Download Sexually Transmitted Diseases

Sexually Transmitted
Infections
Presented by:
Why do you need to know about
STIs?
 The average age both male and female Canadians have
sex for the first time is 16.5.
 28% of teens aged 15-17 report having had sexual
intercourse at least once. By age 20-24, this increases
to 80%.
 In a 2005 report, 41% of males aged 15-17 and 39% of
those aged 18-19 reported having more than one sexual
partner in the previous year.
 For females in the study, 29% of 15-17 year olds and
31% of those aged 18-19 reported having more than
one sexual partner in the previous year.
Overview
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What is an STI?
What causes STIs?
Risk Factors
How can STIs be transmitted?
Common STIs
What should you do if you
suspect you may have an STI?
 Preventing the spread of STIs
 Quiz
What is an STI?
 Sexually transmitted infections are
infections usually transmitted through
sexual intercourse.
 STIs often do not have any symptoms; it
is possible to have an STI and not even
be aware of it.
General Warning Signs
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different vaginal discharge
discharge from penis
burning during urination or sex
sores or growths on genitals or around anus
itch or odour
Any STI…
 can increase chances of getting another STI.
 can be passed from the mother to the baby during the
birthing process.
 may lead to infertility in women.
What causes STIs?
 bacteria
 viruses
curable with antibiotics
easily cured if caught
early; however, there
are often no symptoms
http://matcmadison.edu/is/hhps/mlt/mljensen/image
s/Bacterium.jpeg
http://micro.magnet.fsu.edu/c
ells/viruses/images/virus.jpg
not curable
 other organisms
can treat symptoms
www.ento.okstate.edu/ddd/insects/pubiclice.htm
Risk Factors
 Anyone who has had sexual intercourse is at risk for
having an STI.
 factors that increase risk:
- more than one sexual partner
- sex with someone who has more than one partner
- sex without a condom
STIs are NOT transmitted via…
toilets
eating
utensils
holding
hands
towels
STIs are NOT transmitted via…
bedding
swimming
pools
telephones
insect
bites
How are STIs transmitted?
sharing/using dirty
needles
sexual
intercourse
(anal, vaginal, oral)
at birth
Before we learn about STIs…
What do normal genital areas look like?
Female
http://upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Vagina-anatomy-labelled2.jpg/444px-Vagina-anatomy-labelled2.jpg
Male
http://upload.wikimedia.org/wikipedia/commons/8/84/Human_penis_both_flaccid_and_erect.jpg
Common STIs
 bacterial:
 chlamydia
 gonorrhea
 syphilis
 viral:
 HIV
 human papillomavirus/genital warts
 hepatitis
Chlamydia & Gonorrhea
 chlamydia: up to 90% of women and 70% of men with chlamydia
have no symptoms
 gonorrhea (‘The Clap’): 80% of women & 40% of men with
gonorrhea have no symptoms
 common symptoms:
- discharge from penis/vagina
- painful urination and bowel movements
- painful intercourse
- in women: bleeding between periods, bleeding after intercourse
 Symptoms usually appear a couple of days to a few weeks after
infection.
Prevalence of Chlamydia
http://www.health.alberta.ca/documents/STI-ND-Annual-Report-2011.pdf
Prevalence of Gonorrhea
http://www.health.alberta.ca/documents/STI-ND-Annual-Report-2011.pdf
Updated October 2013
Chlamydia
 can easily be treated with a single dose of antibiotics
 a significant cause of blindness
 passed through vaginal/anal sex, but not usually through
oral sex
Gonorrhea
 can be treated with antibiotics
 arthritis
 pelvic inflammatory disease
Syphilis
 several stages of infection:
 primary
 3 weeks to 3 months after infection
 chancres on genital area—painless and VERY
contagious
 secondary
 2-3 months
 spotty skin rash
 fever, fatigue, hair loss
Syphilis
 chronic
 period of no symptoms
 may continue for years!
 may progress right on to tertiary
 tertiary
 serious organ damage occurs anytime after one year
 affects eyes, brain, muscles  can be fatal
Updated March 2008
Syphilis
 infection can be spread to fetus in pregnant women and
cause stillbirth or lifelong disabilities
 fetal abnormalities  prenatal care!
 treatment:
 infection <1 year long: a single shot of penicillin
 infection >1 year long: many doses of penicillin over three weeks
Human Papillomavirus
 HPV can lead to genital warts in the genital or anal areas
 #1 cause of cancer of the cervix
 symptoms:
- genital warts (cauliflower-like)
- often recurrent and resistant
- up to 90% of people have no symptoms (self-heal within 2
years)
 extremely common, with up to 80% sexually active people
being infected
 newborn babies rarely get the virus during the birthing process
Human Papillomavirus
 diagnosis of HPV done using the Pap smear
 once sexually active, females need yearly Pap smears
 symptoms (genital warts) can be treated, but there is no
cure
Human Papillomavirus
 protection: females are vaccinated between the ages of
9-26 (up to age 45 in women at high risk)
 Gardasil®:
 offers protection against cervical cancer and genital
warts
 given as 3 injections over 6 months
 covers 4 out of 6 HPV viruses that can cause cancer
(70% of cervical cancer and genital warts)
 Speak to a health care professional about whether
you should receive it.
Herpes
 symptoms can occur 2-10 days after exposure
 may show no symptoms
 can cause itching, blisters/sores, pain/discomfort of
genital area, difficulty or pain in urinating
 estimated 1/7 Canadians aged 14-59 have herpes
 estimated only 1/10 of those know they have it
Herpes
 symptoms can be treated, but herpes cannot be cured
 may be passed on to partners at any time
 viral shedding occurs even when blisters are absent
 pregnant women should be tested
 herpes can be passed on to unborn child, causing
disability or miscarriage
Herpes
 recurrent episodes are usually shorter and less severe
 people have on average about four outbreaks per year
 stress and anxiety are common triggers for outbreaks
HIV/AIDS
 True or False?
 Only MSMs, sex trade workers, and people in third
world countries can get HIV.
 There is a cure for HIV.
HIV/AIDS
 HIV = Human Immunodeficiency Virus; AIDS = Acquired
Immune Deficiency Syndrome
 HIV is a virus that attacks the immune system; an HIV
infection can progress to the AIDS syndrome
 HIV may have no symptoms, or mild symptoms; AIDS
patients can have life-threatening infections or cancer
HIV/AIDS
 an estimated 70 000 people have HIV in Canada; 2500 new
cases each year
 HIV infection increases chances of getting another STI, and
vice versa
 can be passed from a mother to baby through breast milk or at
birth
 There is no cure for HIV!
Hepatitis
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hepatitis = inflammation of the liver
many types of hepatitis; most common are A, B, C
diagnosed via simple blood tests
vaccines available for Hepatitis A & B
each one is transmitted a bit differently:
 A - fecal/oral
 B - blood and body fluids
 C - blood products
 Hepatitis A & B symptoms: flu-like symptoms, darker
urine
 Hepatitis C symptoms: extreme fatigue
 may have no symptoms
Other ways to get HIV and
hepatitis
 IV drug use (20-40% of IV drug users are infected with
hepatitis C within the first year, and up to 90% after 5
years; can also get HIV from IV drug use)
 tattoos
 Prevention!
 Don’t share needles, syringes, and other drug
paraphernalia.
What should I do if I suspect I
have an STI?
stop having sex
get tested at a doctor’s
office or clinic
treat your partners as
well
Preventing STIs
abstinence: the only 100% way of preventing the
spread of STIs
mutual monogamy: limiting sex to one uninfected
partner who only has sex with you
It’s a good idea to ask your partner if she/he has an
STI and work out a risk reduction plan.
Preventing STIs
Do not use/share needles with anyone.
Use a condom during intercourse; this can drastically
decrease the chances of getting an STI. (N.B. Proper
use is EXTREMELY IMPORTANT!)
Other birth control methods: the pill, diaphragms,
spermicide—do those prevent STIs?
Test and treat for STIs as quickly as possible.
Condom Disclaimer
Condoms are not 100% effective against
infections that can be transferred from skin
to skin contact (i.e. herpes, HPV).
Condom Dos and Don’ts
 Do store in a cool dry place.
 Do not leave condoms in the sunlight, a wallet or glove
compartment.
 Do check the expiry date.
 Do use a water based lubricant (e.g. KY Jelly®).
 Do not use oil-based product (e.g. Vaseline®).
Condom Dos and Don’ts
 Do open a package carefully.
 Do not open with teeth or scissors.
 Do not use spermicide with condoms; it may cause
vaginal irritation or cause latex to break down.
 Do practice putting on and taking off the condom.
 Do read the instructions carefully.
Resources
 school guidance counselor
 www.sexualityandu.ca
 family doctor, pharmacist, other health care
professional
 walk-in clinics (Medicentres, SHINE Clinic)
 Capital Health STD centre and info line
1-800-772-2437
What your pharmacist can do
for you
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advice
referral to support services
condoms and other methods of birth control
Plan B®
clean needles and syringes
Quiz! – True or False
1. STIs are transferred
through using public
toilets.
1. False: STIs are commonly
transferred by sexual intercourse
and dirty needles.
2. STI’s are caused by a
variety of organisms.
2. True: Bacteria, viruses, and other
organisms may all cause STIs.
3. Chlamydia is curable.
3. True: Chlamydia can be treated
with antibiotics.
Quiz! – True or False
4. HIV is more easily
transmitted when
another STI is present.
4. True: The presence of an STI
increases the likelihood of
HIV transmission.
5. HPV can be cured.
5. False: HPV can be treated but
not cured.
6. Gonorrhea may lead to
infertility in women.
6. True: Even though gonorrhea
often has no symptoms, it can
cause infertility.
Quiz! – True or False
7. Hepatitis is an
inflammation of the liver.
7. True: The hepatitis virus affects
the liver.
8. Herpes can be transmitted
even when no symptoms
are present.
8. True: Herpes can be transmitted
before any visible signs occur.
9. Syphilis is not a fatal STI.
9. False: If untreated, syphilis can
be fatal.
10. Condoms provide 100%
protection against STIs.
10. False: Only abstinence
provides 100% protection.
Updated March 2008
Questions?
References
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UptoDate. (September 2013). Patient Information: Chlamydia (Beyond the Basics).
Retrieved October 12, 2013: http://www.uptodate.com/contents/chlamydia-beyond-thebasics
Minnesota Department of Health. (March 2013). What you and your partner should
know about gonorrhea and chlamydia. Retrieved October 12, 2013:
http://www.health.state.mn.us/divs/idepc/dtopics/stds/importantinfo.html
Cleveland Clinic. (2013). Understanding Cervical HPV. Retrieved October 12, 2013:
http://my.clevelandclinic.org/disorders/genital_warts/hic_understanding_hpv.aspx
CTV News. (April 2013). One in 7 Canadians has genital herpes: StatsCan study.
Retrieved October 12, 2013: http://www.ctvnews.ca/health/health-headlines/one-in-7canadians-has-genital-herpes-statscan-study-1.1241792
Public Health Agency of Canada. (November 2012). At a Glance – HIV and AIDS in
Canada: Surveillance Report to December 31st, 2011. Retrieved October 12, 2013:
http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2011/dec/index-eng.php
Infectious Diseases Society of America. (2013). A Systematic Review and MetaAnalysis of Interventions to Prevent Hepatitis C Virus Infection in People Who Inject
Drugs. Retrieved October 12, 2013: http://jid.oxfordjournals.org/content/204/1/74.full