Condom Do’s and Don’ts

Condom Do’s and Don’ts DO’s: • DO use only latex or polyurethane (plastic) condoms. • DO keep condoms in a cool, dry place. • DO put the condom on an erect (hard) penis before there is any contact with a partner’s genitals. • DO use plenty of water-based lubricant (like KY Jelly® or Astroglide®) with latex condoms. This re- duces friction and helps prevent the condom from tearing. • DO squeeze the air out of the tip of the condom when rolling it over the erect penis. This allows room for the semen (cum). • DO hold the condom in place at the base of the penis before withdrawing (pulling out) after sex. • DO throw the condom away after it’s been used.

DON’Ts: • DON’T use out of date condoms. Check the expiration date carefully. Old condoms can be dry, brittle or weakened and can break more easily. • DON’T unroll the condom before putting it on the erect penis. • DON’T leave condoms in hot places—like your wallet or in your car. • DON’T use oil-based products, like baby or cooking oils, hand lotion or petroleum jelly (like Vase- line®) as lubricants with latex condoms. The oil quickly weakens latex and can cause condoms to break. • DON’T use your fingernails or teeth when opening a condom wrapper. It’s very easy to tear the condom inside. If you do tear a condom while opening the wrapper, throw that condom away and get a new one. • DON’T reuse a condom. Always use a new condom for each kind of sex you have.

1 in 5 people have a sexually transmitted disease

GENITAL HERPES What is herpes? • Herpes is caused by a virus: the herpes simplex virus (HSV). • There are two types of herpes simplex; herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2). • HSV is a common and usually mild recurrent skin condition. • HSV can cause oral herpes (cold sores) as well as genital herpes

What are the signs or symptoms of genital herpes? Outbreaks of genital herpes can vary greatly from person to person. They can be mild for one individual and severe for another. Symptoms may last for up to 3 to 4 weeks, but they usually heal within 2 to 12 days. Symptoms may include the following:

• One or more sores, blisters, cuts, pimples, bumps or a rash • Itching, burning or tingling in the genital area • Aches or pains in the genital area • Flu-like symptoms (headache, fever, swollen glands in lymph nodes near groin) • Painful urination and a discharge (vaginal or penile) are possible, but uncommon, symptoms for genital herpes • Many people have outbreaks that heal quickly, cause no pain or occur in an unno- ticeable spot.

How often do outbreaks of genital herpes occur? • The amount of outbreaks someone has varies from person to person. • The average number of outbreaks per year is four to five. • The first outbreak may be the most extreme outbreak a person will have. • Usually, there are more outbreaks during the first year. • Many people find that recurrences tend to lessen in severity and frequency with time. • Illness, poor diet, emotional or physical stress, friction, surgical trauma and steroidal medication (such as asthma treatment) may trigger a herpes outbreak.

How can someone reduce the risk of contracting genital herpes? • If someone has a symptom around the mouth (oral herpes), she or he should not per- form oral sex until all signs have healed. • If someone has signs or symptoms around the genital region (genital herpes), he or she should not have sexual activity until all signs have healed. • When there are no symptoms present, using latex condoms for genital-to-genital contact reduces the risk of transmission. . • Microbicides/Spermicides have not been proven to reduce the risk of transmission.

75% of women infected with HIV were infected through heterosexual contact

1 in 5 Americans has genital herpes, yet 90% of those with herpes don’t know they have it.

2/3 of all STD’s occur in people under 25

Hepatitis B is 100 times more infectious than HIV

HPV is the most common STD in the US. More than 5 million people are infected with HPV a year.

Information was taken from: American Social Health Association http://www.ashastd.org/

Chlamydia What is chlamydia? Chlamydia is a common and curable infection caused by the bacteria Chlamydia trachomatis. The bacteria target the cells of the mucous membranes including: • the surfaces of the urethra,vagina, cervix and endometrium • the fallopian tubes • the anus and rectum • the lining of the eyelid • and less commonly, the throat.

How common is chlamydia? In the United States, chlamydia is the most common bacterial sexually transmitted disease (STD), par- ticularly among sexually active adolescents and young adults. In 2000, 702,093 cases of chlamydia were reported to the Centers for Disease Control and Prevention (CDC). However, it is estimated that 3 million cases actually occurred and as many as one in 10 adolescent females test positive for chlamy- dia. How can I get chlamydia? • Chlamydia is passed primarily during anal or vaginal sex. It is less likely to be transmitted through oral sex. It can be passed when the mucous membrane, the soft skin covering all the openings of the body, comes into contact with the mucous membrane secretions or semen of an infected person. • Chlamydia is less likely to be transmitted during oral sex because the bacteria that cause chlamydia prefer to target the genital area rather than the throat. • Even a woman who has not had anal sex can get chlamydia in the anus or rectum if bacteria are spread from the vaginal area, such as when wiping with toilet paper. • Eye infections in adults may result when discharge caries the disease into the eye during sex or hand- to-eye contact. • Chlamydia is not passed through things like shaking hands or toilet seats. • It can also be passed from mother to newborn as the baby passes through the infected birth canal.

What are the signs and symptoms of chlamydia? Approximately, seventy-five percent of women and fifty percent of men do not experience symptoms. If a person does have symptoms, they usually develop within one to three weeks after exposure to chlamydia. Women Most women are asymptomatic, but if symptoms are present they may be minor, including: • vaginal discharge • burning sensation during urination • If the infection spreads to the fallopian tubes, women may experience: lower abdominal or back pain, pain during intercourse, bleeding between menstrual periods, nausea or fever. Men Men may be asymptomatic or symptoms may be minor. Symptoms can include: • Pus (thick yellow-white fluid) or watery or milky discharge from the penis • pain or burning during urination • Pain or swelling of the testicles

Gonorrhea What is gonorrhea? Gonorrhea, also known as "the clap," is a curable infection caused by the bacteria Neisseria gonorrhoea. The bacteria targets the cells of the mucous membranes including: • the surfaces of the urethra,vagina, cervix and endometrium • the fallopian tubes • the anus and rectum • the lining of the eyelid How can I get gonorrhea? • Gonorrhea is passed during oral, anal or vaginal sex. It can be passed when the mucous membrane, the soft skin covering all the openings of the body, comes into contact with the mucous membrane secretions or semen of an infected person. • Gonorrhea can be passed even if the penis or tongue does not go all the way into the vagina or anus. • Even a woman who has not had anal sex can get gonorrhea in the anus or rectum if bacteria are spread from the vaginal area, such as when wiping with toilet paper. • Eye infections in adults may result when discharge caries the disease into the eye during sex or hand- to-eye contact. • Gonorrhea is not passed through things like shaking hands or toilet seats. • It can also be passed from mother to newborn as the baby passes through the infected birth canal. This can result in eye infections, pneumonia or other complications. What are the symptoms of gonorrhea? Most men exhibit symptoms within two days to five days after exposure, with a possible range of one to 30 days. Although most women infected will remain asymptomatic (without symptoms), women who develop symptoms will do so within 10 days of infection.

Men: Yellowish-white discharge from the penis, burning or pain during urination, urinating more often than usual, pain or swelling of the testicles.

Women: Abnormal discharge from the vagina that is yellow and sometimes bloody. Burning or pain dur- ing urination. When the infection spreads to the fallopian tubes, some women still have no signs or symp- toms. Others may experience one or more of the following symptoms, which can be an indication that the infection has progressed to PID: Lower abdominal pain Lower back pain Pain during intercourse Bleeding between menstrual periods Nausea Fever

Human Papillomavirus (HPV) How common is HPV? In the United States, HPV is considered to be the most common sexually transmitted disease (STD). Some studies estimate that the majority of the sexually active population is exposed to at least one or more types of HPV - although most do not develop symptoms. Because HPV is so common and prevalent, a person does not need have to have a lot of sexual partners to come into contact with this virus.

What about HPV and cervical cancer? • There are many different types of genital HPV. • Only certain types of HPV are linked with cervical cancer. These are usually called "high-risk" types. • The types of HPV that cause raised external genital warts are not linked with cancer. These are called "low-risk" types. • These wart-types of HPV usually are not usually found on a female's cervix, and therefore, are not going to carry any risk of cancer. • It is common for a person to be exposed and have more than one type of HPV, including several "high-risk" types. Yet, most women do not develop cervical cancer. • Cervical cancer usually takes years to develop. • The majority of cases of cervical cancer are in women who have either never had a Pap smear, or have not had one in five years or more. • Cervical cancer can be prevented if a female gets a Pap smear at regular intervals. This way, if abnor- mal cell changes are found, it can be monitored and / or treated before progressing to cervical cancer. • Most of the time, men will not have any symptoms or health risks such as cancer with the "high-risk" types of HPV. It is the female's cervix that needs to be monitored.

What are the symptoms of genital warts? Only certain types of HPV cause genital warts. Other types, not related to genital warts, can cause abnor- mal cell changes on the genital skin, usually on a female's cervix.

What do warts look like? Genital warts appear as growths or bumps. Warts may be raised or flat, single or multiple, small or large. They tend to be flesh-colored or whitish in appearance. Warts usually do not cause itching or burning.

Sometimes genital warts are so small that they can not be seen with the naked eye. This is sometimes called "subclinical HPV." Therefore, a person may not even know he or she has the type or types of HPV that cause genital warts.

How are genital warts treated? • Currently, there is no treatment to cure HPV; there is no cure for any virus at this point. However, there are several treatment options available for genital warts. • Some treatments are done in a clinic or doctor's office; others are prescription creams that can be used at home for many weeks. Where can genital warts appear? Males Females Penis Vulva (entire outer female genital area) Scrotum (balls) In or around vagina In or around the anus In or around the anus Groin Groin Cervix

Syphilis What is syphilis? Syphilis is a curable infection caused by an bacteria called Treponema pallidum. Syphilis has three very distinct phases, each with unique signs. • The first phase, chancre, is represented by a sore. • The second phase may include a skin rash, fevers, hair loss, sore throat or other flu- like symptoms; however, many people may not have any of these. • The third phase, latency, is usually the time when there are no symptoms; however, the bacteria may cause damage to the heart, brain, liver and other internal organs.

Transmission • Syphilis is passed during vaginal, oral and anal sex, even if there is no sexual penetration. • It is most easily passed during the first phase because there is a sore. • Someone in the latent phase may also pass the bacteria to a sex partner. • If warts are present, they may easily spread the syphilis bacteria.

Signs or symptoms First phase, also called Primary Syphilis • Develops in ten to 90 days after contact with the bacteria. • Usually a single, painless sore, that might look like a crater. • The sore can last from one to five weeks. • It will go away by itself, but if you don't get treatment, you still have syphilis. Second Phase • Develops from 17 days to six and one-half months after you are infected. • A rash may appear on the palms of your hands or the soles of your feet and may last for two to six weeks. • Sores that may look grayish-white in your mouth and throat, also around the cervix in women. • Hair loss in patchy areas and a general sense of not feeling well. Third Phase, also known as latency • Develops from two to 30, or more, years after infection. • Small bumps (known as tumors) may appear on your skin, bones or internal organs. • You have problems with your heart and blood vessels. • You may go blind, or have problems with your central nervous system. • If you get treated at this phase, you will stop future damage to your body, BUT you cannot repair or reverse the damage that has been done before you get treated.

Hepatitis B What is hepatitis B? Hepatitis B (HBV) is a serious viral infection of the liver. HBV can cause chronic infection, cirrhosis (scarring) of the liver, liver cancer, liver failure and death. It is estimated that 4,000 to 5,000 people die each year in the United States due to the complications of cirrhosis and liver cancer as a result of HBV.

How common is hepatitis B? According to Centers for Disease Control and Prevention (CDC), it is estimated that 1 to 1.25 million people in the United States have chronic HBV. There are an estimated 140,000 to 320,000 new HBV in- fections each year in the United States.

How can I get hepatitis B? HBV is found in transmittable levels in body fluids including: • Semen • Vaginal secretions • Saliva • Blood HBV may be transmitted: • Sexually (having unprotected sex with an infected person) • Intravenously (sharing injecting drug needles or paraphernalia with an infected person) • Neonatally (mother-to-child if the mother is infected with HBV) HBV may also be transmitted in rare cases: • Horizontally (oral exposure to infected secretions such as saliva). Saliva can be a means of transmis- sion through bites; however, other types of exposure to saliva, including kissing, are unlikely ways of transmission. • Risk of transmission from blood transfusion is currently low in the United States since blood banks screen donated blood that appears to be infected. HBV is not spread through food or water or by casual contact.

What are the signs or symptoms of hepatitis B? Many adults have few or no symptoms. Symptoms may include: • Loss of appetite • Malaise • Nausea and vomiting • Abdominal pain • Dark urine • Jaundice (yellowing of the skin and eyes) • Rash or arthritis may occur during the early acute stage.

What can I do to reduce my risk of getting hepatitis B? Hepatitis B is preventable through vaccination. Since hepatitis D can only co-exist with hepatitis B, getting vaccinated against hepatitis B also protects you against hepatitis D. • The HBV vaccine is given in a series of three doses. • The first and second doses must be given at least one month apart. • The first and third doses must be given at least 4 months apart.