The Secret Epidemic: STIs on Campus

American College Health Association

The Secret Epidemic:STIs on Campus

A Presentation of the American College Health Association



Sexually Transmissible Infections (STIs)

Three Common STIs among Teens and Young Adults

The Most Common STI among Teens and Young Adults

What to do if you think you have an STI

Discussion Points for Today


Infections—Generally Speaking

What are they?• Overgrowths of bacteria, viruses, fungus (yeast), or protozoal

pathogens

How are they spread?• Inhalation of infected air, contact with infected body fluids, contact

with infected skin (rashes, lesions)

How can they be prevented?• Avoiding contact with infected air, fluids, and skin


Sexually Transmissible Infections (STIs)

Also known as• Sexually Transmitted Diseases (STDs)

• Venereal Diseases

What are your risks?


Sexually Transmissible Infections

Bacterial Infections• Chlamydia

• Gonorrhea

• Syphilis

Viral Infections• Herpes

• Hepatitis B

• Molluscum contagiosum

• HIV

• Human papillomavirus


Common STIs among Teens and Young Adults

Human Papillomavirus (HPV) (virus)• Warts on genitals and anus (men and women)

• Warts and pre-cancers on cervix (women)

• Often asymptomatic, presenting no visible symptoms

• Communicable or non-communicable when asymptomatic

Chlamydia (bacteria)• Infected cervix, tubes, epididymis

• Sometimes no symptoms at all


Common STIs among Teens and Young Adults

Herpes (HSV I & II) (virus)• Painful ulcers

• Often no symptoms at all

Molluscum Contagiosum (virus)• Pimple-like lesions

• Often confused with pimples or folliculitis


“Risky Contact” for the Spread of STIs

You don’t have to have sexual intercourse to contract an STI• Many STIs are spread by direct skin contact

• Everyone who has “risky contact” is at risk

• Teens and young adults are more “at risk” than other populations



Condoms do NOT completely protect from infections spread by skin contact, because they do not cover all infected areas of the skin

Infection with these organisms does not require penetration during intercourse if there is other “risky contact.”

HPVHPV HerpesHerpes MolluscumMolluscum



Avoid “risky contact,” which is any contact with skin or fluids that may contain the viruses and bacteria that cause STIs

Don’t share intimate apparel such as swimwear or underwear


Who gets STIs?

Anyone who has “risky contact” with a person with an STI

One contact might be all it takes to get an STI

The more contacts, the greater the risk


STI Prevention

Abstinence works best• Avoid genital touching

• Many teens and young adults are now choosing abstinence

• Abstinence reflects feelings of self worth and self esteem

• Not everyone is “doing it”

• Sexual activity is NOT a requirement for friendship or social acceptance


The Most Prevalent STIs

Chlamydia Women: infects urethra, cervix

• Often no symptoms• Sometimes pain with urination or lower abdominal pain• Infection can spread to tubes and ovaries• Can cause infertility

Men: infects urethra, epididymis• Can cause pain with urination • Swelling and pain of the testicles

Spread by body fluids

SemenSemen VaginalVaginal AnalAnal


Epididymitis due to Chlamydia - the swelling of this infection is seen above the right testicle


Hydrosalpinx resulting from Chlamydia - closed, swollen and water-filled left tube in a young woman



Genital herpes Men and women: genital skin

• Extremely painful lesions• Often no symptoms

Women: cervix• Abnormal vaginal discharge• Often no symptoms• May infect newborns during delivery

Spread by skin contact

Genital-GenitalGenital-Genital Hand-GenitalHand-Genital Oral-GenitalOral-Genital


Penis with vesicles (blisters) from genital herpes


External genital skin of female with herpes ulcers



Molluscum• Can appear anywhere on the skin

• Bumps that look like pimples

• Can become infected with bacteria

Spread by body skin contact



Molluscums of lower abdomen


External genital skin of female with huge molluscums


Human Papillomavirus (HPV)

Over 100 types of HPV• More than 20 types of HPV can infect genital skin

• Men and women: genital and anal warts

• Women: lesions on the cervix and vagina

Spread by skin contact



Human Papillomavirus (HPV)

HPV: Genital Warts• Men and women: external genital skin, anus, in urethra

• Women: cervix, vaginal walls

• Condoms offer some protection, but don’t cover all of the skin that can be infected


Papillary genital warts of female


Flat genital warts of male


Papillary genital warts of male


Papillary genital warts of male anus


HPV Treatments

Treatments for External Genital Warts

Patient-applied prescription remedies• Aldara™ (imiquimod) Cream, 5%

• Condylox™ gel 0.5% (podofilox)

Procedures performed in the doctor’s office• Freezing–cryoprobe or liquid nitrogen

• Caustic chemicals–TCA, BCA, podophyllin

• Laser


HPV and Pre-Cancers

Cervix and anus: some HPV types cause lesions that can be pre-cancers

• If not treated, they can eventually become cancers

The Pap smear detects lesions on cervix• Cells scraped from cervix are examined under a microscope

• If they have ever had sexual contact, women need yearly Paps


Genital warts on cervix of female


Pre-cancer changes on cervix


HPV—Treatments of the Cervix and Anus

Cervix: destruction of lesion by freezing, laser, loop excision• These treatments are about 90% successful

Anus: similar to external genital warts• Aldara™, Condylox™, freezing, caustic chemicals, laser


HPV Protection

Consistent condom use can cut down, but not eliminate, the transmission of HPV

Many HPV-associated lesions resolve spontaneously, but they may return

Warts can be treated and removed, but the virus may remain in latent form

See your health care provider for an accurate diagnosis and appropriate treatment


What about HIV/AIDS?

HIV usually leads to AIDS• AIDS is fatal—newer treatments prolong life, but not to a full life

expectancy

• Having an STI can increase the risk of acquiring HIV

• 2 in 1,000 young adults are HIV positive

• 92 in 1,000 young adults have chlamydia or HPV

HIV is spread by body fluids

SemenSemen VaginalVaginal AnalAnal


If you think you have an STI

See a health care professional

Be honest about your sexual behavior

Ask for explanations

If you do have an STI, notify your partner


Testing for STIs

There is no single test that detects all STIs

No test is perfect (every test can fail to detect an infection)

Screening tests (used when no symptoms are present)• HPV (visual examination; Pap smear tests the cervix only)

• Chlamydia, gonorrhea (tests of genital secretions or urine)

• HIV, syphilis (specific blood tests)

• There is no reliable test for herpes when symptoms are absent


STI Prevention

Alcohol and Drugs contribute to becoming infected with an STI

Combined with sexual activity, the use of alcohol and other drugs is strongly associated with:

• Sexual activity when you are not really ready

• The spread of STIs

• Unwanted/unplanned pregnancy

• Acquaintance/date rape


Remember: Abstinence works best

Avoid genital touching

Many teens and young adults are choosing abstinence for now (this does NOT mean life-long celibacy)

Abstinence reflects feelings of self worth and self esteem

Not everyone is “doing it”

Sexual activity is NOT a requirement for friendship or social acceptance


For more information about STIs, contact your health service or other health care professional.

Visit the National HPV & Cervial Cancer Prevention Resource Center at www.ashastd.org/hpv/hpvrc/toc.html

or contact ACHA at (410) 859-1500

The Secret Epidemic: STIs on Campus

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