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

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
People are unaware of infection, year in the U.S.
and don’t receive treatment.

More than 50% of

Long-term damage all people will
have an STD at
May have passed infection to
some point in
others their lifetime
Impact on Youth
Chlamydia in Oklahoma Gonorrhea in Oklahoma
(2017) (2017)

28% 15-19 yrs. 33%
18% 20-24 yrs.
25-29 yrs. 27%
37% Other

N=21,752 N=9,081
Myth or Fact?
1. You CANNOT get an STD from oral sex.
2. Birth control protects against pregnancy and STDs.
3. Once you’ve had an STD, you CANNOT get it again.
4. Anal sex has a higher risk of spreading STDs than many
other types of sexual activity.
5. Only gay and bisexual men get STDs.
6. You CANNOT get an STD if your partner is a virgin.
7. Only promiscuous or “trashy” people get STDs.
8. You CANNOT have two STDs at once
9. You can get an STD from a toilet seat.
10.Women are more likely to get tested for STDs.
11.Lesbians CANNOT get STDs.
12.If my partner has an STD, I’ll know/see it.
Are STDs Curable?
Antibiotics can cure Treatment can improve
bacterial STDs, but the lives of many people
cannot reverse the long- living with viral STDs,
term damage (but there is NO CURE)

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

but not always the

long-term damage.
In the U.S.
• Most frequently reported STD
• Estimated 1.71 million new cases in 2017
Could fill the OU Football Stadium 20x!

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.
The “Silent” Disease!!!

Possible symptoms include:

• Abnormal vaginal/penile discharge
• Burning sensation when urinating
• Rectal pain, discharge, or bleeding
• Pain/swelling in one or both testicles (less common)

Can lead to:

• Sterility or infertility
• Infection spreading to tube that carries sperm
to/from the testicles (causing pain and/or fever)
• Pelvic Inflammatory Disease (PID)
-Long-term abdominal/pelvic pain
-Scar tissue formation in fallopian tubes
-Ectopic pregnancy
Rates (Reported) by Age and Sex, U.S. in 2017
In the U.S.
• 2nd most common disease reported
• Estimated 555,608 new cases in 2017

How’s It Spread?
1. Vaginal, anal, or oral sex with someone who has
2. A pregnant woman infected with gonorrhea can give
the infection to her baby during childbirth
Possible symptoms include:
• Painful or burning sensation when urinating
• Abnormal vaginal/penile discharge (white, yellow, or green)
• Rectal discharge, itching, soreness, bleeding
• Vaginal bleeding between periods
• Painful or swollen testicles (less common)

Can lead to:

• Sterility or infertility
• Disseminated infection (rash, arthritis, fever, meningitis, etc.)
• Painful infection of tubes attached to the testicles
• Pelvic Inflammatory Disease (PID)
-Scar tissue formation in fallopian tubes
-Ectopic pregnancy
-Inability to get pregnant
-Long-term pelvic/abdominal pain
Rates (Reported) by Age and Sex, U.S. in 2017
Pelvic Inflammatory
Disease (PID)
 A serious infection that affects a woman’s reproductive organs
 Often caused by untreated STDs, like chlamydia and gonorrhea
 May experience mild or no symptoms
• 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
 Treatment can help if caught early but won’t undo any damage or
complications to the reproductive system
• Formation of scar tissue outside & inside the fallopian tubes (blockage)
• Ectopic pregnancy
• Infertility
• Long-term pelvic/abdominal pain
Primary & Secondary
“The Great Imitator” affected approximately
30,644 people in 2017 in the U.S.
How is Syphilis Spread?
• Direct contact with a syphilis sore (chancre)
during vaginal, anal, or oral sex.
• Can be spread from an infected mother to her
unborn baby.
Primary Secondary Tertiary/Late
Syphilis Syphilis Syphilis
Primary Syphilis

Chancre - syphilis sore

• Firm, round, and painless
• Appears within 2-6 weeks after exposure (could take up
to 3 months)
• Found on the part of the body exposed to the infection
(penis, vagina, anus, lips, in rectum, or in mouth)
• Typically disappear after a few weeks without treatment
(still progresses to next stage)
Secondary Syphilis
• Appears about 4 weeks after chancre heals
• Will go away without treatment, but infection will progress

non-itchy RASH with Alopecia or Mucous Patches

rough red or patchy hair loss usually in the mouth,
reddish brown spots vagina, or anus

Condylomata lata or “fleshy warts” in anogenital region

Primary and Secondary Syphilis
Rates (Reported) by Age and Sex, U.S. in 2017
Latent Syphilis
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.
Late (Tertiary) Syphilis
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
• Gumma: soft, gummy tumor

• Cardiovascular Syphilis
• Late Benign Syphilis
• Neurosyphilis Syphilis
Neurosyphilis Syphilis
Usually occurs during late syphilis but can occur at
anytime during the infection

• 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!
Congenital Syphilis
40% will be stillborn or die in the hospital
Transmission can occur during any stage of
syphilis and during any trimester of pregnancy

Can cause:
• Prematurity
• Birth defects
• Hutchinson’s teeth
• Osteochondritis
• Developmental delays
Estimated 3.7 million in 2016

Parasite passed during vaginal sex

70% of infected people have no signs/symptoms

Possible symptoms include:

• Itching, burning, redness or soreness of the genitals
• Burning with urination or ejaculation
• Thin discharge: can be clear, white, yellowish, or greenish
- Can produce unusual or foul smell

Infection usually occurs:

• Lower genital tract (vulva, vagina, penis or urethra)

Greatly increases the risk of getting/spreading other STIs!

Genital Herpes

How is it Spread?
Vaginal, oral, or anal sex OR skin-to-skin contact
with someone who has the virus

 One or more blisters on or around the genitals, rectum, or mouth
 The blisters break & leave painful sores that take weeks to heal
 These symptoms are sometimes called “having an outbreak”

Usually characterized by NO or very mild symptoms… NO CURE.

1 in 8 people aged 14-49 have genital herpes.

Most people do not know it!
Human Papillomavirus
How is HPV transmitted?
• Skin-to-Skin contact
• Vaginal, Anal, and 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 (estimated 80%).
HPV-Related Health Problems
1. Genital warts
2. Cervical pre-cancer
3. Other HPV-related cancers

- #1 cause of cervical, anal, and penile cancers

- Most people with HPV do not know they have it
- There is no treatment for the virus itself, but there
are treatments for health problems it can cause
- In most cases, the immune system will overcome
HPV on its own
Hepatitis “inflammation of
the liver”

Hepatitis A Hepatitis B Hepatitis C

How is it Person ingests Blood, semen, or Blood from a person
spread? infected fecal other body fluids infected with the
matter—even in very from a person with virus - even in very
small amounts—from the virus - even in small amounts -
contact with very small amounts - enters the body of a
contaminated enters the body of a non-infected person
objects, food, drinks non-infected person

How long A few weeks to Mild illness (a few Mild illness (a few
does it several months weeks) – Lifelong or weeks) – Lifelong
last? chronic condition

How Most recover from 15-20% develop 75-85% develop

serious is mild illness with no chronic liver disease chronic liver disease,
it? lasting liver damage, including cirrhosis, 5-20% develop
but death can occur liver failure, or liver cirrhosis, and
(although rare) cancer 1-5% will die
Human Acquired
Immunodeficiency Immune
Virus Deficiency
HIV is spread through bodily
fluids and affects specific AIDS is a late stage of the HIV
cells of the immune system. infection.
HIV attacks CD4 (T-cells) that Once diagnosed, the body has
help fight disease. a hard time fighting disease
and certain cancers.
Without treatment, HIV will There is NO cure for AIDS, but
continue to replicate itself. there is treatment.
Why is This Important?
In the U.S. (2016 year-end)
38,739 people diagnosed with HIV
17,803 people diagnosed with AIDS
How is HIV Spread?
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
Can experience “flu-like” symptoms (if any)
about 2-4 weeks after exposure:
Fever, Enlarged lymph nodes, Sore throat, Rash

What Fluids How Can HIV Enter

Transmit HIV? the Body?

•Blood Semen •Vagina •Mouth

•Vaginal Fluids •Penis •Nose
•Rectal Fluids •Anus •Eyes
• Broken •Ears
•Breast Milk Skin
Extends Lives
BUT, medication can be:
Expensive - $30,000 a year
($379,668 lifetime/2010)
Complicated – many pills at specific times of day
Toxic – side effects are common
Ineffective – not all strains of HIV respond
PrEP as Prevention
Pre-Exposure Prophylaxis (PrEP): daily medicine
that can stop HIV from replicating inside the body

PrEP is only prescribed for HIV-negative individuals who are

at ongoing substantial risk of getting HIV

PrEP reduces the risk of getting HIV

when taken consistently
 more than 90% from sexual contact
 more than 70% among IDUs
Reducing the Risk of STDs
NO Risk
Abstinence (sex): not having oral, vaginal or anal sex
Abstinence (drugs): not using drugs (HIV, HCV)
No genital contact since some are spread by touch (HPV, HSV)
Mutual monogamy between non-infected partners

Protected Sex: “correct and consistent” use of condoms/barriers
Fewer sexual partners
Regular HIV/STD Testing: at least once a year
Never sharing needles or “works” (HIV, Hepatitis)
PrEP: daily preventative medication (HIV)
Male Condoms
More than 98% effective when used
correctly and consistently

Latex (most common and effective)

“Non-Latex”: Polyurethane, Polyisoprene
Natural Membrane: Lambskin*
Male Condom Use

Looks like a hat

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

Female Condoms Dental Dams

• Worn inside the vagina • Thin, square pieces of latex
(or anus) • Used for oral sex
• Thicker and more • Could make your own
tear-resistant dental dam
• Always latex-free (from a condom, latex
• Wider opening covers more glove, or non-microwavable
pelvic area plastic wrap)
All sexually active people are
at risk for STDs
Get Yourself Tested!
HIV: Syphilis:
--Everyone aged 15 through 64 --If you are pregnant
should get tested at least once
--Are a man who has sex with
--People who have occasional other men (MSM)
exposure to HIV risks = at least
once a year --Have sex for drugs or money
--People who are at high risk for --Have HIV or another STD
HIV infection = 3-6 months --Had sex with someone who
tested positive for syphilis

Chlamydia & Gonorrhea:

Age 24 or younger and having sex = once every year
Age 25 or older = if you have had more than one sex partner or with
a new sex partner
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

Community-Based Organizations

Local Health Departments

Check out these Apps:

“STD Info, Symptoms & Testing”
“STD Testing Centers Locator”

OSDH-HIV/STD Service: 405-271-4636

National HIV/AIDS Hotline: 800-535-2437