STIs, stigma, and risk management

Types of STIs

Gonorrhoea, chlamydia, syphilis, HEP B, HIV, HSV (herpes simplex virus), HPV (human papillomavirus)

How are STIs transmitted?

Direct skin contact, sexual (oral, genital, anal), and sharing sex toys (sometimes even toilet seats)

Bacterial infections

Gonorrhoea and chlamydia

Symptoms (5)

None, pain, discharge, skin lesions, systemic

Painful symptoms of infection

Urination, bowel movements, abdominal pain, sore throat — gonorrhoea, chlamydia, herpes, Hep, HIV

Discharge (symptoms of infection)

Genitals or anus (irregular) — gonorrhoea and chlamydia

Skin lesions (symptoms of infection)

Local or generalized, rash, painful or non-painful — herpes, syphilis, HIV ,gonorrhoea, HPV

Systemic (symptoms of infection)

Flulike, swollen lymph nodes (local or generalized) — HIV, syphilis, Hep, herpes

How to test for STI (3)

Urine testing (gonorrhoea or chlamydia), swabs for lesions, blood test

Different blood tests for STIs (3)

Serology (typical testing), point of care (show up seeking healthcare), self-test (do it urself)

Herpes blood test is a waste of money

Most ppl test positive bc of cold sores

When and how to be tested for gonorrhoea and chlamydia

Genital testing, extragential testing — gay, bi, men/men, trans women, sex workers, in contact w someone who has it, sings/symptoms

Getting tested for HIV

U had sexual contacts, u have symptoms, specific situations — gay, bi, trans, ACB, indigenous, PWUID

HIV testing process

Test as baseline, 3 weeks after, 6 weeks after → negative = prEP → positive = care ; every 3 months if ongoing risk

When to get tested for Hep B

Boxing, sharing needles; if born outside CAN (1 time lifetime test)

What is prEP

Pre exposure prophylaxis

Active offer (prEP)

Anyone who has risks should get it, even those who dont realize they’re at risk… offer it to ppl

Highest group for HIV diagnosis in Ontario

Black / indigenous women (4/5)

Immigrants tend to have higher rate of HIV

True

Two forms of prEP

Two oral pills everyday OR injectable every 2 months

Frequency of visits for prEP

First month, a month later, every 2-4 months (check-ins)

You only take prEP until…

Risk of HIV acquisition is gone

PrEP is ___ effective

99%

HIV prevention

Condoms, PEP, prEP, U=U (undetectable = untransmittable), vaccination

What is getakit?

Lab based testing sent to ur home (or go in person), Ontario based, register online, receive HIV home test → finger stab or saliva test → prep offered here too

Most ppl dont take prEP bc

They dont think they’re truly at risk or dont care enough to take it

Types of condom and barriers (5)

External, internal, barrier method, dental dam, latex gloves

External condoms

On top of penis; everytime there’s a withdrawal u have to change it

Internal condom

Female condom, not sold in normal stores, keep it on the whole time during sex

Barrier method

No bacteria can go thru (like STIs)

Dental dam

Latex and no latex ; for oral sex

__ of ppl never use condoms

33%

Why dont ppl use condoms?

Other preventative methods (IUD), partner/i dont like using it, been tested, no risk of pregnancy

__ of young Canadians dont engage in regular STI and HIV testing in the last 6 months

80%

Why dont that many young Canadians get tested?

They dont think they need to, dont know where to go or feel embarrassed

If you go to the clinic to get tested, they test for…

Syphilis, chlamydia, HIV gonorrhoea, HEP B (reportable STIs, less severe)

Chlamydia, syphilis and gonorrhoea are

Bacterial

HEP and HIV are

Viral (antivirals suppress it)

What STI is related to cancer

HPV

Herpes is harsh psychologically bc of

Stigmas

Prodrome phase (herpes)

Tingly feeling that smth is coming

Asymptomatic shedding (herpes)

Virus comes out but you dont know (3% of year)

HSV-1

Around mouth but can be transmitted to genitals

HSV-2

Commonly in genitals, more agressive, doesn’t usually transfer to other parts of body

HPV

No cure, over 100 strains, body can flush the virus, warts can be burned off

HPV is the most….

Prevalent in the world

Almost half of young Canadians feel like sex ed stigmatized STIs

Silence around it, being a “whore”, not having sex is best option and encouraged, fearmongering

More than half of young Canadians felt like sex ed did NOT make them feel prepared for sex

Ppl are made to feel like they can’t talk abt it openly, talking abt STIs might make partner feel untrusted, uncomfy, embarrassing, dirty, not being careful, etc.

Stigma (def) and judgments

Attribute / label that sets a person apart from others, links labeled person to undesirable charac, and represents socially shared knowledge understood even by targets of stigma

5 types of stigma

Perceived, internalized, social, intersectional, institutionalized

Perceived stigma

Awareness of negative social attitudes, fear of discrimination and feelings of shame (like other ppl would treat u differently)

Internalized stigma

A persons acceptance of negative beliefs, views and feelings abt themselves and the grp which they belong to (self hate)

Social stigma

Acts of discrimination (physical exclusion, psych exclusion, abuse) and can affect livelihood (lose friends or jobs)

Intersectional stigma

Joint effects of having more than one stigmatized identity (racism, sexism, homophobia)

Institutionalized stigma

Stigma of a grp of ppl thru the application of policies and procedures (ex: gay men had to wait to give blood)

Why is stigma a problem?

Less communication, less disclosure to partners, delay testing, others may judge (which brings ppl’s mental health down), feeds prejudice toward certain grps of ppl, violence

STI and risks management

Become informed, have an open conversation w partner, go for testing, negotiate explicit agreement w regards to sexual relationship (condom use for ex)