Transcript STI`s and Unplanned Pregnancy

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Pain during sexual intercourse
Genital itching
Burning pain when urination/bowel
movement
Sores, rashes, lumps, bumps, blisters
Discharge from penis & and vagina (may
have an odour)
Pain/swelling of glands in groin
Deep abdominal pain
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Syphilis - presence of sores in the mouth or the genital region. Sores last about five weeks generally
heal by themselves. Fever, patchy hair loss, headaches, weight loss and swollen glands with no itch
indicate the second stage. Paralysis, gradual blindness dementia and death are a possibility in the last
stage of syphilis. The infection is treated with antibiotics.
Chlamydia- usually has no visible symptom. There is an abnormal discharge from the vagina and
penis. It could also be accompanied with pain in the testicles and burning sensation during urination.
Pelvic organ inflammation is also seen in women. Chlamydia has to be treated with oral antibiotics.
Genital Herpes: Type 1- HSV-1 causes cold sores and fever blisters in the mouth but can be spread to
the genitals.
Type 2-HSV-2 usually occurs on the genitals bit can spread to the mouth. An outbreak of Herpes
causes painful blisters to appear on the genital organs, buttocks or thighs. There is no cure. An
antiviral drug can help the pain and itching and also reduce the frequency of frequent outbreaks.
Gonorrhea- pain or burning while urination. There may be a yellowish or sometimes, even a bloody
discharge from the penis or vagina. A sexual intercourse may itself be painful. Gonorrhea is treated
with oral antibiotics.
Chancroid- tiny swellings in the genital organs. These swellings gradually turn into ulcers and are
usually painful. Often, there is an associated tenderness in the lymph nodes. Chancroid is treated with
oral antibiotics.
Hepatitis B- mild fever, headaches, muscle aches and joint pain. It is also accompanied by loss of
appetite, nausea and vomiting. Fortunately, there is hope that all future cases of the infection will be
eliminated by routine immunizations of all children with the Hepatitis B vaccine
Bacterial
Chlamydia
An often-asymptomatic infection
That can lead to reproductive complications
What is it?

• The most common bacterial sexually transmitted infection
• Greatest number of infections found in people 15 to 24 years old
• Can affect the cervix and urethra, and occasionally the rectum,
throat, and eye
How is chlamydia transmitted?
• Chlamydia can be spred through unprotected oral, vaginal or
anal sex with an infected partner
• Penetration and ejaculation are not required for transmission
• It can be passed from an infected mother to her infant during
birth, causing lungand/or eye infections
Bacterial
Gonorrhea
An often-asymptomatic infection
That can lead to reproductive complications
What is it?

• The second most common bacterial STI
• Two-thirds of reported cases in Canada are in men
• Most common in individuals 15 to 29 years
• Can affect the cervix, urethra, rectum, throat, and occasionally the eyes
• Often occurs as a co-infection with chlamydia
How is gonorrhea transmitted?
• Gonorrhea can be spread through unprotected oral, vaginal or anal sex
with an infected partner
• Penetration and ejaculation are not required for transmission.
• It can be passed from an infected mother to her infant during birth,
causing an eye infection.
Bacterial
Syphilis
A staged STI once considered rare in
Canada, but now on the rise
What is it?

• An infection sometimes called the great imitator because symptoms
mirror those of some common medical conditions
• Progresses in stages
• Infectious in the first year after contraction
How is syphilis transmitted?
• Through oral, vaginal or anal sex with an infected partner
• Through direct contact with bacteria contained in syphilitic sores or
rashes
• In rare cases, from sharing unclean needles or receiving a blood
transfusion
• From an infected mother to her fetus, which can result in fetal death or
congenital syphilis (causing birth defects)
Viral
Genital Herpes
A very common viral infection that can cause genital and anal sores
What is it?

•Herpes simplex virus (two types: HSV-1, traditionally associated with
cold sores, and HSV-2, traditionally associated with anogenital herpes)
• May cause a single outbreak or recurrences over time
Recurrences may be triggered by:
• The menstrual cycle in women
• Emotional stress
• Illness (especially fever)
• Sexual intercourse
• Surgery
• Exposure to sun (including tanning beds)
• Use of certain medications
Viral
Hepatitis B
A vaccine-preventable viral infection that affects the liver
What are the signs and symptoms?

In up to 50% of people, there are no outward signs of infection.
Up to eight weeks after exposure to the virus, some people experience flulike symptoms including:
• Tiredness
• Nausea and vomiting
• Decreased appetite
• A rash
• Joint pain
• Yellowing of the eyes and skin (in rare cases)
epatitis B:
H
People with chronic hepatitis B are at
risk of suffering progressive liver
disease and liver cancer.
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Human Immunodeficiency Virus (HIV)
◦ Transmitted through the exchange of bodily fluids passed through mucous
membranes or blood
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Acquired Immune Deficiency Syndrome (AIDS)
◦ Occurs when a person’s immune system has become so weak that it can no
longer successfully fight off infection
What is it?
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Virus that destroys cells critical to a
person’s immune system, robbing the
body of its ability to fight other
infections and illnesses.
Weakens the immune system over time
(months to years) until other infections
occur and Acquired Immunodeficiency
Syndrome or AIDS (the fatal stage of
HIV infection) develops
How is HIV transmitted?
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When the body fluids of an infected person
(blood, semen, pre-semen, vaginal
secretions, breast milk) enter the blood
stream of another individual—specifically,
from:
Unprotected vaginal, oral or anal sex
Use of contaminated sex toys
Shared needles or other drug equipment
(i.e. water, cookers, crack pipes)
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HIV-infected blood or blood products
Household items such as toothbrushes and razors that have
touched infected blood
Transmission during pregnancy, childbirth or breastfeeding
(transmission from mother to child)
HIV cannot be transmitted by mosquitoes or other insects that have
made contact with infected blood, nor can it be transmitted through
saliva, sweat, tears, urine or feces of infected individuals, unless
blood is present.
What are the signs and
symptoms?
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Two to four weeks after
exposure, some infected
individuals may experience
mild flu-like symptoms that
last a few weeks then
disappear.
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For most people, symptoms
don’t emerge until years after
exposure.
Once the immune system is
weakened, the following may
develop:
• Frequent fever or sweats
• Joint or muscle pain
• Persistent skin rashes
• Swollen glands
• Sore throat
• Fatigue or lack of energy
• Headaches
• Rapid, unexplained weight
loss
• Nausea, vomiting, or diarrhea
HIV:
An individual who is diagnosed with HIV
requires regular medical consultation.
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A blood test to check for
HIV antibodies is the
only way to detect HIV
infection.
It may take up to three
months for an infection
to be detectable.
Anyone at high risk who
tests negative initially
should retest three
months later for
certainty.
HIV destroys cells critical to the immune system,
leaving carriers susceptible to other infections.
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In Canada, it is estimated that 27% of people with HIV
do not know they are infected and risk transmitting the
virus to others.
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Partner notification is important; infected individuals
should seek guidance from their healthcare providers.
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What you need to know about HIV/AIDS:
◦ HIV can live in a person’s body for ten years or longer
before any signs of it appear
◦ No sure way of knowing whether someone has
contracted HIV without a blood test
◦ Initial symptoms can include fever, diarrhea, weight
loss, dry cough, and swollen glands
◦ There is no cure
Testing/Screening
Importance and Timing
The early detection and treatment of STIs is critical
to prevent further spread of infections
When to get tested

esting men:
T
A penile exam using a swab to collect
urethral discharge
• Individuals who suspect they may have contracted an STI should ask
their health care provider for guidance about when to get tested.
Recommendations vary by type of infection.
• Regardless of symptoms, at-risk individuals should be screened
regularly.
• Visible symptoms should not be the only reason for testing, as many

infections are asymptomatic. If symptoms are not present or a person is
infectious before symptoms appear, the infection can be unknowingly
passed on to others.
• At the start of any new sexual relationship, it is a good idea for both
partners to get assessed and screened for infections.
• Suspicion or diagnosis of an STI should prompt testing for other STIs if
not already done.
esting women:
T
A pelvic exam using a speculum to take
swabs from the cervix and vagina
Testing Methods
Diagnosing Sexually Transmitted Infections
rine sample:
U
For testing of certain STIs, a urine sample
may be requested.
The main methods of testing/screening are:

1. Swab from the urethra, cervix, vagina, anus or throat
2. Urine test
3. Blood test
Approaches differ by infection and gender, and vary across the country.
lood test:
B
For testing of some STIs, a blood
sample is required.
mear:
S
Cervical and urethral samples may be used to
prepare a smear for testing.
Chapter 10
THE VOLUNTARY
THE VOLUNTARY
PREVENTION OF PREGNANCY
PREVENTION OF PREGNANCY
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Ortho Evra is a hormonal birth control
method whereby synthetic hormones are
delivered directly through the skin and into
the bloodstream via a thin patch.
Women can wear the Ortho Evra
contraceptive patch on the buttocks,
abdomen, upper torso (front and back,
excluding the breasts), or upper outer arm.
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Ortho Evra is replaced on the same day of the
week for three consecutive weeks, and the
fourth week is "patch-free."
The patch remains attached and effective
while exercising, bathing or in hot, humid
conditions.
It contains the same synthetic hormones as
combined oral contraceptive pills (estrogen and
progestin) and is
thought to be about as effective as the
Pill.
With NuvaRing®, estrogen and
progestin release is activated once
the ring comes into contact with the
vagina.
The hormones are then absorbed and
distributed into the bloodstream.
In a given 1-month period, NuvaRing® must
be inserted into the vagina, removed after 3
weeks, and a new ring must be inserted no
more than 7 days later.
 Come in different forms
◦ Single hormone -- Progestin only
◦ Combined hormone - progestin & estrogen
◦ With Blanks or with lactose pills or ferrous sulfate so
there are no blank days
◦ Pill should be taken the same time each day
◦ Extended-cycle COC- a 91 day regimen in which the
woman takes a pill for 84 days followed by 7 days of
menses.
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Contraindicated in woman with history of
◦ Thrombophlebitis and thromboembolic disorders
◦ Cerebrovascular or cardiovascular diseases
◦ Estrogen-dependent cancer or breast cancer
◦ Benign or malignant liver tumors
◦ Hypertension
◦ Migraines with focal aura
◦ Diabetes with vascular involvement
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Contraindicated in woman with
◦ Any of the above conditions
◦ Impaired liver function
◦ Suspected or known pregnancy
◦ Undiagnosed vaginal bleeding
◦ Heavy cigarette smoking
◦ Major surgery requiring prolonged immobilization
Used after unprotected intercourse (condom
breaks, rape, contraceptive not used correctly or
did not use contraceptive).
Ovral Therapy - Two tablets taken 72 hours after unprotected intercourse
and 2 tables taken 12 hours later.
Ovral
Action: High levels of estrogen interfere with
production of progesterone. Progesterone levels
fall and therefore the endometrium will slough.
Preven (kit) available by prescription - estrogen and progestin.
Plan B – progestin-only method.
women over 18 years old.
May insert IUD within 5 days
Available OTC to
› Prevents implantation
› Most common is copper T-shape
› Patient must check placement after menses
and before intercourse
› Side Effects:
PID, increase in bleeding and spotting,
cramping, uterine perforation. Report pelvic
pain.
The Mirena Intrauterine System, which releases
levonorgestrel gradually, may be left in place for up to
5 years
 Sheath to cover the penis in the male
 Sheath inserted into the vagina and
anchored around the cervix
Prevent the transport of sperm
to the ovum
 Some should be used with a sperimicide
 Teach how to apply and how to remove to
be effective.
moisten well with water and insert into the vagina with
the concave portion positioned over the cervix.
Should be left in place for 6 hours and may be worn for
24 hours
Dome shaped rubber device with a
flexible wire rim that covers the cervix.
May be used with gel or foam
Cervical Cap
Similar to the diaphragm
but smaller and
may stay in for up
to 48 hours.
Act as spermicides
Foams
Jellies
Suppositories
Creams
Gel
from STI’s and un-planned pregnancy is
Abstinence: not having sexual intercourse, or
high risk sexual activities, and to abstain from
any contact with infected people.
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Children of teenagers are more
likely to have low birth weights, and to suffer the associated
health problems.2
Pregnant teens themselves are also at greater risk of health
problems, including, for example, anemia, hypertension,
renal disease, eclampsia and depressive disorders.3,4
Teenagers who engage in unprotected sex are putting their
own health at risk of sexually transmitted infections.1
Teenage pregnancy also has economic consequences.
Childbearing may curtail education and thereby reduce a
young woman's employment prospects in a job market that
requires ever higher levels of training.8,9 In addition, to
maintain an adequate standard of living, dual earning is the
norm in many Canadian households.10 But teenagers who
give birth, particularly at ages 15 to 17, are likely to be
single. Consequently, most teenage mothers lack a partner
to contribute to the household income.3