Transcript Preventing STDS… - Northwest Portland Area Indian Health Board

Project Red Talon
Preventing STDs and HIV among Tribes in
Oregon, Washington, and Idaho.
NORTHWEST PORTLAND AREA
INDIAN HEALTH BOARD
Northwest Portland Area
Indian Health Board
Established in 1972, the Board is a non-profit tribal
organization serving the 43 federally recognized
tribes of Oregon, Washington, and Idaho.
INDIAN LEADERSHIP FOR INDIAN HEALTH
MISSION:
To assist Northwest tribes
to improve the health
status and quality of life of
member tribes and
Indian people in their
delivery of culturally
appropriate and
holistic health care.
Project Red Talon: Four Objectives
Increase
Capacity to
Prevent STDs
Increase
Awareness
about STDs
Improve
AI/AN
Representation
Improve
Testing &
Treatment
Puberty &
Sexuality
Girls
General order for girls:
 Breast budding (between ages 8 and 13, on average)
 Hips broaden
 Straight pubic hair
 Growth spurt
 Pubic hair becomes kinky
 Menstruation or moon cycle (about 2 yrs. after
start of breast development)
 Underarm hair (in some people)
Boys
General order for boys:
 Growth of testes and scrotum (usually between 10 & 13)
 Straight pubic hair
 Early voice change
 First ejaculation (about 1 year after testicular growth)
 Pubic hair becomes kinky
 Growth spurt
 Underarm hair (in some people)
 Significant voice change
 Facial hair develops (most Native men do not get
facial hair)
Traditional Ceremonies
 What ceremonies were used by
your tribe to celebrate a young
person's “coming of age”?
 If you do not know any - who might
you ask?
 What would you want to do to
celebrate this special time?
Traditional Ceremonies
 The Sunrise Ceremony is a ceremony for Apache
girls to acknowledge and celebrate their transition
from childhood to womanhood. It was traditionally a
four day ceremony, but today it often lasts only a day
or two. During these days, the girls run toward the
four directions to sing songs and dance. They also
participate in and conduct sacred rituals, and receive
and give gifts and blessings. During this ceremony
the girls are filled with the physical and spiritual
power of the White Painted Woman in order to learn
their role as women of the Apache nation.
Traditional Ceremonies
 The Vision Quest is a ceremony for Lakota boys at the
beginning of the path to adulthood. The quest itself is
usually a journey alone into the wilderness seeking
personal growth and spiritual guidance from the spirit
Wakan Tanka. They often last two to four days, during
which the boy drinks only water and does not eat food.
Preparing for a vision quest includes fasting and the
guidance of a tribal Medicine Man to guide the vision
seeker. Although it is often not practical for a 10 or 11 year
old boy to go off on their own these days, elements of a
vision quest can be incorporated into a ceremony to
celebrate the beginning of puberty.
What is Body Image?
?
What is Body Image?
 Body image is the picture you have
of your physical self in your head…
What is Self Esteem?
?
What is Self Esteem?
 Self esteem is how you feel about
yourself as a person…
❉ Both are influenced by society, cultural background, and
life experience.
❉ The way you feel about your body can affect how you feel
about yourself as a whole.
Body Image & Self Esteem
 What sort of things do we
experience that impact our body
image and self esteem?
Sexuality
 Sexuality is not only about having sex, or taking
part in sexual behaviors. Sexuality is also about:
❥ how you feel as a person
❥ how you feel as a boy or girl
❥ the way you dress, move and speak
❥ the way you act and feel about other people
Sexual Orientation
 Sexual orientation refers to a person’s physical or
romantic attraction to other people. The most
common labels are heterosexual, homosexual, or
bisexual. So what do these labels mean?

Heterosexual or straight is used to describe people who
are attracted to and fall in love with people of another gender.

Homosexual (lesbian for females and gay for males) is used
to describe people who are attracted to and fall in love with
people of the same gender.

Some people are bisexual, which means they can be attracted
to and fall in love with people of both genders.
Gender
 Gender refers to how a person feels about being
male, female, or a combination of these. Gender
roles are ways that society expects people to behave
based on their biological sex. Making fun of people
who act differently than the way society expects them
to is hurtful.

Two-Spirit is a term for third gender people that are among
most Native American tribes. It usually implies a masculine
spirit and a feminine spirit living in the same body. These
individuals are often viewed as having two spirits occupying
one body. And they have distinct gender and social roles in
their tribes.
What are some labels that you have
heard used to describe gender
identity or sexual orientation?
How do you feel when adults or
friends inaccurately label you?
What can teens do to prevent or
avoid labels that are hurtful?
Reproductive
Health
The Birds and the Bees…
What mom and Dad may
not have told you.
Male Reproductive System
Male Reproductive System
Male Reproductive System
Urinary bladder
Vas deferens
Prostate gland
Seminal vesicle
Epididymus
Urethra
Penis
Testis
Human Reproductive Endocrine System
Hypothalamus
GnRH
Pituitary gland
FSH
LH
Adrenal glands
Estrogen
Progesterone
Testosterone
Testis
Ovary
Female Reproductive System
Female Reproductive System
Fallopian tube
Uterus
Urinary bladder
Vagina
Sagittal View
Female Reproductive System
Copyright © 2001-2004
Campaign for Our Children
Men’s
Fertility
Cycle
Women’s
Fertility
Cycle
Women’s
Fertility
Cycle
Fact: 1 of every 5
sexually active teen
females will get
pregnant this year.
Sexual Health
Part of growing up is taking
responsibility for our bodies and
our health – this includes STD and
pregnancy prevention.
STDs…
How Many Can you
Name?
Sexually Transmitted Infections
 Chlamydia
 Herpes
 Gonorrhea
 Hepatitis
 Syphilis
 HIV/AIDS
 Crabs
 Human
 Trichomoniasis
 Bacterial Vaginosis
Papillomavirus
(HPV)
Bacteria or Virus
 What is the difference between a
bacterial infection and a viral infection?
Chlamydia trachomatis
Bacteria or Virus
You can cure
with Antibiotics
Chlamydia trachomatis
No Cure:
Just Treatment
Bacteria
Virus
 Herpes
 Chlamydia
 Hepatitis
 Gonorrhea
 HIV/AIDS
 Syphilis
 Human
Papillomavirus
(HPV)
STDs…
 What does the media say about STDs?
 What do our parents say about STDs?
 What do our culture & traditional teachings say?
 What do our friends say about STDs?
 What do our partners say about STDs?
STD: Transmission
Ingest
Fecal
Material
Skin-toSkin
Contact
Sexual
Fluids
STD: Transmission
Ingest
Fecal
Material
Skin-toSkin
Contact
Sexual
Fluids
STD: Transmission
Ingest
Fecal
Material
Skin-toSkin
Contact
Sexual
Fluids
STD: Transmission
Ingest
Fecal
Material
Skin-toSkin
Contact
Sexual
Fluids
STD/HIV
Rates
How common are they?
1 out of 4
sexually
active teens
will get a
STD this
year.
Cases per 100,000
Guess the rates…
which STDs do you
think are most
common?
Cases per 100,000
Chlamydia Rates per 100,000, by Ethnicity
United States – 1996-2004
Fill in the blank…
Fill in the blank…
1 in 10 sexually active
teens has chlamydia
right now.
Compared by ethnicity,
American Indians and Alaska
Natives ranked 3rd in their
rate of HIV/AIDS diagnoses
in 2005.
New AI/AN HIV Diagnoses - 2005
Guess the proportion… What proportion of new HIV
infections occur among youth? What proportion occur
among women?
New AI/AN HIV Diagnoses - 2005
Fact: Two U.S. teens are
infected with HIV every
hour of every day.
STD
Impacts
Copyright © 2001-2004
Campaign for Our Children
Most Infections are Silent!
 Most STDs do not produce
noticeable signs or symptoms.
 75% of women and 50% of men
with chlamydia have no signs or
symptoms.
This woman’s cervix has manifested signs of a erosion
and erythema due to chlamydial infection. (1985)
This patient presented with a case of gonorrhea with symptoms including
cervicitis and vaginal discharge.
This patient presented with a case of gonorrhea with symptoms
including penile discharge.
This patient presented with a lesion of the right hand due to a
disseminated Neisseria gonorrhoeae bacteremia. (1979)
Though a sexually transmitted disease, if a Gonorrhea infection is allowed to go untreated,
the Neisseria gonorrhea bacteria responsible for the infection can become disseminated
throughout the body, forming lesions in extra-genital locations.
These images show chancres on the penile shaft due to a primary syphilis
infection caused by Treponema pallidum bacteria.
The primary stage of syphilis is usually marked by the appearance of a single sore
called a chancre. The chancre is usually firm, round, small, and painless. It
appears at the spot where T. pallidum bacteria entered the body, and lasts 3-6
weeks, healing on its own.
This syphilis patient presented with symptoms indicative of the secondary stage
of the disease, which included multiple lesions located on the penis and scrotum.
Secondary syphilis is the most contagious of all the stages, and is characterized by a systemic
spread of the Treponema pallidum bacterium. The secondary maculopapular rash usually causes
no itching, and can appear as the chancre, or chancres found during the primary stage of syphilis
are healing, or several weeks after the chancres have healed.
Copyright © 2001-2004
Campaign for Our Children
This is an illustration comparing the Head Louse, Pediculus humanus,
with the Pubic Louse, Phthirus pubis.
This patient presented with what was diagnosed as a herpes genitalis
outbreak on the penile shaft due to HSV-2. (1978)
This patient presented with genital warts caused by HPV (Human Hapillomavirus)
Are STDs Serious?
 Yes. STDs are the most preventable
cause of infertility in the U.S.
 Without treatment, chlamydia and
gonorrhea can cause permanent
damage to the reproductive organs.
NW Rates: Youth Impact
 In the Northwest, over 800 Native
youths age 10-24 years were diagnosed
with chlamydia in 2005.
NW Rates: Youth Impact
 40% = PID (N=320) Pain and
permanent scaring in the uterus and
fallopian tubes.
 20% = Infertility (N = 64) AI/AN girls
not able to have children.
Increased Risk for HIV!
 Having an STD increases our
chances of getting HIV 2-5 times
if exposed.
Copyright © 2001-2004
Campaign for Our Children
Importance of
STD Testing
In many States (including Oregon,
Washington, and Idaho), teens age
14 years and above may consent
to STD and HIV testing & treatment
without parental consent.
Chlamydia and Gonorrhea
 The CDC recommends that all sexually
active men and women age 25 years or
younger be screened annually for
chlamydia.
 Test: Urine test, vaginal swab…
 Treatment: Antibiotics cure infection.
How Is It Treated?
 Chlamydia and Gonorrhea are easily
treated with antibiotics.
 It's important to take all the
medicine because the infection can
come back if you don't.
 Also, avoid having sex for a full week
after treatment.
HPV Vaccine
• The HPV vaccine is recommended
routinely for all 11 and 12 year-old
girls. (Tested in girls 9 through 26)
• Vaccine: Three doses over 6 months
• Gardasil®: Protects against 4 HPV
types: Responsible for 70% of cervical
cancer and nearly all genital warts.
HIV
 HIV testing is recommended for
everyone - regardless of age, gender,
or risk.
 Test: Blood, urine, oral fluid – results
take 20 min to one week.
 Treatment: No cure, many treatments.
STD Prevention
& Risk Reduction
The only way to completely
prevent STDs is to abstain from
all types of sexual contact.
If you decide to have sex, you
must take responsibility to
protect yourself and your
partner from unplanned
pregnancy and STDs.
Preventing STDS…
What Works?
Preventing STDS…
What Works?
ABSTINENCE.
Latex condoms.
Sticking to one partner, who has
been tested and is uninfected.
Good communication about sexual
history & STDs.
Avoiding alcohol and drugs.
Latex condoms are the only
form of birth control that can
lessen your risk of
contracting an STD.
Questions?
Northwest
Portland Area
Indian Health
Board
Indian Leadership for
Indian Health
527 SW Hall, Suite 300
Portland, Oregon 97201
Phone: (503) 228-4185
Fax: (503) 228-8182
Email: [email protected]

Stephanie Craig Rushing, MPH
Director – Project Red Talon
[email protected]

Lisa Griggs
Administrative Assistant, Blackfeet
[email protected]
NPAIHB: www.npaihb.org
PRT: http://www.npaihb.org/epicenter/
project/project_red_talon/
Stop the Silence: www.stopthesilence.org