Transcript STD 101 Workshop

May 4, 2015
NURS 330
Human Reproductive Health
Agenda for 5/4/15
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Grades
Review mid-term
Review In-Class Assignments (4/13/15 & 4/27/15)
Lecture
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Sexually Transmitted Diseases (STDs)
Sexuality
 Group Time
 Distribute Quiz Study Guide
 5/4/15 In-Class Assignment
Grades
Date
Assignment
Possible Points
4/6/15
In-Class #1
10
4/13/15
In-Class #2
10
4/20/15
Mid-term
100
4/27/15
In Class #3
10
Total Possible Points (through 4/27/15)
130
5/4/15
Quiz
25
5/11/15
In Class #4
10
5/18/15
Group Project
25
6/1/15
In-Class #5
10
6/8/15
Final Exam
200
What Are STDs?
 Sexually – relating to having sex, personal intimate
contact (e.g., rubbing of genitals, masturbating a
partner), etc.
 Transmitted – passed by means of, spread by
 Disease – being sick (with or without symptoms),
body not working properly
So, an STD = a disease/infection you can get from or
give to someone else by having oral, vaginal, or anal
sex or other intimate contact with him/her.
Source: County of Los Angeles STD Program
Health Consequences of STDs
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Various Cancers
Infertility
Ectopic pregnancy
Miscarriage
Persistent pain
Death
Other chronic conditions or illnesses
Source: County of Los Angeles STD Program
STDs in the United States
• The CDC estimates that there are approximately 19
million new cases each year in the US 1
• There are an estimated 65 million people in the US
living with a viral STD 2
• More than half of all people will have an STD/STI at
some point in their lifetime. 2
• One in two sexually active persons will contact an
STD/STI by age 25. 2
• The cost of STDs to the U.S. health care system is
estimated to be as much as $15.9 billion annually 1
1
2
Source: Centers for Disease Control and Prevention, cdc.gov
Source: American Social Health Association, www.ashastd.org
BACTERIAL Chlamydia
STDs
Gonorrhea
Syphilis
Transmission
Pre-cum, semen, Pre-cum, semen, Skin-to-skin; genital
vaginal secretions vaginal secretions to genital rubbing
Perinatal
Perinatal
Symptoms
NOTHING or
Discharge from
penis, vagina
NOTHING or
Discharge from
penis, vagina
1-chancre
2-skin, genital rash
3- organ damage
Complications
PID in females
Epidimytis in
males
PID in females
Epidimytis in
males
Blindness, paralysis,
heart problems, etc
Diagnosis
Urine sample
Urethral, cervical
swab
Urine sample
Blood sample
Urethral, cervical
swab
Treatment
Curable with
antibiotics
Curable with
antibiotics
Curable with
antibiotics
Source: County of Los Angeles STD Program
CHLAMYDIA
Risk factors:
Unprotected oral, vaginal or anal sex
GONORRHEA
Risk factors:
Unprotected oral, vaginal or anal sex
SYPHILIS
Oral, vaginal or anal sex
(protected or unprotected)
VIRAL
STDS
HPV
HERPES
HEP B
Transmission
Skin-to-skin;
genital to genital
rubbing
Skin-to-skin; genital Blood, pre-cum,
to genital rubbing;
semen, vaginal
social kissing
secretions
Symptoms
NOTHING –orHigh Risk: Cervical
changes
Low Risk: Warts in,
on around genitals
NOTHING –orBlisters in, on
around genitals
(HSVII) or
mouth (HSV I)
NOTHING –orFatigue, flu-like
symptoms,
jaundice
Complications
Cervical Cancer
Psychosocial
Psychosocial
Complications of
the liver
Diagnosis
HPV test
Pap smear screening
Blood test, blister
sample
Blood sample
Treatment
Not curable
Vaccine available
Not curable
Not curable
Vaccine available
Human Papilloma Virus (HPV)
Vaginal or anal sex
(protected or unprotected)
Pap Smears
 Screens for pre-cancerous cells in cervix
 When to start
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3 years after sexual debut or at age 21, whichever comes first
Remember, you do NOT have to be sexually active to get a pap
smear
 Does not necessarily test for STDs
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You have to ask for specific STD tests
It is important to be your own health advocate
 How often should I get pap smears?
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It varies, depending on your pap results
Your doctor or nurse will let you know
HPV Vaccine
 Vaccine
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Gardasil® by Merck approved in 2006
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Provides protection against four HPV types which together cause
70% of cervical cancers and 90% of genital warts
Three shots over six-month period Licensed for use in girls/women
9-26 years old
In October 2009, FDA approved for use in boys/men 9-26 years old
Another HPV vaccine by GSK currently in final stages of
development
•
Would provide protection against two HPV types that cause most
(70%) cervical cancers
Source: County of Los Angeles STD Program
HERPES
Risk Factors:
Oral, vaginal or anal sex
(protected or unprotected)
HEPATITIS B
Risk factors:
Unprotected sex, sharing needles,
tattoos, sharing household items
such as razors, toothbrushes
OTHER
Yeast
Bacterial
Vaginosis (BV)
Trichomoniasis
Cause
Not an STD.
Caused by an
overgrowth of yeast.
Sexual transmission STD
possible.Overgrowth
of bacteria.
Symptoms
Women - Thick,
cloudy discharge
from vagina, itching
Men – rash on penis
White or yellow
Bubbly, frothy
discharge, fishy odor discharge.
Irritation upon
urination
Complications
No major
complications
Excessive scratching
can cause irritation in
genital area
Increases chance of
HIV infection; If
pregnant, a woman
runs the risk of
pregnancy
complications
Increased risk of
getting HIV
Can cause
Complications
during pregnancy
Diagnosis
Vaginal culture
Whiff test
Vaginal culture
Treatment
Anti-fungal cream
Prescription Drugs
Prescription Drugs
STD Prevention Review
 Abstinence
 Use latex or polyurethane condoms (male or female) and
barriers as much as possible
 Water-based lubricants
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Reduces friction
Get tested regularly
Reduce number of sex partners
Reduce frequency of risky situations
Spectrum of sexual risk, depending on the STD
 e.g., oral sex may be considered low risk for HIV but not
for syphilis
 Talk to partners
 Vaccines - Hepatitis B, HPV
 Get to know your bodies!
What is Sexuality?
“The integration of the physical, emotional,
intellectual and social aspects of sexual being
in ways that are positively enriching and that
enhance personality, communication, and love.
Every person has a right to receive sexual
information and to consider sexual
relationships for pleasure as well as for
procreation. “-WHO
What factors influence Sexuality?
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Values
Attitudes
Behaviors
Physical Appearance
Beliefs
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Emotions
Personality
Likes/Dislikes
Spirituality
Other
Source:http://www.engenderhealth.org/res/onc/sexuality/introduction/index.html
Sex Hormone
Testosterone
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“Male” hormone
Found in small amounts in women
Affects sexual response in men and women
• Men – produced by the seminiferous tubules
• Women - produced by the ovaries
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Increase energy, sex drive (libido), aggression,
appetite, muscle mass Increases libido in both men
and women
FACT
A person’s emotional and mental states also
help determine whether that person
experiences arousal
Sexual Response Cycle
Models of Human Sexual
Response
 Master’s and Johnson
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Proposed their four-stage model of human
sexual response cycle
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Stage I - Excitement
Stage II - Plateau
Stage III - Orgasm
Stage IV - Resolution
EXCITEMENT- 1ST STAGE:
•Response to stimuli
FEMALE
MALE
Transudation
Vasocongestion
Tenting Effect
HR, BP, RR
Myotonia
Penile Erection
Vasocongestion
Testis enlarge
 HR, BP, RR
Myotonia
RR – Respiratory Rate; BP – Blood Pressure; HR – Heart Rate
PLATEAU – 2ND STAGE
FEMALE
MALE
Orgasmic Platform
Tenting Effect
Seminal Pool
Erection is maintained
(if there is enough
stimulation)
Cowper’s Gland
secretes fluid
ORGASM – 3RD STAGE
FEMALE
MALE
Muscle spasms
Involuntary
Collection of semen in the
urethral bulb
Ejaculatory Invariability
-bulbocavernosus muscle
Expulsion of semen
RESOLUTION – 4TH STAGE
FEMALE
MALE
Return to non-aroused
state
Refractory Period
Comparing male and female
sexual response
 Key difference
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Male has a refractory period
There’s a potential for multiple orgasms in women
 Controversies in understanding the female orgasm
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Freud
• vaginal orgasm is true orgasm
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Master’s and Johnson
• only one kind no matter how achieved
Sexual Dysfunctions
Sexual Dysfunctions
 Recurrent or persistent sexual problems that interfere
with normal performance and cause distress
 Nine types of sexual disorders
 Four categories
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Sexual Desire Disorders
Sexual Arousal Disorders
Orgasmic Disorders
Sexual Pain Disorders
Prevalence
Sexual Dysfunctions - Differences
in Men and Women
Female
Male
Sexual Aversion Disorder
Sexual Aversion Disorder
Dyspareunia
Dyspareunia (rare in men)
Vaginismus
Premature Ejaculation
Female Orgasmic Disorder
Male Orgasmic Disorder
Hypoactive Sexual Desire
Disorder
Hypoactive Sexual Desire
Disorder
Female Sexual Arousal
Disorder
Male Erectile Disorder
General Causes
 Physiological/Biological
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Medication and illicit drugs
 Psychological/Emotional
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Anxiety
Negative beliefs
Sexual trauma
 Interpersonal/Social
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Relationship problems
 Environmental
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Cultural factors
Treatment of Sexual Dysfunctions
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Medical treatment of sexual dysfunctions
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Sex therapy
Medical Treatment
 Viagra
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FDA approval in March 1998
Prescription only
Lasts about four hours
Side effects
• Short duration
Sex Therapy
 Principles of sex therapy
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Mutual responsibility is emphasized
Information and education are integral components
Attitudes, expectations, and sexual scripts usually
must be modified
Rape Drugs
 What is a Rape Drug?
A rape drug is one that is used in a drug
facilitated sexual assault.
Rape Drugs (cont)
 The most common rape drugs:
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Rohypnol
GHB
Other common rape drugs
• Ecstasy
• Ketamine
 Odorless, colorless
 Easily dissolved into drinks
Effects of Rape Drugs
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Drowsiness
Disorientation
Disinhibition
Amnesia
Is alcohol a rape drug?