Sexually

Transmitted
Diseases
 What is an STD?
an infection that can be transmitted through sexual
contact with an infected individual. They are sometimes
called sexually transmitted infections (STIs).1

STDs can be transmitted many different ways,

but most can be passed by:

• Vaginal sex
• Anal sex
• Oral sex
• Skin-to-skin contact
• Infected Mother to child
 Why Is This Important?
Often no signs or symptoms

20 million new infections every

year in the United States.2
People are unaware of infection, and
don’t receive treatment.

More than 1/2 of all people

Long-term damage
will have an STD at some
point in their lifetime.3

May have passed infection to others

Myth or Fact?
1.You can’t get an STD from oral sex?
1.MYTH
Any exposure to genitalia or body fluids puts you at
risk for getting an STD. There are many STDs that can
be transmitted through oral sex, including genital
herpes, genital warts (HPV), gonorrhea, hepatitis A,
hepatitis B, chlamydia, chancroid, and syphilis. To
prevent getting an STD from oral sex, you and your
partner should get tested for all STDs, and you should
always use a condom or dental dam (a latex square or
cut open condom) during oral sex.
 Myth or Fact?
1.Sexually active people aged 15-24
years are at higher risk of acquiring
STDs. 3

. FACT
2

1 in 2 sexually active
persons will contract an
STD by age 25 .
 Myth or Fact?
1.Birth control protects against
pregnancy and STDs.
3. MYTH
The birth control pill does not protect
against STDs. Couples having sex must
always use condoms or another barrier
along with the Pill to protect against STDs
and pregnancy at the same time.
Myth or Fact?
1.Once you’ve had an STD, you can’t
get it again.
8

4. MYTH
You can get some STDs more than just
once. Some STDs are yours for life, like
herpes and HIV. Others, like chlamydia
and gonorrhea, can be treated, but you
may get infected again if you have sexual
contact with someone who has them.
 Myth or Fact?
1.Anal sex has a higher risk of spreading STDs
than many other types of sexual activity.9

4. FACT
Anal sex does have a higher risk of
spreading STDs. The lining of the
anus is thin and can easily be
damaged, which makes it more
vulnerable to infection.
 Myth or Fact?
1.Abstinence is the only method of
contraception that is 100% risk-free. 11

Abstinence - avoiding all types of intimate

genital contact can prevent STDs. Avoiding all
types of intimate genital contact — including
anal and oral sex — is complete abstinence.
Because a person does not have any type of
intimate sexual contact when he or she
practices complete abstinence, there is no risk
of passing on a sexually transmitted infection.
Myth or Fact?
1.Only gay and bisexual men
get STDs.10
Anyone who has sex can get an STD, but men who
have sex with men are affected disproportionately
and are at a greater risk. Many factors contribute to
the higher rates of STDs among MSM:
•Higher rates of HIV and STDs among MSM increase
a person’s risk of coming into contact with an
infected partner and becoming infected
themselves.
•Certain behaviors- such as not using condoms
regularly and having anal sex - increase STD risk.
•Homophobia, stigma, and discrimination can
negatively influence the health of gay, bisexual,
and other men who have sex with men.
Myth or Fact?
8.You can’t get an STD if your
partner is a virgin. 12

8. MYTH
Depending on how your partner defines being a virgin,
it is possible for them to have contracted an STD/STI.
Your partner might not have had vaginal sex, but may
have had oral sex with someone (and still consider
themselves a virgin), putting themselves at risk for an
STD. Also, there are other STIs (herpes and HPV) that
are passed through skin-to-skin contact, even if no
penetration has taken place.
Myth or Fact?
8.Only “trashy” people get
STDs.8

STDs don’t discriminate. The

only people who have no risk of
getting an STD are people who
haven’t had sex or any kind of
sexual contact.
Myth or Fact?
You can’t have two STDs at
once.6

You can have multiple STDs at a time.

For example, if you have just one
other untreated STD, you are 10 times
more likely to have HIV. Your chances
are greater if you have genital warts,
lesions or ulcers like those you can get
with syphilis or herpes.
Myth or Fact?
8.You can get an STD from a
toilet seat.
13

STD/STI’s cannot be passed from a

toilet seat. Even if the bacteria and
viruses that can cause an STI got onto
the seat, they cannot survive for long
after leaving the human body. Most
organisms do not last any more than a
few minutes, because they dry out and
Myth or Fact?
8.Women are considered at higher risk
for STDs than men. 14

account for a disproportionate number of

these new infections. Anatomical
differences place women at greater risk
than men of contracting sexually
transmitted infections, and age-related
physiological changes in the cervix make
risk of infection even higher for adolescent
women.
Myth or Fact?
8.Lesbians can’t get STDs. 15

While women who sleep with women can be at a lower

risk for some forms of STDs, they can – and do –
contract STDs as well. Any form of unprotected genital
contact carries some risk of exposure, so safer sex
practices are important, no matter what your sexual
orientation.
Surrounding all of these myths is the overarching notion
that outside of HIV/AIDS, LGBTQ youth do not have to
worry about STDs. The truth is that anyone engaging in
unprotected genital contact is at risk for contracting an
STD.
Myth or Fact?
8.If my partner has an STD, I’ll see it. 8

There’s often no sign that a person has an

STD. Even doctors often can't tell by
looking if people have STDs. So they need
to do tests, like bloodwork. People with
STDs might not know they have them: STDs
don't always cause symptoms. But it is
possible to carry and spread the virus
without ever having an outbreak.
 Are STDs curable?
Curable Not Curable
Antibiotics can cure Treatment can
bacterial STDs: improve the lives of
many people living
with viral STDs:

Chlamydia HIV
Gonorrhea* Herpes
Syphilis HPV
Trichomoniasis Hepatitis B
Antibiotics can cure
bacterial STDs…

but not always the

long-term damage.
 Chlamydia
How is it spread?
1. Vaginal, anal, or oral sex with someone who
has chlamydia.
2. Infected pregnant women can pass it to their
baby during pregnancy or childbirth.
17
Chlamydia Usually NO
SYMPTOMS!!!

Female Male
Symptoms: Symptoms:
• Abnormal vaginal discharge • Discharge from the penis
• Burning sensation when urinating • Burning sensation when
urinating
• Pain & swelling in one or both
Can lead to: testicles (less common)
• Pelvic Inflammatory Disease
(PID) Can lead to:
-Abdominal & pelvic pain • Infection spreads to tube that
-Long-term pelvic pain carries sperm from the testicles
-inability to get pregnant -Pain
-ectopic pregnancy -Fever
• Inability to have children
(rare)
 Gonorrhea

How’s It Spread?
1. Vaginal, anal, or oral sex with someone who has
gonorrhea19

2. A pregnant woman infected with gonorrhea can give

the infection to her baby during childbirth.
19
 Gonorrhea 19

Female Male
Symptoms: Symptoms:
• Painful or burning sensation when • Burning sensation when urinating
urinating • A white, yellow, or green discharge
• Increased vaginal discharge from the penis
• Vaginal bleeding between periods • Painful or swollen testicles (less
common)
Can lead to:
• Pelvic inflammatory disease (PID) Can lead to:
-Formation of scar tissue • Painful condition in the tubes
that blocks fallopian tubes attached to the testicles.
-Ectopic pregnancy -Inability to have children
-Inability to get pregnant (rare)
-Long-term -Sterile
pelvic/abdominal pain
 Syphilis
“The Great Imitator” 20

affects approximately 32,000 people each year in

the U.S. 14

How is Syphilis Spread?

• Direct contact with a syphilis sore (chancre) during
vaginal, anal, or oral sex. 20

• Can be spread from an infected mother to her unborn

baby.
20

Primary Secondary Latent/Late

Syphilis Syphilis Syphilis
Primary Syphilis

Chancre (ˈshaŋ-kər) – the syphilis sore

• Appears within 2-6 weeks after exposure
(could take up to 3 months)
• Firm, round, and painless
• Typically disappear after a few weeks without treatment
(still progresses to next stage)
Primary Syphilis
Secondary Syphilis

Rash:
• Can develop anywhere on the body
• Usually rough, red or reddish brown spots when on palms
of the hands and/or the bottoms of the feet
• Non-itchy
• Usually appears 4 weeks after chancre heals21

• Will go away without treatment, but infection will progress

to next stage of syphilis. 20
Latent Syphilis 20

The period when there are no signs/symptoms but syphilis is still

present in the body

If left untreated, you can continue to have syphilis in your body

for years without any signs or symptoms.
Neurosyphilis Syphilis 20

Usually occurs during late syphilis but can occur at

anytime during the infection

Symptoms:
• Difficulty coordinating muscle movements
• Paralysis (not able to move certain parts of your body)
• Numbness
• Blindness
• Dementia (mental disorder)
• Damage to internal organs
• Can result in death

More likely to occur early in the disease process if HIV infection is

also present.
Late (Tertiary) Syphilis 20

Typically Occurs 10-30 years after infection begins.

• Can damage almost any part of the body including

the heart, brain, spinal cord, eyes and bones
• Can result in mental illness, blindness, deafness,
heart disease and death
• Gummas

Types
• Cardiovascular syphilis
• Late benign syphilis
 • Passed during sex
Trichomoniasis 22 • 70% of infected people
have no signs/symptoms.

Female Male
Symptoms: Symptoms:
• Itching, burning, redness or • Itching or irritation inside the
soreness of the genitals penis
• Discomfort with urination • Burning after urination or
• Thin discharge (can be clear, ejaculation
white, yellowish, or greenish) • Some discharge from the penis
with an unusual smell

Infection usually occurs: Infection usually occurs:

• Lower genital tract: vulva, • Inside of the penis (urethra)
vagina, or urethra

Complication: can increase the risk of getting or spreading other sexually

transmitted infections.
 Pelvic Inflammatory
Disease (PID) 23

A serious infection that affects a woman’s reproductive organs.

Often caused by untreated STDs, like chlamydia and gonorrhea.

No tests for PID

May experience mild or no symptoms

Symptoms may be:

• Pain in your lower abdomen
• Fever
• An unusual discharge with a bad odor from your vagina
• Pain and/or bleeding when you have sex
• Burning sensation when you urinate
• Bleeding between periods
 Pelvic Inflammatory
Disease (PID) 23

PID can be cured if caught early.

However, treatment won’t undo any damage that has already

happened to your reproductive system.

Some complications of PID are:

• Formation of scar tissue both outside and inside the fallopian tubes
that can lead to tubal blockage
• Ectopic pregnancy (pregnancy outside the womb)
• Infertility (inability to get pregnant)
• Long-term pelvic/abdominal pain
 Genital Herpes
an STD caused by two types of viruses 23

The viruses are called herpes simplex type 1 (HSV-1)

and herpes simplex type 2 (HSV-2).23

NO CURE 14

1 in 6 people aged 14-49 have genital herpes 23

 Genital Herpes 23

How is Herpes Spread?

• Vaginal, oral, or anal sex with someone who has the disease.

Usually NO or very mild symptoms.

Symptoms:
1. One or more blisters on or around the genitals, rectum, or mouth.
2. The blisters break and leave painful sores that may take weeks to
heal.
These symptoms are sometimes called “having an outbreak”.

Most people who have herpes do not know it!

 Human Papillomavirus
(HPV) 24

How is HPV transmitted?

• Vaginal sex
• Anal sex
• Oral sex
(Vaginal & anal most common)

HPV is VERY common.

Most sexually-active men and women will get at least one
type of HPV at some point in their lives.
 Health Problems
Caused by HPV 24

Most people with HPV do not know they are infected

and never develop symptoms or health problems from
it.

There is no treatment for the virus itself. However, there are

treatments for the health problems that HPV can cause:

1. Genital warts
2. Cervical pre-cancer
3. Other HPV-related cancers
 Hepatitis 25

The most common types of viral hepatitis are:

Hepatitis A, Hepatitis B, Hepatitis C

“Hepatitis” means inflammation of the liver.

How is Hepatitis spread?

Hepatitis A Hepatitis B Hepatitis C
when a person when blood, semen, when blood from a
ingests fecal matter— or other body fluids person infected with
even in very small from a person the virus - even in
amounts—from infected with the very small amounts -
contact with objects, virus - even in very enters the body of
food, or drinks small amounts - someone who is not
contaminated by enters the body of infected.
feces from an someone who is not
infected person. infected.
 Hepatitis 25

How long does Hepatitis last?

Hepatitis A Hepatitis B Hepatitis C
A few weeks - several Mild illness (a few Mild illness (a few
months weeks) – Life long or weeks) – life-long
chronic condition

How serious is it?

 HIV AIDS
Human Acquired
Immuno
Immunodeficiency
Deficiency
Virus
Syndrome

“HIV is a virus spread through • AIDS is a late stage of the

body fluids that affects
specific cells of the immune
system, called CD4 cells, or T
cells”. 26
HIV infection
• Once diagnosed, body has
hard time fighting disease
and certain cancers.
• NO cure for AIDS, but
there is treatment
 How is HIV Spread?
HIV is passed from person to person through
the exchange of bodily fluids.

3 Main Ways:
1. Unprotected sex with people living
with HIV (vaginal, oral, or anal)
2. Blood to blood contact
3. Exposure to HIV before or during birth
or through breastfeeding 27
 HIV
“Flu-like” symptoms (if any) about 2-4 weeks after exposure:
Fever
Enlarged lymph nodes
Sore throat
Rash26

What Fluids Transmit HIV Can Enter The

HIV? 28 Body Through:
•Blood
•Vaginal Fluids
•Semen
•Breast Milk
Reducing your risk of
STDs
No Risk —
Abstinence (sex): not having oral,
vaginal or anal sex
No genital contact:
Mutual monogamy between non-infected
partners

Reduced Risk —
Protected Sex: “Correct and consistent”
use of condoms/barriers
29

Fewer sexual partners

Regular STD testing
 Male Condoms
More than 98% effective when used
correctly and consistently

Different kinds: 30

• Latex
• Polyurethane (“Non-Latex”)
• Lambskin 31
 Do’s and Don’ts of
male condom use
Do’s
• DO keep condoms in a cool,
dry place
• DO put the condom on an
erect (hard) penis before any
genital contact
• DO hold the condom in place
at the base of the penis
before withdrawing (pulling
out) after sex
• DO throw the condom away
after it’s been used
• DO use water-based
lubrication (vaginal sex) or
silicone-based (anal sex)
32
Don’ts
• DON’T use expired condoms.
• DON’T unroll the condom before
putting it on the penis
• DON’T leave condoms in hot
places (wallet, car, etc.)
• DON’T use oil-based products
(baby or cooking oils, hand
lotion, Vaseline, etc.) as
lubricants with latex condoms
• DON’T use your fingernails or
teeth while opening the condom
wrapper.
• DON’T reuse a condom
• DON’T use more than one
condom at a time
 More Protection

Female Condoms 33 Dental Dams 34

• Worn inside the vagina or • Used for oral sex

anus • Could make your own dental
• Thicker, more tear-resistant dam
• Always latex-free
• Wider opening covers more
pelvic area
 STD Testing
HIV: 35
Syphilis:36
• Everyone aged 15 through 64 should get tested Get tested for syphilis if you:
at least once. • Are pregnant
• People who have occasional exposure to HIV • Are a man who has sex with men
risks = at least once a year • Have sex for drugs or money
• People who are at high risk for HIV infection = • You have HIV or another STD
3-6 months. • You’ve had sex with someone who tested positive for
syphilis

Chlamydia & Gonorrhea: 37

For women:
If you are age 24 or younger and having sex = once every year
If you are age 25 or older = if you have more than one sex partner or a new
sex partner.
If you have had sex with someone who tested positive for chlamydia or
gonorrhea.
For men:
Talk with a doctor about getting tested if you have had sex with someone who
tested positive for chlamydia or gonorrhea.
 Where To Get Tested
•https://gettested.cdc.gov/

•https://www.stdcheck.com/std-test-center.php

•www.gytnow.org

• County Health Departments

(http://www.ok.gov/health/Disease,_Prevention,_Prepar
edness/HIV_STD_Service/STD_HIV_Testing_Locations/)

•Planned Parenthood
(http://www.plannedparenthood.org/health-center)
All sexually active people are
at risk for STDs
 Resources
1. http://www.news-medical.net/health/What-is-an-STD-(Sexually-Transmitted-Disease).aspx
2. http://www.cdc.gov/std/stats/STI-Estimates-Fact-Sheet-Feb-2013.pdf
3. http://www.ashasexualhealth.org/stdsstis/statistics/
4. http://www.cdc.gov/std/stats13/tables/10.htm
5. http://www.cdc.gov/std/stats13/tables/21.htm
6. http://knowyo.org/the-myths/std-myths/
7. http://kidshealth.org/teen/sexual_health/contraception/contraception_birth.html#
8. http://kidshealth.org/teen/sexual_health/stds/std_myths.html#
9. http://www.nhs.uk/Livewell/STIs/Pages/Sexualactivitiesandrisk.aspx
10. http://www.cdc.gov/std/life-stages-populations/stdfact-msm.htm
11. http://kidshealth.org/teen/sexual_health/contraception/abstinence.html
12. http://www.iwannaknow.org/teens/myths_facts/overview.html
13. http://www.abc.net.au/health/talkinghealth/factbuster/stories/2011/05/12/3212346.htm
14. http://www.rhtp.org/std/types.asp
15. http://www.ncsddc.org/blog/std-awareness-lgbtq-youth
16. http://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm
17. https://www.nichd.nih.gov/health/topics/stds/conditioninfo/Pages/types.aspx
18. http://www.cdc.gov/std/stats12/slides.htm
19. http://www.cdc.gov/std/Gonorrhea/STDFact-gonorrhea.htm
20. http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm
21. http://www.cdc.gov/std/training/std101/presentations-2014/std-101-common-clinicians-2014.pdf
22. http://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm
23. http://www.cdc.gov/std/herpes/stdfact-herpes.htm
24. http://www.cdc.gov/std/hpv/stdfact-hpv.htm
 Resources
25. http://www.cdc.gov/hepatitis/abc/index.htm
26. http://www.cdc.gov/hiv/basics/whatIshiv.html
27. https://aidsinfo.nih.gov/education-materials/fact-sheets/20/50/preventing-mother-to-child-transmission-of-hiv
28. https://aids.gov/hiv-aids-basics/hiv-aids-101/how-you-get-hiv-aids/
29. http://www.cdc.gov/condomeffectiveness/brief.html
30. . http://www.avert.org/condom-use-types-sizes.htm
31. http:///advocatesaz.org/2012/05/02/allergic-to-latex-you-can-still-have-safer-sex
32. http://www.ashasexualhealth.org/sexual-health/all-about-condoms/
33. http://www.plannedparenthood.org/learn/birth-control/female-condom
34. http://www.nakedtruth.idaho.gov/dental-dams.aspx
35. https://www.ghc.org/healthAndWellness/?item=/common/healthAndWellness/conditions/std/hivTests.html
36. http://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/hiv-and-other-stds/syphilis-testing-
questions-for-the-doctor
37. http://healthfinder.gov/HealthTopics/Category/health-conditions-and-diseases/hiv-and-other-stds/get-tested-for-
chlamydia-and-gonorrhea#the-basics_2
• https://www.optionsforsexualhealth.org/sexual-health/sexually-transmitted-infections/transmission
• http://www.rhtp.org/std/types.asp
• http://www.cdc.gov/nchhstp/newsroom/docs/STD-Trends-508.pdf
• http://www.iowartl.org/get-the-facts/sexually-transmitted-diseases-stds/
• http://www.who.int/mediacentre/factsheets/fs400/en/
• http://www.cdc.gov/std/training/std101/home.htm
• http://kidshealth.org/teen/sexual_health/stds/std.html#