Sex education is a difficult course to teach, particularly when taught to teenagers; nevertheless, it is a matter that needs to be addressed.

Bequeathing students with a sex education allows them to make responsible decisions for their future. Everyone, including adolescents, have hormones and sexual needs. Depriving students of an informative sex education would be denying this reality. Honest method to teaching sexual education has also been verified to be successful. There was an article published in Drug Week in 2003 which talk about a rare viral disease known as Buske-Lowenstein tumor (BLT). It is basically transmitted during sexual intercourse and is harmful to those who engage in unprotected sexual behavior. A. Elmejjad (2003) claimed that the best way to avoid this and other harmful diseases is through sex education. The article recommends teaching safe-sex practices in order to prevent the risk of unwanted STDs. This has not only been successful in STD but also AIDS. Baldwin et al. (1990) performed research using a survey to assess the effectiveness of a human sexuality class in altering college student's AIDS and fertility-related behavior. Baldwin et al. (1990) found that straightforward education about the use of condoms and other forms of birth control concluded in safer behaviors and increased awareness of the risks concerned sexual activity. Teens that are infected with the virus are not even aware of it. It is important that people get tested to make sure they do not contract and spread the disease without knowing the consequences of their unsafe behavior. There is either unsafe sex or safe sex. Safe sex means sexual activities which you can do even if one person is infected with HIV, and they definitely won't pass it on to the other person. Loads of activities are completely safe. You can kiss, cuddle, massage and rub each other's bodies. But if you have any cuts or sores on your skin, make sure they are covered with band - aid. Safer sex also means using a condom during sexual intercourse. Using a condom is not absolutely safe as condoms can break, but condoms can be effective if they are used correctly (http://www.avert.org/). Educating girls who are sexually active focuses on the use of condoms. This is important; however research shows that there are significant components involved in sex education that do not associate immediately to sex. Furthermore, there are issues such as communication and self- understanding that can be taught, which then circuitously effect teens decisions concerning sex.

HIV/STD prevention and sexuality education supports positive physical and mental health of youth as they grow into young adults. Schools play an important role in HIV/STD prevention and sexuality education for youth and healthy lifestyles. Here you will find a collection of valuable resources for schools, teachers, administrators, and others involved in sexuality and HIV/STD prevention education.

The Nurses Role In The Epidemic Of STDs Among Teens, Venice

Sexually transmitted diseases (STDs) are a common source of morbidity for adolescents and young adults ( Crosby, & Danner, 2008, p.2). Estimates suggest that about 48% of nearly 19 million cases of sexually transmitted diseases (STDs) occurring annually in the United States are acquired by persons aged 15-24 years (Crosby, & Danner, 2008, p. 1). STDs can be symptomatic or asymptomatic. High portion of STD cases are asymptomatic; for example, as many as 85% of women with chlamydial infection are asymptomatic ( Tilson et al., 2004, p. 3). Since there's an epidemic of STDs among teens, nurses can play a vital role by educating teens, providing information about health care access, and encouraging teens to practice safer sex. Since teens often become sexually active at an early age, it is vital that nurses provide them with the information they need to protect themselves. Nurses have a key role in educating, managing and supporting patients across a range of clinical and nonclinical settings (Ritchie, 2006, p.39). Communication is a key factor on how to get the information across with this age group. One of the most important techniques for this age group is to listen first and remain nonjudgmental. Every effort should be made to

give the adolescent a sense of modesty and privacy (Harrington & Terry, 2009, p.275). STDs may or may not cause symptoms and it is easy to pass it around. Teens need to know the right tools to protect themselves against STDs and it is vital that they learn to practice safer sex to reduce their risk. Getting tested is also important so that the necessary early treatment can be provided. Sexually transmitted diseases (STDs) are caused by sexually transmitted infections. They are passed from one person to another through sexual intercourse or intimate contact. Some common STDs include chlamydia, gonorrhea, HIV, genital herpes, HPV, hepatitis, and syphilis (MayoClinic, n.d.). STDs contribute to pelvic inflammatory disease, infertility, ectopic pregnancy, premature births, and anogenital cancer and may contribute to the spread of the HIV epidemic ( Tilson, Sanchez, Ford, Smurzynski, Leone, Fox, Irwin, and Miller, 2004, p. 2). Some STD symptoms can be treated easily and eliminated and some require more involved and long-term treatment (MayoClinic, n.d.) Either way, it's essential to be evaluated, and if diagnosed with an STD be treated. It's also essential to inform any partners so that they can be evaluated and treated (MayoClinic, n.d.). Teens often dont inform their partners because some STDs are asymptomatic. STDs have a long term effect on the reproductive health and that is why early screening and treatment is necessary. When it comes to screening for STDs, teens encounter barriers that deter them from seeking treatment. Many barriers to STD care include lack of knowledge of STDs, cost, inconvenient services, shame, and urethral swabs as method of specimen collection (Tilson et al., 2004, p. 12). Teens start

becoming sexually active at such a young age that most cant drive themselves to clinics or let alone pay for the cost of treatment. It is the nurses role to bridge these barriers so that teens can get the proper care they need. STDs are a major public health problem among teens. They can cause reproductive morbidity and poor health outcomes. Young people may experience more barriers to STD services due to limited resources, lack of information, and increased sensitivity to others perception of themselves (Tilson et. at. 2004, p.2). Since there's an epidemic of STDs among teens, nurses need to find a way to reach out to teens and provide them the right tools to protect themselves. By nurses being actively involved with teens, further transmission of STD and morbidity can be reduced. Strategy 1: Nurses can take steps to ensure that teens stay safe during the period between childhood and adulthood which involves biological, social, and psychological changes accompanied by an increased interest in sex ( as cited in Ritchie, 2006). Sexual health must be continued and improved within schools, as this is a forum in which young people can be educated about health during their formative years (as cited in Ritchie, 2006). This will also be of value to parents that are not comfortable talking to their kids about sex or those parents that dont know too much about different STDs. The importance of knowledge should be stressed so that teens can make the right decision to protect themselves when they choose to become sexually active. Disadvantage 1: Some sexual health lessons are hindered by competition for curriculum time ( Ritchie, 2006). Nurses need to advocate that sexual health should be

given priority in school curriculum. School is where teens are going to learn the most and nurses need to take advantage to that. Disadvantage 2: Schools may have a varied level of sex education because of religious and cultural beliefs (Ritchie, 2006). Part of being a nurse is having cultural awareness and knowledge. Nurses need to gain cultural competence to understand beliefs in different schools and adjust accordingly to that. Strategy 2: School-based lessons are the main source of information about sexual matters for young people. They spend most of their time in school so nurses need to take advantage of that fact. School nurses are ideally placed to deliver sex and relationship education in schools, which should be encouraged in partnership with teachers ( Ritchie, 2006). Nurses should use careful and considerate communication style when working with teens. It is important that nurses are nonjudgmental to gain trust and have a better learning interaction with teens. Sex education should be positive and should provide information about clinics where teens can go to. Disadvantage 1: Young people often cite judgmental attitudes as a reason for not being open about their sexual health (Hayter, 2005). As stated before, nurses need to listen first and remain nonjudgmental. This will encourage the teens to express themselves. Disadvantage 2: Confidentiality is also of concern (Hayter, 2005). Some teens stressed that they cant ask questions because theyre peers are around (Hayter, 2005). Adequate information about sexual health should be available and easily

accessible in schools. Nurses need to advertise health clinics so that teens can access it to get more information. Strategy 3: It is important that teens are informed about health care services. STD screening plays an important role in STD prevention. Other components of STD prevention include counseling, condom use, STD vaccines, and partner notification and treatment. Essential elements of good sexual health are equitable relationships and sexual fulfilment with access to information and services to avoid the risk of unintended pregnancy, illness, or disease' (as cited in Ritchie, 2006). STD is an important aspect of clinical care for adolescents. Preventing infections by teaching, counseling, condom use, periodic screening, and treatment contribute to reduction of further transmission of STD and morbidity. Disadvantage 1: Teens who had accessed services in public health settings described frustrations with lengthy waits for care ( Tilson et al., 2004). Some are embarrassed to seek out heath services because of lengthy wait and being witnessed accessing services ( Tilson et al., 2004) In order to spur on more government initiatives, options such as providing career support for nurses willing to working with these population segments should be pursued (Ritchie, 2006). Disadvantage 2: Another significant barrier for teen seeking out public health settings is the cost of services. Fear of a bill for STD services being sent to their parents might serve as an added deterrent to seeking services (Tilson et al., 2004) Free or low-cost services would facilitate seeking care.

Sexually Transmitted Disease A Sexually Transmitted Disease (STD), also known as Venereal disease (VD), is a disease that is transmitted primarily by sexual contact including vaginal intercourse, oral sex and anal sex. STDs are also transmitted via the needles, birth canal and breast feeding. The infection may be bacterial, fungal, viral or protozoan. Bacterial infection includes Chancroid caused by Haemophilus ducreyi , Donovanosis caused by Granuloma inguinale or Calymmatobacterium granulomatis ,Gonorrhea caused by Neisseria gonorrhoeae and Syphilis caused by Treponema pallidum.. Fungal infection includes Jock Itch and Yeast Infection .Viral infection includes AIDS caused by HIV, Cytomegalovirus infection, Genital Herpes and Genital warts caused by Human Papillomavirus strains. Protozoal infection includes Trichomoniasis caused by Trichomonas vaginalis. The prevalence of sexually transmitted diseases is a serious social problem across the globe. Sociological changes brought about by rapid modernization in the twenty-first century has led to chronic problems like pre marital sex, homosexualism and multiple partnerships in sexual life and these have greatly contributed to moral degradation and subsequent rise in STDs. Nurse Attitudes Nurse care for such patients is complex in the sense that such sexually transmitted infections can occur even in patients who are not actually guilty of an act that can cause a STD. For example, Gonorrhea or Syphilis is transmitted to a child via the birth canal and HIV is transmitted by blood transfusion process. STD nurse care and risk assessment involves sexuality and intimacy issues that can be challenging for nurses. Although treatment of STDs has been the primary focus, little has been done to know about the attitudes, beliefs and problems of nurse practitioners who care for such patients. A survey including a 21-item AIDS Attitude Scale measuring the constructs of avoidance and empathy to describe the nurse attitudes and care

practices related to such patients has shown that nurses have relatively low avoidance and high empathy and hence, are comfortable treating such patients (Martin and Bedimo, 2000). But, nurses awareness, fear and emotions do play a role in determining the comfort level. A study to determine nurses knowledge, attitudes and overall level of comfort in giving nursing care to acquired immune deficiency syndrome patients and identify the sociodemographic variables that influence nurses attitudes has shown that nurses with low levels of knowledge show negative attitudes towards people with acquired immune deficiency syndrome and other STDs. Nurse's specialty, rank, prior education and experience with patients have been shown to influence their attitudes (Oyeyemi, 2006).The positive beliefs and values about sexuality of nurses do play a role in shaping nurse attitudes in STD care (Nustas et.al , 2002). The conflict between nurses belief and values about sexuality and patients sexual behaviour has been well documented (Yun-Fang Tsai, 2002). A strong fear of acquiring HIV infection at work substantiated by the fact that needlestick and sharps injuries are the most common method of transmitting blood-borne pathogens between patients and the nurses has been shown in a sample of 601 surgical and emergency nurses and this fear factor has been shown to instigate inappropriate HIV testing of all surgical patients and inpatients (Gaczak and Barss, 2007). A cross-sectional survey from seven health settings undertaken with a self-administered written questionnaire to study HIV-related knowledge, attitudes and risk perception and to identify predictors of willingness to provide care for such patients has shown that perceived risk of fatal occupational infection and previous experience in STD care greatly influence the attitudes of nurses although these nurses have a positive attitude towards caring for people with HIV and STDs (Kermode et .al, 2005). A recent study to assess nurses' level of comfort in providing care to

patients living with AIDS and to determine the sociodemographic variables that influence nurses' comfort using a questionnaire to elicit information on their comfort taking vital signs, handling, administering enema and mouth-to-mouth resuscitation and in recommending exercise or physical therapy to patients living with AIDS has shown that nurses are uncomfortable with resuscitation and prefer wearing gloves while handling these patients (Oyeyemi et.al,2008). A study using a five-point Likert scale ranging from strongly agree to strongly disagree with seven statements regarding the nurse attitudes towards caring for patients with HIV and two statements regarding perceived risk of occupational HIV infection has shown that nurses unwillingness to care for such patients was associated with a lack of prior experience in STD patient care and the majority (63%) perceive their risk of occupational infection with HIV as high especially following a needlestick injury with a needle contaminated with HIV-positive blood (Kermode et .al,2005). Studies have also shown that nurses want to prevent themselves or colleagues from becoming infected after experiencing a needle stick accident (Tsai and Hsiung, 2003). Studies have also shown that nurses who have training in communication aspects of STD care are better equipped to care STD patients. Nurse Care Nurse care and risk assessment of patients with sexually transmitted diseases involves conduct of physical examinations, determination of medical and personal histories of patients and providing treatment. This involves active interviews, review of medications used and collection of specimens. The STD nurse care requires a thorough knowledge of the principles, practices and techniques of nursing and their application to patient care diseases, the anatomy and physiology of the reproductive system and current trends in STD practices (Tsai and Hsiung, 2003). The STD nurse care also requires a capability to perform pelvic examinations and general physical

examinations, evaluate results of examinations and instruct and counsel patients in the area of sexually transmitted diseases. The nurse practitioner must obtain detailed, comprehensive information on sexual history while investigating any sexually transmitted disease in a factual manner. This includes details of vaginal, oral or anal sites of sexual contact, homosexual, bisexual or heterosexual sexual orientation, use of condoms to prevent STDs, use of other birth control methods, number of sexual partners in recent past, history of sex with injection drug users, period since last sexual intercourse with most recent partner and previous history of STDs (Kimberly et.al, 2006). Initial medical examination includes the investigation of symptoms of STDs in client and in his or her partner/partners, enlargement of lymph nodes and fever. Detailed examination in men includes the investigation of urethral discharge, dysuria, itch or irritation in distal urethra or meatus, pain or swelling in the scrotum or inguinal region, genital rash or lesions, rectal discharge, itch or pain, joint pain, arthritis, conjunctivitis and rash at other body sites. Detailed examination in women includes the investigation of vaginal discharge , painful intercourse on penetration or deep dyspareunia, burning sensation with urination, genital rashes or lesions ,pain in lower abdominal region, postcoital, midcycle or excessive menstrual bleeding ,dysuria, nocturia, hematuria , joint pain, arthritis, conjunctivitis ,rash at other body sites, enlargement of lymph nodes, fever, last menstrual period and pregnancy. The clinical findings are substantiated by diagnostic tests (Kimberly et.al, 2006). Conclusion STD nurse care and risk assessment involves sexuality and intimacy issues that can be challenging for nurses. Nurses awareness, fear and emotions do play a role in determining the comfort level of care for STD patients. A strong fear of acquiring sexually transmitted infections at work, especially following a needlestick injury and prior STD care experience greatly

influence the attitudes of nurses towards STD patient care. Such Knowledge gaps on perceived risk of exposure, and attitudes toward STD patients must be well addressed in the nursing curriculum. The doctor or nurse should give the patient advice about having sex whilst receiving treatment. There are some non-prescription treatments available for genital HPV, but it is advisable to always seek medical advice. Never try to treat genital warts by yourself. It is important that a woman who is pregnant, or trying to become pregnant, informs her doctor. Podophyllin treatment could harm the developing baby and an alternative treatment should be used.

Follow-up
It is important to return regularly for treatment until all of the genital warts have gone so the doctor or nurse can check progress and make any necessary changes in your treatment. Sometimes treatment can take a long time. The majority of people whose genital warts initially disappear will get a recurrence. In the majority of cases, the immune system keeps the virus under control and eventually destroys it a few years after the initial infection.