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American College Health Association
The Secret Epidemic:STIs on Campus
A Presentation of the American College Health Association
American College Health Association
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American College Health Association
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
Discussion Points for Today
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American College Health Association
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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American College Health Association
Sexually Transmissible Infections (STIs)
Also known as• Sexually Transmitted Diseases (STDs)
• Venereal Diseases
What are your risks?
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American College Health Association
Sexually Transmissible Infections
Bacterial Infections• Chlamydia
• Gonorrhea
• Syphilis
Viral Infections• Herpes
• Hepatitis B
• Molluscum contagiosum
• HIV
• Human papillomavirus
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American College Health Association
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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American College Health Association
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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American College Health Association
“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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American College Health Association
“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
Infection with these organisms does not require penetration during intercourse if there is other “risky contact.”
HPVHPV HerpesHerpes MolluscumMolluscum
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American College Health Association
“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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American College Health Association
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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American College Health Association
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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American College Health Association
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
SemenSemen VaginalVaginal AnalAnal
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American College Health Association
Epididymitis due to Chlamydia - the swelling of this infection is seen above the right testicle
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American College Health Association
Hydrosalpinx resulting from Chlamydia - closed, swollen and water-filled left tube in a young woman
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American College Health Association
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-GenitalGenital-Genital Hand-GenitalHand-Genital Oral-GenitalOral-Genital
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American College Health Association
Penis with vesicles (blisters) from genital herpes
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American College Health Association
External genital skin of female with herpes ulcers
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American College Health Association
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-GenitalGenital-Genital Hand-GenitalHand-Genital Oral-GenitalOral-Genital
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American College Health Association
Molluscums of lower abdomen
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American College Health Association
External genital skin of female with huge molluscums
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American College Health Association
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-GenitalGenital-Genital Hand-GenitalHand-Genital Oral-GenitalOral-Genital
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American College Health Association
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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American College Health Association
Papillary genital warts of female
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American College Health Association
Papillary genital warts of female
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American College Health Association
Flat genital warts of male
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American College Health Association
Papillary genital warts of male
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American College Health Association
Papillary genital warts of male
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American College Health Association
Papillary genital warts of male anus
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American College Health Association
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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American College Health Association
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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American College Health Association
Genital warts on cervix of female
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American College Health Association
Pre-cancer changes on cervix
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American College Health Association
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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American College Health Association
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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American College Health Association
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
SemenSemen VaginalVaginal AnalAnal
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American College Health Association
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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American College Health Association
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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American College Health Association
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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American College Health Association
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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American College Health Association
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