The Secret Epidemic:
STIs on Campus
A Presentation of the American College Health Association
American College Health Association
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Discussion Points for Today
 Sexually Transmissible Infections (STIs)
 Three Common STIs among Teens and Young Adults
 The Most Common STI among Teens and Young Adults
 What to do if you think you have an STI
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Infections—Generally Speaking
 What are they?
• Overgrowths of bacteria, viruses, fungus (yeast), or protozoal
pathogens
 How are they spread?
• Inhalation of infected air, contact with infected body fluids, contact
with infected skin (rashes, lesions)
 How can they be prevented?
• Avoiding contact with infected air, fluids, and skin
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Sexually Transmissible Infections (STIs)
 Also known as
• Sexually Transmitted Diseases (STDs)
• Venereal Diseases
 What are your risks?
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Sexually Transmissible Infections
 Bacterial Infections
• Chlamydia
• Gonorrhea
• Syphilis
 Viral Infections
• Herpes
• Hepatitis B
• Molluscum contagiosum
• HIV
• Human papillomavirus
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Common STIs among Teens and Young Adults
 Human Papillomavirus (HPV) (virus)
• Warts on genitals and anus (men and women)
• Warts and pre-cancers on cervix (women)
• Often asymptomatic, presenting no visible symptoms
• Communicable or non-communicable when asymptomatic
 Chlamydia (bacteria)
• Infected cervix, tubes, epididymis
• Sometimes no symptoms at all
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Common STIs among Teens and Young Adults
 Herpes (HSV I & II) (virus)
• Painful ulcers
• Often no symptoms at all
 Molluscum Contagiosum (virus)
• Pimple-like lesions
• Often confused with pimples or folliculitis
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“Risky Contact” for the Spread of STIs
 You don’t have to have sexual intercourse to contract an STI
• Many STIs are spread by direct skin contact
• Everyone who has “risky contact” is at risk
• Teens and young adults are more “at risk” than other populations
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“Risky Contact” for the Spread of STIs
 Condoms do NOT completely protect from infections spread by
skin contact, because they do not cover all infected areas of the
skin
HPV
Herpes
Molluscum
Infection with these organisms does not require penetration
during intercourse if there is other “risky contact.”
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“Risky Contact” for the Spread of STIs
 Avoid “risky contact,” which is any contact with skin or fluids
that may contain the viruses and bacteria that cause STIs
 Don’t share intimate apparel such as swimwear or underwear
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Who gets STIs?
 Anyone who has “risky contact” with a person with an STI
 One contact might be all it takes to get an STI
 The more contacts, the greater the risk
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STI Prevention
 Abstinence works best
• Avoid genital touching
• Many teens and young adults are now choosing abstinence
• Abstinence reflects feelings of self worth and self esteem
• Not everyone is “doing it”
• Sexual activity is NOT a requirement for friendship or social
acceptance
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The Most Prevalent STIs
Chlamydia
 Women: infects urethra, cervix
•
•
•
•
Often no symptoms
Sometimes pain with urination or lower abdominal pain
Infection can spread to tubes and ovaries
Can cause infertility
 Men: infects urethra, epididymis
• Can cause pain with urination
• Swelling and pain of the testicles
Spread by body fluids
Semen
Vaginal
Anal
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Epididymitis due to Chlamydia - the swelling of this
infection is seen above the right testicle
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Hydrosalpinx resulting from Chlamydia - closed,
swollen and water-filled left tube in a young woman
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The Most Prevalent STIs
Genital herpes
 Men and women: genital skin
• Extremely painful lesions
• Often no symptoms
 Women: cervix
• Abnormal vaginal discharge
• Often no symptoms
• May infect newborns during delivery
Spread by skin contact
Genital-Genital
Hand-Genital
Oral-Genital
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Penis with vesicles (blisters) from genital herpes
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External genital skin of female with herpes ulcers
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The Most Prevalent STIs
 Molluscum
• Can appear anywhere on the skin
• Bumps that look like pimples
• Can become infected with bacteria
Spread by body skin contact
Genital-Genital
Hand-Genital
Oral-Genital
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Molluscums of lower abdomen
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External genital skin of female with huge molluscums
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Human Papillomavirus (HPV)
 Over 100 types of HPV
• More than 20 types of HPV can infect genital skin
• Men and women: genital and anal warts
• Women: lesions on the cervix and vagina
Spread by skin contact
Genital-Genital
Hand-Genital
Oral-Genital
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Human Papillomavirus (HPV)
 HPV: Genital Warts
• Men and women: external genital skin, anus, in urethra
• Women: cervix, vaginal walls
• Condoms offer some protection, but don’t cover all of the skin that
can be infected
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Papillary genital warts of female
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Papillary genital warts of female
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Flat genital warts of male
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Papillary genital warts of male
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Papillary genital warts of male
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Papillary genital warts of male anus
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HPV Treatments
Treatments for External Genital Warts
 Patient-applied prescription remedies
• Aldara™ (imiquimod) Cream, 5%
• Condylox™ gel 0.5% (podofilox)
 Procedures performed in the doctor’s office
• Freezing–cryoprobe or liquid nitrogen
• Caustic chemicals–TCA, BCA, podophyllin
• Laser
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HPV and Pre-Cancers
 Cervix and anus: some HPV types cause lesions that can
be pre-cancers
• If not treated, they can eventually become cancers
 The Pap smear detects lesions on cervix
• Cells scraped from cervix are examined under a microscope
• If they have ever had sexual contact, women need yearly Paps
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Genital warts on cervix of female
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Pre-cancer changes on cervix
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HPV—Treatments of the Cervix and Anus
 Cervix: destruction of lesion by freezing, laser, loop excision
• These treatments are about 90% successful
 Anus: similar to external genital warts
• Aldara™, Condylox™, freezing, caustic chemicals, laser
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HPV Protection
 Consistent condom use can cut down, but not eliminate, the
transmission of HPV
 Many HPV-associated lesions resolve spontaneously, but they
may return
 Warts can be treated and removed, but the virus may remain in
latent form
 See your health care provider for an accurate diagnosis and
appropriate treatment
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What about HIV/AIDS?
 HIV usually leads to AIDS
• AIDS is fatal—newer treatments prolong life, but not to a full life
expectancy
• Having an STI can increase the risk of acquiring HIV
• 2 in 1,000 young adults are HIV positive
• 92 in 1,000 young adults have chlamydia or HPV
HIV is spread by body fluids
Semen
Vaginal
Anal
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If you think you have an STI
 See a health care professional
 Be honest about your sexual behavior
 Ask for explanations
 If you do have an STI, notify your partner
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Testing for STIs
 There is no single test that detects all STIs
 No test is perfect (every test can fail to detect an infection)
 Screening tests (used when no symptoms are present)
• HPV (visual examination; Pap smear tests the cervix only)
• Chlamydia, gonorrhea (tests of genital secretions or urine)
• HIV, syphilis (specific blood tests)
• There is no reliable test for herpes when symptoms are absent
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STI Prevention
 Alcohol and Drugs contribute to becoming infected with an STI
 Combined with sexual activity, the use of alcohol and other
drugs is strongly associated with:
• Sexual activity when you are not really ready
• The spread of STIs
• Unwanted/unplanned pregnancy
• Acquaintance/date rape
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Remember: Abstinence works best
 Avoid genital touching
 Many teens and young adults are choosing abstinence for now
(this does NOT mean life-long celibacy)
 Abstinence reflects feelings of self worth and self esteem
 Not everyone is “doing it”
 Sexual activity is NOT a requirement for friendship or social
acceptance
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For more information about STIs, contact your health
service or other health care professional.
Visit the National HPV & Cervial Cancer Prevention Resource Center
at www.ashastd.org/hpv/hpvrc/toc.html
or contact ACHA at (410) 859-1500
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