CANNOT BE CURED. Can spread to your partners; can pass to infant during childbirth which can be very serious for the baby

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1 Infection When Symptoms Appear (if present) Symptoms How do you get it? What happens if you don't get treated? How is it treated? Type of test When to get tested Where to get tested National Stats Maine Stats Chlamydia 7 days to a month Usually no symptoms, or mild burning when you pee & discharge from genitals. FEMALES: may also have bleeding between someone who has it. periods and/or after sex, belly pain, pain with sex. Can spread to your partners; can turn into a more serious infection leading to infertility; can pass to infant during childbirth. Increases risk of getting HIV by 2-5x. Antibiotic pills. Test/Treat sex partners within past 2 months to prevent reinfection. Sexual contact should be avoided until treatment is complete (7 days). urine or swab (throat, 2 weeks for genitals, and/or accurate test rectum) STD Clinic, Doctor's Office, Family Planning Provider 1.4 million reported; estimated 2.86 million new infections annually. Estimated 1 in 15 females 14-49yo have chlamydia cases (2013) Genital Herpes usually 2-30 days, but may not have an outbreak until much later Cluster of tender, painful blisters in genital area; painful urination. Symptoms may come back in the future. someone who has it. CANNOT BE CURED. Can spread to your partners; can pass to infant during childbirth which can be very serious for the baby There is no cure. Prescription drugs may help prevent recurrences and help blisters dry up. Warm baths and keeping area dry and clean may decrease discomfort. visiual test or swab sores Estimated 8-12 weeks or Doctor's Office when sores appear 776,000 new infections annually. One out of six people 14-49yo have HSV-2. n/a Gonorrhea average is 3-5 days, can take up to 30 days Abnormal discharge from vagina, penis, or rectum; pain during urination. 80% of women show no symptoms; some men (20%) show no symptoms. someone who has it. Can spread to your partners; can turn into a more serious infection leading to infertility; can pass to infant during childbirth; can cause heart trouble, skin disease, arthritis, and blindness. Increases risk of getting HIV by 2-5x. Antibiotic injection and pills. Test/Treat sex partners within last two months to prevent re-infection. Sexual contact should be avoided until treatment is complete (7 days). urine or swab (throat, 2 weeks for genitals, and/or accurate test rectum) STD Clinic, Doctor's Office, Family Planning Provider 321,849 cases reported; estimates 820,000 occur annually (less than half detected and reported). 246 cases (2013) Estimated 570,000 cases are among 15-24yo. HIV/AIDS few months to several years after infection Can be present for years with no symptoms. Unexplained weight loss or tiredness; flu-like sypmtoms that don't go away; severe diarrhea; white patches in mouth or throat; drenching night sweat. FEMALES: yeast infection that won't go away. CANNOT BE CURED. Can spread to your partners; can pass to infant during childbirth or someone who has it. Blood during breastfeeding. People with HIV can get to blood-contact (espeically other illnesses and infection that people with sharing needles). Mother-tohealthy immune systems don't get. Most people Child (during birth, or from die from the disease. breastmilk). There is no cure. Medications can help slow the spead of virus and delay onset of other infections. Inform and protect your partners/self. blood test or cheek swab 3-6 months for accurate results with oral rapid HIV test; 2+ months with blood test clinical; community HIV testing sites Estimated 1.1 million living with HIV; 161% unaware of infection. Estimated about 50,000 new infections annually. About 47,500 new infections in new cases; 1706 people living with HIV in Maine in 2013.

2 Infection When Symptoms Appear (if present) Symptoms How do you get it? What happens if you don't get treated? How is it treated? Type of test When to get tested Where to get tested National Stats Maine Stats Viral Hepatitis (Hep A, B & C) 1-9 months after infection May not have sypmtoms or have flu-like symptoms (tiredness, achy). Yellow skin, dark urine, light-colored bowel movements. Hepatitis A, B, & C can be spread during vaginal, anal, someone infected. HBV/HCV can be spread by blood to blood contact (i.e. sharing needles, razors, nail clippers, etc.); HAV is transmitted from oral exposure to fecal matter. You can give it to your sexual or needle-sharing partner(s). Some people never recover. Some people get better but can still pass on the virus. Can cause irreversible liver damage (leading cause of liver transplants). Mother can pass HepB to her child during birth. Hep A& B is vaccine-preventable. No medication for acute HAV or HBV. HCV treated with combination antiviral therapy, which can take 6-12 months. May not be effective. blood test clinical; some community sites offer rapid HCV test About 20,000 new cases of HAV annually. Estimated 43,000 new cases of HBV (reported much lower); 800, million chronic HBV. HCV: most common chronic bloodborne infection in US; estimated 3.2 million currently infected; annually 17,000 new cases. 12,000 people die annually from HCV-related liver disease. HAV: 6. Acute HBV: 8; Chronic HBV: 105. Acute HCV: 12; Chronic HCV: HPV (Human Papilloma Virus; genital warts) 1-8 months (3 months, average) Wart-like bumps (sometimes itchy and irritating) on genitals, rectum, or throat. May have no symptoms or symptoms may go away and come back later. someone who has it. CANNOT BE CURED. Can spread to your partners. Can pass to infant during childbirth. Linked with cervical cancer, penile cancer, throat cancer. Most cases clear up without treatment. Most cancer-causing strains are preventable with vaccination. Warts may be "frozen" off (cryosurgery) or treated with trichloracetic acid (TCA), liquid nitrogen, condylox, podophyllum, aldara. visual; pap smear can detect cervical testing not cell recommended abnormalities caused by HPV STD Clinic, Doctor's Office, Family Planning Provider 79 million currently infected; 14 million new infections each year. So common that nearly all sexually active men and women get at least one type of HPV at some point in n/a their lives. About 360,000 get genital warts annually. About 12,000 women get cervical cancer each year. Syphilis days, usually 3 weeks 1st stage (primary): painless sore (chancre) appears lasting 3-6 weeks. 2nd stage (secondary): usually 6 weeks after primary, lasting 2-6 weeks; body rash, tiredness, loss of hair, sore throat, someone who has it. swollen glands. 3rd stage (latent): no symptoms, lasts up to two years. Can spread to sexual partner(s). Mother can pass to infant during birth or cause miscarriage. Can cause heart disease, brain damage, blindness, and death. Antibiotics (injection of penicillin). Treat sex partners. Sexual contact should be avoided until cure is complete. blood test STD Clinic, Doctor's Office, Family Planning Provider reported cases; estimated 55,400 annually. 13, 970 were primary/secondary. 16 cases (2013) Trichomoniasis (trich) 1-4 weeks Females: heavy, frothy discharge, vaginal odor, intense itching, burning or redness of genitals. Sometimes no syptoms. MALES: usually no symptoms. someone who has it. Increases risk of other genital infections in females. Metronizdazole (Flagyl) for all partners. Sexual contact should be avoided until cure is complete. visual and/or slide smear STD Clinic, Doctor's Office, Family Planning Provider Estimated 3.7 million, but only 30% develop symptoms. Most common curable STD. n/a

3 STD Basketball A Lesson Plan from Life Planning Education: A Youth Development Program Purpose: To provide information about STDs, how they are contracted, and how they affect health Materials: Leader's Resource, STD Facts: True or False ; container; prizes (optional) Time: minutes Planning Notes: Invite a practitioner from a local STD or health clinic to co-lead this session with you and provide an opportunity for teens to become familiar with information about the clinic. Knowing a friendly face at the clinic might make it easier for teens to go there for services. Duplicate the Leader's Resource, and cut the copy into strips that contain the statements only. Fold the strips before placing them in the container for Steps 5, 6 and 7. Obtain pamphlets on STDs from a local health department or a family planning clinic. Display these with business cards from the clinic in a prominent area of the room. Procedure: 1. Tell teens that knowing the risk of STD infection and how using latex (or polyurethane/polyisoprene) condoms can help reduce the risk is important. Equally important is knowing more about STDs, how they are spread and how to identify them. 2. Divide into four teams and have each team move to one corner. 3. Tell teens their team will play against the others in a game that is scored like basketball. The team with the most points wins. Go over instructions for the game: Each team will draw a statement about STDs from the container. The team must decide whether the statement is true or false. If the answer is correct, the team will get two points. If they can also explain why their answer is correct, they get another point, like the extra point for a free throw. If the team cannot explain their answer, another team can try to explain their answer for the extra point.

4 Team members can confer within their group. 4. Have someone from the first team draw a statement and decide whether it is true or false. Encourage the team member to confer with her or his group. 5. Ask the team to explain the statement and award an extra point if the explanation is correct. If not, allow any other team to try for the extra point. You can award more than one extra point. Use your judgment to determine if a team provides useful information. 6. As the game progresses, use the Leader's Resource to add any additional information about the statements. Make sure to keep an accurate score. 7. When all statements have been addressed, announce first, second, third and fourth places and give out prizes if you have them. 8. Conclude the activity using the Discussion Points. Discussion Points: 1. What are the signs and symptoms of STDs? (Answers include: redness or soreness of the genitals; pain when urinating (mostly for guys); strong smelling or cloudy urine; unusual discharge from the penis or vagina; sores or blisters on or around the genitals, mouth or anus; a sexual partner with symptoms.) 2. What are the two most effective ways to avoid STDs? (Answers: [1] abstain from sexual intercourse of any kind and [2] use latex condoms every time you have any kind of intercourse.) 3. What three things should you do if you are worried that you have been infected with an STD? (Answers: [1] seek medical treatment right away, [2] inform your sexual partner(s) and [3] abstain from sexual contact until your health care provider says you are not infectious.) 4. How could you bring up using condoms if you were about to have sexual intercourse with a partner you cared about? How would you feel if your partner brought up condom use when you were about to have sex? What would you say to her or him? 5. What would be most difficult about having an STD? 6. Men who have sex with men can use condoms to protect themselves and their partners from STDs. What can women who have sex with women use? (Answer barriers such as squares of latex called dental dams, cut open latex condoms or non-porous plastic wrap to cover the vulva and form a barrier so body fluids are not exchanged.)

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6 Leader's Resource STD Facts: True or False? 1. A person can always tell if they have an STD. False. People can and do have STDs without having any symptoms. Women often have STDs without symptoms because their reproductive organs are internal, but men infected with some diseases like chlamydia also may have no symptoms. People infected with HIV, the virus that causes AIDS, generally have no symptoms for some time, even years, after infection. 2. With appropriate medical treatment, all STDs except HIV can be cured. False. STD caused by viruses, such as herpes (HSV) or HPV, cannot be cured at the present time. However, some viruses, like HPV or Hepatitis B, can be prevented with a vaccine. 3. Condoms are 100% effective against the spread of STDs. False. Condoms are 98% effective if used correctly and consistently. Condoms reduce but don t eliminate the risk of STDs that are spread by skin-to-skin contact, like HPV or herpes. Only abstinence is 100 percent effective. Bonus information!: In most cases, when people using condoms get pregnant or infected with and STD, it s NOT because the condom broke; it s because they either did not use the condom correctly, or they did not use it the whole time they were having sex. Each latex condom manufactured in the U.S. is tested for holes before packaging. Before using a condom it s still a good idea to inspect to check the expiration date and make sure there has been no damage. 4. Wearing two condoms is better than wearing one. False. Wearing two condoms at the same time causes friction, which will make the condom break.

7 5. The organisms that cause STDs can only enter the body through either the woman's vagina or man's penis. False. STD bacteria and viruses can enter the body through any mucous membranes, including the vagina, penis, anus, mouth and, in some cases, the eyes. HIV and Hepatitis C can also enter the body when people share unclean needles. 6. Women who have regular Pap smears will also find out if they have an STD. False. The Pap smear is a test specifically designed to detect cervical cancer and may detect a herpes infection, but it will not indicate the presence of other STDs. A woman who thinks she may have been exposed to an STD, must be honest with her health practitioner and ask for STD tests. 7. Teenagers can receive testing and treatment for STDs from the age of 14 and older without having their parents notified. True. Teens can take responsibility for their sexual health and request confidential testing from their doctor or a clinic without a parent's or guardian s permission or notification. Many community health clinics provide STD tests and treatment at no cost, or for a small fee, to adolescents or other patients who cannot pay. In every state, minors 12 years or older in most states, 14 years and older in some states can be tested and treated confidentially for STDs. 8. You cannot contract an STD by masturbating, or by holding hands, talking, walking or dancing with a partner. True. STDs are only spread by close contact with an infected person. Anyone can be infected by having oral, anal or vaginal intercourse with a partner who is infected. In the case of HIV, a person can also be infected by sharing needles or works to use IV drugs with an infected partner.

8 9. STDs are a new medical problem. False. STDs have existed since people began recording history. There is evidence of medical damage caused by STDs in ancient writings, art and skeletal remains. Writers of the Old Testament, Egyptians writing on papyrus and the famous Greek physician Hippocrates all mention symptoms of diseases and sufferings which we know today was caused by STDs. Cures for most STDs were not found until the 1900s, and some still cannot be cured. Bonus Information!: STDs used to be called VD, or venereal disease, the word venereal being derived from the Latin word venereus, and meaning relating to sexual intercourse or desire, ultimately derived from Venus, the Roman goddess of love. 10. STDs can cause major health problems and some can even result in death if left untreated. True. HIV infection, which can be spread through sexual contact, can be fatal if untreated. Some STDs such as gonorrhea and chlamydia can cause pelvic inflammatory disease (PID). If untreated, PID may lead to chronic pain, infertility, and ectopic pregnancy. Some strains of HPV can lead to cancers of the cervix, penis, anus, throat, and mouth. 11. Only people who have penetrative sex can contract an STD. False. Some STDs like herpes and HPV can be transmitted through prolonged skin-to-skin contact. HIV and HCV can be passed through sharing used needles for injecting drugs. Infants can contract STDs such as herpes, gonorrhea and HIV infection during their mother's pregnancy and/or during the birth process. 12. You can put off STD testing and treatment until after you think you have been infected. False. Once an STD infects a person, it begins damaging health. If someone waits weeks or months before getting tested and treated, her or his health may be permanently damaged, even after treatment begins. In addition, the person can spread untreated STDs to sexual partners.

9 13. A woman on the pill should still insist that her partner use a latex condom to protect against STDs. True. Oral contraceptives do not prevent STDs, so a condom is still necessary for protection. 14. By the age of 25, half of sexually active people will have or had an STD. True. Bonus point question: Guess within 1 million how many new infections happen within each year. Answer: The CDC has estimated that there are 19 million new STD infections every year. Sexually active people under the age of 25 generally have higher rates of STD infection because most people who are infected with STDs do not show symptoms or seek testing. 15. It is possible to get some STDs from kissing. True. It is rare but possible to be infected by syphilis through kissing, if the infected person has chancres (small sores) in or around the mouth. The herpes virus can also be spread by kissing if active lesions are present. 16. Oral sex is a safe way to have sex if you do not want to get a disease. False. Almost all STDs that can be passed on through unprotected vaginal sex can also be passed on through unprotected oral and anal sex. This includes herpes, HPV (genital warts), gonorrhea, chlamydia, syphilis, and HIV. The possibility of contracting an STD from oral sex is generally less risky as compared to vaginal and anal sex, although any unprotected sex with someone who is infected with HIV or an STD carries some risk. Unprotected anal sex is riskier than oral or vaginal sex. Male latex condoms, when used consistently and correctly meaning EVERY time, and from start to finish are highly effective in preventing the spread of HIV. They also reduce the risk of many other STDs.

10 17. Having an STD increases your chances of getting other STDs. True. If you are infected with an STD, your chances of becoming infected with HIV if you have sex with someone who is infected increases by 2 to 5 times. This is because the STD infection brings more immune response cells to the genital region, and HIV targets immune cells. Also, some STDs create sores or microscopic lesions which increases the chance for HIV to get through. 18. The most important thing to do if you think you have an STD is to inform your sexual partner or partners. False. The most important thing to do is to seek immediate medical treatment. Symptoms of an STD may never appear, or may go away after a short time, but the infection continues inside the person's body. She or he can suffer serious physical damage and can continue to infect others. Once medical treatment is begun, the person or a health practitioner can inform sexual partners. In the meantime, it is also important for the infected person to abstain from any sexual contact. 19. Pulling out will prevent someone from getting STDs. False. Withdrawal or pulling out is NOT an effective means of preventing HIV or other STDs. Pre-cum (seminal fluid) can contain viruses or bacteria. Based on typical use that is, the experience of most who use it withdrawal is significantly less effective at preventing pregnancy as compared to other methods, such as condoms, the Pill or shot. For those who are sexually active, the only option that protects against both pregnancy and STDs is condoms. For maximum protection, use both a birth control method, like the Pill or Depo, WITH condoms. 20. Once you ve had an STD, there s no chance of ever getting it again. False. 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.

11 21. You can get herpes from a toilet seat. False. Herpes simplex virus (HSV) is spread by direct skin to skin contact. So unless you and another person are sharing a toilet seat at the same time, the toilet is not likely the source of the infection. So while you might want to check to see if the seat is clean and dry before sitting, you can leave worries about herpes behind.