1. •By age 15, only 13% of U.S. teens have ever had sex
•By age 19, 70% of teens of both sexes have had
intercourse.
2. CASE STUDY
A woman gets a call from her ob/gyn. Apparently, she had
an abnormal pap smear when she had her check-up.
•Should she be concerned?
•What is a Pap Smear?
•How often should a woman get one?
•At what age should a woman get her first pap smear?
•What does a pap smear test for?
3. Quick Facts
•More than 800,000 women younger than 20
become pregnant each year
• 80% of these pregnancies are unintended
•Nine million teenagers and young adults
acquire an STD each year
•Two young people every hour become infected
with HIV
4. Decreasing Teen Pregnancy Rate
Source: U.S. Census Bureau, Current Population Survey, 2007 Annual Social and Economic
Supplement
6. Behavioral Methods
•Require no hormones or
medication.
•Their moderate
effectiveness depends on
consistent adherence
•Only risks are
inconvenience and failure as
a contraceptive
•Theses methods include:
• Withdrawal
• Periodic Abstinence
(Rythmic Method)
• Lactational Amenorrhea
7. Barrier Methods
•Attempt to prevent the fertilization of an ovum by physically preventing sperm
from entering the uterus.
•Condoms and spermicide are available without prescription
•Latex and polyurethane condoms protect against HIV and other STDs
•Successful use of the barrier method as contraception requires consistency
and discipline.
•All barrier methods are safe for use during lactation.
•Types of barrier methods:
• Male Condoms
• Female Condoms
• Cervical Caps (not in USA)
• Diaphragm
• Spermicide
8. Hormonal Contraceptives
•Attempts to prevent fertilization of the ovum or ovulation itself via the use of progesterone and estrogen
(combined contraceptives) or just progesterone.
•Combined contraceptives (progesterone/estrogen)
• Act by preventing ovulation
• Can be dispensed via pill (daily), patch (weekly), or vaginal ring (monthly)
• Benefits include: improvement of menorrhagia, acne, reduced risk of ovarian cancer, quick return to
fertility with discontinued use.
• Side effects can include: nausea, spotting,
• Contraindications for use: Migraine with aura, smoking, stroke, ischemic heart disease, liver
disease, major surgery with immobilization, hypertension, breast cancer, deep vein thrombosis.
• Types: Pill “The Pill”, Patch, Ring
•Progesterone-only contraceptives
• Act by thickening cervical mucus, thus becoming a barrier to sperm entering the uterus.
• Can be dispensed via pill (daily), injection, intrauterine device, or implant.
• Well-suited to women who cannot take estrogen (breastfeeding, etc.)
• Common side effects include: spotting, hair or skin changes, weight gain, headaches, depression,
decreased libido.
• Types: Pill “The Mini Pill”, Injection,
9. Intrauterine Devices (IUD)
•These are devices placed in the uterus to prevent conception by
suppressing ovulation and thickening cervical mucus.
•They are highly effective, well tolerated, long-acting and reversible.
•For women who do not plan on becoming pregnancy in the next two
years, IUD’s are the most cost-effective contraceptive.
•Suited for women who cannot take estrogen, for those who have
never born a child, and for those with STDs
•There is a risk of uterine perforation, infection and expulsion within the
first year.
•Fertility returns quickly after removal.
•There are two types available:
• Copper IUD
• Progestin IUD
10. Sterilization
•Sterilization provides permanent,
non-reversible protection against
pregnancy.
•There are several procedures for
men and women
•Male sterilization procedures cost
less and carry less risk than
female sterilization, however, in
the US, female sterilization is
preformed more often than male
sterilization.
•Female Procedure: Tubal
Sterilization
•Male Procedure: Vasectomy
11. Emergency Contraceptives
•Lower the risk of pregnancy following unprotected
intercourse.
•There are four types:
• Progestin-only (levonorgestrel) Pill
• Estrogen/Progestin Pill
• Copper IUD
• Selective Progesterone Receptor Modulator
(ulipristal) Pill
14. U.S. teenagers have higher rates of pregnancy,
birth and abortion than teenagers in most other
developed countries
15. Levels of teenage sexual activity across
developed countries are similar…
16. …but U.S. teenagers have higher rates of
unintended pregnancy and STDs
because they
•Are less likely to use contraceptives
•Have shorter relationships
•Have more sexual partners
17. Why this discrepancy?
•Other countries have:
• Greater access to contraceptive and reproductive
health services
• Comprehensive sex education
23. The Rise of STIs
•One in four U.S. women aged 14–19 has a sexually transmitted infection
(STI), according to a study released in March 2008 by researchers from the
Centers for Disease Control and Prevention (CDC).
• Young people aged 13–24 made up about 17% of all those who received a
diagnosis of HIV/AIDS in 2008
• Although 15–24 year-olds represent only ¼ of the sexually active
population, they account for nearly ½ (9.1 million) of the 18.9 million new
cases of STIs each year.
• Human papillomavirus (HPV) infections account for about half of STIs
diagnosed among 15–24-year-olds each year.
25. Human Papillomavirus (HPV)
• The virtual “marker” for having had sex.
• The CDC estimates that 20 million people are currently infected with HPV, 6.2
million Americans become infected each year and at least 50% of sexually active
individuals will acquire an HPV infection at some point in their lives.
• Most HPV infections cause no clinical problems and resolve on their own without
treatment. (As many as 91% of new infections clear up within two years.)
• Certain HPV strains lead to genital warts. These warts can be removed, but if the
immune system fails to clear the virus entirely, symptoms may reappear.
• Other HPV strains are deemed “high-risk” because they occasionally develop into a
persistent infection that can progress to cervical cancer if left untreated, usually over
the course of decades.
• Pap tests can detect not only early-stage cervical cancer, which is highly treatable,
but also cervical dysplasia—precancerous changes of cervical cells which can linger
for years—allowing for the removal of affected tissue long before invasive cancer sets
in.
26. Chlamydia and Gonorrhea
•bacterial infections that can be cured with antibiotics
•Untreated chlamydia and gonorrhea infections in women may
lead to pelvic inflammatory disease (PID), a serious infection
that itself may lead to ectopic pregnancy, infertility and chronic
pain.
•In 2007, the overall reported rate of chlamydia infection among
women (544 cases per 100,000 females) was almost three
times the rate among men (190 per 100,000 males)
•Rates of gonorrhea and chlamydia are heavily concentrated
among young people. Young women aged 15–24 are hit
hardest by chlamydia, with rates more than five times as high
as women overall.
•Routine screening is the most widely recommended
preventative healthcare for these two diseases
27. Other STIs A and B, which are
•viral infections, such as herpes and hepatitis
incurable but treatable;
•and bacterial and parasitic infections, such as syphilis and
trichomoniasis, which can be cured with antibiotics.
•About 7.4 million new cases of trichomoniasis occur each year.
Left untreated, trichomoniasis can be an irritant, causing vaginal
discharge, discomfort during intercourse and painful urination.
•Late-stage syphilis can, years later, cause irreversible damage
to the nervous system and heart, possibly leading to blindness,
insanity, paralysis and death.
•Hepatitis B can cause inflammation of the liver, and chronic
cases can cause liver cell damage, which can lead to cirrhosis of
the liver and cancer.
• It is estimated that 5,000 people die each year in the United
States due to the complications of cirrhosis and liver cancer as a
result of hepatitis B.
•HIV/AIDS
28. Prevention
•To date, there are vaccines for only
two viral STIs: hepatitis B and HPV.
•Abstinence
•Long term, mutually monogamous
relationship with a partner without an
STI
•Use condoms consistently and
correctly!
29. Testing and Treatment
•Get tested regularly: pap smear, blood work
•For most STIs, screening and treatment to cure or
suppress existing infections, often referred to as secondary
prevention, can play as important a role in preventing long-
term harm to an individual’s health and to reducing the
spread of STIs as preventing infections in the first place.
30. CASE STUDY
A woman gets a call from her ob/gyn. Apparently, she had
an abnormal pap smear when she had her check-up.
•Should she be concerned? Maybe
•What is a Pap Smear?
•How often should a woman get one?
•At what age should a woman get her first pap smear?
•What does a pap smear test for?
31. CASE STUDY
A woman gets a call from her ob/gyn. Apparently, she had
an abnormal pap smear when she had her check-up.
•Should she be concerned? Maybe
•What is a Pap Smear? A test to check the condition of
cervical cells
•How often should a woman get one?
•At what age should a woman get her first pap smear?
•What does a pap smear test for?
32. CASE STUDY
A woman gets a call from her ob/gyn. Apparently, she had
an abnormal pap smear when she had her check-up.
•Should she be concerned? Maybe
•What is a Pap Smear? A test to check the condition of
cervical cells
•How often should a woman get one? Yearly
•At what age should a woman get her first pap smear?
•What does a pap smear test for?
33. CASE STUDY
A woman gets a call from her ob/gyn. Apparently, she had an abnormal
pap smear when she had her check-up.
•Should she be concerned? Maybe
•What is a Pap Smear? A test to check the condition of cervical cells
•How often should a woman get one? Yearly
•At what age should a woman get her first pap smear? 21 or within a
year of first sexual experience (whichever comes first).
•What does a pap smear test for?
34. CASE STUDY
A woman gets a call from her ob/gyn. Apparently, she had an abnormal
pap smear when she had her check-up.
•Should she be concerned? Maybe
•What is a Pap Smear? A test to check the condition of cervical cells
•How often should a woman get one? Yearly
•At what age should a woman get her first pap smear? 21 or within a
year of first sexual experience (whichever comes first).
•What does a pap smear test for? Cancerous and pre-cancerous cells.
