STIs: Facts, Prevention, Outcomes
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Everything in life has risks associated with it and sexual behaviour is no different. If a person is not sexually active STIs will not pose a risk, although it is still important to be aware of the ...

Everything in life has risks associated with it and sexual behaviour is no different. If a person is not sexually active STIs will not pose a risk, although it is still important to be aware of the following information.

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STIs: Facts, Prevention, Outcomes Presentation Transcript

  • 1. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 2Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated (B) - through vaginal, anal or oral sex - mother to baby during childbirth RATE: 80% of reported cases are in 15-29 year olds Rising trends in 15-19 years: • 2002: 5,652 cases • 2008: 14,560 cases • 2011: 21,661 cases Rising trends in 10-14 years: • 2002: 251 cases • 2008: 508 cases • 2011: 711 cases 2011 - 80,800 diagnoses in all groups Because the infection usually doesn’t cause symptoms and many people remain untested, numbers may be even higher. - Increasing rates of diagnosis of chlamydia are reported in all States and Territories. Ref: (A) (1) (2) (3) (4) (5) (36) ALWAYS USE CONDOMS and water based lubricant during vaginal, anal and oral sex Use Dental Dams during oral sex. Regular testing is recommended, especially if sex has occurred with more than one partner. Chlamydia can be transferred to the eyes through rubbing or touching with unwashed hands. The greater the number of sex partners, the greater the risk of infection. Because the cervix (opening to the uterus) of teenage girls and young women is not fully matured and is more susceptible to infection, they are at particularly high risk for infection if sexually active. If symptoms are present, they usually appear 1-3 weeks after exposure Females: Please note: Over ¾ of women have no symptoms • Abnormal discharge from the vagina • Pain when passing urine • Menstrual changes such as longer, heavier, more painful periods Other symptoms occur if it travels to the fallopian tubes (see Infertility below) Males: Please Note: about ½ of men have no symptoms • Discharge from the penis • Pain when passing Urine • Burning and itching around opening of penis or pain • Pain and swelling in the testes is uncommon Other symptoms occur if it travels to the epididymis (see Infertility below) • Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause rectal pain, discharge, or bleeding. • Chlamydia can also be found in the throats of women & men having oral sex with an infected partner. Antibiotics through a single oral dose or twice daily for 7 days Abstain from sexual intercourse for 7 days after single dose of antibiotics or during the 7 day course of antibiotics No sexual activity until follow-up testing reveals no signs of infection and effectiveness of treatment All sexual partners need to be notified and treated Re-testing within 3 months is recommended High Risk** Groups should be tested every 12 months Since chlamydia can be transmitted by oral or anal sex, men who have sex with men are also at risk for chlamydial infection and need regular testing Babies born to mothers with untreated chlamydia may develop eye or lung infections, hence the importance for pregnant women to have a test for chlamydia early in pregnancy. Females: Inflammation of the cervix, which if untreated can spread to the uterus, fallopian tubes, ovaries and other parts of the lower abdomen causing Pelvic Inflammatory Disease (PID) and possible infertility (see Infertility below) Males: Epididymitis (inflammation of the epididymis) and non-gonococcal urethritis (urethral infection) and possible infertility (see Infertility below) NOTE: Often called the“silent” disease because the majority of infected people have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure. Substantially higher rates of diagnosis of chlamydia are recorded in the Aboriginal and Torres Strait Islander population compared with non-Indigenous population. Chlamydia
  • 2. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 3Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated Infertility may result from untreated Chlamydia or Gonorrhoea Females: Pelvic Inflammatory Disease Males: Epididymitis RATE: Females: • 10 - 40% of women with untreated chlamydia will develop PID • Post-infection tubal damage is responsible for 30 – 40% of female infertility • Women who have had PID are 6 – 10 times more likely to develop and ectopic pregnancy • 30 – 40% of ectopic pregnancies relates to previous PID Ref: (2) (7) (8) (9) (10) (35) • Treatment of Chlamydia and Gonorrhoea with antibiotics. • Follow-up testing within 3 months is highly recommended. Females: If the infection travels from the cervix to the fallopian tubes: • Often no symptoms • Pain in lower abdomen indicating infection and damage of uterus (womb), fallopian tubes (tubes that carry eggs from the ovaries to the uterus) and other reproductive organs • Low back pain • Nausea or fever • Pain during intercourse • Bleeding between menstrual periods Males: • Abdominal, lower back or groin pain • Scrotal pain and swelling • Pain/blood on urination • Discharge • Fever and chills / nausea Advanced stages are untreatable The risk of infertility following chlamydia infection depends on: • Time frame of infection • Whether the infection had spread, before treatment, into the uterus or fallopian (egg- conducting) tubes (females), or into epididymis (sperm- conducting tubes), (males.) Females: Irreversible consequences: • infertility • ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside the womb, requiring emergency surgery and can be fatal) Other complications: • abscess formation • chronic pelvic pain Males: • Increased DNA fragmentation in male sperm and lower fertility rates • Sterility • Prostatitis (infection and swelling of the prostate gland) • Abscess – (ball of pus accumulating inside epididymis or nearby structures - surgery is needed to drain the pus) • Destruction of the epididymis. The inflammation can permanently damage or destroy the epididymis and testicle, leading to infertility. • Spread of infection – the infection can spread from the scrotum to any other structure or system of the body. Infertility
  • 3. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 4Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated (B) Through vaginal, anal or oral sex RATE: • It’s the second most commonly reported STI in Australia • The number of diagnoses of gonorrhoea increased by 25% from 7987 cases in 2009 to 10,007 in 2010, and again rose to 12,119 cases in 2011. Males: Diagnosis increased from 49 in 2008 to 61.7 in 2010 to 72.9 in 2011 (per 100,000) Females: • Diagnosis increased from 23.7 in 2009 to 27.8 in 2010 to 35.6 in 2011 (per 100,000) • In 2011, 61% of reported cases were in 15-29 year olds • There was a slight drop in rates during 2007, however overall there is an upward trend in the number of infections from 2003 onwards. Ref: (A) (6) (7) (11) (12)(13) (14) (36) • ALWAYS USE CONDOMS and water based lubricant during vaginal, anal and oral sex • Use Dental Dams during oral sex. • Regular testing is recommended, especially if sex has occurred with more than one partner. PLEASE NOTE: There are often no obvious symptoms. If symptoms do occur, they usually develop a few days to a week after the bacteria have been introduced into genital area while having sex with an infected person Females: • Cramps/pain in lower abdomen just above the pubic bone • Change in vaginal secretions (may be more secretion or may change in colour and/or smell) - Pain and/or burning sensation when passing urine • Bleeding or spotting between periods and after having sex • Pain during or after sex Males: • Yellow discharge from penis • Pain / burning sensation when passing urine • If the infection travels up the urethra, testes may become swollen and sore • Urine Sample • Swab from cervix • Swab from opening of penis • Swab from anus • Swab from throat • Antibiotics through a single does or a course of treatment Other Infected areas: Rectal infections: • Pain in the rectum • Discharge or mucus from the anus Throat infections: • Sore throat - however, there may be no symptoms at all Females: • PID (see infertility notes above) • Babies born to mothers infected with gonorrhoea may be born early, have low birth weights or develop eye infections. Pregnant women are encouraged to have STI check early in their pregnancy Males: Infection can spread to the testes, causing pain and some risk of infertility. (see infertility notes above) Rare complications in both men and women include septicaemia and arthritis Substantially higher rates of diagnosis of gonorrhoea were recorded in the Aboriginal and Torres Strait Islander population compared with non-Indigenous population Gonorrhoea
  • 4. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 5Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated (V) Human Papillomavirus (Genital Warts) Highly Transmissible • through vaginal, anal or oral sex • skin to skin contact • mother to baby during childbirth RATE: • 4 in 5 (80%) of sexually active men and women will acquire HPV infection at some time in their lives • Some estimates of prevalence amongst women are much lower, ranging from 2% - 44%, depending on age • If current incidence trends continue, the annual number of HPV-positive Oropharyngeal (mouth and throat) cancers is expected to surpass the annual number of cervical cancers by the year 2020. (USA) Ref: (15) (16) (17) (18) (19) (20) • ALWAYS USE CONDOMS and water based lubricant during vaginal, anal and oral sex. • Use Dental Dams during oral sex. • Condoms reduce risk but only protect the skin which is covered. • There is no evidence that condoms reduce the chance of getting HPV during oral or anal sex. • Regular testing is recommended, especially if sex has occurred with more than one partner. PLEASE NOTE: Most people have no symptoms; or: • Genital warts which can multiply, grow and bleed • Usually appear as small bumps or groups of bumps, usually in the genital area or thighs. Can be raised; flat; single; multiple; small; large; cauliflower shaped • May appear within weeks or months after sexual contact with an infected person • Over 90% of genital warts are caused by HPV genotypes 6 and 11 PLEASE NOTE: Even when the warts have gone, the virus remains. • Most people with HPV do not develop symptoms or health problems from it. • In 90% of cases, HPV is cleared by the body’s immune system within 2 years • If left untreated, genital warts may go away, remain unchanged, or increase in size or number. They will not turn into cancer • Genital warts can be removed: painting with a solution; burning off using a laser or diathermy; freezing with liquid nitrogen or nitrous oxide. • Get tested regularly: especially if you or your partner has had sex with more than one partner. • Maintain good general levels of health. The Gardasil Vaccination for girls and boys protects against HPV 16 & 18 which cause cancers – see below Regular Pap Smears – see below The two most common“high-risk” genotypes are 16 and 18 - they cause approximately 70% of all cervical cancers. • Over 100 known HPV genotypes. 30 of these are sexually transmitted. At least 13 of which can cause cancer of the cervix. • HPV can also contribute to Anal Cancer. Oropharyngeal: • 70% of all new oral cancer cases are linked to HPV: those who have given oral sex six or more times are at greatest risk, with men also at high risk for the disease. • Men who have multiple sex partners are at higher risk for oral cancers. • Survival rates are better for those with HPV-positive oral cancers than those of HPV-negative oral cancers. HPV
  • 5. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 6Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Rates Prevention Protects against Things to consider Vaccine side effects National Vaccination Coverage (3 Dose) for girls aged 15 in 2009: QLD – 71.1% NSW – 73%) VIC – 76.1% SA – 72.4% WA – 64.7% TAS – 63.7% NT – 76.1% ACT - 79.6% National - 70.8% Since GARDASIL, diagnosis rate in young Aust. women with genital warts dropped: from 12.1% (2007) to 2.2% (2011) Ref:(6) (21) (22) (23) (24) (25) (36) A Pap Smear does not diagnose cancer. It looks for pre-cancers (cell changes on the cervix that might become cervical cancer if not treated). • Approximately 1 in 179 Aust. women will develop cervical cancer by age 85 (2007) • It can present at any age after a woman becomes sexually active, but is extremely rare before the age of 20 years Ref: (26) (27) • Vaccine available through the National Immunisation Program in Schools. • It has the potential to reduce, but not eliminate, the risk of cervical cancer. GARDASIL may not fully protect everyone, and does not prevent all types of cervical cancer. • GARDISIL is available for use in young men with associated fees: inquire with local GP. • The national school-based HPV Vaccination Program, has been extended to include males. From February 2013, males and females aged 12-13 years will receive the HPV vaccine at school. Males aged 14-15 years will also receive the vaccine as part of a catch-up program until the end of the 2014 school year. • Simple procedure when cells are collected from the cervix (the neck of the womb at the top of the vagina) and placed (smeared) onto a slide. • The slide is sent to a laboratory where the cells are tested for anything unusual. • If abnormal changes are found at screening, further tests will be done to see if treatment is needed. • Gardasil helps protect against 4 types of HPV, including: • 2 types (16 and 18) that cause 75% of cervical cancer cases • 2 more types (6 and 11) that cause 90% of genital warts cases. • The effectiveness of GARDASIL is much lower if a woman is infected prior to getting the vaccine. • A regular Pap Smear can find precancerous changes early so treatment is more effective. • A Pap smear only takes a few minutes. No drugs or anaesthetics are required and it can be done by a general practitioner, nurse or women’s health worker. • GARDASIL will not protect against diseases caused by other HPV types or against diseases not caused by HPV. • Women will still be at risk from other high-risk genotypes, so it’s important to continue routine cervical cancer screenings (Pap Smears). • Those severely allergic to yeast or other GARDISIL ingredients, and pregnant women, should not receive the vaccine. • All women over 18 who have ever had sex are advised to have a Pap smear every two years (even if they no longer have sex.) NOTE: • The Pap smear does not check for other problems in the reproductive system. It is not a check for sexually transmitted infections. STIs require different tests. • Side effects can include pain, swelling, itching, bruising and redness at the injection site; headaches; fever; nausea; dizziness; vomiting and fainting, paralysis. • These symptoms may happen even months after getting the vaccine. It is recommended to see a GP if any of these symptoms or general unwell feelings occur. In addition to persistent HPV infection, other factors associated with increased risk of cervical cancer: • High parity (large no. children) • High no. sexual partners • Young age at first sexual intercourse (<18 years) • Prior history of abnormal cytology tests or cancer of the vagina or vulva Low socio-economic status • History of smoking • Women with immunodeficiency disorders • Indigenous women. GardasilPapSmear
  • 6. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 7Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated (B) • Sexual contact with a person who has syphilis. • Spread through skin-to-skin contact with an infected area and oral, vaginal or anal sex without a condom. • Can also be passed from mother to baby during pregnancy. RATE: • 29% of reported cases are in 15-29 year olds • Rate across all age groups (2009) 5.8 per 100,000 • The rate of diagnosis of infectious syphilis increased by 60%, from 4.2 in 2006 to 6.7 in 2007 and declined to 4.9 in 2010. • Syphilis infections doubled in NSW and Victoria between 2004 and 2007 almost entirely through increased numbers of cases among homosexual men. Ref: (6) (28) (29) (30) (31) • ALWAYS USE CONDOMS and water based lubricant during vaginal, anal and oral sex • Use Dental Dams during oral sex. • Regular testing is recommended, especially if sex has occurred with more than one partner. • Condoms provide some protection but only if they cover the infected area. • Sexual activity should be avoided after treatment until any rashes or sores have gone. Three stages: Primary, Secondary and Tertiary Primary Syphilis • May be no symptoms; or • Early stages (3 – 4 weeks): development of a painless ulcer which can turn into a rash across the whole body. • Flu-like symptoms and swollen glands. • Infectious Secondary Syphilis • 2 to 4 months: flat red skin rash may develop on back, chest, hands and feet. • Fever, swollen glands, genital rash and lethargy • Symptoms may come and go for 2 years. • Highly infectious. • Effectively treated with penicillin. • Tested by a swab from initial sore or a blood test. • If it is not treated, a sore or ulcer will heal and go away; however the syphilis infection remains in the body. Late (tertiary) syphilis May develop after many years and cause: • Nervous system problems • Other organ system problems • Heart failure • Shooting pains • Dementia • Widespread ulcers At this stage specialist management is required. Latent and late syphilis are not infectious. • Estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present. Note: • The increased rates in recent years are particularly in men who have sex with men, and some Aboriginal and Torres Strait Islander communities Syphilis
  • 7. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 8Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated (V) Herpes Simplex Virus (HSV) HSV-1 – Herpes on the mouth HSV-2 – Genital Herpes • Transmitted through vaginal, anal and oral sex as well as genital skin to skin contact. • Shed from genital tract even when sores are not present so it’s not possible to predict when a person is infectious. • Passed from mother to baby through childbirth RATE: • Approximately 1 in 8 sexually active Australians has genital herpes. • Of these, 20 per cent are aware that they have the virus, 60 per cent are unaware that they have it, but have symptoms, while another 20 per cent have no symptoms. • Approximately 12% of Australian adults are infected with HSV-2, and 76% are infected with HSV-1. Ref: (32) (33) (34) (35) • ALWAYS USE CONDOMS and water based lubricant during vaginal, anal and oral sex • Use Dental Dams during oral sex. • Regular testing is recommended, especially if sex has occurred with more than one partner. • Condoms may provide limited protection from transmission of genital herpes, but only protect the skin that is covered. • Although HSV-1 prefers the mouth and lips and HSV-2 prefers the genitals, both can affect both sites (although the symptoms may not be as severe.) • This means a person can become infected with HSV-1 on their genitals if they receive oral sex from a person with HSV-1 on his or her lip. • HSV is highly contagious. • Can occur on genitals, around the anus or on the mouth. • Can be asymptomatic; or • May cause itching, tingling, or pain in the genital area, which is followed by blisters. • May be accompanied by flu-like symptoms. • Symptoms usually appear within 4 days but can appear anywhere from 2 to 12 days • Sores can last anywhere from 8 to 10 days and form a scab. • The amount of pain ranges from mild to severe. • Recurring outbreaks can be triggered by things like fatigue, stress and low self-esteem. • A swab is taken from an open blister. • There is no cure for genital herpes, however there are medications that help manage outbreaks and reduce the risk of transmission • After an initial outbreak some people will have further outbreaks. This generally becomes less frequent and less severe. • www.herpes.com.au has comprehensive information • Sexual health clinics often list local support groups • Sometimes herpes can cause dysuria or urinary retention. • (HSV2) is estimated to affect 12% of adult Australians and can cause significant psychological morbidity and some physical morbidity • If left untreated, the herpes virus can cause meningitis • Infection with HSV2 also increases the risk of acquiring HIV several-fold (particularly exposed blisters), but efforts to treat HSV2 to prevent HIV infection have so far proved ineffective. • Transmission to neonates is rare, but potentially fatal. Herpes
  • 8. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 9Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated (V) • It can be spread sexually through exposure to infected blood or body fluids including breast milk, saliva, vaginal secretions and semen. • Primary risk factors are unprotected sex with an infected partner, birth to an infected mother, unprotected sex with more than one partner, men who have sex with other men (MSM), history of other STIs, and illegal injection drug use. RATE: • The population rate between 2005 – 2009 has been stable. • Diagnosis of hepatitis B infection – 31 per 100 000 • Diagnosis of newly acquired hepatitis B: 1.2 per 100 000 • An estimated 209,000 people in Australia were living with the Hepatitis B infection in 2011 Ref: (6) (36)(37) (38) • A vaccination against hepatitis B is available. • ALWAYS USE CONDOMS and water based lubricant during vaginal, anal and oral sex • Use Dental Dams during oral sex. • Regular testing is recommended, especially if sex has occurred with more than one partner. • Condoms may provide limited protection from transmission of Hepatitis B only if no bodily fluids are exchanged • Risk increases with drug injection use • Presence of signs and symptoms varies by age. • Most children under age 5 years and newly infected immunosuppressed adults are asymptomatic. • 30%–50% of persons aged >5 years have initial signs and symptoms. Signs and symptoms may be: • Fever • Fatigue • Loss of appetite • Nausea • Vomiting • Abdominal pain • Dark urine • Clay-colour bowel movements • Joint pain • Jaundice • There are several types of medication available to treat hepatitis B and most adults will recover completely • Can cause inflammation of the liver. It can lead to severe liver diseases and liver failure. • Premature Death • Based on reported cases, hep B and hep C transmission in Australia continue to occur predominantly among people with a recent history of injecting drug use. HepatitisB
  • 9. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 10Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated (P) Trichomonas vaginalis (TV) It is estimated that 1 in 5 sexually active women will contract trichomoniasis during her life time • Transmitted through penis-to-vagina intercourse or vulva-to-vulva (the genital area outside the vagina) contact with an infected partner. • Women can acquire the disease from infected men or women. • Men usually contract it only from infected women. RATE: • Previously reported at an incidence of 1.1%, however new reports indicate a higher prevalence of 4.8% • Likely underdiagnosed in urban STI clinic settings using only traditional methods of detection. This may present re-emergence with important Public Health consequences. • Some data suggest that trichomonal infection is endemic in Aboriginal and Torres Strait Islander populations Ref: (39) (40) (46) • A single celled parasite that infects the urogenital tract • ALWAYS USE CONDOMS and water based lubricant during vaginal, anal and oral sex • Use Dental Dams during oral sex. • Regular testing is recommended, especially if sex has occurred with more than one partner. • Condoms provide some protection but only if they cover the infected area. • Sexual activity should cease until completion of treatment and resolution of symptoms Whilst it infects both men and women it is unusual for men to have any symptoms Women • 1/3 asymptomatic • Symptoms can include discharge, pain when urinating and during sex and itching of the genital area. Men • Usually asymptomatic but may develop urethritis. • The infection can usually be cured with antibiotics • The symptoms in infected men may disappear within a few weeks without treatment. However, an infected man, who has never had symptoms or whose symptoms have stopped, can continue to infect or re-infect a female partner until he has been treated. Therefore, both partners should be treated at the same time to eliminate the parasite. • Having trichomoniasis once does not protect a person from getting it again. They may still be susceptible to re-infection. Associated with adverse outcomes of pregnancy. These include: • Infertility • Preterm delivery • Low birth weight babies • Premature rupture of the membranes Trichomoniasis can cause genital inflammation that makes it easier to get infected with the HIV virus, or to pass the HIV virus on to a sex partner Trichomoniasis
  • 10. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 11Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. Transmission/rate of infection Prevention Symptoms of the infection Methods of treatment/testing Possible consequences if untreated (V) Human Immunodeficiency Virus • Transmitted through bodily fluids, including semen, vaginal fluid, passing on from mother to baby through pregnancy or breast milk; and sharing needles or infected blood. • Oral Sex is also a mode of transmission (low risk) RATE: The annual number of new HIV diagnoses in Australia has remained relatively stable at around 1 000 cases per year in previous years From 2005 – 2009, diagnoses occurred among: • 66% men who have sex with men • 23% heterosexual contact • 3% injecting drug use However, new diagnosis of HIV in 2011 was 1,137: an increase of 8.2% over the number in 2010 In Australia it is estimated 20,956 people are living with diagnosed HIV Tasmania and Qld have experienced that largest relative increases in HIV diagnosis over the past 10 years Ref: (6) (36) (41) (42) (43) (44) (45) (47) • Testing and treatment of STIs can be an effective tool in preventing the spread of HIV • Chlamydia, gonorrhoea, syphilis, and genital herpes all increase the risk of HIV acquisition and transmission. • Consistent and Correct use of Condoms is an effective protection against HIV. • You can’t get HIV from casual contact such as shaking hands or hugging. • PEP (Post Exposure Prophylaxis), is a course of anti-HIV drugs taken shortly after possible exposure to HIV infection. These drugs may help reduce the risk of acquiring HIV after unprotected sex, sharing needles or needlestick injury. • Please note: Safe injecting and safe sexual practices have been important in keeping Australia’s HIV infection rate low. Post Exposure Prophylaxis is not intended to replace these safe practices. After infection, the virus may lay dormant and cause no symptoms, so a person who is infected may not realise it. Even without symptoms, an infected person can pass on HIV. Some people experience: • Flu-like illness • Develop a rash • May be asymptomatic • The only way to know for certain if someone is infected with HIV is for them to be tested. • Without treatment, people with HIV develop AIDS, which can be fatal. • AIDS invades the immune system and slowly destroys it. Reduces ability to fight off infections and cancer. • The body becomes more vulnerable to infections, which it will have difficulty in fighting off. It is at the point of very advanced HIV infection that a person is said to have AIDS. It can be years before HIV has damaged the immune system enough for AIDS to develop. • Some people may experience flu-like symptoms, extreme fatigue, weight loss and mouth ulcers. • There is no cure for AIDS. Antiretroviral treatment can prolong the time between HIV infection and the onset of AIDS. • In 2009, the number of AIDS diagnosis dropped to 100 partly due to the wide availability of effective antiretroviral treatment for HIV infection. HIVandAIDS
  • 11. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 12Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. **High Risk Groups: Young people, particularly women aged 15-25 years; Aboriginal and Torres Strait Islander people; men who have sex with men; those with a pattern of inconsistent or no condom use; or a recent change in sexual partner. - Notifiable diseases such as chlamydia, gonorrhoea, syphilis, and HIV will have accurate statistical records available. There are many other STIs which are not notifiable and therefore rates are concluded from research reports – not surveillance. The rates may be higher than indicated due to the asymptomatic nature of many STIs. - Gonorrhoea, syphilis, chlamydia, anogenital herpes, anogenital warts, enteric pathogens (eg. giardiasis, shigellosis) and HIV are currently common among homosexually active men in large cities of the world. Lymphogranuloma venereum (LGV) has also recently emerged among some HIV+ gay men - Women who perform receptive anal sexual practices are also at risk of similar problems. - STIs may be spread through anal sex when blood, semen or other body fluid is shared even if there is no anal penetration. - Oral-anal contact, kissing or oral contact with fingers that have been touching the anus or genitals and/or the sharing of sex toys may also transmit certain infections. - The rates of notification of chlamydia, gonorrhoea and infectious syphilis in the Northern Territory continue to be substantially higher than those in other State/Territories Important notes to highlight: - Any unusual discharge, sore, or rash, particularly in the groin area, should be a signal to refrain from having sex and to see a doctor immediately - The surest way to avoid transmission of sexually transmitted infections is to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. - Avoiding alcohol and drug use may also help prevent transmission because these activities may lead to risky sexual behaviour. - It is important for open communication to be encouraged between sex partners so that preventive action can be taken. - Partner notification: It is important to encourage infected individuals to inform all their sexual partners from at least the past six months so they may be tested and treated if necessary. Refer to www.letthemknow.org.au for advice and assistance with partner notification. Useful Websites and documents: - (A) National Notifiable Diseases Surveillance System: http://www9.health.gov.au/cda/Source/CDA-index.cfm - Australian Government; Department of Health and Aging; STI Facts: http://www.sti.health.gov.au - Centers for Disease Control and Prevention; CDC Fact Sheets: http://www.cdc.gov/std/healthcomm/fact_sheets.htm - Queensland Government; Queensland Health; I Stay Safe: http://www.health.qld.gov.au/istaysafe/be-safe-with-sex/sti/ - Young Australians: Their Health and Wellbeing; 2011; Australian Institute of Health and Welfare; Available for download from URL: http://www.aihw.gov.au/publication-detail/?id=10737419261 - Magnus Hirschfeld Archive for Sexology; Falling and rising STD rates; Available from URL: http://www2.hu-berlin.de/sexology/ECE4/html/falling_and_rising_std_rates.html - Sexual Health; Society of Victoria; National Management Guidelines For Sexually Transmissible Infections; 2008; p 53 (60); p 115 (122); Available from URL: http://www.mshc.org.au/portals/6/nmgfsti.pdf - Second National Sexually Transmissible Infections Strategy: 2010–2013; Australian Government: Department of Health & Aging; 2010; Available from URL: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-national-strategies-2010-sti/$File/sti.pdf - SEXUAL HEALTH SERVICES - AUSTRALIA AND NEW ZEALAND - A comprehensive list of Sexual Health Clinics can be found on Pages 66 – 82 of the 2010-2011 Directory of HIV, Viral Hepatitis & Sexual Health Services, available for download from: http://www.ashm.org.au/images/Publications/2010-11_Directory.pdf - Register of Public Sexual Health Clinics in Australia and New Zealand (updated September 2012) http://www.racp.edu.au/page/sexual-health-publications Otherinformation
  • 12. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 13Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. (1) Department of Health & Ageing; Australian Government; STIs – Chlamydia; Available from URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/content/Chlamydia (2) Centers for Disease Control and Prevention; Chlamydia Fact Sheet; Updated February, 2013 Available from URL: http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm (3) Carroll, J.L; Sexuality Now – Embracing Diversity; 3rd Edition; University of Hartford ; 2010; p 428; Wadsworth Cengage Learning; Belmont, CA, USA. (4) A Queensland Health Fact Sheet; 2009; Available from URL: http://access.health.qld.gov.au/hid/InfectionsandParasites/SexuallyTransmittedDiseases/chlamydia_fs.pdf (5) Guy, R; A,H, Wand, H; Franklin, N; Fairley, C.K; Chen, M.Y; O’Connor, C.C; Marshall, L; Grulich, A.E; Kaldor, J.M; Hellard, M; Donovan, B; Re-testing for chlamydia at sexual health services in Australia, 2004–08; ACCESS Collaboration; Available from URL: http://www.publish.csiro.au/?act=view_file&file_id=SH10086.pdf (6) HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2011; p 7, 8, 15, 16, 17; Available from URL: http://www.med.unsw.edu.au/NCHECRweb.nsf/resources/2011/$file/KIRBY_ASR2011.pdf (7) Centers for Disease Control and Prevention; Epididymitis: Sexually Transmitted Diseases Treatment Guidelines, 2010; Available from URL: http://www.cdc.gov/std/Treatment/2010/epididymitis.htm (8) Gallegos, G; Ramos, B; Santiso, R; Goyanes, V; Gos alvez, J; Fernandez, JL; Sperm DNA fragmentation in infertile men with genitourinary infection by Chlamydia trachomatis and Mycoplasma; 2007; Available from URL: http://cat.inist.fr/?aModele=afficheN&cpsidt=20573037 (9) Government of Western Australia; Department of Health; Chlamydia: Most people haven’t got a clue; Available from URL: http://couldihaveit.com.au/media/Chlamydia_Fact_Sheet.pdf (10) Family Planning Victoria; Better Health Channel; Epididymitis Fact Sheet; Updated March, 2013; Available from URL: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Epididymitis (11) Department of Health & Ageing; Australian Government; STIs – Get the Facts; Gonorrhoea – Why Worry?; Updated January 2011; Available from URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/Content/Gonorrhoea (12) Queensland Government; Queensland Health; Gonorrhoea; Available from URL: http://access.health.qld.gov.au/hid/InfectionsandParasites/SexuallyTransmittedDiseases/gonorrhoea_is.pdf (13) Centers for Disease Control and Prevention; Gonorrhea Fact Sheet: Updated February, 2013 Available from URL: http://www.cdc.gov/std/Gonorrhea/STDFact-gonorrhea.htm (14) Stancombe Research and Planning; QUANTITATIVE RESEARCH REPORT: Measuring awareness and attitudes among young Australians towards STIs, including HIV/AIDS; p 1; prepared for Department of Health and Ageing; 2009; Link to page available from URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/content/campaign3 (15) Department of Health & Ageing; Australian Government; STIs – Get the Facts; Updated December, 2010 http://www.health.gov.au/internet/sti/publishing.nsf/Content/hpv (16) Centers for Disease Control and Prevention; HPV Fact Sheet: Updated February, 2013 Available from URL: http://www.cdc.gov/std/HPV/STDFact-HPV.htm (17) Chaturvedi, A; Engels, E.A; Pfeiffer, R.M; Hernandez, B.Y; Xiao, W; Kim, E; Jiang, B; Goodman, M.T; Sibug-Saber, M; Cozen, W; Liu, L; Lynch, C.F; Wentzensen, N; Jordan, R.C; Altekruse, S; Anderson, W.F; Rosenberg, P.S; Gillison, M.L; Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States; 2011; Journal Clinical Oncology 29:4294-4301; doi: 10.1200/ JCO.2011.36.4596 Available from URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221528/ (18) Perrett, L; Studies uncover associations between Human Papilloma Virus and Oral Cancer; 2010; National Cancer Institute; http://benchmarks.cancer.gov/2010/10/studies-uncover-associations-between-human-papillomavirus-and-oral-cancer/ (19) Carroll, J.L; Sexuality Now – Embracing Diversity; 3rd Edition; University of Hartford ; 2010; p 434; Wadsworth Cengage Learning; Belmont, CA, USA. (20) Skinner et al; Human papillomavirus vaccination for the prevention of cervical neoplasia: is it appropriate to vaccinate women older than 26? 2008; The Medical Journal of Australia; Available from URL: https://www.mja.com.au/journal/2008/188/4/human-papillomavirus-vaccination-prevention-cervical-neoplasia-it-appropriate (21) Human Papilloma Virus and HPV Vaccines: technical information for policy makers and health professionals; 2007; World Health Organisation; Department of Immunization, Vaccines and Biologicals; p 16; Available from URL: http://whqlibdoc.who.int/hq/2007/WHO_IVB_07.05_eng.pdf References
  • 13. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 14Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. (22) Gardasil Website: About Gardasil; Available from URL: http://www.gardasil.com/about-gardasil/about-gardasil/ (23) Klein, R; Gardasil: The Denial Continues; ON LINE Opinion: 30th June 2009; Available from URL: http://www.onlineopinion.com.au/view.asp?article=9112 (24) Department of Health and Ageing; Australian Government; Immunise Australia Program; Updated February, 2013 Available from URL: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-hpv (25) Robbins, S.C.C; Bernarda, d; McCaffery, K; Brotherton, J; Garlandd, S; Skinner, R;“Is cancer contagious?”: Australian adolescent girls and their parents: Making the most of limited information about HPV and HPV vaccination; 2010; Journal of Vaccine; doi:10.1016/j.vaccine.2010.02.078 (26) Medical Services Advisory Committee (MSAC); Human papillomavirus triage test for women with possible or definite low-grade squamous intraepithelial lesions; March 2009; MSAC reference 39; p 6,7 (24,25); Available from URL: http://www.msac.gov.au/internet/msac/publishing.nsf/Content/8FD1D98FE64C8A2FCA2575AD0082FD8F/$File/39_MSAC_Assessment_Report.pdf (27) Australian Government; Department of Health & Ageing; National Cervical Cancer Screening; Updated March, 2012 Available from URL: http://www.health.gov.au/internet/screening/publishing.nsf/Content/papsmear#1 (28) Queensland Government; Queensland Health; Syphilis; 2011; Available from URL: http://access.health.qld.gov.au/hid/InfectionsandParasites/SexuallyTransmittedDiseases/syphilis_fs.pdf (29) Centers for Disease Control and Prevention; Syphilis Fact Sheet; Updated February, 2013: Available from URL: http://www.cdc.gov/std/Syphilis/STDFact-Syphilis.htm (30) Ward, J.S; Guy, R.J; Akre, S.P; Middleton, M.G; Giele, C.M; Su, J.Y; Davis, C.A; Wand, H; Knox, J.B; Fagan, P.S; Donovan, B; Kaldor, J.M; Russell, D.B; Epidemiology of syphilis in Australia: moving toward elimination of infectious syphilis from remote Aboriginal and Torres Strait Islander communities? 16 May, 2011; Medical Journal of Australia; Volume 194, Number 10; Available from URL: https://www.mja.com.au/journal/2011/194/10/epidemiology-syphilis-australia-moving-toward-elimination-infectious-syphilis (31) Australian Government; Department of Health & Ageing; STIs – Get the Facts; Updated December, 2010 Available from URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/Content/syphilis (32) Australian Government; Department of Health & Ageing; STI facts: Herpes; Updated December, 2010 Available from URL: http://www.sti.health.gov.au/internet/sti/publishing.nsf/content/Herpes (33) Reducing the Sexual Transmission of Genital Herpes: Clinical Guideline; 2011; Australian Herpes Management Forum (AHMF); Available from URL: http://www.austhmf.com.au/guidelines/ (34) Carroll, J.L; Sexuality Now – Embracing Diversity; 3rd Edition; University of Hartford ; 2010; p 432,433; Wadsworth Cengage Learning; Belmont, CA, USA. (35) Aust. Govt.; Dept. of Health & Ageing; Second National Sexually Transmitted Infections Strategy: 2010-2013; p 4, 5; Available from URL: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-national-strategies-2010-sti/$File/sti.pdf (36) Australian Government; Department of Health & Ageing; Blood borne viruses and STIs: Data on Blood Borne Viruses and Sexually Transmissible Infections; Hep B; Updated November, 2012 Available from URL: http://health.gov.au/internet/main/publishing.nsf/Content/ohp-bbvs-data (37) Centers for Disease Control and Prevention; Hepatitis B Information for Health Professionals; Updated June, 2010 Available from URL: http://www.cdc.gov/hepatitis/HBV/PDFs/HepBGeneralFactSheet.pdf (38) Virtual Medical Centre: Hepatitis B Virus; Updated January, 2011 Available from URL: http://www.virtualmedicalcentre.com/diseases.asp?did=122 (39) Trichomonas vaginalis: underdiagnosis in urban Australia could facilitate re-emergence M Josephine Lusk, Zin Naing, Ben Rayner, et al. Sex Transm Infect 2010 86: 227-230; June, 2010; doi: 10.1136/sti.2009.039362; Available from URL: http://www.ncbi.nlm.nih.gov/pubmed/19880969 References
  • 14. Sexually Transmitted Infections (STIs) Everything in life has risks associated with it and sexual behaviour is no different.If a person is not sexually active STIs will not pose a risk,although it is still important to be aware of the following information. (B) - Bacterial (treatable) (V) - Viral (incurable) (P) - Parasite (treatable)Facts Prevention Outcomes 15Youth Wellbeing Project - providing whole-person centred education, resources and training for high schools and youth support workers who need cutting-edge strategies to assist teens in navigating healthy sexuality and relationships. (40) Centers for Disease Control and Prevention; Trichomonas Fact Sheet: Updated August, 2012 Available from URL: http://www.cdc.gov/std/trichomonas/STDFact-Trichomoniasis.htm (41) Centers for Disease Control and Prevention; Oral Sex and HIV Fact Sheet; June 2009; Available from URL: http://www.cdc.gov/hiv/resources/factsheets/PDF/oralsex.pdf (42) Avert; AVERTing HIV and AIDS; What is HIV? Available from URL: http://www.avert.org/hiv.htm (43) Avert; AVERTing HIV and AIDS; Australia HIV and AIDS Statistics; http://www.avert.org/aids-hiv-australia.htm (44) Centers for Disease Control and Prevention; The Role of STD Detection and Treatment in HIV Prevention - CDC Fact Sheet; Updated September, 2010 Available from URL: http://www.cdc.gov/std/hiv/STDFact-STD-HIV.htm (45) Aids Action Council; PEP - Post Exposure Prophylaxis; Available from URL: http://aidsaction.org.au/content/hiv_sti_health/post_exposure_prophylaxis-pep.php (46) Sexually Transmitted Infections Diseases Services; Royal Adelaide Hospital; Trichomoniasis: Statistics; Updated 12 April, 2010; Available from URL: http://www.stdservices.on.net/std/trichomoniasis/details.htm#Statistics (47) Mapping HIV outcomes: geographical and clinical forecast of numbers of people living with HIV in Australia; National Centre in HIV epidemiology and Clinical Research; University of New South Wales; Available from URL: http://www.kirby.unsw.edu.au/publications/mapping-hiv-outcomes-geographical-and-clinical-forecasts-numbers-people-living-hiv References For more great resources, visit our website: www.youthwellbeingproject.com.au You can also connect with us on Facebook, Twitter and LinkedIn! Youth Wellbeing Project has taken every measure to ensure all references and links are correct at the time of publication. This document is intended as a guide only and cannot replace or substitute the services of trained professionals in any health field. © April, 2013