GET THE FACTS ABOUT SUICIDE IN THIS ISSUE THE FACTS WARNING SIGNS HOW TO HELP SUICIDE PREVENTION RESOURCES

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1 GET THE FACTS ABOUT SUICIDE IN THIS ISSUE THE FACTS WARNING SIGNS HOW TO HELP SUICIDE PREVENTION RESOURCES

2 TEENS & SUICIDE Native communities have always represented unity and strength. Today we must continue this tradition and come together to help those in need. Suicide has become a serious problem in Native communities, but suicide can be prevented. You can help by paying attention to warning signs, talking about it, and getting connected with family, friends, and your culture. You may save a life.

3 THE FACTS Suicide always occurs with little or no warning signs. FALSE: In most cases, a suicidal person has shown signs that they were in trouble before they committed suicide. Signs of suicide may not be what you expect or can be hard to spot if you don t know what they are. The first step to preventing suicide in your community is learning and talking about suicide. Asking someone if they are thinking about suicide puts the thought in their head. FALSE: When someone is suicidal, their choice isn t caused by a concerned friend or family member asking Are you thinking about suicide? Often, by the time someone asks that question the person has been thinking about suicide for a long time. Not asking if someone is thinking about suicide is more dangerous than asking. Suicide attempts are just someone wanting attention. It s not for real. FALSE: Every suicide attempt should be taken seriously. In fact, a previous attempt at suicide is a high risk factor for a potential suicide. Part of being a good friend is listening to your friends when they need help. Someone who attempts suicide is in need of help. There s no way to stop someone from committing suicide. FALSE: The best way to prevent suicide is to learn about risk factors, warning signs, how to talk to a friend or family about suicide, and taking action to help. Most people who commit suicide don t want to die, they just want to stop the hurt that is leading them to suicide.

4 WARNING SIGNS SUDDEN WARNING SIGNS RISK FACTORS Previous attempts or friend and families who have attempted or completed suicide Exposure to sexual or physical violence History of depression or mental disorders Substance abuse Physical or chronic illness Questioning sexual orientation or gender identity Stress resulting from economic difficulties Making threats or talking about harming oneself Searching for the means of killing oneself with firearms or medications Asking persistent questions about suicide, death and dying Giving away valued personal possessions OTHER WARNING SIGNS Feelings of hopelessness and that there is no way out, having no purpose and no will to live Anger or rage that appears to be uncontrolled, or vengeance-seeking Withdrawal; feeling lonely and troubled Engaging in reckless and dangerous behavior, such as going snowmachining under the influence or driving at high speeds, with no thought of consequences Mood changes, anxiety, agitation with little sleep or too much sleep Depression

5 HOW TO HELP ASK Talk to your friends and family members who you are worried about. It s important to ask Are you thinking about suicide? Practice a few times, you ll get more confident. Make sure you don t leave them alone if they say yes. Ask an adult to help you keep them safe by limiting access to guns, medications, and poisons. TALK Remember to keep checking up on them. It might be necessary to approach your friend a few different times before they are willing to open up to you. When you are talking to your friend remember to not judge, give advice, or ask why? this can make your friend feel defensive or not want to talk. Remember - you can ask for help too. Another friend or trusted adult can help you talk to the person you're concerned about. ACT Okay, you ve talked to your friend and now they have agreed to get help so they can stop feeling suicidal. For many people, going to get help can overwhelm them with lots of different feelings. This is a good time to ask a trusted adult for resources to help your friend. Then you can share those resources with your friend and assist them with getting the help they need.

6 REMEMBER! It is important to always have a trusted adult aware of what s going on with you and the friend you re worried about. DEPRESSION We all go through ups and downs in our mood. Sadness is a normal reaction to our everyday and life struggles, setbacks, and disappointments. Many people use the word depression to explain these kinds of feelings, but depression is much more than just sadness. Some people describe depression as living in a black hole or having a feeling of impending doom. Men in particular may even feel angry, aggressive, and restless. Depression can look different for lots of people and cause them to act in ways that are out of character or abnormal for them. Depression is different from normal sadness. Depression impacts your day-to-day life and interferes with your ability to work, study, eat, sleep, or have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief. Sometimes when someone is depressed, thoughts of suicide can start. Even though depression makes you feel like there is no end or no way out, there is an end to feeling that way through seeking help and talking to a mental health professional.

7 SUICIDE PREVENTION COMMUNITY We as a community can prevent suicide by being strong and connected. Here's what you can do to strengthen your community: Stay connected to your friends and family. Participate in your culture's traditional activities. Ask and elder or an adult about your heritage. Share what you're proud of about your culture with someone you know. Be engaged with youth from across different Native communities. Check out the resources in the fact sheets to connect with other Native communities. Host an event about suicide awareness at your school or in your community. Talk to your friends about warning signs and how to ask, talk, and take action with a friend you're worried about. Speak out against bullying. HELPING YOURSELF If you feel that you are at risk for suicide, or you have attempted suicide in the past, try these strategies to prevent you from completing suicide: Immediately reach out to a trusted person in your life that can support and help you. Avoid alcohol and drugs. Make your home safe, such as creating a space for you that is filled with things that give you joy. Learn positive and constructive ways to control stress. Seek treatment. Take 3 deep breaths and count to 10 to gather your thoughts. Engage in your favorite activities. Exercise. Create a list of people who love and support you, people you can call on in times of need. Create a survival kit of objects and memories that bring you comfort or make you smile that you can take out in your darkest moments.!!! If this is an immediate emergency or you are trying to commit suicide please call 911 or call TALK (8255)!!! RELATIONSHIPS If your girlfriend or boyfriend is threatening to kill themselves at anytime talk to a trusted adult immediately. Don t stay together with someone because you are worried that they are suicidal, it is best to get yourself help from an adult to deal with it. If your girlfriend or boyfriend is suicidal it s not your job to fix them, but you can support them in getting help for themselves.

8 RESOURCES FREE National Suicide Prevention Lifeline: TALK (8255) someone_died.html The University of Texas Health Science Center at Houston

9 ANSWERS TO ALL YOUR BURNING QUESTIONS GET THE FACTS ABOUT STDs Pubic Lice Genital Herpes IN THIS ISSUE POSSIBLE SIGNS & SYMPTOMS Learn what you need to look for TREATING STDs Find out which STDs are curable & how they are treated PROTECTING YOURSELF How to avoid STDs Chlamydia Gonorrhea HIV

10 Itchies & Scratchies? STD means Sexually Transmitted Disease. You may have also heard them called STIs which means Sexually Transmitted Infections. People use both names but they are talking about the same thing. They are infections that are transferred from one person to another through sexual contact. Below are some of the possible symptoms of STDs. Most Common Symptom Not having any symptoms On or Near Your Vagina, Penis or Anus: Blisters or sores Discharge Irritation or itching Pain or burning Warts or bumps General Symptoms: Pain or burning when urinating Painful vaginal sex Severe vaginal yeast infections Flu-like symptoms such as colds, chills, and fever Q: What's the most common symptom of any STD? A: Having no symptoms Not knowing anything is wrong Not having any symptoms No symptom

11 Treating STDs Some STDs are caused by bacteria. Some are caused by viruses. And others are caused by parasites (tiny animals that live off human blood) or protozoa (single-celled organisms that live where moisture exists). Health care providers treat patients with the best medication available. Bacterial Infections Bacterial infections can be cured with antibiotics. However, finding the infection early is important. Antibiotics may be given as pills, creams, or shots. Some examples of bacterial infections are: Gonorrhea Chlamydia Syphilis Viral Infections Viruses, like the common cold, can not be cured with antibiotics, but finding the infection early is important to help control the infection. Some examples of viral infections are: Genital Herpes Human Papillomavirus (HPV) Human Immunodeficiency Virus (HIV) Parasite Infections Parasite infections can be cured with antibiotics or medicated shampoos and lotions. Some examples of parasitic infections are: Pubic Lice ( crabs ) Scabies Protozoan Infections Protozoan infections can usually be cured with antibiotics or antiprotozoal medications. It is important to get treated even if symptoms go away. An example is: Trichomoniasis ( trich )

12 Why get tested? Finding out early gives you the best chance of curing or controlling the infection. Early treatment can prevent some pretty nasty symptoms from developing or getting worse and prevents you from passing it on to others. FAST Here are some of the things that can happen, if STDs are not treated: FACTS Severe infection of female or male reproductive parts (ovaries, uterus, testicles, etc.) Permanent damage to reproductive parts (can make it hard to have a baby later) Problems with the brain, heart, eyes, joints, and skin Cancers of the cervix, anus, or penis Death Know your status! Having one STD that isn't treated makes it easier to get infected with another STD.

13 Protect Yourself... Choosing not to have sex is the only sure way to protect yourself against STDs. It's Your Game..Keep It Real! If you do choose to have sex, ALWAYS use a condom. Had sex? Get Tested. Condoms won't prevent everything all the time, but they prevent MOST things MOST of the time. If you decide to have sex, you should have a condom ready. If your partner won't agree to use a condom, don't have sex. It's not worth the risk! CON CONDOM DOM

14 RESOURCES sexetc.org CDC National STD and AIDS Hotline (English & Spanish) 800-CDC-INFO ( ) National STD Line Planned Parenthood PLAN for the nearest location The University of Texas Health Science Center at Houston

15 GET THE FACTS ABOUT MENSTRUATION pads cramps s wing secur ity IN THIS ISSUE P.M.S What is a normal period? Wonder why everyone has a different take on periods? tampons Keeping You Covered The basics on pads & tampons PMS Pimples & pain? Period Plotting Keeping track of your period.

16 WHAT IS A NORMAL PERIOD? No two people have the same period or cycle. As long as you aren t having any problems, chances are that you are okay. Below are several examples of how periods can be different and still be normal. men stru al cy cle: The time from the first day of one period to the first day of the next period. CYCLE LENGTHS can be from 21 to 45 days. Cycles can vary by a few days or be the same number of days every time. CYCLE REGULARITY If you ve just started menstruating, it s normal to have irregular cycles for the first year or so. It s also normal to have your cycles go like clockwork from the beginning. DAYS OF BLEEDING It s normal to bleed for three days. Or five. Or seven. Or anything in between. SYMPTOMS Cramps, backpain, or discomfort. More bowel movements than usual or constipation for the first day or so. Or other symptoms (see PMS). How much blood is too much? Sometimes girls worry about how much blood actually comes out. However, most days it only amounts to a teaspoon or two of blood. If you have any of the following problems, you should speak to your health care provider: blood that soaks through one or more pads or tampons every hour for several hours in a row. need to use pads and tampons at the same time to control the blood flow for several hours at a time. if you bleed or have your period more often than every 21 days.

17 KEEPING YOU COVERED the basics on pads & tampons The decision to use either pads or tampons depends on what you are most comfortable using. Both are made from a soft cotton-like material and both control your menstrual flow. PADS Pads work by absorbing the blood as it passes out of the vaginal opening. Pads fit inside a girl's underwear. The outside is lined with a lightweight plastic to prevent leaks and has a sticky strip that sticks to the underwear. Pads come in several different thicknesses for heavier or lighter days or nighttime use. Change pads every 3 or 4 hours, even when you're not menstruating very much. If your period is heavy, you should change pads more often. Used pads should be wrapped in toilet paper and put in the trash can. Never try to flush a pad down the toilet - they're too big and will make a huge mess and back up the toilet. uterus vaginal opening cervix tampon Change pads & tampons every 3-4 hours to prevent buildup of vaginal bacteria and eliminate odor. TAMPONS Tampons are inserted into the vagina and left there for several hours at a time to absorb the blood as it passes into the vagina from the uterus. Most tampons have a plastic or cardboard applicator that is easy to insert. Others, however, are inserted just by using a finger. Tampons can't ever get lost inside you - the opening at the cervix (located at the top of the vagina) is just too tiny for a tampon to get through. All tampons have a string attached to one end so that you can pull it out of the vagina. Tampons should be changed at least every 3 to 4 hours in order to prevent Toxic Shock Syndrome (TSS). TSS is a rare illness caused by bacteria. Changing your tampons regularly is the best way to prevent this. Tampons and tampon applicators should not be flushed down the toilet. Wrap tampons and tampon applicators in a tissue and put them in a trash can.

18 PMS PIMPLES AND PAIN? PMS - premenstrual syndrome - is a term that refers to physical and emotional symptoms that girls sometimes feel before or during their period. Most PMS symptoms are mild and last only a few days. The symptoms are related to a change in the girl s hormone levels. Most physical symptoms can be relieved by over-thecounter pain medications. Symptoms girls may experience: Cramps Headaches Backaches Bloating or water retention Breast tenderness Acne or pimples Mood swings including depression For cramps, try: Light exercise A heating pad on the lowest setting Over-the-counter medications Most PMS symptoms are mild & last only a few days

19 PERIOD PLOTTING Keeping track of your period will help you identify problems and avoid accidents. A calendar is an easy way to do this. Begin counting on the first day of your period that will be day one. For example, if your period begins on the 10th of the month, make your first mark on that day. Your chart may look like this: 1 8 SUN MON TUE WED THU FRI SAT X X X X X X X XHeavy XNormal XLight 7 28 OR SUN MON TUE WED THU FRI SAT XLittle Spotting You might also want to keep track of how you feel during your period and how heavy your flow is. That way when you see your doctor, you will have accurate information to report X X X X X After you start menstruating, your health care provider will ask if your cycles are regular & if you have any problems. You can get pregnant if you have sex while you are on your period. WHAT IS DOUCHING? Douching is rinsing the inside of the vagina with a liquid mixture (usually water and vinegar, baking soda, or iodine). People think that douching can get rid of odor or help clean out the vagina to prevent infections or pregnancy but it can actually cause an infection called bacterial vaginosis. Douching does not prevent pregnancy. Most health experts do not recommend douching.

20 RESOURCES sexetc.org Planned Parenthood PLAN for the nearest location The University of Texas Health Science Center at Houston

21 GET THE FACTS ABOUT LGBTQ2S ISSUES IN THIS ISSUE WHAT DOES LGBTQ2S MEAN? BEING ME TALKING TO OTHERS COMING OUT RESOURCES

22 WHAT DOES IT MEAN??? LESBIAN: girls who are sexually and emotionally attracted to other girls GAY: guys who are sexually and emotionally attracted to other guys Sexuality Sexuality is a basic part of our physical, mental, emotional, and spiritual lives. It influences how we feel about things and how we experience the world. Having a healthy attitude about sexuality means knowing your own values, limits, and boundaries, and respecting those same boundaries in others. This can help us be ourselves. BISEXUAL: guys or girls who are sexually and emotionally attracted to both guys and girls TRANSGENDER: people who feel they were born into the wrong body, for example, being born with guy body parts but feeling that you are really a girl, or vice versa. QUESTIONING: People who are unsure of their sexual orientation may consider themselves questioning. What is Two Spirit (2S)? Native cultures have historically been open to multiple gender identities: male, female, or a blend of the two, called Two Spirit. Historically, Two Spirit people had special roles in many tribes. They were revered counselors, medicine people, and representatives in negotiations.

23 BEING ME Accept Yourself. Protect Yourself. Sex ed. at school isn t always inclusive - Many LGBTQ2S people do not get the information they need. Check out and iknowmine.org to protect yourself and the ones you love. What if I m not sure? There s really no easy way to answer this because every person is different. While there are some people who are sure about their orientation from a young age, there are many others who need time to figure things out. It can be even harder when you feel pressure from other people, like your family and friends, to be a certain way. Don t worry about feeling like you have to identify yourself a certain way, there is no rush. When you re ready, you ll know. Protect yourself from STD/HIV. Always use a condom when you have sex. Every time, for every kind of sex oral, vaginal, anal, whatever. Get tested. And make sure your partner gets tested too. Avoid drugs and alcohol. They mess with your judgment and can lead to unprotected sex. If you do drink, know your limits, so you can still make safe choices and have no regrets in the morning. Learn about your tribal culture's traditions around different sexual orientation and gender identities. What is normal? Normal is whatever you are. This goes for everything about you, from your body shape, to your skin color, personality or whether you re gay, straight, or questioning. Many teens worry that being LGBTQ2S is wrong, weird, or shameful but there is really nothing wrong with how you or people you know choose to identify yourselves. If you think you may identify yourself as LGBTQ2S you are definitely not alone! In fact, 1 out of 10 teenagers identifies as LGBTQ2S.

24 TALKING TO OTHERS FRIEND OR FRENEMY? If you have a friend who identifies as LGBTQ2S, it can be hard to figure out exactly how to show your support. The best thing to do is be supportive, listen, and not share private conversations with others. As with any friendship, you want to respect your friend s choices and accept who they are. Many students have started Gay-Straight Alliances or GSAs at their schools to increase support for LGBTQ2S issues. If you re interested in starting one at your school, check out this website: WHO CAN I TALK TO??? Even if you re not sure about your orientation you might still want to talk with someone to share your thoughts and feelings. It can be hard to talk with your family about this and friends might tell others without your permission. Look for someone you can fully trust, like a counselor at your school or another trusted adult who will support you. ABOUT COMING OUT AT HOME Coming out at home can be a difficult thing to do. There are a few things to consider before you do so, like thinking about what your family s reactions might be or if you re really ready to come out to them. Check out the links below for more information on this topic:

25 RESOURCES Sexual health information for Info on sexual health and issues of concern to LGBTQ2S trans youth youth sexetc.org Parents, Families and Friends of Lesbians and Gays Trevor Helpline Crisis Intervention for LGBTQ2S Youth 24 hours a day, seven days a week Social networking site for LGBTQ2S youth, friends, & allies Individual stories of lesbian, gay, bisexual and transgender youth in the U.S. Support if you feel alone or bullied Sexual health information inclusive of LGBTQ2S people The University of Texas Health Science Center at Houston

26 GET THE FACTS THE 411 ON ABUSE IS MISUSE IN THIS ISSUE WHAT IS ABUSE? RAPE ESCAPE PLAN ANSWERS TO COMMON QUESTIONS RESOURCES

27 WHAT IS ABUSE? Abuse is when someone does things to control, bully, or hurt someone else. Abuse can be: PHYSICAL Causing harm or injury to your body EMOTIONAL/MENTAL Causing harm to your feelings or ability to think clearly VERBAL Causing harm to you by using mean or hurtful words What Is Sexual Abuse? Sexual abuse happens when someone has forced sexual activity on you. You've also been sexually abused if someone you admire and respect has talked you into sexual activity, even if they didn't use force. Examples of sexual abuse Having sex (oral, anal or vaginal) against your will Touching your sex parts or making you touch their sex parts against your will Showing you his/her sex parts or making you show yours Touching or kissing in a sexual way against your will Asking to have sex against your will Showing pictures or movies of other people having sex These are not the only forms that sexual abuse can take, but these are the most common. A Word About Abuse Abuse can be sexual, physical, verbal, or emotional/mental. In a perfect world all relationships would be happy and healthy. However, sometimes things go wrong. Abuse can happen within a family, a friendship, or a romantic relationship but no matter who does it, it is ALWAYS wrong.

28 RAPE Rape, or sexual assault, is when one person forces another person to have sex. IT IS A CRIME. Rape is about POWER and CONTROL it is NOT about love or intimacy. The act of rape could be committed by anyone, a stranger, or someone you know. Rape could occur at any moment, whether you are spending time with someone you like, at a dance, or in a car. Always remember... Rape is NOT the fault of the victim. Victims do, however, need comfort and support from friends and family. They also need support from professionals who help victims recover from this traumatic event. Rape can also happen when someone is drunk or drugged and is unable to say yes or no to sex. Regardless, no one has the right to force someone else to have sex against his or her will. Being raped is traumatic and may leave the person feeling depressed, degraded, angry, and scared.

29 HOW TO GET OUT OF AN UNHEALTHY RELATIONSHIP The A-B-C Escape Plan A. AVOID Avoid contact with the person. B. BREAK Tell the person you do not want to see him or her. Do this over the phone that so they cannot touch you. Do this when a parent or guardian is home so you know you will be safe in your house. C. CIRCLE of SUPPORT FRIENDS: Spend time with your other friends, and avoid walking by yourself. TRUSTED ADULTS: find an adult that you trust parent/guardian, counselor, doctor, teacher, or spiritual or community leader and go to them for advice when you need it. If you still feel that you are in danger, take some extra steps EQUIPMENT (Phone and cash) EQUIPMENT - PHONE & CASH Carry a cell phone, phone card, or money in case you need to call for help. Use code words on the phone that you and your family decide on ahead of time. If you are in trouble, say the code word on the phone so that your family member knows you can't talk openly and need help right away. Also think of safe places to go in case of an emergency, like a police station or a public place like a restaurant or mall In any emergency and you feel threatened call 911. If someone was violent towards you, be prepared to tell the police exactly where you were, exactly what the person did, and exactly what effects it caused. Write this information down because the police need it to order that person to stay away from you.

30 ANSWERS TO COMMON QUESTIONS Can someone tell if I've been abused? The physical signs of abuse will fade over time, and unless your health care provider tells you about specific problems, no one will be able to see that any physical abuse happened. Will other people know if I tell? Teachers, counselors, and doctors will have to report the abuse to the child protection authorities, but your friends will never know unless you decide to tell them. How do I get it to stop? Tell someone and get help. You can tell your parents, a teacher, counselor, doctor, or a child protective services worker. If the first person you tell doesn't listen, tell someone else. I'm a guy who was abused by another guy. Does this make me gay? No. Sexual orientation is not determined by abuse. The abuse has stopped. Why should I tell? Telling is still important. Below are just a few reasons to tell: No one has a right to do that to you To make sure you are physically and emotionally okay The abuser may do the same thing to someone else Ever since the abuse, I've had a lot of problems. What can I do to feel better? Talking to a professional will help. It is common for abuse victims to have problems. Some of the problems that may occur are: sleeping problems angry outbursts anxiety, depression, or panics withdrawing from friends physical aches and pains low self-esteem or low confidence Will being abused make me an abuser? No, it does not automatically make you an abuser. The more you emotionally heal from the abuse the less likely you are to act out in abusive ways. Seeing a counselor will help.

31 RESOURCES National Domestic Violence Hotline 24/ SAFE (7233) National Sexual Assault Hotline Carries out programs to prevent sexual assault, help victims and ensure that rapists are brought to justice. 24/ HOPE Love is Respect Texting: "lovlies" to The University of Texas Health Science Center at Houston

32 GET THE FACTS RX ABOUT DRUGS & ALCOHOL IN THIS ISSUE WHAT IS A DRUG? DANGEROUS GROUND OUT OF CONTROL HOW TO HELP RESOURCES

33 WHAT IS A DRUG? A drug is any substance that changes the way your brain and body works. ALCOHOL Alcohol is considered a drug but people of a certain age can use it legally. What s the big deal? PRESCRIPTION DRUGS Prescription drug use, like painkillers, antidepressants, and stimulants, is only legal when it is prescribed to you by a doctor. It is illegal to use prescription drugs when they are prescribed for someone else. OTHER DRUGS Other drugs are always against the U.S. law, like marijuana and cocaine. Being under the influence of drugs or alcohol can make it hard to stick to your personal rules like not having sex or always using a condom during sex. Not only can drugs and alcohol affect your judgement, but they can also make it more difficult to say "No" or get out of a risky situation.

34 DANGEROUS GROUND Besides making it harder to stick to your rules, there are lots of other consequences that can happen from using drugs or alcohol how it affects your body and health Unwanted, unplanned, and unprotected sexual activity Inability to play sports and participate in youth activities Lack of good sleep and rest Brain damage (difficulty concentrating, difficulty learning, memory loss) Liver, stomach, kidney and intestinal damage Cancer SOCIAL MENTAL how it affects your mind School problems: have poor grades, fail class, miss school, drop out of school Feelings of isolation, helplessness, shame and depression Change in personality how it affects your relationships Loss of trust and respect from parents and other family members Arguments, fighting, and violence Loss of friends, isolation from peers RX PHYSICAL

35 OUT OF CONTROL What s the harm in just trying it? Having just a drink or trying drugs just once can lead to much more Youth who begin drinking before the age of 15 are more likely to become dependent or abuse alcohol later in life. Teens who abuse alcohol are more likely to abuse illegal drugs too. Signs that someone has had too much to drink might include: Problems putting words together to make a sentence Acting strangely and doing things that they wouldn t normally do Throwing up A glassy look in their eyes Inability to walk straight and bumping into people and objects Passing out DANGERS OF BINGE DRINKING Binge drinking is drinking a lot of alcohol in a short amount of time. Playing drinking games, taking multiple shots, chugging or funneling are all considered binge drinking. BINGE DRINKING can lead to vomiting, passing out, losing memory or blacking out, and in extreme cases, alcohol poisoning. Alcohol poisoning is when the body cannot filter out alcohol in the bloodstream. Alcohol poisoning is deadly, so it s important to recognize the signs: extreme confusion unconsciousness vomiting seizures slow or irregular breathing blue tinged or pale skin low body temperature

36 HOW TO HELP If you think someone has alcohol poisoning: 1. Try to wake the person 2. Put the person on their side 3. Check their breathing, skin color, and temperature 4. Stay with the person 5. Call 911 for help WHAT CAN I DO? Helping someone stop drinking or using drugs is hard especially if they don t want to stop. The decision for them to get help is ultimately their responsibility. If you decide to try and help here are some things you can do as a good friend: Tell them you are worried about them calmly. Think of things you can do together instead of drinking or using drugs. Talk to a trusted adult like a family member, teacher, or youth worker. You may be able to help them by encouraging them to get help from an adult, doctor, or counselor.

37 RESOURCES teens.drugabuse.gov The University of Texas Health Science Center at Houston

38 GET THE FACTS ABOUT THE PREGNANCY TEST IN THIS ISSUE Pregnancy Testing 101 when and where to go for testing Pregnancy Testing 101 : The Mechanics the test, the types, the results

39 Pregnancy Testing 101 THE FACTS ABOUT GETTING PREGNANT FACT: There's no such thing as a "safe" time of the month for having sex. A woman can become pregnant anytime even while on her period. FACT: Women can get pregnant the very first time they have sex, and every time after that. FACT: To avoid pregnancy, it is best to use birth control each and every time you have sex. But remember, choosing not to have sex is the only 100% effective way to protect against STDs and pregnancy. NOT SURE... THINK SHE IS... THINK YOU ARE PREGNANT? Some of the most common signs and symptoms of pregnancy include a late or missed period, breast tenderness, having to urinate (pee) frequently and nausea. However, every pregnancy is different and not all women will experience these signs and symptoms. If a woman has had sex and thinks she is pregnant, the only way to know for sure is to get tested. HOW TO FIND OUT FOR SURE Women who think they are pregnant can go to a healthcare provider or clinic to be tested or use a home pregnancy test. If a home pregnancy test is used, it is also a good idea for a woman to see a doctor or clinician to make sure the home pregnancy test results are right. Some local health centers also provide pregnancy tests and counseling. Check the website: Stayteen.org for contact information about these centers.

40 The Mechanics HOW DOES THE TEST WORK? Pregnancy tests check for the pregnancy hormone, human chorionic gonadotropin (HCG), to see if a woman is pregnant. TYPES OF PREGNANCY TESTS Urine Test Used by health care providers in clinics and hospitals. Home pregnancy tests are urine tests. A person, of any age, can buy a test without a prescription at most drugstores or pharmacies. Results are provided a few minutes after the test. Health care providers recommend that a urine test be taken when a woman's period is late for one or more days. If the test is taken sooner it may not detect the pregnancy hormone, HCG. Blood Test Used by health workers in clinics and hospitals. It may take several days to get the results. Some clinics may ask the person to return to the clinic. Other clinics may call with results, or have the person call the clinic to get the results. Any person going for testing should ask how the clinic tells people about the results. POSITIVE If a home test is used and shows a positive result, the woman may be pregnant and should all her doctor or a clinic. Many doctors and clinics will want to do another test to be sure the home test results were correct. During the appointment the doctor will determine how far along the pregnancy is and discuss what to expect. NEGATIVE If a home pregnancy test shows a negative result, a woman may not be pregnant but it is a good idea to schedule an appointment at a health center. Many health care providers will want to do another test to be sure the home test results were correct. You can also talk to the health care provider about birth control options and testing for sexually transmitted diseases.

41 RESOURCES sexetc.org Planned Parenthood PLAN for the nearest location The University of Texas Health Science Center at Houston

42 GET THE FACTS ABOUT BIRTH CONTROL: FOR GUYS AND GIRLS IN THIS ISSUE Birth Control Basics Takin Control Types of Birth Control The Truth about Pregnancy Common questions answered

43 Birth Control Basics Birth control means the same thing as contraception. Birth control or contraception is something both a girl and guy uses if they have sex and don't want to get pregnant. There are a few different types of birth control. However, some work better than others. The only kind of birth control that is 100% effective against pregnancy is not having sex. IMPORTANT! IMPORTANT! IMPORTANT! There are some kinds of birth control that teens can get without seeing a health care provider first. CON CONDO DOM M BUT... There are other kinds that teens must see a health care provider to get. A health care provider can be a doctor, nurse, physician assistant, or health aide.

44 Takin CoNTROL If you are having sex, or even thinking about having sex, you should decide what to use to not get pregnant. 1 Learn about birth control. Take a look at all birth control choices. Look at the cost, how easy it is to get it, and how well it works. 2 Talk with your partner. Talking with your partner will help you work out things like who will pay for it and if they know how to use it correctly. From talking with your partner about sex you might find out things that you didn't know before. Do they support your decision to wait to have sex, or to use contraception every time? If not, you might want to think twice about this person. 3 See your health care provider. See your health care provider for a physical exam and to discuss your choice of birth control. Take a list of questions to ask, and make sure you understand EXACTLY how the birth control should be used. If you have questions after the office visit, don t hesitate to call your health care provider. 4 Use your birth control correctly every time. Make sure that you always use your birth control correctly EVERY TIME you have sex. Use condoms as a back up method if you miss a pill, are a few days behind on your Depo, or have any other issue that might affect your birth control like using antibiotics.

45 Birth Control TEENS CAN GET WITHOUT SEEING A HEALTH CARE PROVIDER These charts describe how well each type of birth control works by showing the percentage of women (number out of 100) who avoid pregnancy with typical use in a year. Typical use means that even though someone is using birth control, they might not use it correctly or might not use it every time. For example: condoms are 85% effective with typical use that means 85 out of 100 women will avoid pregnancy if they use condoms. Abstinence Latex Condom Spermicide How do you use it? By choosing not to have oral, anal, or vaginal sex A latex (rubber) or polyurethane sheath that covers the penis Can be a film, foam, cream, or jelly that is put into the vagina before sex What does it do? Protects against pregnancy and STDs Provides a barrier that keeps sperm from entering the vagina Also provides protection against STDs Has a chemical that kills sperm Does NOT lower the chances of getting or giving STDs Does it work? 100% protection against STDs and pregnancy 85% effective at avoiding pregnancy with typical use When used with spermicidal products, they work even better to avoid pregnancy 71% effective at avoiding pregnancy with typical use When used with condom, they work even better to avoid pregnancy Other Stuff Abstinence is the only 100% sure way to not get pregnant or get an STD Before using, check the expiration date on the package Before using, read the instructions on the box Some condoms are lubricated with spermicide There are also female condoms which are inserted into the vagina up to 6 hours before sex to lower the chances of pregnancy and STDs Spermicide products are usually found by the condoms in the store hat, rubber vaginal contraceptive film

46 Birth Control THAT TEENS MUST SEE A HEALTH CARE PROVIDER FIRST TO GET Using a condom with prescription birth control is the second-best way to reduce your chances for getting pregnant or getting an STD. However...the BEST way to prevent pregnancy and STDs is to not have sex at all. Birth Control Pills Contraceptive Patch Contraceptive Ring Contraceptive Shot How do you use it? A pill is taken once a day, every day, around the same time of day A patch that looks like a band-aid is worn and changed once a week for 3 weeks in a row no patch is worn the 4th week when the girl has her period A small plastic ring is inserted into the vagina for 3 weeks then taken out the 4th week when the girl has her period A shot is given by a health care provider once every 3 months in the arm or buttocks What does it do? Stops the egg from being released so it won't be fertilized Does NOT lower the chances of getting or giving STDs Stops the egg from being released so it won't be fertilized Does NOT lower the chances of getting or giving STDs Stops the egg from being released so it won't be fertilized Does NOT lower the chances of getting or giving STDs Stops the egg from being released so it won't be fertilized Does NOT lower the chances of getting or giving STDs Does it work? 92% effective at avoiding pregnancy with typical use 92% effective at avoiding pregnancy with typical use 92% effective at avoiding pregnancy with typical use 99% effective at avoiding pregnancy with typical use Other Stuff Birth control pills only work if they are taken EVERY DAY the pill Ortho Evra NuvaRing Depo Provera A new shot MUST be given in a timely fashion every 3 months

47 ...MORE Birth Control THAT TEENS MUST SEE A DOCTOR OR CLINICIAN FIRST TO GET Contraceptive Implant Emergency Contraception (EC) Intrauterine Device (IUD) How do you use it? A thin, flexible rod is inserted just under the skin of the girl s arm and provides protection for up to 3 years One pill is taken as soon as possible after sex (within 5 days of sex) and a second pill is taken 12 hours later A small T-shaped device is inserted by a health care provider into the uterus What does it do? Stops the egg from being released so it won't be fertilized Does NOT lower the chances of getting or giving STDs It is a concentrated dose of birth control hormones that prevent the egg from becoming fertilized when taken AFTER unprotected intercourse It does NOT cause an abortion Does NOT lower the chances of getting or giving STDs Changes how the sperm moves and the lining of the uterus so the egg won't be fertilized Mirena can also stop the egg from being released so it won't be fertilized Does NOT lower the chances of getting or giving STDs 99% effective at avoiding pregnancy 75% effective at avoiding pregnancy with typical use 99% effective at avoiding pregnancy EC is for emergencies only like when a condom or birth control pill wasn t used The sooner EC is used after sex, the better it works to reduce the risk of pregnancy A female should see the health care provider no more than 3 months after getting the IUD to make sure it s still in place Regular checkups with the health care provider are important Depending on the type of IUD, it should be replaced between 5-12 years after it is first inserted Implanon Does it work? Other Stuff Preven, Plan B, Plan B One-Step ParaGard,Mirena

48 the TRUTH about pregnancy: common common questions questions answered answered Q: Is it true that a girl can get pregnant the first time she has sex? A: Yes, it s true. A girl can get pregnant even if it s her first time to ever have sex. Q: I heard that if you pull out, the girl won t get pregnant. Is that true? A: No, that s not true. Pre-cum is a fluid that carries sperm and can leak out of the penis any time before ejaculation. That means sperm could have entered the vagina before a guy "pulls out" or "withdraws" and this could get the girl pregnant." Q: I heard that if you have sex standing up, you can t get pregnant. Is that true? A: No, that s not true. It doesn t matter what position you re in if you have sex, you can get pregnant or get someone pregnant. You could also get an STD or give an STD to someone else. Q: It s a guy s responsibility to make sure he has a condom right? A: No. Birth control is both the girl s and guy s responsibility. If you are sexually active, make sure that both of you are prepared to protect yourself. Q: Can douching or showering after sex stop me from getting pregnant? A: No, it cannot. Pre-cum and semen cannot be washed or rinsed out of the vagina. Douching actually increases the risk of infection.

49 RESOURCES Planned Parenthood PLAN for the nearest location The University of Texas Health Science Center at Houston

50 GET THE FACTS ABOUT BODY ART o o t s t a T P i e rcings IN THIS ISSUE Not Intended for Home Use Why your friends should never tattoo or pierce you Infection Section 3 infections that may make you do a double-take No Amateurs Allowed How to spot risky body art studios

51 Tattooing & Piercing Not Intended For Home Use If you are considering a tattoo or piercing, you should always go to a licensed, state-regulated business. DON T DO IT at home, at school, a party, or anywhere else except at a professional business or studio. Why? You could: get a serious infection have an allergic reaction permanently damage your skin not like the way it looks ATTENTION Professionals are more likely to use equipment that is properly cleaned and sterilized. They are more likely to be educated about the risks that come with getting body art.

52 Infection Section Just like sharing needles for drugs, home piercings and tattoos increase the risk of getting a blood-related infection. A few of the most serious infections are: Hepatitis B and C viruses that cause permanent liver damage and even death HIV the virus that causes AIDS there is no cure Staph Infection caused by bacteria most are minor if treated early severe staph infections can be deadly there is no cure DID YOU KNOW... wearing jewelry in or near your mouth can chip your teeth or cause an infection in your tongue or gums? See a dentist every six months to make sure your piercing is not doing permanent damage to your teeth or gums. A body art professional knows how to place a piercing correctly so it won't cause damage.

53 No Amateurs Allowed If you are thinking about getting a tattoo or piercing, know that every state has different laws on age limits and parental consent. Call your local licensed body art shop to ask about your local laws. All good shops have the laws posted in public view. Check out the resource page for a list of state laws. Things to look for: au to clave: pressurized and steam heated container used to sterilize equipment. Use a licensed artist. Home tattoos or piercings can put you at risk for disease or injury. Is the business licensed (this looks like a certificate and should be posted where people can see it)? Does it appear clean? Does it have an autoclave? Is the artist's work area sterilized between customers? Things to ask: Are the artist's hands washed using antibacterial soap AND are medical gloves used? How often is the place cleaned and tested for bacteria? For tattoos, does the artist pour the ink into a disposable container? What procedures are used to prevent the spread of HIV and other infections? Are needles or instruments that pierce the skin used only once and then thrown away? Are disposable piercing needles used instead of piercing guns?

54 RESOURCES A listing of all state laws about tattooing and body piercing tattoo.about.com Has personal stories, designs, and information about risks and how to care for tattoos properly The University of Texas Health Science Center at Houston

55 GET THE FACTS ABOUT TESTING FOR HIV AND OTHER STDs IN THIS ISSUE DID YOU KNOW... the who, what and where of testing for HIV & other STDs More than one location, cost, and type of testing for HIV & other STDs RESOURCES

56 DID YOU KNOW... You are at risk for HIV & other STDs if you: Have had vaginal, anal, or oral sex (the risk is higher if no condom was used) Have shared needles or syringes when injecting drugs, medications or vitamins Have shared needles for tattoos or body piercing If you are under 18 you do not need parent's permission for HIV & most STD testing In most states, a person under the age of 18 can get tested for HIV and most other STDs without permission from a parent. However, check with the doctor's office or clinic before going to find out if you need your parent's permission. Even if you don't need your parent's permission, talking about getting tested for STDs with your parents or a trusted adult is a good idea. Many STDs, including HIV, have no symptoms. The only way to know for sure is to GET TESTED. A person should get tested every year or before starting a new sexual relationship. In the United States, HIV tests can be confidential or anonymous. CONFIDENTIAL TESTING: You give your name. The results go in your medical record and can only be shared with people authorized to see your medical records. ANONYMOUS TESTING: You don t have to give your name and you re assigned a number to get your results. Anonymous testing is not available in every state.

57 THERE ARE MORE THAN ONE... COSTS The cost of testing varies at each location. At family planning and public health clinics, the cost of testing is usually free or very low cost. The cost of treatment varies at each location. At-home test are between $35-80 depending on the type of STD test. At tribal clinics testing is free. TYPE OF HIV TESTS There are several different ways to get tested for HIV, including: HIV BLOOD TEST: Blood is drawn. Results are usually ready within a few days to 2 weeks. RAPID HIV TEST: A blood sample is drawn or a fingerprick is done and then tested immediately. ORAL TEST: The inside of the mouth is rubbed with a cotton swab. Results are usually ready within a few days to 2 weeks. RAPID ORAL TEST: The inside of the mouth is rubbed with a small plastic comb. Results are available within 20 minutes. Must be reconfirmed with another test if positive. HOME TEST: A blood sample is taken at home and sent to a lab by mail. Results are usually ready by phone within a few days. RAPID HOME TEST: This is an at-home rapid oral test that will provide results at-home within 30 minutes. Must be reconfirmed with another test if positive. TYPE OF TESTS FOR OTHER STDs There are several different ways to get tested for other STDs, including: Blood tests Urine tests Pelvic and physical exams Genital (penile and vaginal), anal, and rectal swabs LOCATIONS Public health clinics Family planning clinics Private doctors and clinics Hospital emergency rooms Tribal health clinics