Chapter Outline. Adolescent Sexuality Chapter 6. Please be advised This lecture contains graphic pictures and images of sexual organs

Transcription

1 Adolescent Sexuality Chapter 6 Please be advised This lecture contains graphic pictures and images of sexual organs Chapter Outline Exploring Adolescent Sexuality A Normal Aspect of Adolescent Development The Sexual Culture Developing a Sexual Identity Obtaining Research Information about Adolescent Sexuality Sexual Attitudes and Behavior Heterosexual Attitudes and Behavior Sexual Minority Attitudes and Behavior Self-Stimulation Contraceptive Use

2 Chapter Outline Adolescent Sexual Problems Adolescent Pregnancy Sexually Transmitted Infections Forcible Sexual Behavior and Sexual Harassment Sexual Literacy and Sex Education Sexual Literacy Sources of Sex Information Sex Education in Schools Stages of Sexuality Autosexuality: Love of one s self (masturbation) Homosexuality: Love of members of one s own sex Heterosexuality: Love of members of the opposite sex Autosexual Behavior Masturbation begins around 4-5 years of age, stops, and then starts again at 14 No intrinsic harm Considered normal and helps form a positive sexual attitude

3 Sexual Minority The majority of sexual minority (same-sex) individuals experience their first same-sex attraction, sexual behavior, and self-labeling as a gay male or lesbian during adolescence (Savin-Williams, 2006). The term bisexual refers to someone who is attracted to people of both sexes. Discrimination and Bias Having irrational negative feelings against individuals who have same-sex attractions is called homophobia In its more extreme forms, homophobia can lead individuals to ridicule, physically assault, or even murder people they believe to have same-sex attractions Homophobia Associated with avoidance of same-sex individuals, faulty beliefs about sexual minority lifestyles (such as believing the falsehood that most child molesters have same-sex attractions), and subtle or overt discrimination in housing, employment, and other areas of life (Meyer, 2003). One common form of self-devaluation is called passing, the process of hiding one s real social identity

4 Are Adolescents Having Sex? Timetables What About Oral Sex?

5 Adolescent Sexual Problems Sexual problems in adolescence include: Adolescent pregnancy Sexually transmitted infections Forcible sexual behavior Sexual harassment Adolescent Pregnancy Pregnant adolescents were once virtually invisible and unmentionable, shuttled off to homes for unwed mothers where relinquishment of the baby for adoption was their only option, or subjected to unsafe and illegal abortions. But yesterday s secret has become today s dilemma. Incidence of Adolescent Pregnancy Adolescent girls who become pregnant are from different ethnic groups and from different places, but their circumstances have the same stressfulness. More than 200,000 females in the United States have a child before their eighteenth birthday.

6 Teen Pregnancies Teen mothers: Are more likely to smoke Are less likely to receive prenatal care Have limited educational and employment opportunities Comprehensive programs that teach abstinence AND contraception reduce risks of teen pregnancy Teen Pregnancies The Teenage Parent Risk Factors : Poverty Unsafe communities Single-parent households History of sexual abuse Have sexually active teenage siblings

7 Birth Control Methods Abstinence Tubal Ligation Vasectomy Implants Birth Control Pills Condoms Diaphragm Spermicidal foams, creams, etc. Contraceptive Use What factors are related to unsuccessful contraceptive use? Being from a low-ses family is one of the best predictors of adolescents failure to use contraceptives (Nadeem, Romo, & Sigman, 2006). Younger adolescents are less likely to use contraceptives than older adolescents (Hofferth, 1990). Not being involved in a steady, committed dating relationship is also associated with a lack of contraceptive use (Chilman, 1979). Obstacles to Using Birth Control Parents and Educators fail to discuss and teach Lack of seeking and obtaining services Lack of planning to have sex Not prepared for the emotionality of sex Stigmatism with use Pressured to have sex Birth devise interfere with sex

8 Abortion U.S. Supreme Court Roe v. Wade (1973): Stated that women have the legal right to choose abortion Before Roe v. Wade, thousands of women died each year from illegal abortions Psychological Reactions to Abortion Relief Sadness, a sense of loss, or other negative feelings Adjustment is better when: Abortion occurs early in the pregnancy Woman feels competent Friends and family are supportive Children Children born to women who have been denied an abortion are significantly more likely to experience psychological and social difficulties than children from a wanted pregnancy.

9 Sexually Transmitted Infections (STI) Contracted primarily through sexual contact Not limited to vaginal intercourse but includes oral-genital and anal-genital contact STIs are an increasing health problem Three STIs caused by viruses: AIDS (acquired immune deficiency syndrome), genital herpes, and genital warts Three STIs caused by bacterial infections: gonorrhea, syphilis, and chlamydia. Sexually Transmitted Diseases AIDS Syphilis Chlamydia Gonorrhea Pelvic Inflammatory Diseases (PID) Genital Herpes Genital Warts Hepatitis B Sexually Transmitted Diseases Syphilis: Can be passed on to the fetus and newborn Chlamydia: Can cause infertility and can be passed down to the newborn Genital Herpes: NO CURE! Can passed to the newborn. Can cause deadly cervical cancer Genital Warts: NO CURE! Can cause deadly cervical cancer Gonorrhea: Can lead to infertility. Can be passed on to the newborn

10 Sexually transmitted disease caused by the bacterium Treponema pallidum. The syphilis bacterium is very fragile, and the infection is almost always transmitted by sexual contact with an infected person. The bacterium spreads from the initial ulcer (sore) of an infected person to the skin or mucous membranes (linings) of the genital area, mouth, or anus of an uninfected sexual partner. It also can pass through broken skin on other parts of the body. Syphilis

11 The first symptom s a usually painless open sore called a chancre (pronounced "shanker"). The chancre can appear within 10 days to 3 months (usually 2 to 6 weeks) after exposure. Secondary syphilis is marked by a skin rash that appears anywhere from 2 to 12 weeks after the chancre disappears. The rash may cover the whole body or appear only in a few areas, such as the palms of the hands or soles of the feet. Because active bacteria are present in these sores, any physical contact - sexual or nonsexual - with the broken skin of an infected person may spread the infection at this stage. The signs of secondary syphilis occasionally come and go over the next 1 to 2 years. Like the symptoms of the primary stage, those of secondary syphilis can be very mild and go unnoticed. Syphilis A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

12 Pediculosis pubis/crabs: lice found in the pubic hair of humans Barely the size of a pinhead, lice are organisms that live only with the help of another organism, called a host. There are thousands of types of lice, some of which have developed an attraction to humans. The source of infection for pubic lice is intimate contact with an infected person; th f bi li ft t itt d The main symptoms of infection are itching and burning of the pubic area. The itching may spread as the pubic lice move to other moist areas of the body such as the armpit. Many people who have crabs say the itching is worse at night Permethrin 5% Be sure to get the 5% cream formula because crabs may be resistant to the 1% liquid form (Nix). Apply to affected area and leave on for 10 minutes. Rinse with warm water afterward. Avoid mucous membranes, which are found at the tip of the penis and the opening of the vagina. Repeat anti-lice treatment in seven to 10 days to kill nits that may have hatched.

13 Chlamydia: Caused by the bacterium, Chlamydia trachomatis The most frequently reported bacterial sexually transmitted disease in the United States Can damage a woman's reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur "silently" before a woman ever recognizes a problem Chlamydia is known as a "silent" disease because about three quarters of infected women and about half of infected men have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure. In women, the bacteria initially infect the cervix and the urethra. Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. When the infection spreads from the cervix to the fallopian tubes, some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. Chlamydial infection of the cervix can spread to the rectum. Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Pain and swelling in the testicles are uncommon. Men or women who have receptive anal intercourse may acquire chlamydial infection in the rectum, which can cause rectal pain, discharge, or bleeding. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner. Chlamydia can be easily treated and cured with antibiotics. A single dose of azithromycin or a week of doxycycline are the most commonly used treatments. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV negative. All sex partners should be evaluated, tested, and treated. Persons with chlamydia should abstain from sexual intercourse until they and their sex partners have completed treatment, otherwise re-infection is possible. Having multiple infections increases a woman's risk of serious reproductive health complications, including infertility. Retesting should be considered for women, especially adolescents, three to four months after treatment.

14 TRICHOMONIASIS, HEPATITIS B, AND GENITAL WARTS Trichomoniasis One of the most common curable sexually transmitted infections. It is caused by a parasitic protozoan called Trichomoniasis vaginalis. Trichomoniasis & HIV Trichomoniasis has also been found to be a cofactor for HIV transmission. It is thought that this infection, which causes lesions and inflammation, increases risk of HIV infection upon exposure. It may also be passed from infected mother to child during birth. Trichomoniasis may cause a woman to deliver a low-birth-weight or premature infant

15 Symptoms Symptoms include: Vaginal itching, burning, greenish-yellow vaginal discharge, burning or pain when urinating. Sexual intercourse can be painful. In men, symptoms include mild itching and irritation of the penis, pain during intercourse and discomfort when urinating. Men who have trichomoniasis usually don't experience any symptoms and may unknowingly infect their sexual partners. Treatment Flagyl (Metronidazole) about 1.5 to 2 grams Curing approximately 85% of infections. The physician may also choose to treat the partner of the patient to prevent reinfection. It's important not to consume alcoholic beverages during treatment with Flagyl because it could cause severe vomiting. Hepatitis B The hepatitis B virus (HBV) is passed from person to person through contaminated body fluids. Although transmission can occur in many ways, the most important mode of transmission in the United States is sexual contact percent of adults with the Hepatitis B Virus (HBV) recover completely The virus can cause severe liver disease and death.

16 This woman is not pregnant! Hepatitis B This is a woman who has been infected with the Hepatitis B disease. This is a tumor on her liver that was caused by Hepatitis B damage to her liver. Symptoms Nausea Vomiting Loss of appetite Abdominal pain Jaundice (the skin turns yellow) Weakness/fatigue Brown urine (may look like tea) Symptoms of hepatitis B can range from mild to severe. Symptoms similar to the stomach flu

17 Hepatitis B HBV is the only sexually transmitted infection that is preventable with vaccination. But about 200,000 Americans get HBV every year because they have not been vaccinated.. How HBV is spread: In semen, saliva, blood, and urine by: Intimate and sexual contact, from kissing to vaginal, anal, and oral intercourse Use of unclean needles to inject drugs Accidental sticks with contaminated needles in the course of health care. Hepatitis B Hepatitis B (serum hepatitis) is the only form of hepatitis known to affect the newborn. There does not appear to be an increased risk of birth defects in infants of infected mothers, but an infected mother is very likely to pass the infection on to her newborn due to exposure to maternal blood and feces. The infected infants have a 25 percent chance of dying of liverrelated diseases such as chronic hepatitis, cirrhosis, and liver cancer. Hepatitis B Unless they are treated within an hour of birth, 90 percent of the infants born to women with HBV will carry the virus. Pregnant women who may have been exposed to HBV should consider being tested before giving birth so that their babies can be vaccinated at birth or treated if they become ill. Like many other viruses, HBV may remain in the body for life. HBV is the only sexually transmitted infection that is preventable with vaccination. But about 200,000 Americans get HBV every year because they have not been vaccinated..

18 Genital Warts Caused by one of many strains of the Human Papilloma Virus (HPV) Highly infectious Genital warts are small projections of skin around the vaginal opening in women or on the penis or scrotum in men. Genital Warts The size may range from less than one millimeter across to several square centimeters when many warts join together. Men and women with genital warts will often complain of painless bumps, itching, and discharge. Genital Warts Many individuals exposed to the genital wart virus will not develop visible warts but will simply carry the virus in their skin cells. Viral genetic material actually incorporates itself into the skin and can remain there for years. Some women develop generalized irritation and burning of the vaginal skin from viral changes that do not create visible warts.

19 Genital Warts The viral genetic material of certain strains of HPV is strongly associated with cervical and vaginal cancers Women who have been identified as carrying the HPV virus are considered at high risk for cervical cancer. The Centre for Disease control estimates that there are 500,000 to 1 million new cases of genital warts in the United States each year. Genital Warts Genital warts may cause a number of problems during pregnancy. Sometimes genital warts get larger during pregnancy, making it difficult to urinate. If the warts are in the vagina, they can make the vagina less elastic and cause obstruction during delivery. In rare cases, infants born to women with genital warts develop warts in their throats. Although uncommon, it is a potentially life-threatening condition for the child, requiring frequent laser surgery to prevent obstruction of the breathing passages. Treatment Depending on factors such as the size and location of the genital warts, a doctor will offer several ways to treat them. The primary treatment for visible genital warts is the removal of the warts with laser surgery. If left untreated, visible genital warts might resolve on their own, remain unchanged, or increase in size or number. Treatment possibly reduces, but does not eliminate, HPV infection. Sometimes genital warts will disappear without treatment

20 Advise for Adolescents