This lecture is part of Adulting 101 Series on Sexual Responsibility, The Ateneo Hearter Way at the Sacred Heart School - Ateneo de Cebu on December 4, 2018 at the Pope Francis Servant Leadership Hall

1. ConSEXuences
Helen V. Madamba, MD MPH-TM FPOGS FPIDSOG
Sacred Heart School – Ateneo de Cebu
December 4, 2018
The Devastating
Consequences of Sexual
Irresponsibility

2. OBJECTIVES
• To discuss the complexity of adolescent love
and sexuality, marriage and family
• To understand the different consequences of
sexual behavior outside the bonds of marriage
• To explore ways to prevent transmission of
sexually transmitted infections, such as
HIV/AIDS

9. CONSEQUENCES OF
CONTRACEPTIVES
•Sex without pregnancy
•Pre-marital sex
•Gender-based violence
•Unwanted pregnancy
•Abortions
•Sexually transmitted infections
•Infertility rates

10. Majority of pregnant
patients who deliver at
VSMMC are single mothers ~
up to 20% are ≤19 years old

11. Sexually
Transmitted
Infections

12. Pediculosis Pubis
• Pediculosis pedis is an infestation of the
crab louse, Phthirus pubis
• lice in pubic hair is the most contagious of
all STDs: 90% single exposure

13. Scabies
• Scabies is a parasitic infection of the itch
mite, Sarcoptes scabiei, transmitted by
close contact, widespread over the body
without a predilection for hairy areas

14. Molluscum contagiosum
• Caused by the poxvirus and is spread by
close contact. Poxvirus does not grow on
mucous membranes.
• Characteristic skin lesion – umbilicated
papule.

15. Condyloma Acuminatum
• Most common viral STD due to Human
Papillomavirus (HPV) infection
• More than 50% of sexually active persons become
infected at least once in their lifetime.

16. HPV Vaccination
•a bivalent vaccine
(Cervarix)
•a quadrivalent vaccine
(Gardasil)
•a nonavalent vaccine
(Gardasil-9)

17. Diseases Characterized by
Genital Ulcers
• Genital herpes
• Granuloma inguinale (Donovanosis)
• Lymphogranuloma venereum (LGV)
• Chancroid
• Syphilis

18. Chancroid
• Painful genital ulcer
• Tender suppurative inguinal adenopathy
• Diagnosis: identification of H. ducreyi

19. Genital HSV Infection
• Most are caused by HSV-2
• Painful multiple vesicular / ulcerative lesions -
absent in many infected patients

20. Granuloma Inguinale
• Klebsiella granulomatis
(Calymmatobacterium granulomatis)
• Painless, slowly progressive ulcerative lesions on genitals
or perineum, no regional lymphadenopathy

21. Lymphogranuloma
Venereum
• C. trachomatis serovars L1, L2 or L3
• tender inguinal and / or femoral lymphadenopathy,
unilateral

22. Syphilis
• Treponema pallidum
• Primary, secondary, neurologic, tertiary
infection

23. Primary Syphilis: Chancre

24. Secondary Syphilis:
Palmar/Plantar Rash

25. Secondary Syphilis:
Condyloma lata

26. Secondary Syphilis:
Nickel/Dime Lesions

27. Tertiary Syphilis:
Gummatous Lesions

28. TRICHOMONIASIS
• caused by Trichomonas vaginalis
• a unicellular protozoon that inhabits the vagina and lower
urinary tract, specially the Skene’s gland in females, a
highly contagious sexually transmitted disease.

29. Chlamydia trachomatis
Neisseria gonorrhoea

30. Chlamydia trachomatis
•most frequently reported
infectious disease
•prevalence is high among
persons aged 25 years or less
•most serious sequelae:
• PID
• ectopic pregnancy
• infertility

31. Fitz-Hugh-Curtis
intraoperative findings in PID

32. Major Sequelae of PID
•Ectopic pregnancies: ↑6 to 10-
fold
•Chronic pain: ↑4-fold
•Infertility: 6% to 60%
depending on severity of the
infection, the number of
episodes and the age of the
patient

33. “THE PHILIPPINE HIV EPIDEMIC”
30th WORLD AIDS DAY

34. BASIC HIV KNOWLEDGE

35. WHAT IS HIV?

36. What is HIV?
H – Human
I - Immunodeficiency
V – Virus
• Two types: HIV-1 and HIV-2
• HIV causes AIDS in humans

37. WHAT ARE THE STAGES
OF HIV INFECTION?

38. WHO CLINICAL STAGING OF HIV
Asymptomatic
Persistant
generalized
lympadenopathy
Average 10
years
Antibodies
are
detectable in
the blood
The immune
system
deteriorates
Opportunistic
infections start
to appear
Rapid decline
in number of
CD4 T cells
Opportunistic
infections
become severe
and cancer
may develop

39. WHO CLINICAL STAGING OF HIV

40. How is HIV different
from AIDS?
AIDS is an acronym for Acquired Immune
Deficiency Syndrome
• Acquired – transmitted from person to
person
• Immune – the body’s system of defense
• Deficiency – lack of
• Syndrome – a group of signs and symptoms

41. The Immune System
•Antibodies - a collection of cells
and substances that defend the
body against foreign substances,
also known as
•Antigen – a substance (such as
HIV) that, when introduced into
the body, stimulates the
production of an antibody.

42. The Immune System
• Army guarding borders of a state and
protecting it from foreign invasion

43. The Immune System
• HIV infects T-lymphocytes that carry CD4 receptors
• As T-cells are destroyed, the immune system is
weakened and the person is more likely to develop
opportunistic infections.

44. WHAT ARE THE THREE
MODES OF TRANSMISION
OF HIV INFECTION?

45. Principles of HIV Transmission

47. WHAT ARE THE FOUR BODY
FLUIDS THAT TRANSMIT
HIV INFECTION?

48. •Semen
•Vaginal fluids
•Blood
•Breastmilk
Four Body Fluids
that Transmit HIV

49. •EXIT
•SURVIVAL
•SUFFICIENT
•ENTER
Principles of HIV Transmission

50. •Temperature
•Atmosphere
•Moisture
•Acidity
Survival of HIV
(TAMA)

51. Principles of HIV Transmission

52. HOW DO WE PREVENT
HIV INFECTION?

53. ABCDE of HIV Prevention
A – abstinence
B – be mutually faithful
C – check your status
D – don’t inject drugs
E – educate yourself and
others for early detection

54. “HIV will end with me!”

55. #HealthXPH
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56. ConSEXuences
Helen V. Madamba, MD MPH-TM FPOGS FPIDSOG
Sacred Heart School – Ateneo de Cebu
December 4, 2018
The Devastating
Consequences of Sexual
Irresponsibility