Chapter 11

Lowering Your Risk of Sexually Transmitted Infections

Elizabeth Lytle, MPH, BSN, RN Los Altos School District

Learn About Sexually Transmitted Infections

Symptoms, treatments and Common STIs transmission

Safer Sex HIV

STI risk factors Behaviors to reduce risk Incidence, treatment and protection

Odds of acquiring a Sexually Transmitted Infection in your lifetime are 1 in 4

STIs Have Dramatic Effects

They can:
Last a lifetime Impair fertility Cause birth defects

Put stress on relationships

Lead to major illness and death Cause serious medical complications

Here Is How STIs Are Spread

Direct sexual contact with someones STI symptoms Direct sexual contact with infected semen, vaginal fluids, blood and other body fluids Sharing contaminated needles Maternal Transfer

How STIs spread

STI Risk Different For Men And Women

Women
More mucosal membranes exposed to trauma during sex, so higher risk for STI Symptoms are silent, so may not know you have STI Ask for testing or it wont be done

Men
Less like to avoid error if partner is involved in protection After exposure, urinate and wash genitals with antibacterial soap

Ask for testing or it wont be done

STI Risk Is A Continuum

Here are factors that put you at risk:
Feelings of invulnerability Multiple partners

Failure to use condoms

Substance abuse Failure of partner to be notified and treated

ABCs Of Safer Sex

A
B C

Abstain Be faithful Use condoms and store them properly

Human Papillomavirus: Most common STI

Most people have no symptoms HPV can cause cervical cancer Condoms provide only limited protection against HPV

Danger

Treatment Nothing completely eliminates it

Gardisil and Cervarix (women)

Vaccine Must be under 26 years old and not pregnant 3 doses over 6 months required

Genital Herpes
Contagious even when no Danger symptoms Risk to infant during childbirth Lives in host for their lifetime Anitviral medications decrease transmission Treatment Acyclovir Valacydovir Famcydovir

Chlamydia
Higher risk of HIV infection May lead to Pelvic Inflammatory Disease Babies exposed during birth can have pneumonia and eye infection Epididymitis which can cause sterility Many do not have symptoms

Danger

Treatment Antibiotics for both partners

Symptoms Painful urination and intercourse

Cervical or rectal inflammation

Gonorrhea or The Clap

Urinary obstruction and sterility in men

Danger

Pelvic Inflammatory Disease in women

Newborn infections Blood-borne infection

Treatment Antibiotics for both partners

Thick, yellow-white pus from penis

Symptoms
Pain and fever in women

Syphilis Rates Are Increasing In US

Urinary obstruction and sterility in men Pelvic Inflammatory Disease in women

Danger
Newborn infections Blood-borne infection

Treatment Antibiotics for both partners

Syphilis Can Have Effects 10-20 Years Later

Primarychancre Secondary (not all experience this) skin rash, patches on mucous membranes, fever, swollen glands, more sores Stages of Late & Latent2-4 years later Syphilis makes its way into brain and organs Tertiary10-20 years later Ruptured aorta, heart damage, brain or spinal cord damage, blindness, insanity or paralysis

Effect of STI: Pelvic Inflammatory Disease

Affects women 10-20% experience enough scarring of fallopian tubes to cause infertility Half of cases have no symptoms Responsible for Danger half of ectopic pregnancies 15-30% of infertility cases Half of cases caused by gonorrhea Cause and chlamydia Treatment Antibiotics for woman and partner

Trichomoniasis Is Curable
Danger
May increase susceptibility to HIV None, commonly

Symptoms Discomfort during urination, intercourse

or ejaculation

Treatment Antibiotics for both partners

Chancroid
Infection of lymph glands with destruction of tissue May increase susceptibility to HIV

Danger

Symptom Soft, painful sore Treatment Antibiotics for both partners

Keep genitals clean and wash after Prevention possible exposure

HIV Risk Highest For Four Groups

Gay and Bisexual Men
Only group with new infections on rise

Black Americans
Black men: rate 8 times that of white men Black women: rate 19 times that of white women

Women
Black women followed by Latina and then white

Young People
Account for 34% of new infections

Reducing Risk of HIV Transmission

Sexual Practices Influence Risk
All types of sex can result in infection: oral, anal and vaginal Have fewer sexual partners and avoid high risk partners More susceptible when you have another STI Teenage girls especially vulnerable

Use protection

Recognizing HIV
Many experience a flu-like illness followed by no symptoms for weeks to years
Swollen lymph nodes Fever, chills, night sweats Diarrhea and weight loss Coughing and shortness of breath Symptoms Persistent tiredness Skin sores Other infections such as pneumonia Blurred vision and headaches

Effects of HIV
Susceptibility to cancers and tuberculosis Diminished mental function

Impaired coordination
Psychological problems Stroke and bone fractures

When AIDS Is Diagnosed

AIDS diagnosis occurs when HIV severely compromises the immune system
CD4+ counts less than 200 (800-1200 is normal) Recurrent pneumonia Cervical cancer Pulmonary tuberculosis

Effects of AIDS
Secondary infectious Neurological disease diseases Involuntary weight loss Kaposis sarcoma

Treatment of HIV
Antiretroviral Therapy
Decreases viral load, but does not eradicate virus Uses one of 250 combinations of medications Not available everywhere