Education and Training Events

STIs and Youth

Syphilis

Caused by the bacteria Tryponema pallidum
Transmitted by direct contact with a syphilitic sore, known as a chancre.
Has different stages, and if not treated properly or early on, can have significant consequences as it advances through each stage
- Primary: Single chancre, which is typically firm, round, and painless
- Secondary: Skin rash
- Latent: No visible signs or symptoms
- Tertiary: 10-30 years after; can be fatal, and symptoms are system dependent
How is it spread?
- Receptive fellatio
- Insertive fellatio
- Receptive cunnilingus
- Insertive cunnilingus
- Anal receptive sex
- Anal insertive sex
- Penile-vaginal sex
Treatment
- Primary: Benzathine penicillin G 2.4 million U IM for 1 dose
- Latent: Benzathine penicillin G 7.2 million U, divided as 3 separate IM shots of 2.4 million U, one per week
- Neurosyphilis: penicillin G 18-24 million U per day, administered as 3-4 million U IV every 4 hours for 10-14 days

Gonorrhea

Like syphilis, this is caused by a bacterium. That is good news because antibiotics can treat most strains of gonorrhea.
What is it?
Unlike syphilis – which creates an ulcer anywhere is penetrates the skin, gonorrhea is a urethral infection (meaning that is grows in the urinary tract) and it also “likes” moist mucous membranes, such as rectum, vagina, and mouth.
What are the specifics?
Usually asymptomatic in females (80%) and rarely asymptomatic in males – this is also true with other STIs and is known as biological sexism.
Symptoms: Males
Very painful urination if infected in the urinary tract.
Pus-like discharge
- Example of gonococcal urethritis
- Example of epididymitis
In females…
- Greenish – yellow vaginal discharge
- Lower abdominal pain
- Dysuria (painful urination)
- Pelvic Inflammatory Disease (PID)
  - What is PID?
    - This is an inflammation of the cervix, uterus, fallopian tubes, and ovaries – it is extremely painful (often leading to hospitalization) and is a common cause of infertility.
    - Infertility – female cannot reproduce
    - Sterility – male cannot reproduce
Can also contract orally

Chlamydia

Much like gonorrhea, chlamydia can infect moist mucus membranes and it has a proclivity for the urinary tract.
How is it spread?
- Receptive fellatio
- Insertive fellatio
- Receptive cunnilingus
- Insertive cunnilingus
- Anal receptive sex
- Anal insertive sex
- Penile-vaginal sex
Often called non-gonococal urethritis (NGU) when the urinary tract is infected
Primary cause of PID
Symptoms are similar (often indistinguishable) to symptoms of gonorrhea, except fever and flu-like symptoms may be present
75% of females are asymptomatic (50% males)
Most common among teen females because of cervical ectopy (chlamydia cervicitis)

Treatment

Gonorrhea: Ceftriaxone 250 mg IM single dose + 1g azithromycin PO single dose
Chlamydia: Doxycycline 100 mg PO BID for 7 days OR 1g azithromycin PO single dose

Trichomoniasis

T. Vaginalis is a parasite, not a bacteria. It has a flagella.
What is it?
- The parasite causes a frothy yellow-green discharge in females and a strong (bad) odor. Vaginal irritation and mild pain during urination may occur. Men rarely have symptoms or problems.
How is it spread?
- Sex between women
- Penile-vaginal sex

Now, a viral STI: Herpes

This one is complicated.
- Herpes simplex virus type 1 (mostly oral)
- Herpes simplex virus type 2 (mostly genital)
Stages
- Acute (new also called primary) infection – fever, flu-like symptoms, vesicles form
- Subsequent outbreaks become progressively less severe but they can occur at any time for the rest of the person’s life.
Person will always shed virus – always contagious

HPV

Group of over 150 related viruses, implicated in genital warts, but more worrisome, cancer
- Cervical cancer: Virtually all cases of cervical cancer are caused by HPV, and just two HPV types, 16 and 18, are responsible for about 70% of all cases.
- Anal cancer: About 95% of anal cancers are caused by HPV. Most of these are caused by HPV type 16.
- Oropharyngeal cancers (cancers of the middle part of the throat, including the soft palate, the base of the tongue, and the tonsils): About 70% of oropharyngeal cancers are caused by HPV. In the US, more than half of cancers diagnosed in the oropharynx are linked to HPV type 16.
- Rarer cancers: HPV causes about 65% of vaginal cancers, 50% of vulvar cancers, and 35% of penile cancers. Most of these are caused by HPV type 16.
HPV vaccination before sexual activity can reduce the risk of infection by the HPV types targeted by the vaccine.
- Recommended range is vaccinating between 9 and 26 years old
- There are three FDA approved vaccines to prevent HPV infection: Gardasil®, Gardasil® 9, and Cervarix®. These vaccines provide strong protection against new HPV infections, but they are not effective at treating established HPV infections or disease caused by HPV.
Correct and consistent condom use is associated with reduced HPV transmission between sexual partners.

Challenges of teaching sex education

Audience
- What age group are you teaching?
  - Elementary school children: ensuring they understand the facts in a meaningful way
- Adolescents

Defining Sex

In Misclassification bias: diversity in conceptualizations about having ‘had sex’ by Sanders et al, nearly 95 percent of people agreed that penile-vaginal intercourse meant "had sex."
11 percent of respondents would not use the phrase "had sex" if "the man did not come." About 80 percent said penile-anal intercourse meant "had sex.”
About 70 percent of people believed oral sex was sex.

Mississippi Law

HB 999 prohibits the following:
- Condom demonstrations
- Discussion of abortion as a means to prevent the birth of a baby
- Co-ed sex education lectures
School districts must understand and comply with the requirements of the CHART Initiative, the PREP grant, and House Bill 999, Mississippi’s sex education law.
- Creating Healthy and Responsible Teens (CHART): Initiative was created by Mississippi First in conjunction with the Mississippi State Department of Health to reduce teen pregnancy, improve teen sexual health, and increase responsible decision-making
- Works with Mississippi school districts to increase adoption and implementation of comprehensive or “abstinence-plus” sex education policies and evidence-based, medically accurate, and age-appropriate programs.
- The Personal Responsibility Education Program (PREP) grant is a federal grant received by the Mississippi State Department of Health to support teen pregnancy prevention efforts in Mississippi public schools and communities.

Challenges

Think outside the box….

Questions?

Thank you!