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Sexually Transmitted DiseasesDefinitionoAny infection that can be spread through sexual intercourse, anal sex, oral sex, and using fingers, other body parts, or sex toys that have come into contact with another person’s genitals or body fluidsgenerally- genitals, anus, or throatcalled STD or STIEpidemiologyo19 million STDs each year in the USo50% of these in 15-24omedical costs of STDs is $16 billion annuallyomost reported STD is Chlamydiaomost common STD in adolescents in HPVomost of the clinical syndromesuncomplicated urethritis (inflammation of the urethra)itchingPID (pelvic inflammatory disease) (can cause infertility and chronic pelvic pain)complications of pregnancy wartstertiary syphilliscervical cancerHIV infection and AIDSAdolescent Sexualityoone of the top 10 leading public health issues facing the nationo47% of US high school students have had sexual intercourseo34% report current sexual activityoprevalence of sexual activity rises from 24-62% in females from age 15-18o61% of HS students used condom with last sexual intercourseo14% of HS students report having more than 4 partnersFactors Causing Increase Risk in Adolescentsoalcohol and drug useoimmature cognitive functioning oSocioeconomic factors- poverty and lack of access to healthcareosense of invulnerabilityolack of communication and partner-negotiation skills
Healthcare Provider Issuesoless than 1% of patients visits include counseling on HIVBarriers to Discussion of Sexualityonarrow conception of health care and the role of the physician in health education and preventionostigma associated with STDs, HIV, and discussion of sexual behavioropractical constraints of time and resourcesPrinciples for discussing sexualityoconfidentialityonormalization- clinicians must treat this part of the history just like all othersorespect for diversityoavoidance of assumptionsospecific questioningolisten to responses and use appropriate body languageoavoid medical jargonorecognize the link- help patients see links between different risk- taking behaviorsothink preventionoknow your resources- community and in office5 “P’s” of taking a sexual historyopartnersoprevention of pregnancyoprotection from STDsopracticesopast history of STDsRisk Factors for STDso15-24oAfrican-AmericanoUnmarriedoGeographical residenceonew sex partners in past 60 daysomultiple sexual partnersohistory of prior STDoillicit drug useoadmission to a correctional facility or JV detentionomeeting partners on the internet
ocontact with sex workersCommon STDsochlamydiaogonorrheaoHIVosyphilis oherpes simplex (HSV)oHPVoHepatitisoTrichomoniasisoPediculosis PubisChlamydia Pathogenesis and Transmissionocaused by chlamydia trachomatisoinfection occurs when it invades the mucous membranes (mouth, anus, throat, vaginas, or urethra)oejaculation is not necessaryo
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Sexual intercourse, Human sexual behavior, Oral sex, Human papillomavirus