Sexually Transmitted Infections Audience: High School Students Time: 90 minutes Enduring Understanding: I feel empowered to protect my body from sexually transmitted infections. Essential Questions: 1. What is the only method that will give someone 100% protection from sexually transmitted infections? 2. Generally speaking, what are some signs and symptoms of sexually transmitted infections? 3. If someone is engaging in sexual activity, what can they do to lower their risk of sexually transmitted infections? Assessment: 1. Involvement in A/C activity and discussion throughout class. 2. Partner share/whip-around of symptoms 3. Partner/group share of most effective prevention strategies Materials: group agreements poster and community resources poster Easel paper and markers or white board markers I have a question sheets pencils for students note cards labeled as such: Blank, A or C Chlamydia, Gonorrhea, Pelvic Inflammatory Disease, Syphilis, Trichomoniasis, Public Lice and Scabies, non-curable: Herpes, HPV, Hepatitis B, HIV/AIDS) High/Low/No risk laminated cards PPAU STI grid or other resource for STIs STI laminated name cards (hung up on wall in two sections: curable: Education Department 1
Activities: Name of Activity Time 1 Group agreements 3 minutes 2 Introduction of STIs 5 minutes 3 Card Transmission activity 25 minutes 4 Basic STI overview 10 minutes 5 High/Low/No Risk Activity 25 minutes 6 Final Assessment: Pair Share 7 minutes 7 Anonymous questions 13 minutes 8 Closure 2 minutes 1. Group agreements and introductions 3 minutes Introduce yourself. Introduce or review group agreements. Introductions of students if not a series or new students have been added. If necessary, quickly go over Planned Parenthood, what we are and what this program is. If it is a series, ask students to recap what they remember from the previous class. If using, go over community resources poster. 2. Introduction of STIs 5 minutes STI vocabulary usages points to make before activities: STD vs. STI. Ask: What does STD stand for? Sexually Transmitted Disease. What does STI stand for? Sexually Transmitted Infection. Why the change? Affirm student responses. Some students may say something like, Because infection sounds better. Explore this response with students. Ask students what they think of when they hear the word disease. Disease: scary, lifelong, bad, gross, cancer, don t want it Ask if infection sounds better or worse. Infection sounds better to many. PP doesn t want anyone feeling scared, dirty, or guilty or shameful about his or her body. We want people taking care of themselves. So, Planned Parenthood and other health organizations started calling them STIs. Explain that students can call them STIs or STDs; you will be saying STIs. How many people have heard people go, ewww gross when discussing STIs? If people were in a class and they had an STI, how would they feel with people saying, ewww? Would they go get help or would they feel guilty? Good health practice is people taking care of themselves and bodies. No ewww or gross comments in class. Education Department 2
3. Card Transmission activity 25 minutes Ask for a volunteer. Give volunteer a card with I (for Infection) on it and let volunteer know that you ll be using her or him in one moment. Using the cards that are already coded, distribute an index card to all other participants. (1/3 of Students get A, 1/3 of students get C, 1/3 of Students get blank cards. Explain that, in a moment, each student will be talking with a partner about a question you will suggest. After the question he or she should sign his or her partner s card. Partners should only talk around one minute. After discussing the question, remind them to sign their partner's card. There will be another question and each student will find a different partner to talk with. There will be a total of three questions and students will talk to a total of three different people. For clarification, you may ask, How many names will be on your card at the end? Three. It may be helpful to have all questions written down, unveiling each question one at a time. Questions: Of the 20 million total STI infections in the United States every year, what percentage are made up of teens and young adults? Answer 50% 15-24 year olds (Regardless of race or gender, data show that sexually active adolescents and young adults are at increased risk for STDs when compared to older adults. For example, young people (ages 15-24) have four times the chlamydia rates than older adults). Source CDC *** Check in before the next question ask a few students to share what they talked about just to make sure they re following instructions.*** Can you tell if someone has an STI by looking at them, why or why not? (Good to let students know that most often people will not show any signs or symptoms of an STI) What can teens do to lower the rates of STI infections among teens? What can you do personally, your class, peers, school, neighborhood, city, state, country. After the final minute, make sure they sign each other s cards the final time and return to their seats. Have everyone check and make sure that they have at least three names on their card. It is okay if they have more than three. Ask students to share their thoughts on the topics. Engage in discussion for 5 minutes or so, depending on students interest. Affirm their opinions, challenging them and playing devil s advocate, if necessary. Now, ask the volunteer, who has the I letter written on the back of their card, to stand up and say their name. Explain that this isn t true, but for the sake of this activity, we re going to pretend that this volunteer has been infected with an STI. Have the volunteer read the 3 names on his or her card. These three people must stand up now. Explain that they also may be infected. Repeat a few times so more students stand. Have the students who are sitting look at the people that Education Department 3
are standing, if any of their names are on their cards, they must stand up. Repeat until all, or most of the class is standing. Now, have people look at the back of their cards. Cards will be labeled A, C or be blank. Explain: this is an activity about protection so now we re going to talk about methods people can use to protect themselves. Abstinence Ask students: What s a method of protection from STIs that begins with an A? Abstinence. Write basic information on the board. Ask: What is it? Important to affirm that different people may have different definitions. Some different definitions: no sex play with a partner; no genitalto-genital or genital-to-mouth contact; no vaginal, anal, oral sex. How effective is it? If it doesn t include oral, anal, vaginal sex or any sex play, and is used perfectly every time, it s 100% effective from infections and pregnancy. It s the only 100% effective method. Abstinence is the most effective method. What happens if abstinence isn t used perfectly every time? What happens if two people who want to use abstinence both have a different idea of what abstinence means? What should they do? People with an A on the back of their cards may sit down because they have used abstinence correctly and cannot get an STI. Condoms What is a method of protection that begins with a C? Condoms. Write basic information on the board. Ask: What are condoms? Are there only condoms for males? Condoms are a barrier method. What does barrier mean? When people use condoms, what is being blocked? Body fluids. Semen and/or vaginal fluids. What about skin to skin contact? What if a male has a herpes blister on his scrotum? Condoms only protect they area that they cover. How effective are condoms? 85% to 98%. Why the difference between these numbers? Allow students to guess. Explain perfect and typical use. Condoms break, slip, pop, tear, rip, fall off not because the condom was bad but because people were using them incorrectly. People with a C on their card may sit because they used condoms correctly and this method, when used correctly, can lower the risk of spreading STIs. Blank Those with nothing on their card (Blank) did not use abstinence, or condoms, so they may be infected with an STI, but since this is just an activity, they re not really infected so they can sit down. Possible discussion questions: Do you think this activity is a good example of the way STIs can travel through a group of people? How are STIs transmitted? Over 50% of U.S. high school students have not had intercourse. Does this seem accurate to you? Why or why not? What are other behaviors can people, who choose to be sexual active, do to lower their risk of getting an STI? Write these on the board. (Monogamous Education Department 4
relationships (marriage), limiting partners, talking to partners about sexual histories, relationships that have open communication, trust, honesty, regular testing, partners being tested together before starting a sexual relationship, vaccinations, not mixing drugs and alcohol with sexual activity.) 4. STI Graffiti Sheets 25 minutes Tell students: Now we re going to spend some time talking about STIs themselves. Hang poster paper around the room with the following statements: Some STIs I know are: Someone is at risk for getting an STI if they: Someone can protect themselves from STIs by: Someone knows they have an STI if: Give each student a marker or pen and tell them to move around the room and finish the sentence on each poster. Students should try to write something on each poster. Encourage them to write what they know, even if they are not sure whether it is correct. Tell students that you will be discussing the answers as a class when everyone is finished. When the students have finished, collect posters at the front of the room so they are visible to everyone. Starting with the list of STIs, add or correct information on each poster. Facilitate discussion with each poster, using the questions below, or create your own based on the specific class needs/interests. Possible Discussion Questions for each poster Some STIs I know are: Add other STIs if it isn t an exhaustive list. Are all STIs Curable? (NO), Are all STIs Treatable? (Yes) Which STIs are curable? Which are non-curable? What is the difference between the two columns? Curable and non-curable or can-get-rid-of and cannot-get-rid-of or bacterial/parasitic and viral. Which STIs are treatable? All are treatable. What is the difference between curable, treatable? Even though some STIs people may have for life, there is always something they can do to make themselves feel better; there is always something they can do protect themselves and their partners. Someone knows they have an STI if: What are symptoms of STIs? Burning, itching, bumps, discharge, etc. Can add other common symptoms if the class hasn t listed them. Do all STIs always have symptoms? The catch: almost all STIs can have no symptoms what so ever. (Examples: Estimated 250,000 Americans with HIV that do not know. That s ¼ of already HIV+ U.S. population. Chlamydia has no visible symptoms in 75% of women; 50% of men. It still can cause painful, permanent internal damage.) Education Department 5
If someone has no symptoms, how would they find out they had an STI? Discuss testing and treatment. Someone is at risk for STIs if: How are STIs transmitted? Body Fluids; skin-to-skin contact. This information should already be on the board; if not, write it down. What activities? Genital Contact. If time, have students rearrange the columns into those that are more often transmitted by body fluids and those that are more often transmitted by skin to skin contact. More often transmitted by body fluids: HIV/AIDS, Hepatitis B, Chlamydia, Gonorrhea, and Trichomoniasis More often transmitted by skin to skin contact: Herpes, HPV, Syphilis, Pubic lice, and Scabies PID is a secondary infection caused, most likely, by untreated Chlamydia or Gonorrhea. Someone can protect themselves from STIs by: Practicing Abstinence consistently. If nobody has listed condoms it is ok to say that they offer protection against some STI s but abstinence is the most effective. Getting vaccinated. There are vaccines available to protect against Hepatitis B, and some strains of HPV. Avoiding skin to skin contact especially in the genital area. Syphilis, HPV, Herpes, Pubic Lice and Scabies are transmitted through skin to skin contact, and a condom does not always cover the infected area. 5. High/Low/No Risk activity 25 minutes Make a long continuum on the wall or board with the risk cards reading no risk, low risk, and high risk. Divide participants into groups of three or four and give each group a number of behavior cards. Group members must try to agree where on the continuum each behavior belongs in terms of the risk of STI or HIV transmission. Then, each group should come to the board and tape their cards where they think they belong on the continuum. Participants should only focus on the activity on the card not what it may lead to. Do a whole class example with the card flirting, reminding students to only think of the activity on the card. High/Low/No Risk discussion: After all the cards are posted, ask for volunteers to read the cards aloud to the whole class. Have a group discussion about the location of the cards. For each column ask students if there are any they have questions about, are unsure about or need to be moved. Allow students to debate. Possible discussion questions: Make sure to discuss the Waiting to have intercourse card. Why might someone wait to have intercourse? (Religion, values, waiting for marriage, protection from pregnancy, protection from STIs, not that into the person, want to be in love, still getting over last relationship, want to focus on school, have too much going on, etc.) Education Department 6
What are the advantages of waiting to have intercourse? What are the possible affects of taking these risks? STIs? Pregnancy? Others? It is important that students understand that any sexual activity will carry some risk. What of these activities can two people do with each other if they choosing abstinence? What do all the cards under High risk have in common? No protection. What can someone do to lower his or her risk from high risk to low risk? Low risk to no risk? Where do you think most teenagers are on this scale? Silently, think of your own behaviors. Where are you on this chart? What is something that you can do to lower your risk? Check for questions. 6. Final Assessment: Partner-share 7 minutes With your partner, using our discussions, activities and information on the board, think of three risk-reducing behaviors that you think would offer the best protection from STIs for someone who is sexually active. Partners team up with another set of partners. Share your risk-reducing behaviors. Together, pick your top-three risk reducing behaviors. Come back together as a class and have each group share one risk-reducing behavior. Each group should share a different behavior. 7. Anonymous questions 13 minutes Explain now that everyone will have a chance to ask questions anonymously. Have them take a moment and think about any questions they would like to ask. Tell them you will be answering the questions today. Wait a minute before you give any more instructions to give them time to think. Once they ve thought of a question, have them write these questions on their paper. Also, explain that if they don t have a question, they will write one thing that they learned in class. It is important that all students are writing to protect the anonymity of students writing questions. Once students are finished, collect papers and read questions aloud, answering factually and succinctly. Explain to students that sometimes you will ask the class to answer the question, sometimes you and the class will work on the answer together and sometimes you will answer the question. Explain to students that if you don t know the answer to a question, you will say you don t know and try to find the answer and get back to them. 8. Closure 2 minutes Thank students for their participation and respect for this sometimes difficult topic. Check again for any closing comments or questions. Let students know that you ll be around afterwards if they have a question they d like to ask you individually. Refer students to the community resources poster, if using and any trusted adult. Education Department 7