HIV awareness and prevention. STi awareness and prevention

Human Immunodeficiency Virus
• A virus spread through body fluids and affects specific cells of the
immune system, called CD4 cells or T cells.
• A virus that kills the CD4 cells (T cells) damaging the immune
system.
• A virus that replicates inside the human body, so it must invade a
healthy cell in the body to survive.
3

• AIDS occurs in the late stages of the HIV infection process.
• Once diagnosed, the body has a hard time fighting diseases and
certain cancers.
• NO cure for AIDS, but there is treatment.
Positive HIV Test
+
Very low CD4 count (<200)
OR
presence of specific cancers
or opportunistic infections
=
AIDS
4

True or False?
1. I'm HIV-positive, now my life is OVER.
2. I CAN get HIV by being around people who are
HIV-positive.
3. I would NOT be able to tell if my partner or I were
HIV-positive.
4. I CANNOT get HIV from mosquitos.
5. I'm straight and don't inject drugs, so I CANNOT get
HIV.
6. I CAN get HIV from oral sex.
7. My partner and I are both HIV-positive, so there is
NO NEED to use condoms.
5

HIV is passed from person to person
through the exchange of body fluids.
3 Ways:
1. Unprotected sex (anal, vaginal, or oral) with
People Living With HIV (PLWH)
2. Blood to blood contact
3. Exposure to HIV before or during birth or
through breastfeeding
6

Mouth Vagina
Nose Penis
Eyes Anus
Open Skin
8

Many people who have HIV have NO symptoms at all for 10
years or more.
It is estimated 300,000-500,000 people in U.S. have HIV,
but do not know it.
Symptoms vary from person to person. Some people who
have HIV report having flu-like symptoms 2-4 weeks
after exposure. 9

CD4 (T4) Count
Number of white blood
cells in the blood
Viral Load
Amount of HIV in the blood
10

•HIV antibody found.
•Have the virus and can
pass to others.
•Need to begin treatment
immediately.
• No HIV antibody found.
• May not have HIV
(consider the window
period).
• Retest in three months.
Positive
+
Negative
-
11

Opportunistic Infections (OIs) are infections that occur more
frequently and are more severe in individuals with weakened
immune systems including people living with HIV.
People with healthy immune systems can be exposed to certain
viruses and have no reaction.
HOWEVER…
PLWH can face serious threats
from the same viruses.
12

The presence of a STI increases the possibility of
Acquiring HIV & Transmitting HIV.
WHY?
 Compromised immune system
 Additional STIs
 Irritation/inflammation of mucus membranes
14

Newly Diagnosed? START TREATMENT!
Treatment benefits
your own health
and the
health of others
Because of better treatments, PLWH are now living longer
and with a better quality of life than ever before.
15

UNDETECTABLE = UNTRANSMITTABLE
 Launched in 2016 by PLWH.
 Promotes control of HIV by preventing HIV transmission, and
reducing stigma towards PLWH.
 PLWH and taking ART are considered undetectable when levels of
virus in the body are too low to detect, by lab tests.*
 As long as people stick to their treatment and are consistently
monitored, PLWH are unable to transmit virus to others, after 6
months of viral suppression, through sex.
16
*The person still has HIV.

NO RISK
Abstinence from Sex
Abstinence from Injection Drugs
Mutual Monogamy w/Negative Partner
REDUCED RISK
Protected Sex “Correctly and Consistently”
Fewer Sexual Partners
Never Sharing Needles or “Works”
Regular HIV/STI Testing
17

Pre-Exposure Prophylaxis (PrEP): daily medicine can
prevent HIV from making copies of itself in the body.
 PrEP is only prescribed for people who are HIV-negative and who are
at ongoing substantial risk of getting HIV.
 PrEP reduces the risk of getting HIV when taken consistently:
 by about 99% through sex
 at least 74% among People Who Inject Drugs (PWID)
18

Post-Exposure Prophylaxis (PEP): a 28-day regimen of HIV medicine,
started within 72 hours, of possible exposure to HIV to prevent the virus
from making copies of itself in the body.
 PEP is only prescribed for HIV-negative individuals who believe they
were exposed to HIV, such as, during sex, shared needles (works), or
were sexually assaulted.
 PEP is effective in preventing HIV, but not 100%.
 Every time use condoms.
 Always use safe injection practices.
19

STI/STD?
an infection that can be transmitted through sexual contact
with an infected individual. They are sometimes called
sexually transmitted infections (STIs).
STDs can be transmitted many different
ways, but most can be passed by:
1. Vaginal sex
2. Anal sex
3. Oral sex
4. Skin-to-skin contact
5. Infected Mother to child
Oklahoma State Department of Health | STD 101 | 2020 21

• Chlamydia
• Gonorrhea
• Syphilis
• Trichomoniasis*
* (parasitic protozoan)
• HIV
• Herpes
• HPV
• Hepatitis B
Antibiotics can cure
bacterial STDs, but
cannot reverse the
long-term damage:
Treatment can improve
the lives of many people
living with viral STDs,
but there is NO CURE.
• Oklahoma State Department of Health | STD 101 | 2020 22

How is it Spread?
1. Vaginal, anal, or oral sex
with someone who has
chlamydia.
2. Infected pregnant women
can pass it to their baby
during pregnancy or
childbirth.
23

Possible symptoms include:
• Abnormal vaginal/penile discharge
• Burning sensation when urinating
• Rectal pain, discharge, or bleeding
• Pain/swelling in one or both testicles (less common)
Can lead to:
• Sterility or infertility
• Infection of tube that carries sperm to/from the testicles (pain and/or fever)
• Pelvic Inflammatory Disease (PID)
o Long-term abdominal/pelvic pain
o Scar tissue formation in fallopian tubes
o Ectopic pregnancy
The “Silent” Disease!!!

How is it Spread?
1. Vaginal, anal, or oral
sex with someone
who has
gonorrhea.
2. A pregnant woman
can give the infection
to her baby during
childbirth.

• Painful or burning sensation when urinating
• Abnormal vaginal/penile discharge (white, yellow, or green)
• Rectal discharge, itching, soreness, bleeding
• Vaginal bleeding between periods
• Painful or swollen testicles (less common)
Can lead to:
• Sterility or infertility
• Disseminated infection (rash, arthritis, fever, meningitis, etc.)
• Painful infection of tubes attached to the testicles
• Pelvic Inflammatory Disease (PID)
o Scar tissue formation in fallopian tubes
o Ectopic pregnancy
o Inability to get pregnant
o Long-term pelvic/abdominal pain

“The Great Imitator” affected approximately
35,063 people in 2018 in the U.S.
How is Syphilis Spread?
• Direct contact with a syphilis sore (chancre)
during vaginal, anal, or oral sex.
• Can be spread from an infected mother to her
unborn baby.
Primary
Syphilis
Secondary
Syphilis
Tertiary/Late
Syphilis

Chancre - syphilis sore
• Firm, round, and painless
• Appears within 2-6 weeks after exposure usually but
possibly up to 3 months
• Found on the part of the body exposed to the infection
(penis, vagina, anus, lips, in rectum, or in mouth)
• Typically disappear after a few weeks without treatment
(still progresses to next stage)

• Appears about 4 weeks after chancre heals.
• Will go away without treatment, but infection will progress.
Condylomata lata (C. lata) or “fleshy warts” in anogenital region
Alopecia or
patchy hair loss
non-itchy RASH with
rough red or
reddish brown spots
Mucous Patches
usually in the mouth,
vagina, or anus

Typically Occurs 10-30 years after infection begins!
• Can damage almost any part of the body including the
heart, brain, spinal cord, eyes and bones
• Can result in mental illness, blindness, deafness,
heart disease and death
• Gumma: soft, gummy tumor
Types
• Cardiovascular Syphilis
• Late Benign Syphilis
• Neurosyphilis Syphilis
• occurs sooner among HIV co-infected
30
Oklahoma State Department of Health | STD 101 | 2020

Congenital Syphilis
40% will be stillborn or die in the hospital.
Transmission can occur during any stage of
syphilis and during any trimester of pregnancy.
Can cause:
• Prematurity
• Birth defects
• Hutchinson’s teeth
• Osteochondritis
• Developmental delays

Trichomoniasis
Parasite passed during vaginal sex.
70% of infected people have no
signs/symptoms.
• Itching, burning, redness or soreness of
the genitals
• Burning with urination or ejaculation
• Thin discharge: can be clear, white,
yellowish, or greenish - Can produce
unusual or foul smell
Infection usually occurs:
• Lower genital tract (vulva, vagina, penis or
urethra) 32

(HSV-1 and HSV-2)
How is it Spread?
Vaginal, oral, or anal sex OR skin-to-skin
contact
with someone who has the virus.
Symptoms:
• One or more blisters on or around the genitals, rectum, or mouth.
• Blisters break & leave painful sores that take weeks to heal.
• Symptoms are sometimes called “Having an outbreak”.
Usually characterized by NO or very mild symptoms… NO CURE.
1 in 8 people aged 14-49 years old have genital herpes.
Many Do Not Know It.

Human Papillomavirus (HPV)
• Mainly transmitted through
vaginal & anal sex, but can also
occur through oral sex and
skin-to-skin contact.
• Most people with HPV do not
know they are infected and
never develop symptoms or
health problems.

Hepatitis
“Inflammation
of the liver”
Hepatitis A Hepatitis B Hepatitis C
How is it
spread?
Person ingests infected
fecal matter—even in
very small amounts—
from contact with
contaminated objects,
food, drinks.
Blood, semen, or other
body fluids from a
person with the virus -
even in very small
amounts - enters the
body of a non-infected
person.
Blood from a person
infected with the virus -
even in very small
amounts - enters the
body of a non-infected
person.
How long
does it
last?
A few weeks to several
months.
Mild illness (a few
weeks) but Lifelong or
chronic condition.
Mild illness (a few
weeks) but Lifelong.
How
serious is
it?
Most recover from mild
illness with no lasting
liver damage,
but death can occur
(although rare).
15-20% develop chronic
liver disease including
cirrhosis, liver failure, or
liver cancer.
75-85% develop chronic
liver disease, 5-20%
develop cirrhosis and
1-5% will die.

NO RISK
Abstinence from Sex
Abstinence from Injection Drugs
Mutual Monogamy w/Negative Partner
REDUCED RISK
Protected Sex “Correctly and Consistently”
Fewer Sexual Partners
Never Sharing Needles or “Works”
Regular HIV/STI Testing
36

More than 98% effective when used
correctly and consistently
Latex: Most common and effective
Non-Latex: Polyurethane, Polyisoprene
Natural Membrane: Lambskin (not protect against HIV and STIs)
37

DO NOT:
• Reuse a condom.
• Use expired condoms.
• Unroll the condom before putting it
on the penis.
• Leave condoms in hot or extreme
cold places (wallet, car, etc).
38

DO NOT:
• Use oil-based products (baby or cooking
oils, hand lotion, Vaseline, or natural oils,
i.e. coconut oil) as lubricants with latex
condoms.
• Use your fingernails, scissors or teeth to
open the wrapper.
• Use more than one condom at a time,
including an internal AND external condom
(‘double wrapping’).
39

DO:
• Keep condoms in a cool, dry place.
• Put condom on an erect/hard penis before genital contact.
• Hold the condom in place at the base of the penis before
withdrawing (pulling out), after sex.
• Throw the condom away after it has been used.
• Use lubrication to reduce potential tears.
o Water-based or Silicone and apply as often as needed
40

• Worn inside the vagina or anus
• Thicker, more tear-resistant
• Always latex-free
• Wider opening covers more of the external area
41

• Thin, square pieces of latex
• Used for oral sex (NOT on a penis)
• Could make your own dental dam (from a condom,
latex glove, or non-microwavable plastic wrap)
42

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