slides of HIV/AIDS in Adolescents 2006 Flu-like symptoms are usually missed as a sign of HIV infection. * * * * end of notes * * * * HIV viewed under electron micrograph

29 HIV If untreated, HIV infection can progress to AIDS:Pneumosystis pneumonia of the lungs Kaposi’s sarcoma (cancer that causes red or purple skin blotches) Other, less common, diseases Death is possible if untreated.

31 Genital Herpes 1 in 5 sexually active people are infected with herpes simplex 2. 1 in 4 are women 1 in 8 are men Painful and embarrassing, but no known long-term health risks. HS-2 (which causes genital herpes) is related to HS-1 (which causes cold sores in the mouth). Receiving oral sex from someone with a cold sore can result in genital herpes caused by HS-1. Giving oral sex to someone with genital herpes can result in oral herpes caused by HS-2. For more detailed information: CDC: WebMD: * * * * end of notes * * * *

32 Many infected people never have an outbreak.Genital Herpes Symptoms may appear 2 weeks after infection: itchy blisters on the genitals and surrounding skin outbreaks usually become less frequent over time transmission can occur even between outbreaks Many infected people never have an outbreak. genital herpes virus

33 Genital Herpes TreatmentMeds can reduce symptoms during outbreaks. Anti-viral meds may help reduce transmission. Do not have sex during outbreaks. Graphics surrounded by a yellow border are video clips – double click to play. This clip is from Straight Talk About STDs by Human Relations Media. Click above to play video.

34 HPV HPV = human papillomavirus More than 100 viruses in HPV family.40 are sexually transmitted. An estimated half of all sexually active people will be infected with HPV. Unlike other viruses, some types of HPV are eliminated from the body in one to two years. For more detailed information: CDC: WebMD: * * * * end of notes * * * * human papilloma virus

35 Most infected people have no symptoms. computer rendering of HPVSymptoms may appear from 1 month to several years after infection: warts on genitals, anus or groin warts may be flat, raised or cauliflower-shaped may grow, remain the same size or disappear Most infected people have no symptoms. The illustration shows a view of the molecular surface of the atomic model of papillomavirus generated by HHMI investigator Stephen C. Harrison and colleagues. computer rendering of HPV

36 HPV – Risks Several strains of HPV can cause: cancer of the cervixcancer of the penis cancer of the vagina cancer of the anus Cervical cancer caused by HPV is more common; cancer of the penis, anus or vagina are less common. Strains of HPV that cause cancer and different strains than those that cause warts. * * * * end of notes * * * *

37 HPV Vaccine (Gardasil)Protects against HPV strains responsible for 70% of cervical cancers and some genital warts. Must be given before infection occurs. Approved for 9- to 26-year-old women and men. HPV vaccine became available in 2006. The vaccine is given as 3 shots over 6 months. For further information on HPV vaccines: WebMD: * * * * end of notes * * * *

38 HPV – Treatment Warts can be removed.Pre-cancerous tissue detected in Pap smears can be removed. No medication exists for treatment.

39 Hepatitis B About 5,000 cases each year. Virus infects the liver.Can cause liver cancer, liver failure and death. Vaccine available. 44 states require vaccine for public school attendance. New cases of hepatitis B have decline dramatically since routine vaccination of children began in 1991. Three states—Alabama, New Jersey, and West Virginia—have no requirements for hepatitis B vaccination. Three other states—Maine, Nevada, South Dakota—require vaccination for children in child care and/or Head Start, but not for K-12 school attendance. For more detailed information: CDC: WebMD: * * * * end of notes * * * *

41 Other STDs – TrichomoniasisCaused by microscopic protozoa. An estimated 7.4 million cases each year. The most common, curable STD among young, sexually active women. Latex condoms prevent transmission. For more detailed information: CDC: WebMD: * * * * end of notes * * * *

42 Men usually have no symptoms. trichomoniasis protozoaSymptoms may appear in 1-4 weeks: frothy, smelly vaginal discharge discharge from penis genital itching pain during intercourse painful urination Men usually have no symptoms. trichomoniasis protozoa

43 Trichomoniasis TreatmentTreated with anti-microbials. Repeat infections possible. Both partners must be treated at the same time to prevent reinfection.

44 pubic louse under microscopeOther STDs – Pubic Lice Tiny, wingless parasitic insects, also called “crabs.” burrow into the skin feed on blood lay their eggs on skin new lice mature 2 weeks after hatching Transmitted by close physical contact (such as sexual contact), sharing towels or clothing. pubic louse under microscope For more detailed information: CDC: WebMD: * * * * end of notes * * * *

45 pubic louse under microscopePubic Lice Symptoms include: redness swelling itching Can quickly spread to anus, eyelashes and other areas of the body. pubic louse under microscope Prevented by: good personal hygiene quick identification and treatment Lice are killed with over-the-counter lotions. Condoms do NOT prevent the spread of pubic lice. * * * * end of notes * * * *

46 Now What? Be Powerful! You’ve learned about: STD symptomshow to get treatment how to prevent STDs Knowledge = Power Summing Up: Most STDs can be prevented through abstinence, vaccination, and/or consistent condom use. Sexually active teens who are tested for STDs regularly can avoid many of the consequences of ‘silent’ STDs. Early diagnosis and treatment can cure STDs caused by bacteria and protozoans. Viral STDs cannot be cured, but medications may help with symptoms and decrease the risk of transmission. * * * * end of notes * * * * Be Powerful!

47 Credits Project Director: Donna Giachetti Writers: Bonnie DenmarkKarin Rhines, Former Program Director, Westchester County (NY) Department of Health Photo Credits: Big Stock Photo Centers for Disease Control Public Health Image Library (PHIL) Digitalvision The Harrison Laboratory National Institute of Allergy and Infectious Diseases (NIAID) National Institute of General Medical Sciences (NIGMS) National Institutes of Health Stanford University  Human Relations Media • •

48 Other Products Available from Human Relations Media: Parenthood: Are You Prepared? video Human Reproduction and Childbirth video Avoiding the Teen Pregnancy Trap video Preparing for Marriage PowerPoint Contraception Options PowerPoint  Human Relations Media • •