SEX ED AND HIV
FRAMEWORK:
THE NUTS AND BOLTS
11/17/15
Lisa Jo Gagliardi, MPA
lisajo@eupschools.org
Agenda
9:30am: Data-Driven decisions about teaching reproductive health
and choosing curriculum
10:00am: Curriculum Selection and Best Practices
12:00pm: Lunch
12:30pm: The Law-What you need to know to teach Reproductive
Health
2:00pm: Parent Involvement Resources/best practices
2:30pm: Content Update on Sex Offenses
3:15 pm: Content updates in HIV/AIDS and other STIs
4:00pm: Adjourn
• Name
• School/grades
• Why did you come to
this training? What are
you hoping to learn?
WORKING AGREEMENTS
NO KILLER COMMENTS-REPRODUCTIVE HEALTH CAN BE A SENSITIVE
SUBJECT.
NO JUDGING-WE WILL BE DOING A LOT OF DISCUSSION /GROUP WORK
TODAY AND WANT PEOPLE TO FEEL SAFE.
NO RABBIT HOLES-WE WILL TRY TO REFRAIN FROM GOING DOWN RABBIT
HOLES THAT TAKE US AWAY FROM OUR LEARNING OBJECTIVES.
USE “I” MESSAGES-WHEN SPEAKING ABOUT YOURSELF AND YOUR OWN
THOUGHTS AND FEELINGS.
WHAT ARE SOME THINGS YOU THINK WE SHOULD MAKE AS GROUND
RULES FOR TODAY?
GOAL
Provide teachers/other constituents with
the basics of curriculum selection,
instruction and the law, as well as
updates for teaching sexuality and HIV
and STD education
Objectives
• Understand the standards of best practice teaching in HIV
and sexuality education.
• Increase your comfort level for teaching HIV and Sex Ed.
• Understand current trends in youth behaviors and how
HIV and sex education can impact those trends.
• Understand Michigan School Code requirements.
• Identify ways of reaching parents on HIV and sex
education.
• Identify and utilize local, state, and national HIV and
sexuality education resources.
Please note: This training is meant to keep
educators up to date, comfortable and
equipped to teach reproductive health and
HIV/AIDS.
It is required every 5 years for HIV
This is not an endorsement for a teaching
certificate, and has no baring on whether you
are “highly qualified” to teach reproductive
health… that is a teaching
certification/endorsement issue.
HIV/AIDS:
Teacher (no specific
endorsement needed), or a
health professional.
Both must go through
training with the Regional
School Health Coordinator
once every 5 years.
Sex Education (including
Puberty):
Qualified to teach health (§380.1507).
All subjects for elementary classroom teachers.
Secondary level, must have either the MA (health),
MX (health, physical education, recreation and
dance), or KH (family and consumer science)
endorsement.
A HS Health Teacher cannot teach 5th grade
puberty (unless K-12 MA, MX or KH endorsement)
PE is NOT a Health Ed. endorsement.
Ongoing professional development for teachers is strongly
recommended. The Office of Professional Preparation Services at
MDE accepts applications from districts for full-year permits that
allow certified teachers to teach without the required
endorsements, while pursuing coursework toward earning the
endorsement.
HEALTH STANDARDS and
Reviewing GLCEs and MMC
www.eupschools.org
->Programs -> Health Ed.
Looking at
Data.
What we
think vs.
what is
known
TRUE
FALSE
About 52% of Michigan
high school students
have had sex in their
lifetime
True
False- 38.1% according
to 2013 Michigan YRBS
False
About 25% of Michigan
high school students have
had sexual intercourse in
the past 3 months
True
TRUE- 26% according to
2013 Michigan YRBS
False
55% of Michigan high school
students that have had sex in
the past 3 months, did so
under the influence of drugs
or alcohol
True
FALSE- 21% according to
2013 Michigan YRBS
False
Of high school students who
had sexual intercourse in
the past 3 months, 25%
used a condom
True
FALSE- 61% according to
2013 Michigan YRBS
False
8% of Michigan high school
students, who have had sexual
intercourse, have had 4 or
more partners in their lifetime
True
TRUE- according to 2013
Michigan YRBS
False
Michigan high school boys
are more sexually active
than girls
True
FALSE- there is no statistically
significant data to support this
False
ABSTINENCE-BASED V.
ABSTINENCE ONLY
Abstinence
-ONLY
Abstinence-Based
(aka Abstinence+)
Only can talk about
abstaining from
sexual intercourse.
Abstinence is taught as the only
100% safe choice.
Risk reduction is taught.
The degree of risk reduction taught
is up to the Sex Ed. Advisory and
guided by the curriculum chosen (i.e.
condoms, birth control, oral
protection, etc…)
Is your school Abstinence-Only or AbstinenceBased? What are the pros and cons to each?
LET’S TALK
CURRICULUM
See the “Curriculum Evaluation Tool” hand-out
Processing the Curriculum Evaluation
Tool
■Please get into a group of 4
Processing the Curriculum Evaluation
Tool
■Let’s read the first page silently
Processing the Curriculum Evaluation
Tool
■Now, in groups of 4, count off 14
■Each person grab 3 sticky notes.
Processing the Curriculum Evaluation
Tool
■You are assigned to your
section… #1 take section 1, #2
take section 2, etc…
Processing the Curriculum Evaluation
Tool
Read your assigned section silently.
On your sticky notes:
1. Write a word that stands out
2. Write a phrase that stands out
3. Write a sentence that stands out.
Processing the Curriculum Evaluation
Tool
■Now dialogue with your quartet
about why you chose the:
1. Word
2. Phrase
3. Sentence
Be prepared to share out from your group
10 Characteristics of Effective Curricula
-1focus on reducing one or more sexual
behaviors that lead to unintended
pregnancy or HIV/STD infection.
10 Characteristics of Effective Curricula
-2based upon theoretical approaches
demonstrated to be effective in
influencing other health-related risky
behaviors
10 Characteristics of Effective Curricula
-3give a clear message, and continually
reinforce that message.
10 Characteristics of Effective Curricula
-4-
provide basic, accurate information about
the risks of unprotected intercourse and
methods of avoiding unprotected
intercourse.
10 Characteristics of Effective Curricula
-5Includes activities that address social
pressures on sexual behaviors.
10 Characteristics of Effective Curricula
-6Provides modeling and opportunities to
practice communication, negotiation,
and refusal skills.
10 Characteristics of Effective Curricula
-7Employs a variety of teaching methods,
designed to involve participants and
personalize the information.
10 Characteristics of Effective Curricula
-8Incorporates behavioral goals, teaching
methods, and materials that are
appropriate to the students' age, sexual
experience, and culture.
10 Characteristics of Effective Curricula
-9Lasts a sufficient length of time to
adequately complete important
activities.
10 Characteristics of Effective Curricula
-10Has teachers or peer educators who
believe in the program and are provided
appropriate training to deliver the
curriculum
INSTRUCTION
BEST PRACTICES
What is Skills-based Instruction
- explains the skill
- models the skill
- guides practice
- personalizes the use of the
skills.
Why is
Skill-Based
Learning
Important?
Adapted Health
Belief Model
The most important
predictors of current and
future health status
Behaviors
Facts to make
responsible
decisions
Abilities to act
in healthy way
Skills
Understanding
severity
Risks and
benefits
Self-Efficacy
Environmental
Support
Peers, school, home, community support
and reinforcement for healthy behaviors.
Belief that
one can use
the skills to
change life
Typical Practice
Behavior
change
unlikely
Skills
Self-Efficacy
Environmental
Support
SKILLS
-Showing
that they can Analyze Influences
-Exhibiting the ability to Access Information
-Practicing Interpersonal Communication skills
-Demonstrating Decision-making skills
-Demonstrating goal-setting skills to enhance health.
-Practicing health-enhancing behaviors and avoid or
reduce health risks.
-Advocating for personal, family and community
health.
Does your puberty/sex ed or HIV curriculum use skillbased instruction currently? Why do you think is it
important to teach skills-based?
THE LAW FOR
HIV AND SEX ED
Also reviewing Sex Ed. Advisory Board
requirements and 2 year reports
Where to find the laws
Key to Compiled Laws Regarding HIV/STD and Sex Education
MCL No.
Public Act
Last
Action
380.1169
School
Code
Amended
6/04
380.1506
School
Code
Amended
11/77
380.1507
School
Code
Amended
6/04
School
Code
School
Code
Added
7/96
Amended
6/04
388.1766
State Aid
Act
Amended
7/96
388.1766a
State Aid
Act
Added
6/04
380.1507a
380.1507b
Focus
Dangerous communicable diseases; human immunodeficiency virus
infection and acquired immunodeficiency virus infection; teacher
training; teaching materials; curricula; teaching of abstinence from
sex.
Program of instruction in reproductive health; supervision; request
to excuse pupil from attendance; “reproductive health” defined.
Instruction in sex education; instructors, facilities, and equipment;
stressing abstinence from sex; elective class; notice to parent or
guardian; request to excuse pupil from attendance; qualifications of
teacher; sex education advisory board; public hearing; distribution of
family planning drug or device prohibited; “family planning,”
“class,” and “course” defined.
Notice of excuse from class; enrollment.
Sex education and instruction; curriculum requirements.
Dispensing or distributing family planning or drug or device,
dispensing prescriptions for family planning drug, or making
referrals for abortion; forfeiture.
Instruction in reproductive health or other sex education; complaint
process.
Mandated HIV and allowable Sex Ed.
 This means that you must teach HIV/AIDS at each
building level (elementary, middle and High
School)
 This part of the law also says that Sex Ed is
optional and allowable
Sex Ed. Advisory Board
 Every district that chooses to implement sex education
must have a sex education advisory board.
 School board sets terms of service, number of members,
and a membership selection process
■ must include: parents, pupils, educators, local clergy,
and community health professionals--At least half of the
members must be parents. A majority of those parent
members must not be employed by a school district.
■ Members must be given two weeks written or electronic
notice of meetings
Sex Ed. Advisory Board-ROLE
 Establishing program goals and objectives
 Reviewing and recommending materials and
methods to the board, taking into consideration
the district’s needs, demographics, and trends
including, but not limited to: teenage pregnancy
rates, STI rates, and incidents of sexual violence
and harassment.
 Evaluating, measuring, and reporting the
attainment of program goals and objectives and
Sex Ed. Advisory Board-MEMBERS
 Sex Ed. Supervisor; usually a Superintendent,
Principal or School Health Professional.
 2 co-chairs for the advisory. One must be a
parent, and one is a school person.
 ½ Advisory must be “pure parents”.
 The board of a school district shall include pupils
of the school district, educators, local clergy, and
community health professionals on the sex
education advisory board.
Sex Ed. Advisory Board-Definition of Sex
Education
 It’s useful to develop or adopt a definition of sex
education that aligns with existing definitional
language in the law.
Sex Ed. Advisory Board-Curricula Approval
 Curricula that are used as a part of HIV/STI or sex
education instruction must go through the formal
approval process, including two public hearings
and school board approval.
Curricula Approval Factors
Curricula, materials, and methods must be approved
in advance regardless of the:
 class in which it is taught (e.g., health class, schoolwide assembly, English class);
 person providing the instruction (teacher, school
nurse, guest speaker)
 time of day the instruction is offered (during the
school day versus after school); or
 place the instruction takes place (within the
building versus off the school premises).
Prohibited Content and Actions
 Ensure pupils are not taught in a way that condones the
violation of laws of this state including, but not limited to:
those relating to sodomy, indecent exposure, gross
indecency, and criminal sexual conduct in the first,
second, third, and fourth degrees.
 Clinical abortion cannot be considered a method of
family planning, nor can abortion be taught as a method
of reproductive health.
 A person cannot dispense or otherwise distribute a
family planning drug or device in a public school or on
public school property.
Model Curricula-Michigan Model for
Health
7-8 grade HIV/AIDS/STI: Qualifies as
HIV/AIDS curriculum.
9-12 Healthy and Responsible Relationships
(covers sex. Ed and HIV/AIDS and STI).
Elementary Teachers attending today’s
HIV/AIDS/STIs training will be considered
trained for elementary
All of the above are FREE to you thanks to our
State grant, and we can train you in them.
Other curricula that is good
Puberty: the Wonder Years: good for grades
4-6th. (can train, cannot pay for curriculum)
F.L.A.S.H.: Free online curricula for pubertyH.S. Sex Ed. Has a Special Education
curricula too. (It is Free. Not equipped to
train in it)
Healthy Sexuality, from RMC Health: good
for grades 6-8. ($200. Not equipped to train
in it. Need to add in Michigan Law pieces.)
Other curricula
There are many other good curricula out
there. Be sure to use the Curriculum
Evaluation Tool when reviewing a new
curriculum.
Parental Rights and Exclusion from
Instruction
Parents have
 The Right to know the content of the
instruction.
 The right to review materials in advance.
 The right to observe instruction.
 The right to excuse their child without
penalty
Parent Complaint Process
 person can file a complaint with the
superintendent or chief administrator of the
district or ISD in which the pupil is enrolled..
 If the parent is not satisfied with the investigation
or findings made by the superintendent, the
parent can appeal the findings to the ISD in which
the district is located.
 If the parent is not satisfied with the investigation
or findings they can appeal the findings to the
MDE.
PENALTIES!
 If an investigation conducted by MDE reveals that
one or more violations of the Revised School Code or
State School Aid Act, the district or ISD shall forfeit
an amount equal to 1% of its total state school aid
allocation.
 A district in which a school official, member of a
board, or other person dispenses or otherwise
distributes a family planning drug or device,
dispenses prescriptions for any family planning drug,
or makes referrals for abortions shall forfeit 5% of its
total state aid appropriation.
Sex Ed. must include A-K of the law
(Law 380.1507b)
 See A-K curriculum Checklist for next activity.
You will be assigned a Letter.
You will present your letter of the law
with a visual presentation. Use the
chart paper and markers supplied.
You have 15 minutes.
Example
A). Discuss the benefits of abstaining from sex until marriage and the
benefits of ceasing sex if a pupil is sexually active.
NO. I do
not want to
have sex
STOP
HIV/AIDS
&
STI
Looking at Data.
What we think vs. what is
known.
True
False
CHLAMYDIA ACCOUNTS FOR
MOST SEXUALLY
TRANSMITTED INFECTIONS
IN THE OUR REGION.
True
TRUE-according to
MDHHS
False
HIV/AIDS SHOULD BE
TAUGHT AT EVERY BUILDING
LEVEL (ELEMENTARY,
MIDDLE AND HIGH SCHOOL)
True
TRUE-Per Michigan
School Code
False
HIV/AIDS CURRICULUM MUST BE
APPROVED BY THE SCHOOL
BOARD, BUT DOES NOT HAVE TO
GO THROUGH THE SEX
EDUCATION ADVISORY
COMMITTEE
True
TRUE-Sex education must go
through the advisory
False
HIV-AIDS abstinence only has to go through the
School Board
MICHIGANDERS, AGES
15-24 YEARS, ACCOUNT
FOR 75% OF ALL
CHLAMYDIA CASES
True
True- according to MDHHS
False
IN MICHIGAN, 64% OF
ALL GONORRHEA CASES
ARE FOUND IN 24-29
YEAR OLDS
True
FALSE- It is actually 15-24
year olds,
according to MDHHS
False
What Is AIDS?
A = Acquired:
Something that you get from someone who is
infected
I = Immune:
Refers to body’s defense system
D = Deficiency:
A lack of
S = Syndrome:
A collection of diseases or malignancies
What is HIV?
H = Human
Something that you get from someone who is infected
I = Immunodeficiency
Refers to the breakdown in the body’s defense system
V = Virus
a sub-microscopic infectious agent
Window Period
Defined as the point of infection to the development of
enough antibodies to be detectable on a test…
Timeframe for testing HIV antibody positive:
 Most people will develop detectable
antibodies within 2-8 weeks (the average
is 25 days).
 97% by 3 months
Stages of HIV Infection
 Acute HIV Infection
 Asymptomatic
 Chronic Symptomatic
 Advanced HIV Disease (AIDS)
Acute HIV Infection
A person newly infected with HIV may
experience some initial temporary
symptoms including:
Fever
Fatigue
Red rash
Headache
Sore throat
Muscle pain
Swollen lymph nodes
Vomiting
Upset stomach
Asymptomatic HIV Disease
Period of no symptoms
Longest stage of HIV infection. Most people
will experience no symptoms for 5-10 years
(or longer)
95% of persons infected will progress to
experiencing symptoms at some point
Chronic Symptomatic Stage
Signs/symptoms include:
 Fatigue
 Swollen lymph nodes
 Fever/night sweats
 Weight loss
 Diarrhea
 Neurological symptoms
 Respiratory problems
 Unusual skin conditions
 Severe headaches
 Chronic generalized pain
 Thrush
Chronic Symptomatic Stage
Signs in Women:
 Persistent vaginal yeast infections
 Pelvic inflammatory disease (PID)
 Cervical abnormalities
 Invasive cervical cancer is an AIDS
defining illness
 Menstrual irregularities
Advanced HIV Disease (AIDS)
CDC AIDS Case Definition:
To be diagnosed with AIDS, a person must have:
Evidence of HIV infection
and at least one of the following:
A CD4+ count below 200
(normal CD4+: 800-1200)
OR
Has been diagnosed with one or more of the 26
AIDS defining conditions
26 AIDS Defining Conditions
 A few of the most common:
• KS: Kaposi’s Sarcoma
• PCP: Pneumocystis carinii pneumonia
• Toxo: Toxoplasmosis
• Thrush: esophageal candidasis
• TB: Tuberculosis
• CMV: Cytomegalovirus
• HIV encephalopathy: AIDS-related dementia
Point of Infection
Stages of HIV Disease
Immune Strength
Antibody Levels
Viral Load
Acute
Asymptomatic
Chronic Symptomatic
Advanced
HIV Infection
HIV Disease
HIV Disease
HIV Disease
(AIDS)
What are the 5 bodily fluids that can
transmit HIV?
Body Fluids Known to Transmit HIV
Blood
Semen
Vaginal/cervical fluids
Breast milk
Any body fluids containing blood
[Cerebrospinal fluid, fluid
surrounding a fetus, fluid
surrounding joints]
Formula for Assessing Risk
Risk is related to:
• Which body fluid
• Route of entry into the body
• Dose of infected fluid
• How long fluid is out of body
• Number of exposures
• Condition of host
• Condition of recipient
No Casual Spread
Can’t be spread through:
Hugging
Touching
Using a public toilet
Utensils
OTHER Behaviors that can Transmit HIV
Behaviors related to Birth (Perinatal Transmission)
From mother to baby, transmission can occur:
• During the birthing process
• Through breast feeding
Types of Testing
 Anonymous
 Client tested with
number
 Confidential
 Client tested with
name & other
identifiers
 Blood
 Oral fluid
■ Most common HIV test is the antibody screening test- looks for the antibodies that
your body makes against HIV. Can be in a lab or as a rapid test at the testing site.
Performed on blood or oral fluid (not saliva). Because the level of antibody in oral
fluid is lower than it is in blood, blood tests tend to find infection sooner after
exposure. Most blood-based lab tests find infection sooner after exposure than rapid
HIV tests.
■ Some tests detect both antibodies and antigen (part of the virus itself). These tests
can find recent infection earlier than tests that detect only antibodies. These
antigen/antibody combination tests can find HIV as soon as 3 weeks after exposure
to the virus, but they are only available for testing blood, not oral fluid. Not all testing
sites offer this test by default.
■ The rapid test is an immunoassay used for screening, and it produces quick results,
in 30 minutes or less. Rapid tests use blood or oral fluid to look for antibodies to HIV.
If an immunoassay (lab test or rapid test) is conducted during the window period
(i.e., the period after exposure but before the test can find antibodies), the test may
not find antibodies and may give a false-negative result.
■ Follow-up diagnostic testing is performed if the first immunoassay result is positive.
Modes of Testing
 OraSure (collection of oral mucosal
transudate-OMT)
 Dried Blood Spot (Clinic collection finger
stick)
 Clearview (15 min rapid testing)
 Traditional Blood Draw
Global Impact
 Estimated 35 million people living with HIV
and AIDS in 2013
 3.2 million were <15 years old)
 2.1 million new infections occurred in 2013
 HIV is the world’s LEADING INFECTIOUS
KILLER
Michigan Data on HIV/AIDS
■ Estimated 19,800 people living with HIV in Michigan as of January 2013.
■ Below is the 5 year trend from 2008-2012
Michigan Data on HIV/AIDS
■ The number and rate of new HIV diagnoses in Michigan remained stable
between 2008 and 2012, with an average of 809 new cases per year and an
average rate of 8.2.
■ The highest rates of new HIV diagnoses occurred among:
– 20 - 24 and 25-29 year olds
– Black males and females
– Men who have sex with men (MSM)*
– Southeast Michigan residents
■ INCREASES in rates occurred among:
– 20 - 24 year olds (4th consecutive trend report)
■ Almost three quarters of Michigan’s new cases among 13 - 24 year olds were
residents of SE Michigan at diagnosis.
What other skills or concepts, besides
preventing this specific infection/disease,
might we want to teach when teaching
HIV/AIDS? What other skills can we teach
kids when they are learning about HIV?
PREVIEWING A
VIDEO
Understanding HIV & AIDS
Accessing Videos
and other resources on our website!
www.eupschools.org ->Programs
-> Health Education
STIs
Sexually Transmitted Infections
CDC has great fact sheets on
STIs (STDs) here:
http://www.cdc.gov/std/healthcomm/fact_sheets.htm
Michigan STI Surveillance
http://www.mdch.state.mi.us/pha/osr/Index.asp?Id=12
Why STI not STD???
■ STI stands for sexually transmitted infection.
– The medical community has begun transitioning
from “STD” to “STI” to clarify that not all sexually
transmitted infections turn into a disease.
– For instance, the vast majority of women who
contract the VIRUS HPV (human papilloma virus)
will not develop the resulting disease cervical
cancer.
– Nevertheless, currently you will still see STI and
STD used interchangeably.
Types Of STI’s
■ Bacterial Infections: Infections caused by bacteria that can be
cured.
– Chlamydia, Gonorrhea, Syphilis
■ Viral Infections: Infections caused by a virus that can be
treated.
– HBV, HCV, HPV, HIV
■ Parasitic Infections: Infections caused by tiny organisms that
can be cured.
– Trichimoniasis
Chlamydia
Symptoms
■ Females
– NONE
– Low abdominal pain
– Bleeding between
periods or after
intercourse
– Painful intercourse
– Creamy discharge
■ Males
– NONE
– Clear, creamy, or milky
discharge
– Burning or irritation with
urination
■ Newborns
– pneumonia
– ophthalmia
Chlamydia Fast Facts
■ Most common reportable disease in the US
■ Highest age specific rates by gender
Females: 15 - 19 year old
Males: 20 - 24 year old
■ “Silent” Disease:
75% of women have no symptoms
50% of men have no symptoms
■ Complications
– Infertility from PID in women
– Infertility from Epididymitis in men
■ Increases transmission/acquiring of HIV
Chlamydia
Statistics
1,422,976 chlamydial
infections were
reported to CDC for
all 50 states and the
District of Columbia
~CDC 2010
48,505 in Michigan as
of 2013
~MDHHS
Leading STI
our region for
15-24 year
olds
Gonorrhea
Symptoms
■ Females
– NONE
– Creamy, yellowishgreen discharge
– Burning or irritation
when urinating
– Low abdominal pain
– Painful intercourse
■ Males
– NONE
– Creamy or yellowish-green
discharge
– Pain, burning or tingling
sensation when urinating
– Painful or swollen testicles
■ Newborns
– Ophthalmia
Gonorrhea Fast Facts
■ Highest age specific rates by gender
– Females:15-19 year old
– Males: 20-24 year old
– 75% cases in 15-29 years old
■ 50% of women have no symptoms
■ Complications
– Infertility from PID in women
– Infertility from Epididymitis in men
■ Increases transmission/acquiring of HIV
Gonorrhea
Statistics
■ In Michigan, 67% of
all Gonorrhea cases
are from 15-24 year
olds
■ In 2012, 334,826
cases were reported
– CDC
■ In 2014, 9,666
cases in Michigan.
– MDHHS
Syphilis
Symptoms
Primary:
10-90 day incubation period
Painless sore
Secondary:
6 weeks-6 months incubation period
Rash all over; sores, especially on palms of hands and
feet
Tertiary:
> 1 year (latent)
Damage to heart, central nervous system; paralysis; death
Syphilis
■ Highest age specific rates by gender
– Females: 20-29 year old
– Males: 20-29 year old
■ Untreated early syphilis during pregnancy
– Resulted in perinatal death in up to 40% of cases
– If acquired during four years pre-pregnancy may lead to
infection of the fetus in over 80% of cases
■ Increased transmission/acquiring of HIV
Syphilis
Statistics
In Michigan, the
largest percentage of
cases are in 30-44
year old category
In 2012, there were
14,503 cases
reported in the U.S.
~ CDC
1,116 in Michigan
~MDHHS
Herpes
Symptoms
■ Transmission
– vaginal, oral, anal sex
■ 2-20 day incubation period.
■ Flu-like feelings.
■ Painful sores or blisters on the sex organs or
mouth lasting 1-3 weeks, but may recur
periodically.
■ Itching, tingling or burning before blisters
appear.
Genital Herpes
Statistics
■ 45 million people in the United States ages 12 and
older infected
■ 1 in 6 sexually active adolescents and adults infected
■ 1 in 5 sexually active women infected
■ Most people who have genital herpes don't know it
because they never have any symptoms
Human Papiloma Virus (HPV)
Statistics
■ Most common STI
■ 20 million people are currently infected with HPV
■ 6 million Americans get a new genital HPV infection each year
■ More than 100 different strains or types of HPV
■ Over 40 types are sexual HPV
■ 50% sexually active people will acquire genital HPV at some point in their lives.
■ “High-risk” types of HPV may cause abnormal Pap tests
■ “Low-risk" types of HPV may cause mild Pap test abnormalities or genital warts
HPV and Cancer
■ HPV can cause cervical and other cancers including cancer
of the vulva, vagina, penis, or anus. It can also cause cancer
in the back of the throat, including the base of the tongue
and tonsils (called oropharyngeal cancer).
■ Cancer often takes years, even decades, to develop after a
person gets HPV. The types of HPV that can cause genital
warts are not the same as the types of HPV that can cause
cancers.
■ There is no way to know which people who have HPV will
develop cancer or other health problems. People with weak
immune systems (including individuals with HIV/AIDS) may
be less able to fight off HPV and more likely to develop health
problems from it.
The World of HPV
■ HPV (the virus): About 79 million Americans are currently infected with HPV.
About 14 million people become newly infected each year. HPV is so common
that most sexually-active men and women will get at least one type of HPV at
some point in their lives.
■ Health problems related to certain types of HPV include genital warts and
cervical cancer.
■ Genital warts: About 360,000 people in the United States get genital warts each
year.
■ Cervical cancer: More than 11,000 women in the United States get cervical
cancer each year.
■ In most cases, most kinds of HPV go away on its own and does not cause any
health problems. But when HPV does not go away, it can cause health problems
like genital warts and cancer.
■ Genital warts usually appear as a small bump or group of bumps in the genital
area. They can be small or large, raised or flat, or shaped like a cauliflower. A
healthcare provider can usually diagnose warts by looking at the genital area.
Genital Warts (HPV)
■ Types 16, 18, 31, 33, and 35
– Related to cervical cancer
■ Type 16 accounts for more than 50%
■ Types 16, 18, 31 and 45 account for 80%
– Cause Pap smear abnormalities
■ Types 6 and 11
– Cause genital warts
– Cause recurrent respiratory papillomatosis in infants
(STD Surveillance 2010)
MDE TOT October 12, 2009
Genital Warts (HPV)
■ Transmission:
– Direct skin to skin contact during vaginal, anal or possible oral sex
■ Symptoms:
– May be asymptomatic
– Small, bumpy, cauliflower growths on the sex organs, throat or anus
– Itching or burning around the sex organs
■ 4-6 weeks to 9 month incubation period
What To Do if Exposed to an STI
■ Seek health care provider for exam, testing,
and treatment
■ Stop having sex until you and your partner are
treated and have finished all medication
■ Notify partner
■ Get tested for HIV
Risk Reduction from STIs
■ Abstinence from sex & needles is only PREVENTION.
■ Have sex with only one partner who only has sex with you.
■ Avoid using alcohol and other drugs.
■ Talk to your partner about past sex partners.
■ Correct, consistent use of condoms, dental dams, and female
condoms.
Treatment
■ Get tested, tell partner if you think you may
have or were exposed to an STI
■ Entire dose of medication must be taken to
completely treat the STI
■ Avoid sex for duration of treatment and 5 to
7 days after or as directed
■ Do not take anyone else’s prescription
medication
QUESTIONS/COMMENTS?
LISA JO GAGLIARDI
REGIONAL SCHOOL HEALTH COORDINATOR
lisajo@eupschools.org
(906) 632-3373 ext. 132