Sex Ed
La Canada High School
Dr.E
Based in part on Kevin Patton. LionDen.com
Why Sex Ed?
Youth Talk about Sex Education
• We can’t talk to parents
• Schools limit or prohibit discussion
• They only seem to want to restrain it
• Abstinence only Sex Education
• The adults should be helping youth
learn to deal with the consequences
of sex
4
Sexual Initiation
•The younger the age of first
sexual intercourse
• more likely forced sexual
intercourse
• greater the risk of unwanted
pregnancy
• greater the risk of sexually
transmitted infections
5
http://healthriskmanagement.eu/promiscuity.html
6
Teen STI
• 18.9 million new cases of STIs
yearly
• 9.1 million (48%) among 15–24-year-olds
• 25% of teenage females are STI positive
• 25% of the sexually active population
• HPV infections account for about
half of STIs diagnosed among 15–
24-year-olds each year
8
Chances of STI
Let’s Review
–50% of Teens have had sex
10
Chances of STI
Let’s Review
–50% of Teens have had sex
–If you have not had sex of any kind you can
not get an STI
11
Chances of STI
Let’s Review
–50% of Teens have had sex
–If you have not had sex of any kind you can
not get an STI
–25% of female teens have an STI (and
therefore about 25% of all male teens)
12
Chances of STI
That means you
have a 50% of
having sex with
someone that has
an STI
13
14
15
Warning: This part of
the course includes
graphic sexual
content
Sexually Transmitted
Disease
Damage with or without
symptoms resulting from an
infection
that is usually (more than half the
time) passed from one person to
another during sexual activity
Sexually Transmitted
Infection
Invasion of and multiplication in body
tissue by a microorganism (eg,
bacterium, virus, protozoan)
that is usually (more than half the
time) passed from one person to
another during sexual activity
STI Symptoms
• Most people have no symptoms
• Infected people – with or without
symptoms – can be contagious
• If you have been sexually active, you
need to be screened for STIs
Sexually Transmitted
Infections
Facts
• Infection rates highest
among 15-19 year
olds
• 86% of all STD’s are
found in ages 15-29
• Estimated total
annual cost of STD’s
in US is >$35 billion
Sexually Transmitted
Infections
Issues
Facts
• Infection rates highest • reluctance to tell
provider or partner
among 15-19 year
olds
• embarrassed
• 86% of all STD’s are • risk-taking behaviors
found in ages 15-29
• Estimated total
annual cost of STD’s
in US is >$35 billion
Sexually Transmitted
Diseases
Treatable
Crabs
Chlamydia
Gonorrhea
Syphilis
Permanent
Hepatitis
Herpes (HSV)
Genital Warts (HPV)
HIV/AIDS
Exoparasitic STD’s
Pubic Lice
What are pubic lice?
• Crab lice or "crabs," are parasitic
insects found primarily in the pubic
or genital area of humans
• Found worldwide and occurs in all
races, ethnic groups, and levels of
society
24
25
26
http://en.wikipedia.org/wiki/File:SOA-Pediculosis-pubis.jpg
27
http://en.wikipedia.org/wiki/File:Fig._3._Pubic_lice_on_eye-lashes.jpg
Symptoms
• Signs and symptoms of pubic lice
include
–Itching in the genital area
–Visible nits (lice eggs)
–Crawling lice
28
How?
• Sexual contact
• Close personal contact
• Contact with articles used by an
infested person
–clothing, bed linens, or towels
• CAN NOT be spread by sitting on a
toilet seat because lice cannot live
away from a warm human body
29
How diagnoses?
• Finding a “crab” or egg (nit)
• May be difficult to find because may
be only a few
30
Treatment
• Wash at HIGH temp clothing and
bedding
• Clothing and items that are not
washable can be dry-cleaned OR
sealed in a plastic bag and stored
for 2 weeks.
• Do not share clothing, bedding, and
towels used by an infested person
31
Bacterial STD’s
Bacteria
• Single-celled microorganisms that
reproduce by binary fission
• Can grow on nonliving surfaces
–Some are harmful
–Most are beneficial - decomposers
Bacteria Infections
• Infectious bacteria enter your body
– toxins that can damage specific cells they've
invaded
• Contagious bacterial infections
– Strep throat
– Tuberculosis
• Noncontagious bacterial infections
– of the heart valves (endocarditis)
– bone (osteomyelitis)
Bacteria Infections
• Treated with antibiotics
– Antibiotics NOT for viral infection
–Increase bacterial resistance to
antibiotics
Bacterial STD’s
Chlamydia
FACTS
• Number Affected: 4 million
• Young, sexually active females need testing every
year
– Most people have no symptoms
– Pass chlamydia to others without knowing it
• Men usually have NO symptoms
• Chlamydia is easy to treat and cure
• If you do not treat chlamydia, it cause
– PID
– Epididymitis
LOWER MY RISK?
• Not have sex
• Only with someone who’s not
infected and who has sex only with
you
LOWER MY RISK?
• Not have sex
• Only with someone who’s not
infected and who has sex only with
you
• Condoms reduce your risk of
getting chlamydia if used the right
way every single time
Chlamydia — Rates: Total and by sex:
United States, 1993–2013
Note: As of January 2000, all 50 states and the District of Columbia had regulations requiring the
reporting of chlamydia cases.
40
41
42
Transmission
• Having sex with someone infected
–anal
–oral
–vaginal sex
• If you are a pregnant woman who
has chlamydia, you can pass the
infection to your baby
43
Symptoms ♀
• May not have any symptoms
• Vaginal or rectal symptoms:
–An unusual discharge from vagina
–Burning during urination
–Pain, bleeding, or discharge from
rectum during anal sex
–If the infection spreads, may get a
fever or have pain during sex
44
45
Pelvic
Inflammatory
Disease
or
Epididymitis
46
47
Symptoms ♂
• Usually none – the carrier
• Symptoms:
–Discharge from penis
–Burning or itching when urinating
–Pain, bleeding, or discharge from your
rectum during receptive anal sex
48
Diagnosis
• Ask a doctor to give you a test for
chlamydia once every 6 months if
sexually active
• The test is easy and painless
49
Get Test ♀
• At least once a year if you are:
–25 or younger and having sex
–Older than 25 and having sex with
more than one partner
–Older than 25 and have a new sex
partner
–Pregnant
50
Get Tested ♂
• See a doctor if discharge or burning
around penis
51
Test
• A doctor can diagnose chlamydia
through:
• Swab test
– fluid sample from an infected site (cervix or
penis) is tested for the bacteria
• Urine test
– urine sample is tested for the bacteria
52
Treatment
• Antibiotics
• Finish all medicine
–Do not share – Need all of it
• Have partner treated
53
If Left Untreated ♀
• May cause PID
• May pass the infection to your baby
when giving birth
• Higher chance of getting HIV
54
If Left Untreated ♂
• Rarely causes long-term health
problems
• May get an epididymitis
–cause pain and fever
–may prevent you from fathering
children.
55
Bacterial STD’s
Chlamydia
Gonorrhea
Also called
• "clap“
• "drip“
• GC
FACTS
• "Clap": 1.1 million
• Common 15-25
• Can pass gonorrhea to others
without knowing it
• Gonorrhea is easy to treat and cure
58
Gonorrhea — Rates of Reported Cases by
Age and Sex, United States, 2013
59
Gonorrhea — Age-specific rates among
men 15 to 44 years of age:
United States, 1993–2013
60
LOWER MY RISK?
• Not have sex
• Only with someone who’s not
infected and who has sex only with
you
• Condoms reduce your risk of
getting chlamydia if used the right
way every single time
Transmission
• Having sex
– anal
–oral
–vaginal contact
• You can pass infection to baby
62
Symptoms ♀
•Vaginal discharge
•Burning and pain while urinating
•Increased urination
•Painful sexual intercourse
•Severe pain in lower abdomen
•Fever
63
64
Symptoms ♂
• Burning and pain while urinating
• Increased urination
• Discharge from the penis (white,
yellow, or green in color)
• Red or swollen opening of penis
• Tender or swollen testicles
65
66
67
68
Get Tested ♀
• Pain or burning when you pass
urine or vaginal discharge
• A partner who has gonorrhea
• Another STD, such as chlamydia
69
Get Tested ♂
• Penis: discharge, pain inside penis,
or burning when passing urine
• Rectum: itching, soreness, bleeding
• A partner that has gonorrhea
• Another STD, such as chlamydia.
70
Test
• Swab sample from the part of the body
likely to be infected
• Urine test
71
Treatment
• Antibiotics
• Finish all medicine
• If symptoms persist, go back to
doctor
• Test again three or four months
after finish treatment – especially if
not sure if partner was also treated
72
If Left Untreated ♀
• May cause PID
• May pass the infection to your baby when
giving birth
• Higher chance of getting HIV
73
• Children are
susceptible to
eye infection
• Pass through the
birth canal
• May result in
blindness
If Left Untreated ♂
• Rarely causes long-term health problems
• May get an epididymitis
– cause pain and fever
– may prevent you from fathering children.
75
Percent of Neisseria gonorrhoeae isolates with
antibiotic resistance, 1990–2007
76
77
Pelvic
Inflammatory
Disease
78
79
How can I find out if I have PID?
• There’s no test for PID
• Usually, a doctor will decide if you have
it from your symptoms
• The doctor can examine you and give
you a test for chlamydia or gonorrhea
Who's at risk for PID?
• Sexually active women
• Multiple sex partners
• Women who are 25 or younger
What are the symptoms of PID?
• Sometimes none
• Severe symptoms
–Pain in the lower abdomen
–Fever
–An unusual discharge from your
vagina, with a bad odor
–Pain when you have sexual intercourse
–Bleeding between periods
How is PID treated?
• Antibiotics
• Finish all of the medicine to be
sure you are cured
Can I get PID again?
• If you are infected with an STD
again
• You have a higher chance of
getting it again
What happens if I don't get treated?
• Scar tissue in the uterus and other
reproductive organs
• May not be able to get pregnant
• Increased chance of ectopic
pregnancy,
• Chronic pain in the pelvic area
86
STI Complications for Men
Epididymitis
Epididymitis Symptoms
•
Pain in the testes
• Groin pain
• Pain during
–intercourse or ejaculation
–urination
–bowel movement
• Discharge from penis
89
Epididymitis Organisms
•
Urinary tract infection
• STD, such as Chlamydia and
gonorrhea
• Other causes of epididymitis
include
–Injury
–Viruses, such as the mumps
–Genital abnormalities
Epididymitis Treatment
•
•
•
•
•
•
•
Bed Rest - stay in bed to keep the testicles from moving
and promote healing. You will need bed rest until the
swelling subsides
Antibiotics
Anti-inflammatory Medication – to reduce swelling
Scrotal Elevation and Support - wear an athletic
supporter for several weeks
Hot Baths - ease the pain and relieve inflammation
Surgery - severe or recurrent cases of epididymitis
Avoid sexual intercourse or ejaculation for at least one
month during recovery and after symptoms disappear
Epididymitis
May take 2 – 4 weeks for
complete resolution
Bacterial STD’s
Chlamydia
Gonorrhea
Syphilis
Facts:
•
•
•
•
Syphilis: 120,000
Progresses in stages
Easy to cure in its early stages
Without treatment, it can hurt your
body’s organs, leading to severe
illness and even death
94
Syphilis Organism
Caused by a bacterium called
Treponema pallidum
Syphilis How?
• Transmission
–Any form of sex
–Skin-to-skin contact with infected
areas
• Pregnant women with syphilis
can pass it to their unborn child
during pregnancy
Syphilis Symptoms
• Syphilis is a disease of stages.
• Different symptoms
• Symptoms come and go
• Remains in the body and can cause
serious damage over time
• The early stages are:
• Primary
• Secondary
• Latent
Primary Syphilis
• A painless sore (or sores) called a
chancre appears on, around, or inside
the penis, vagina, mouth, or anus
• The chancre appears 10 days to three
months after exposure
• The sore is full of bacteria and is very
infectious
99
Primary Syphilis
• May be inside the vagina or somewhere
else hard to see or feel
• Chancres last two to six weeks and then
disappear on their own
101
Secondary Syphilis
• A few weeks after the chancres
disappear,
• Highly infectious rash may appear on
the body, hands, and/or feet.
• May come and go for a year
104
106
Latent Syphilis
–A year after infection
–Symptoms disappear
–Person is no longer infectious
–The disease is still in the body and
WILL cause problems 10 - 15
years later
Syphilis Complications
• If left untreated, syphilis can affect the
heart, brain and other organs
• Damage becomes apparent in the final
stage of syphilis, known as tertiary or
late syphilis
– occurs decades (10 years or more) after
infection
Syphilis Complications
• Complications
– damage to the skin
– bones and internal organs
– neural problems including swelling of the brain,
blindness, seizures, and insanity
– damage to blood vessels and the heart.
• These complications can lead to death
110
Syphilis — Reported Cases by Stage of Infection,
United States, 1941–2013
112
Testing & Treatment
• A blood sample is required to test
for syphilis.
• Syphilis can be easily treated and
cured with certain antibiotics (given
as a shot)
Untreated
• Death in up to 40% of perinatal
cases
• If acquired during the four years
preceding pregnancy, may lead to
infection of the fetus in 80% of
cases
114
115
Prevention
• Condoms offer some protection against
syphilis, but may not cover all infectious
areas
• Pregnant women should seek prenatal
care early and should be tested for
syphilis during the first trimester
• If syphilis is detected and treated early,
pregnant women can prevent damage to
the baby
Syphilis and HIV
• Genital sores (chancres) caused by
syphilis make it easier to transmit and
acquire HIV infection sexually
• An estimated 2- to 5-fold increased risk
of acquiring HIV if exposed to that
infection when syphilis is present
117
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