1 00:00:02,750 --> 00:00:06,230 Dena Stevens: Hi my name's Dena Stevens and I am the college 2 00:00:06,230 --> 00:00:08,780 nurse here at Moorpark, and today we're going to 3 00:00:08,780 --> 00:00:11,530 talk about sexually transmitted infections, the who, 4 00:00:11,550 --> 00:00:14,240 what, when, where, why, and how of STIs and 5 00:00:14,240 --> 00:00:19,520 college students. Let's get started. So there's 6 00:00:19,520 --> 00:00:22,310 some graphic pictures in this presentation. So if 7 00:00:22,310 --> 00:00:24,370 you feel like you just can't look at them, or you're 8 00:00:24,370 --> 00:00:28,400 grossed out or it's embarrassing, feel free to 9 00:00:28,460 --> 00:00:31,760 turn away, put a something over your screen...Do 10 00:00:31,760 --> 00:00:33,740 whatever you got to do. The good part is as most 11 00:00:33,740 --> 00:00:37,880 of us are home in the privacy of our space and we 12 00:00:37,880 --> 00:00:39,320 don't have to watch this with a bunch of other 13 00:00:39,320 --> 00:00:43,250 people which sometimes can be a little awkward. So 14 00:00:44,540 --> 00:00:49,190 I tell some stories in this and I've been a 15 00:00:49,190 --> 00:00:52,940 nurse a long time and seen a lot of patients. So 16 00:00:52,940 --> 00:00:56,390 sometimes it helps to share some of those stories 17 00:00:56,420 --> 00:01:00,230 just to drive home some points. It's not intended 18 00:01:00,230 --> 00:01:03,530 to offend anyone. None of the individuals I talk 19 00:01:03,530 --> 00:01:08,090 about are students here. So just know 20 00:01:08,340 --> 00:01:11,060 that I'm not here to hurt anybody's feelings or 21 00:01:11,060 --> 00:01:14,630 make anybody feel bad. So let's talk about the who. 22 00:01:15,460 --> 00:01:18,530 Basically anybody could get an STD that's having 23 00:01:18,560 --> 00:01:22,040 any type of sexual relationships. It doesn't have 24 00:01:22,040 --> 00:01:26,130 to be just specifically intercourse. Some STDs 25 00:01:26,180 --> 00:01:32,270 can be transmitted even when there's only skin to 26 00:01:32,270 --> 00:01:35,060 skin contact. And we're going to talk about that. 27 00:01:35,570 --> 00:01:39,230 We know that abstinence is the safest bet but not 28 00:01:39,230 --> 00:01:41,900 always the most fun. So if we're going to choose 29 00:01:41,900 --> 00:01:43,430 to have sex we want to make sure we have the 30 00:01:43,430 --> 00:01:48,010 safest sex we can. So what do you need to know? 31 00:01:48,730 --> 00:01:51,250 Anybody can get an STI, right? We already talked 32 00:01:51,250 --> 00:01:54,520 about that. But how are they spread? Primarily 33 00:01:54,520 --> 00:01:58,330 spread through anal, vaginal, and oral sex. But some, 34 00:01:58,330 --> 00:02:01,000 like I said, are spread by skin to skin contact. 35 00:02:02,010 --> 00:02:06,060 There're two different types of STIs and one 36 00:02:06,060 --> 00:02:10,320 is a viral and the other is a bacterial. Bacterial 37 00:02:10,430 --> 00:02:13,110 one's sort of like better simply because 38 00:02:13,200 --> 00:02:16,810 antibiotics will cure a bacterial infection, where 39 00:02:16,830 --> 00:02:20,550 viruses? Not so much. Viruses don't respond to 40 00:02:20,550 --> 00:02:23,460 antibiotics much like Covid doesn't respond to 41 00:02:23,460 --> 00:02:25,920 antibiotics. So you have to try different 42 00:02:25,920 --> 00:02:28,680 treatments to see what you can do to help people 43 00:02:28,680 --> 00:02:32,610 out. Most of the time with viruses it's not a cure. 44 00:02:32,760 --> 00:02:35,190 It's more about maintaining the symptoms or 45 00:02:35,190 --> 00:02:38,040 containing the symptoms until the virus itself 46 00:02:38,040 --> 00:02:43,020 passes. STIs affect men and women pretty 47 00:02:43,080 --> 00:02:45,900 equally. Oh let me go back for a second. When 48 00:02:45,900 --> 00:02:48,270 we're talking about viruses and bacteria, the 49 00:02:48,270 --> 00:02:50,460 one thing to know when you're trying to tell the 50 00:02:50,460 --> 00:02:53,220 difference is that if it starts with the letter "H" 51 00:02:53,520 --> 00:02:56,850 it's a virus. So the four ones that we think of 52 00:02:56,850 --> 00:03:04,140 most commonly are herpes, hepatitis, HPV, and HIV. So 53 00:03:04,620 --> 00:03:07,680 just how you might delineate between what's 54 00:03:07,680 --> 00:03:11,730 virus-caused and what's bacteria-caused. OK back to 55 00:03:11,730 --> 00:03:14,610 men and women. They're generally equally 56 00:03:14,610 --> 00:03:17,460 distributed. Men and women tend to have the same 57 00:03:17,550 --> 00:03:20,550 amount of STIs, some a little different depending 58 00:03:20,550 --> 00:03:23,580 on the specific STI, but generally overall they're 59 00:03:23,580 --> 00:03:26,820 pretty equally distributed. However the impact on 60 00:03:26,820 --> 00:03:30,540 women is different. And that's primarily because 61 00:03:30,980 --> 00:03:34,340 in guys they're junk's on the outside. Right. They 62 00:03:34,340 --> 00:03:36,960 kind of see it. They kinda have to handle it in 63 00:03:36,960 --> 00:03:39,600 order to kinda get through their day. Women not 64 00:03:39,600 --> 00:03:42,240 so much. We don't generally walk around with our head 65 00:03:42,240 --> 00:03:43,740 between our legs looking to see if there's 66 00:03:43,740 --> 00:03:46,440 something going on up there. And when it's inside 67 00:03:46,440 --> 00:03:49,920 of our body we may not feel it the same way. So 68 00:03:50,100 --> 00:03:52,230 it's important to know that the impact on women 69 00:03:52,230 --> 00:03:54,660 can be significant and they might not even know it. 70 00:03:55,170 --> 00:03:57,810 The other important fact is that women carry 71 00:03:57,810 --> 00:04:01,500 babies. So when our reproductive track is damaged 72 00:04:01,740 --> 00:04:05,280 it can really impact our ability to reproduce. 73 00:04:07,660 --> 00:04:11,130 So lots of different types of STDs. STD 74 00:04:11,130 --> 00:04:14,530 stands for "sexually transmitted disease." STI 75 00:04:14,530 --> 00:04:16,750 stands for "sexually transmitted infection." They're 76 00:04:16,750 --> 00:04:18,700 kind of interchangeable. I've been doing this a 77 00:04:18,700 --> 00:04:21,340 long time, and when I started it was STD, so 78 00:04:21,340 --> 00:04:23,890 sometimes you'll hear me use that word. But 79 00:04:24,280 --> 00:04:26,440 there's three main ones we're going to talk about 80 00:04:26,470 --> 00:04:28,600 mostly because you don't want to sit here all day, 81 00:04:28,690 --> 00:04:31,450 and neither do I. So the main ones we're going to 82 00:04:31,450 --> 00:04:35,280 talk about are the most common ones here at Moorpark 83 00:04:35,280 --> 00:04:39,930 College, and those are chlamydia. HPV, or genital 84 00:04:39,930 --> 00:04:44,010 warts, and herpes. Those are the things we see most 85 00:04:44,010 --> 00:04:47,070 commonly in our office and our most commonly seen 86 00:04:47,070 --> 00:04:51,180 in college students across the country. These 87 00:04:51,270 --> 00:04:53,870 however do not mean they're the only ones we see. 88 00:04:54,000 --> 00:04:57,240 We do see other things. We do see cases of 89 00:04:57,240 --> 00:05:00,330 gonorrhea. We do see syphilis. And we have seen 90 00:05:00,330 --> 00:05:03,810 HIV in our office. However those are just not the 91 00:05:03,810 --> 00:05:06,390 most common ones. And for time's sake we're just going 92 00:05:06,390 --> 00:05:07,780 to talk about the most common ones. 93 00:05:10,590 --> 00:05:13,980 When are you most at risk of getting an STD? I 94 00:05:13,980 --> 00:05:15,930 don't think most people think about there being a 95 00:05:15,930 --> 00:05:20,070 timeframe of when I'm most at risk other than when 96 00:05:20,100 --> 00:05:22,830 I don't use a condom or when I don't practice 97 00:05:22,830 --> 00:05:26,490 safer sex. But the reality is there is a safer 98 00:05:26,490 --> 00:05:32,160 time to get set to get an STD versus others. So 99 00:05:32,220 --> 00:05:35,970 one of the greatest things to remember is that 20 100 00:05:35,970 --> 00:05:41,210 million people in the United States have an 101 00:05:41,260 --> 00:05:45,230 STI at some point. Ten million of that 20 102 00:05:45,230 --> 00:05:48,740 million, so half of that, occur in people between 103 00:05:48,740 --> 00:05:54,470 the ages of 15 to 24. Then, when you take that 104 00:05:54,470 --> 00:05:58,880 10 million 15 to 24, you have to remember 105 00:05:58,880 --> 00:06:03,020 that only 25 percent of people that fall between 106 00:06:03,020 --> 00:06:07,550 the age group of 15 to 24 are even 107 00:06:07,550 --> 00:06:11,510 sexually active. So when you kind of pull this all 108 00:06:11,510 --> 00:06:16,390 apart you can tell a lot of burden, a lot of 109 00:06:16,400 --> 00:06:20,960 these STIs fall on a very small population. So 110 00:06:20,960 --> 00:06:24,110 people between the ages of 15 to 24 are much more 111 00:06:24,110 --> 00:06:27,140 likely to be diagnosed with an STI than people in 112 00:06:27,200 --> 00:06:30,980 other age groups. Young women, in reality have the 113 00:06:30,980 --> 00:06:36,410 highest numbers of STIs, and especially at 114 00:06:36,410 --> 00:06:39,680 sexual debut. And that means that their first 115 00:06:39,680 --> 00:06:44,090 sexual intercourse is the highest risk period of 116 00:06:44,090 --> 00:06:48,380 time for coming down with an STI especially when 117 00:06:48,380 --> 00:06:50,960 they're so young. Fifteen-year-olds are much more 118 00:06:50,960 --> 00:06:55,040 likely. Those cells are virginal as well as 119 00:06:55,040 --> 00:06:58,400 the body. So they're not used to being exposed to 120 00:06:58,400 --> 00:07:01,250 those different germs and viruses and bacterias. 121 00:07:01,550 --> 00:07:05,570 So they tend to not have the strength and power to 122 00:07:05,780 --> 00:07:08,750 fight off infections. So something to be really 123 00:07:08,750 --> 00:07:11,810 aware of when we're looking at sexually 124 00:07:11,810 --> 00:07:13,230 transmitted infections. 125 00:07:15,340 --> 00:07:18,340 When and where. So you know kind of always think 126 00:07:18,640 --> 00:07:21,970 maybe not so much this year but spring break you 127 00:07:21,970 --> 00:07:24,760 know people are out doing things maybe having 128 00:07:24,760 --> 00:07:27,430 experiences we wouldn't normally have. But I love 129 00:07:27,430 --> 00:07:30,490 this cartoon. So you can see the crab's like "Yeah, 130 00:07:30,550 --> 00:07:33,490 spring break." And then, "It's going to be a busy 131 00:07:33,490 --> 00:07:37,480 week guys." And he has a herpes hat on. And then 132 00:07:37,690 --> 00:07:40,950 the last guy says "Hi, my name's Gonorrhea." and he's 133 00:07:40,960 --> 00:07:43,660 just hanging out kind of telling him. So just 134 00:07:43,660 --> 00:07:47,080 knowing that sometimes those really good times can 135 00:07:47,080 --> 00:07:49,450 be high risk periods of time for sexually 136 00:07:49,450 --> 00:07:53,700 transmitted infections. So I thought I'd show you 137 00:07:53,700 --> 00:07:56,130 some pictures of what these look like and in 138 00:07:56,130 --> 00:07:58,590 different areas of the body just so that you can 139 00:07:58,590 --> 00:08:01,110 recognize that just because you have an STI 140 00:08:01,170 --> 00:08:03,960 doesn't necessarily mean it's only in the 141 00:08:03,960 --> 00:08:08,670 reproductive tract. So HPV we can see in the upper 142 00:08:08,670 --> 00:08:12,540 left hand corner is in the mouth. And actually 143 00:08:12,540 --> 00:08:14,970 that's a really common spot for it. And we'll talk 144 00:08:14,970 --> 00:08:19,050 a little more about it. You see it in the upper 145 00:08:19,050 --> 00:08:21,930 right hand corner. It's actually kind of around 146 00:08:21,930 --> 00:08:25,680 the vagina and even towards the anus. Herpes, up on 147 00:08:25,680 --> 00:08:29,640 the face. And then chlamydia is actually shown as a 148 00:08:29,640 --> 00:08:35,670 discharge coming from the penis. So why are they 149 00:08:35,670 --> 00:08:38,400 spreading so much. Well the first thing to 150 00:08:38,400 --> 00:08:40,830 actually remember is that most people don't 151 00:08:40,830 --> 00:08:45,390 maliciously go around spreading STIs, but we do 152 00:08:45,390 --> 00:08:49,740 tend to do things that maybe put us at higher risk, 153 00:08:51,120 --> 00:08:52,980 and we don't really think about those as why 154 00:08:52,980 --> 00:08:56,760 they're spreading so much, especially in terms 155 00:08:56,760 --> 00:08:59,910 of condom use. We'll hear this: "Don't you trust me?" 156 00:09:00,840 --> 00:09:03,600 There're some great responses to this, 157 00:09:03,600 --> 00:09:05,790 like "Well, if you have to ask me that maybe 158 00:09:05,790 --> 00:09:08,460 now I don't trust you so much." I'll let you 159 00:09:08,460 --> 00:09:10,500 guys read these. You can go at your own pace on 160 00:09:10,500 --> 00:09:14,280 this one so you can go back and look at this. If I 161 00:09:14,280 --> 00:09:16,620 had a dollar for the one that says it doesn't fit 162 00:09:16,620 --> 00:09:19,890 me I'm too big, I seriously would be somewhere in 163 00:09:19,890 --> 00:09:22,080 the Bahamas with a very nice drink with an 164 00:09:22,080 --> 00:09:25,320 umbrella in it and would not be sitting in my 165 00:09:25,320 --> 00:09:29,610 office doing this presentation for you. So, you can 166 00:09:29,610 --> 00:09:31,860 kind of read about it. But there are different 167 00:09:31,860 --> 00:09:35,460 sized condoms for different sized men. Making sure 168 00:09:35,460 --> 00:09:38,310 you have the right size is important but most men 169 00:09:38,310 --> 00:09:41,850 fit in a regular sized condom. If you are bored, 170 00:09:41,880 --> 00:09:44,040 and need something to do, because I know you can't 171 00:09:44,040 --> 00:09:46,820 go out and do anything else, you can always 172 00:09:46,950 --> 00:09:53,040 YouTube "condom size" and they'll show you all these 173 00:09:53,040 --> 00:09:55,800 great things like you can put a whole your whole 174 00:09:55,860 --> 00:09:59,400 arm into a condom, all the way from your elbow 175 00:09:59,790 --> 00:10:02,190 into your to your hand. You can fill it up with 176 00:10:02,190 --> 00:10:06,360 all this water. So anyway just letting you know, I've 177 00:10:06,360 --> 00:10:09,390 heard that one a lot. So lots of 178 00:10:11,610 --> 00:10:14,340 different reasons that that people don't use 179 00:10:14,340 --> 00:10:18,290 condoms, and why STIs continue to spread. So 180 00:10:18,450 --> 00:10:20,150 first of all we're going to talk about chlamydia. 181 00:10:21,470 --> 00:10:24,650 Chlamydia is a really, really common STI, and 182 00:10:24,650 --> 00:10:27,620 probably the most common one we see here at 183 00:10:27,620 --> 00:10:31,100 Moorpark College. I've left you some statistics. 184 00:10:31,510 --> 00:10:34,490 There's more than a million. I mean actually the 185 00:10:34,490 --> 00:10:37,880 scary part is I think the statistics for chlamydia 186 00:10:37,880 --> 00:10:39,860 sort-of look like the statistics from Covid 187 00:10:39,890 --> 00:10:44,420 currently. Just really scary. But this is what's 188 00:10:44,420 --> 00:10:47,480 reported. So we actually believe that a large 189 00:10:47,480 --> 00:10:50,400 number of these, people aren't even aware they have. 190 00:10:50,660 --> 00:10:52,940 So they don't get reported. They don't get 191 00:10:52,940 --> 00:10:54,940 diagnosed. And they certainly don't get treated 192 00:10:55,190 --> 00:10:57,720 and they're much more likely to spread. So anyway 193 00:10:57,730 --> 00:11:00,770 you know that this is a really common STI. It is 194 00:11:00,770 --> 00:11:03,620 very common in 15 to 24 year olds. It kind of 195 00:11:03,620 --> 00:11:06,590 showed you that picture. Sixty almost sixty two 196 00:11:06,590 --> 00:11:10,190 percent of these show up in men and women between 197 00:11:10,280 --> 00:11:15,470 15 and 24, so a huge population. AfricanAmericans, 198 00:11:15,470 --> 00:11:17,510 American Indian, Alaska Native, and Pacific 199 00:11:17,510 --> 00:11:21,200 Islanders by race have a higher risk factor. And 200 00:11:21,470 --> 00:11:26,660 they don't really know why that is. But that's the 201 00:11:26,660 --> 00:11:30,350 common trend. Multiracial Asians and native 202 00:11:30,350 --> 00:11:32,930 Hawaiians and Pacific Islanders have the highest 203 00:11:32,930 --> 00:11:36,620 rates by ethnicity. Again not necessarily like a 204 00:11:36,620 --> 00:11:41,630 specific cause. Always looking at 205 00:11:41,990 --> 00:11:45,320 medical inequality, the inability to get 206 00:11:45,320 --> 00:11:47,990 to proper medical care, or afford the proper 207 00:11:47,990 --> 00:11:51,890 medical care, plays a role in it. But it's kind 208 00:11:51,890 --> 00:11:54,320 of an interesting trend that these aren't 209 00:11:54,320 --> 00:11:57,100 necessarily the statistics that are always in that. 210 00:11:57,200 --> 00:12:01,320 Just letting you know what the chlamydia 211 00:12:01,580 --> 00:12:04,680 group make-up is. So how is it 212 00:12:04,680 --> 00:12:08,820 transmitted? It's very easily transmitted. It 213 00:12:08,820 --> 00:12:11,280 comes from dating--you're just hanging, 214 00:12:11,300 --> 00:12:13,200 having sex with somebody that you're 215 00:12:13,200 --> 00:12:16,590 dating. You've got some crazy hookup going on. 216 00:12:17,160 --> 00:12:19,770 Friends with benefits. But in this one you have to 217 00:12:19,770 --> 00:12:22,650 have some type of bodily fluid exchange. This is 218 00:12:22,650 --> 00:12:26,430 not a skin-to-skin contact disease. So there has 219 00:12:26,430 --> 00:12:31,020 to be an exchange of vaginal fluids, semen, saliva. 220 00:12:31,380 --> 00:12:35,190 in order for someone to become 221 00:12:35,250 --> 00:12:39,580 infected. So what are the symptoms. They're really 222 00:12:39,580 --> 00:12:42,430 pretty much the same for men and women in terms of 223 00:12:42,490 --> 00:12:46,900 overall, but it's fascinating that men have one 224 00:12:46,960 --> 00:12:48,700 that they complained about more than women and 225 00:12:48,790 --> 00:12:53,860 vice versa. Pain with urination is common in 226 00:12:53,860 --> 00:12:58,000 both men and women, however, when we hear pain with 227 00:12:58,000 --> 00:13:00,970 urination in a male, we tend much more to think of 228 00:13:00,970 --> 00:13:04,570 of chlamydia than we would 229 00:13:04,570 --> 00:13:08,260 necessarily in a female. In females, lots of things 230 00:13:08,260 --> 00:13:11,320 can cause pain with urination just because of the 231 00:13:11,320 --> 00:13:13,870 way our anatomy is put together. But when I hear 232 00:13:13,870 --> 00:13:16,600 it in guys I usually start to think "I wonder if 233 00:13:16,600 --> 00:13:19,780 they have chlamydia. Discharge can be seen in 234 00:13:19,780 --> 00:13:22,450 both male and females. However it's not the most 235 00:13:22,450 --> 00:13:26,200 common symptom we see. Bleeding after sex is the 236 00:13:26,200 --> 00:13:29,650 complaint most women come in with. They say "You know, 237 00:13:29,740 --> 00:13:31,960 I'm not having any pain but every time I have sex 238 00:13:31,960 --> 00:13:33,880 I have this weird bleeding and I'm not getting my 239 00:13:33,880 --> 00:13:36,880 period." So then we start to think maybe there's an 240 00:13:36,880 --> 00:13:40,840 STI going on. Pelvic pain which is also known as 241 00:13:40,840 --> 00:13:45,760 PID or pelvic inflammatory disease is a result of 242 00:13:45,760 --> 00:13:50,110 when chlamydia or any STI has been left untreated 243 00:13:50,110 --> 00:13:53,320 for too long. It means that the bacteria, because 244 00:13:53,320 --> 00:13:55,790 this is a bacterial virus that doesn't start with 245 00:13:55,790 --> 00:13:59,530 an H. Your bacterial STI, excuse me, doesn't start 246 00:13:59,530 --> 00:14:02,980 with an H. It means the bacteria kind-of climbed its way 247 00:14:02,980 --> 00:14:06,760 up into the other parts of the reproductive tract 248 00:14:06,790 --> 00:14:10,180 like the uterus or fallopian tubes. And this can 249 00:14:10,180 --> 00:14:13,080 cause an enormous amount of pain, infections, scarring... 250 00:14:13,630 --> 00:14:18,460 We can see infertility in this. Testicular pain is 251 00:14:18,490 --> 00:14:22,300 also known as epididymitis. In guys this is 252 00:14:22,300 --> 00:14:24,640 what happens when it's left untreated for too long. 253 00:14:25,000 --> 00:14:27,640 It tends to get all into all the 254 00:14:30,920 --> 00:14:35,330 vessels and wiring so to speak in the testicle, 255 00:14:35,690 --> 00:14:40,220 and it causes pain and swelling. So both pelvic 256 00:14:40,220 --> 00:14:43,550 inflammatory disease, or PID, and epididymitis, or 257 00:14:43,550 --> 00:14:47,180 testicular pain like that require high-level 258 00:14:47,180 --> 00:14:50,510 care. Sometimes they even require hospitalization 259 00:14:50,900 --> 00:14:54,860 because they need I.V. antibiotics rather than 260 00:14:54,860 --> 00:14:57,920 just plain oral antibiotics. It can be really 261 00:14:57,920 --> 00:14:59,990 painful, so we also want to make sure that people 262 00:14:59,990 --> 00:15:04,790 get pain control. The reality is, however even 263 00:15:04,790 --> 00:15:07,520 though those symptoms are possible, up to 70% 264 00:15:07,520 --> 00:15:10,940 of men and 90% of women won't have a 265 00:15:10,940 --> 00:15:13,780 single symptom. So you can see how easily it would be 266 00:15:13,780 --> 00:15:16,760 to be to spread. It's like if you don't have a sore 267 00:15:16,760 --> 00:15:19,250 throat, you don't tend to go to the doctor and say 268 00:15:19,250 --> 00:15:22,250 I think I have strep. So if you don't have 269 00:15:22,250 --> 00:15:25,760 a symptom why would you go and get tested. Because 270 00:15:25,760 --> 00:15:29,870 now you know that depending on your sex that 70% 271 00:15:29,870 --> 00:15:33,260 of men and 90% of women may have no 272 00:15:33,260 --> 00:15:35,510 signs and symptoms at all. So it's important to 273 00:15:35,510 --> 00:15:38,330 get tested if you're sexually active at least once 274 00:15:38,330 --> 00:15:43,010 a year. Testing and treatment: Generally ,in our 275 00:15:43,010 --> 00:15:45,200 office, we do a urine test. All you have to do is 276 00:15:45,200 --> 00:15:48,320 pee in a cup and we can send that up for testing. It 277 00:15:48,320 --> 00:15:52,170 works really great, and not too embarrassing. 278 00:15:52,200 --> 00:15:53,940 Nobody has to go with you or see anything. 279 00:15:54,630 --> 00:15:56,790 Occasionally, if we think it's in a different part 280 00:15:56,790 --> 00:15:59,430 of the body, because you can get chlamydia in other parts 281 00:15:59,430 --> 00:16:04,710 of the body like the eyes, or in the anal tracts, 282 00:16:05,010 --> 00:16:07,320 different spots, we will do what they call 283 00:16:07,500 --> 00:16:10,230 a culture, which is like taking a little Q-tip and 284 00:16:10,230 --> 00:16:12,600 getting some of the cells and maybe some of the 285 00:16:12,600 --> 00:16:15,210 bacteria off the walls of the environment and 286 00:16:15,210 --> 00:16:18,900 sending those to the lab. And the third way is on 287 00:16:18,900 --> 00:16:21,990 a PAP smear. Guys you don't get a pap smear--at 288 00:16:21,990 --> 00:16:26,220 least not yet. So it can be done when a woman goes 289 00:16:26,220 --> 00:16:30,490 for her annual exam. It can be done simultaneously, 290 00:16:30,990 --> 00:16:33,660 but generally in our office we do it 291 00:16:33,660 --> 00:16:36,540 through a urine test. If somebody were to come 292 00:16:36,540 --> 00:16:40,140 back positive we want everybody to get antibiotics. 293 00:16:40,320 --> 00:16:42,150 Obviously the patient that we're taking care of 294 00:16:42,150 --> 00:16:46,200 needs antibiotics. And any partner that they've 295 00:16:46,200 --> 00:16:50,220 had contact with within three 296 00:16:50,220 --> 00:16:55,200 months should be treated with antibiotics. So 297 00:16:55,320 --> 00:16:58,290 pelvic inflammatory disease and epididymitis can 298 00:16:58,290 --> 00:17:00,450 require hospitalization. We talked about 299 00:17:00,450 --> 00:17:04,890 that. And newborns, just by nature, when a baby 300 00:17:04,890 --> 00:17:07,410 is born a few minutes after birth, they put a 301 00:17:07,410 --> 00:17:10,110 little bit of eye drops in the baby's eyes and 302 00:17:10,110 --> 00:17:13,410 that's in case mom had chlamydia during birth and 303 00:17:13,410 --> 00:17:16,860 no one knew it. So that prevents chlamydia in the 304 00:17:16,860 --> 00:17:19,740 eyes of the newborn and prevents blindness. So 305 00:17:19,940 --> 00:17:21,060 it's a common practice. 306 00:17:23,790 --> 00:17:26,790 Chlamydia was the easy one, because we 307 00:17:26,790 --> 00:17:28,770 know that it can be treated with antibiotics and 308 00:17:28,770 --> 00:17:31,410 it goes away but then we're back into those 309 00:17:31,410 --> 00:17:33,930 viruses. Remember we talked about viruses start 310 00:17:33,930 --> 00:17:37,170 with the letter H? So let's start with our first 311 00:17:37,170 --> 00:17:40,260 one, and one of our most common ones which is HPV 312 00:17:40,350 --> 00:17:43,770 or human papilloma virus, also known as genital 313 00:17:43,770 --> 00:17:49,830 warts. Very, very, very common, not only the United 314 00:17:49,830 --> 00:17:53,010 States, but the world in general. Seventy-nine 315 00:17:53,010 --> 00:17:56,790 million Americans, mostly in their late teens and 316 00:17:56,790 --> 00:17:59,610 early 20s are infected with HPV at least at some 317 00:17:59,610 --> 00:18:02,820 point in their life. There're 40 different 318 00:18:02,820 --> 00:18:05,220 strains. There're actually a lot more than 40 but 319 00:18:05,220 --> 00:18:07,650 there're 40 that we really identify with, and we 320 00:18:07,650 --> 00:18:10,440 kind of know what their process is--what those strains 321 00:18:10,440 --> 00:18:16,640 do. 14 out of those 40 are cancer-causing. So what 322 00:18:16,640 --> 00:18:19,730 does that mean? It means that when somebody gets 323 00:18:20,360 --> 00:18:24,440 cancer specifically, an oral cancer, or an anal 324 00:18:24,440 --> 00:18:29,150 cancer, penile cancer, cervical cancer...that a lot of 325 00:18:29,150 --> 00:18:33,980 times we know that it's generally caused by HPV. 326 00:18:34,490 --> 00:18:37,970 However it doesn't work both ways. Just because 327 00:18:38,030 --> 00:18:41,090 they find that cancer strain in your body doesn't 328 00:18:41,090 --> 00:18:44,690 mean it will cause cancer. A lot of people are 329 00:18:44,690 --> 00:18:48,350 able to shed this virus and do just fine with it. 330 00:18:48,380 --> 00:18:51,290 Otherwise a lot of us obviously 79 million 331 00:18:51,290 --> 00:18:53,570 Americans have it. We'd have a lot more cancer 332 00:18:53,570 --> 00:18:57,140 than we do, which thankfully we don't. So while we 333 00:18:57,140 --> 00:19:00,980 know that cancer can be a result of HPV it's not 334 00:19:01,070 --> 00:19:06,590 always. The great part is that 90% of HPV, 335 00:19:06,800 --> 00:19:09,920 90% of those people that are diagnosed 336 00:19:09,920 --> 00:19:12,680 with it, will clear the body of it within two years without 337 00:19:12,770 --> 00:19:15,940 any medical intervention, which is a lot of the reason [why] 338 00:19:15,950 --> 00:19:19,700 testing and things like that aren't even done 339 00:19:19,760 --> 00:19:24,380 until somebody turns 21, because we know that 340 00:19:24,380 --> 00:19:27,140 the body especially, as a young person, does a 341 00:19:27,140 --> 00:19:29,510 really great job of taking care of this virus all 342 00:19:29,510 --> 00:19:32,870 by itself. However, that does not mean that you 343 00:19:32,870 --> 00:19:34,880 can't get it again. And we're going talk about the 344 00:19:34,880 --> 00:19:36,170 vaccine in just a second. 345 00:19:38,270 --> 00:19:42,560 You can actually see oral HPV in the picture on 346 00:19:42,560 --> 00:19:45,200 the right and they have it in the very back of 347 00:19:45,200 --> 00:19:49,410 their throat, and that's generally caused by, 348 00:19:49,430 --> 00:19:53,660 you can guess, oral sex. That's the transmission 349 00:19:53,660 --> 00:19:58,850 mode. It can be skin to skin contact, but 350 00:19:58,970 --> 00:20:02,390 obviously, if it's way deep inside, you're 351 00:20:02,390 --> 00:20:05,600 not going to have skin to skin contact, so it's 352 00:20:05,660 --> 00:20:10,250 transmitted with with sexual intercourse. So 353 00:20:10,250 --> 00:20:14,690 there's actually two types of HPV. The first one 354 00:20:14,690 --> 00:20:17,690 is what they call a low risk type. And it's kind 355 00:20:17,690 --> 00:20:20,450 of the type we say we see on the external parts of 356 00:20:20,450 --> 00:20:23,630 bodies. So generally we see these on the external 357 00:20:23,630 --> 00:20:26,540 part of the penis, testicles ,on the outside of the 358 00:20:26,570 --> 00:20:30,050 anus, on the lips of the vagina. The high risk 359 00:20:30,050 --> 00:20:33,890 kinds, which are highly contagious, are generally 360 00:20:33,890 --> 00:20:36,740 found on the internal parts of our body. So the 361 00:20:36,740 --> 00:20:39,230 internal parts of our cervix, internal part of our 362 00:20:39,230 --> 00:20:44,780 penis, anus, and then it can be the oral orifices. 363 00:20:44,780 --> 00:20:47,540 And you can see obviously in this one, in the back of the 364 00:20:47,540 --> 00:20:53,160 throat. What are the symptoms? Generally the 365 00:20:53,160 --> 00:20:55,470 external kind, the kind that don't cause a whole 366 00:20:55,470 --> 00:20:58,440 lot of problems just look like warts. If you've 367 00:20:58,440 --> 00:21:00,470 ever seen a wart before, like when you were 368 00:21:00,480 --> 00:21:03,420 in elementary school, and you ran around going "Oh they 369 00:21:03,420 --> 00:21:06,330 have a wart! They have a wart!" They're kind of bumpy. 370 00:21:06,390 --> 00:21:08,970 They're usually on the smaller side. They're flesh 371 00:21:09,000 --> 00:21:11,520 colored. They don't really hurt--not painful. They 372 00:21:11,520 --> 00:21:13,800 just kind of sit there. And a lot of times they 373 00:21:13,800 --> 00:21:16,500 just come and go at their own their own pace. 374 00:21:17,010 --> 00:21:19,590 Obviously the ones at the top my pictures are 375 00:21:19,590 --> 00:21:22,710 a little more graphic, and clearly, again, to drive 376 00:21:22,710 --> 00:21:26,190 home the point. You can see that these can 377 00:21:26,190 --> 00:21:28,890 actually clear themselves and go away but they can 378 00:21:28,890 --> 00:21:31,800 also do the reverse which is get huge and get in 379 00:21:31,800 --> 00:21:35,610 the way of being able to go to the bathroom or 380 00:21:35,610 --> 00:21:39,900 swallow or have sex. Lots of things that they can 381 00:21:39,900 --> 00:21:43,980 give away if they're left untreated. In terms 382 00:21:43,980 --> 00:21:49,560 of testing, the only testing available is actually 383 00:21:49,560 --> 00:21:51,950 a pap smear which of course we don't do on men, 384 00:21:51,960 --> 00:21:55,770 remember? However they are starting to do some pap 385 00:21:55,770 --> 00:22:00,330 smears on men in the anus, especially for gay men 386 00:22:01,110 --> 00:22:03,450 at high risk. But at this point that's not a 387 00:22:03,450 --> 00:22:06,390 standard. We primarily do pap smears on women. And 388 00:22:06,390 --> 00:22:10,920 not until the age of 21. So the other thing we can 389 00:22:10,920 --> 00:22:12,660 do is that if somebody comes in and they say "I 390 00:22:12,660 --> 00:22:14,490 have these really weird bumps. I've had them for a 391 00:22:14,490 --> 00:22:16,380 month or so. They don't really hurt. They're kind 392 00:22:16,380 --> 00:22:19,620 of ugly. I just want them to go away," we can diagnose it 393 00:22:19,620 --> 00:22:24,690 just by visualization. But sometimes, guys will 394 00:22:24,690 --> 00:22:26,430 come in and they'll be like "Hi. You know I have 395 00:22:26,430 --> 00:22:29,430 this new partner and I really want to be like safe, 396 00:22:29,430 --> 00:22:32,430 and sure that I got all my testing, and I want to make 397 00:22:32,430 --> 00:22:35,460 sure I get HPV testing." And I have to say "Sorry, 398 00:22:35,460 --> 00:22:39,390 guys, there's no HPV testing yet." I'm sure it's on 399 00:22:39,390 --> 00:22:42,030 the horizon but we're not quite there yet. So how 400 00:22:42,030 --> 00:22:45,240 do we treat these things. The external ones we 401 00:22:45,240 --> 00:22:50,490 freeze them with a very cold liquid nitrogen. This 402 00:22:50,490 --> 00:22:53,760 is Moorpark College, and not USC, so we don't have 403 00:22:53,760 --> 00:22:56,400 laser removal here. The only laser 404 00:22:56,400 --> 00:22:59,520 removal I have is my pointer to go on 405 00:22:59,520 --> 00:23:02,040 the board. So we have no lasers here but that is a 406 00:23:02,040 --> 00:23:04,890 possibility. And sometimes we will use them like a 407 00:23:04,890 --> 00:23:08,820 chemical to help kind of burn them off. Obviously 408 00:23:08,820 --> 00:23:11,520 if they're internal and cancer causing then that's 409 00:23:11,520 --> 00:23:13,890 a cancer treatment in and of itself, and obviously 410 00:23:13,890 --> 00:23:17,790 we don't treat those here at Moorpark. A vaccine came out in 411 00:23:17,790 --> 00:23:22,170 2006, and currently the recommendation is in women 412 00:23:22,180 --> 00:23:25,230 the ages of 11t-26, and men, 413 00:23:25,230 --> 00:23:29,790 11-26. The CDC in 2018 did approve 414 00:23:29,850 --> 00:23:32,940 this vaccine for ages27-45, 415 00:23:32,940 --> 00:23:36,990 depending on your risk factors. The vaccine, when 416 00:23:36,990 --> 00:23:40,020 it came out was really only tested on individuals 417 00:23:40,020 --> 00:23:42,750 between 11-26, so that's what the 418 00:23:43,890 --> 00:23:47,850 FDA approved, but they're recognizing that people 419 00:23:47,850 --> 00:23:50,640 that are older still have multiple sexual partners 420 00:23:50,640 --> 00:23:52,620 and they're still at risk for this and could 421 00:23:52,620 --> 00:23:55,170 benefit from this vaccine, so they just started 422 00:23:55,200 --> 00:23:58,740 opening that up. If you don't think you've gotten 423 00:23:58,740 --> 00:24:02,250 this vaccine I highly recommend you go get it and 424 00:24:02,250 --> 00:24:04,530 you want to do it before you turn 26 because your 425 00:24:04,530 --> 00:24:07,410 insurance will pay for it if you have medical insurance. 426 00:24:08,010 --> 00:24:11,310 It's a covered requirement under the Affordable 427 00:24:11,310 --> 00:24:14,400 Care Act. And otherwise if you have to pay cash 428 00:24:14,400 --> 00:24:16,350 for it it runs, at least the last time I checked, 429 00:24:16,440 --> 00:24:18,480 about $175 per 430 00:24:18,480 --> 00:24:21,480 injection, and it is three injections. So I can 431 00:24:21,480 --> 00:24:23,970 think of a way better ways to spend that kind of money. 432 00:24:24,840 --> 00:24:28,440 If you are under the age of 26, go get that now 433 00:24:28,440 --> 00:24:30,990 while you still can get it for free. We know that 434 00:24:30,990 --> 00:24:34,920 the vaccine has decreased the incidence of HPV by 435 00:24:34,920 --> 00:24:38,100 50 percent in the last 10 years, which when you 436 00:24:38,100 --> 00:24:40,410 reduce that, you're not just reducing the external 437 00:24:40,410 --> 00:24:43,530 types, but we're also reducing cancer. So this is 438 00:24:43,530 --> 00:24:46,830 actually marketed as one of the first cancer 439 00:24:46,950 --> 00:24:50,190 reducing vaccines or cancer prevention vaccines on 440 00:24:50,190 --> 00:24:53,970 the market, which is a huge breakthrough. So we 441 00:24:53,970 --> 00:24:56,670 know that the more we get people vaccinated and 442 00:24:56,670 --> 00:24:59,850 the less this virus has a chance to circulate the 443 00:24:59,850 --> 00:25:03,060 greater the chance we have to eradicate specific 444 00:25:03,060 --> 00:25:05,610 cancers, specifically cervical cancer, in 445 00:25:05,610 --> 00:25:10,200 relationship to HPV which is huge, a huge amazing 446 00:25:10,200 --> 00:25:10,460 thing. 447 00:25:12,460 --> 00:25:16,750 We're on the next one. We talked about chlamydia, talked 448 00:25:16,750 --> 00:25:19,780 about we talked about HPV and 449 00:25:19,780 --> 00:25:23,710 now we're onto herpes. Remember, it's an H. Virus. 450 00:25:23,980 --> 00:25:26,290 It's not one we cure but it is one we can manage 451 00:25:26,290 --> 00:25:30,190 and treat. So herpes actually is a very large 452 00:25:30,190 --> 00:25:33,130 family. I don't know whether they came from Italy 453 00:25:33,130 --> 00:25:35,740 or where they came from. Just kidding. But they 454 00:25:35,740 --> 00:25:38,020 just tend to have a lot of cousins and brothers 455 00:25:38,020 --> 00:25:41,170 and sisters. So when people say I have herpes they 456 00:25:41,170 --> 00:25:44,020 can mean a lot of different things. 457 00:25:44,020 --> 00:25:47,260 These are all different types of herpes. 458 00:25:48,160 --> 00:25:49,930 And some of them are the same. And some of them 459 00:25:49,930 --> 00:25:53,080 are a little different. So let's talk about which 460 00:25:53,080 --> 00:25:56,950 ones are which. So when we're talking about herpes 461 00:25:56,950 --> 00:26:00,820 Type 1, we generally are talking about cold sores. 462 00:26:01,030 --> 00:26:05,170 So you can see that the lower right hand corner is 463 00:26:05,710 --> 00:26:08,950 a young person with some type of little sore on 464 00:26:08,950 --> 00:26:12,280 their lip. And this is generally referred to as 465 00:26:12,280 --> 00:26:17,410 cold sores or Herpes Type 1. It is caused by 466 00:26:17,440 --> 00:26:21,640 a herpes virus but not all the herpes viruses are 467 00:26:21,640 --> 00:26:24,430 the same. It's estimated that about 80 percent of 468 00:26:24,430 --> 00:26:28,210 the population actually carries the virus for 469 00:26:28,210 --> 00:26:30,940 Herpes Type 1 in their system. But not everybody 470 00:26:30,940 --> 00:26:33,460 shows the symptoms. Some people show it more than 471 00:26:33,460 --> 00:26:35,710 others. And it really just depends on immune 472 00:26:35,710 --> 00:26:39,840 system and genetics and things like that. Herpes 473 00:26:39,840 --> 00:26:42,240 Type 2. You can actually see in the upper left 474 00:26:42,240 --> 00:26:45,450 hand corner and that we tend to think of as 475 00:26:45,450 --> 00:26:48,060 genital herpes. We tend to see it more 476 00:26:48,060 --> 00:26:51,750 in the genital region, in the anal region. 477 00:26:52,320 --> 00:26:55,440 And it's it's more the one that I think people 478 00:26:55,440 --> 00:26:58,440 think of as an STI, even though Herpes Type 1 479 00:26:58,440 --> 00:27:01,350 can be sexually transmitted. So if you think of 480 00:27:01,350 --> 00:27:04,110 the number "69" you can see how 481 00:27:04,110 --> 00:27:06,570 Herpes Type 1 and Herpes Type 2 can be 482 00:27:06,570 --> 00:27:09,750 transmitted to different places. They are 483 00:27:09,750 --> 00:27:12,720 interchangeable. However one of the interesting 484 00:27:12,720 --> 00:27:15,900 things is that Herpes Type 1, or cold sores, 485 00:27:16,020 --> 00:27:18,660 doesn't really like to live in the genital region 486 00:27:18,750 --> 00:27:22,440 and Herpes Type 2, genital herpes, doesn't really 487 00:27:22,440 --> 00:27:24,450 like to live in oral region. We're not really sure 488 00:27:24,450 --> 00:27:27,480 why that is. They will do it. They just don't seem 489 00:27:27,480 --> 00:27:31,620 to have the same strength and recurrence that they 490 00:27:31,620 --> 00:27:35,580 do when they live in their "proper" zone. Varicella is also a 491 00:27:35,580 --> 00:27:39,180 herpes virus. So varicella is chickenpox. So you 492 00:27:39,180 --> 00:27:41,220 can see the little boy up in the right hand corner 493 00:27:41,220 --> 00:27:43,860 scratching his neck. We all 494 00:27:43,860 --> 00:27:47,700 remember those days. I do. That's also caused by 495 00:27:47,700 --> 00:27:51,510 herpes virus. And the older lady down in the in 496 00:27:51,510 --> 00:27:53,430 the lower left hand corner has what they call 497 00:27:53,430 --> 00:27:57,000 shingles which is also herpes virus. It's actually 498 00:27:57,000 --> 00:28:01,140 related closer to chickenpox but it's a 499 00:28:01,140 --> 00:28:03,480 reoccurrence, generally happens in people over the 500 00:28:03,480 --> 00:28:06,720 age of 50. Not always--it can happen in young people-- 501 00:28:07,170 --> 00:28:09,720 not sexually transmitted. But just thought I'd 502 00:28:09,720 --> 00:28:12,770 tell you and show you the different variants in 503 00:28:12,960 --> 00:28:14,030 types of herpes. 504 00:28:16,380 --> 00:28:21,090 Shows you which ones are which. What are 505 00:28:21,090 --> 00:28:25,200 the facts about herpes? About 12 percent of people 506 00:28:25,200 --> 00:28:30,600 14 - 49 have a Herpes Type 2. So we're talking 507 00:28:30,600 --> 00:28:33,120 about genital herpes. Twelve percent is a pretty 508 00:28:33,120 --> 00:28:37,560 high percentage, when you think about that. In 509 00:28:38,160 --> 00:28:40,470 oral herpes, the type 1, the cold sores one, is 510 00:28:40,770 --> 00:28:43,500 typically acquired in childhood. 511 00:28:44,040 --> 00:28:47,250 Excuse me in childhood. You're not really sure 512 00:28:47,250 --> 00:28:49,470 why that is. You can get it later on in life, no 513 00:28:49,470 --> 00:28:51,720 question, but we tend to see those infections 514 00:28:51,720 --> 00:28:55,350 starting early on in childhood probably because 515 00:28:55,710 --> 00:28:58,740 kids are much more likely to share glasses and 516 00:28:58,740 --> 00:29:02,100 cups and different things especially with parents 517 00:29:02,100 --> 00:29:04,680 or grandparents who might have already acquired 518 00:29:04,680 --> 00:29:10,020 the virus and have it in their system. We know that 519 00:29:10,740 --> 00:29:13,800 cold sores our highest among Mexican-Americans and 520 00:29:13,800 --> 00:29:17,100 lowest among white people, which seems really funny 521 00:29:17,100 --> 00:29:19,260 to me because I sure see an awful lot of non- 522 00:29:19,260 --> 00:29:22,260 Hispanic white people with type one herpes. But 523 00:29:22,380 --> 00:29:24,810 that's statistically what they're showing. Type 524 00:29:24,810 --> 00:29:28,890 two is highest among Hispanic black and lowest 525 00:29:28,890 --> 00:29:32,520 among non-Hispanic Asian. So you can see it really 526 00:29:32,520 --> 00:29:37,500 does kind of go along ethnic and racial guidelines. 527 00:29:37,610 --> 00:29:40,050 So definitely if you fall in one of those 528 00:29:40,050 --> 00:29:41,760 categories it's really a time you want to make 529 00:29:41,760 --> 00:29:44,640 sure you get tested, make sure you get safe care, 530 00:29:44,640 --> 00:29:49,320 and use those condoms. Prevalence of both Herpes 531 00:29:49,320 --> 00:29:52,020 Type 1 and Herpes Type 2 increase with age. 532 00:29:52,110 --> 00:29:54,980 Even though we know Herpes Type 1 tends to show up in childhood. 533 00:29:57,600 --> 00:30:00,930 How is it transmitted? It's generally transmitted 534 00:30:00,930 --> 00:30:02,640 through, and we're going talk about Herpes Type 535 00:30:02,640 --> 00:30:05,100 2 with this one, because we don't need to get 536 00:30:05,100 --> 00:30:06,840 into all those other ones. But when we're talking 537 00:30:06,840 --> 00:30:11,520 specifically about the STI, Herpes Type 2 is the one 538 00:30:11,520 --> 00:30:13,780 we're talking about, and it's generally spreads 539 00:30:13,810 --> 00:30:17,430 from vaginal, anal, and oral sex. It can be 540 00:30:17,430 --> 00:30:19,710 spread by somebody who's just touching somebody. 541 00:30:19,830 --> 00:30:24,180 You have a herpes infection and somebody with a 542 00:30:24,180 --> 00:30:26,130 wound on their finger touches it. It can be 543 00:30:26,130 --> 00:30:29,370 transmitted that's opening or that wound that does 544 00:30:29,370 --> 00:30:32,850 happen. The thing that's really scary about herpes 545 00:30:32,850 --> 00:30:35,580 is that it can be transmitted without anybody ever 546 00:30:35,580 --> 00:30:39,210 knowing they ever had it. So it means the virus is 547 00:30:39,210 --> 00:30:43,140 what they call "shed" or "given off," even when people 548 00:30:43,170 --> 00:30:46,440 don't have signs and symptoms, which is why we see 549 00:30:46,440 --> 00:30:50,250 such an increased spread of herpes going on, It's 550 00:30:50,250 --> 00:30:52,650 clearly a high risk when somebody has those 551 00:30:52,650 --> 00:30:56,220 symptoms, but we know now that, even without 552 00:30:56,220 --> 00:30:59,250 symptoms, there is that risk. So you are aware of 553 00:30:59,250 --> 00:31:01,620 that and making sure you have good communication 554 00:31:01,620 --> 00:31:04,410 with your partner, and you're using those condoms 555 00:31:04,650 --> 00:31:09,310 is really vital to slow this down. What are the 556 00:31:09,310 --> 00:31:13,990 symptoms? People who have had herpes in the past 557 00:31:14,300 --> 00:31:16,330 will generally tell you they kind of have like 558 00:31:16,330 --> 00:31:19,030 this precursor, They kind-of know they get this 559 00:31:19,030 --> 00:31:21,940 little itching or burning or tingling before the 560 00:31:21,940 --> 00:31:24,340 blisters ever appear. So they may know they're 561 00:31:24,340 --> 00:31:28,030 coming on even before they have an outbreak. The 562 00:31:28,030 --> 00:31:31,060 blisters themselves last about 7-10 days 563 00:31:31,090 --> 00:31:33,190 and then they go away. Whether we treat them or 564 00:31:33,190 --> 00:31:37,420 not they do go away. The blisters do go away but 565 00:31:37,420 --> 00:31:39,430 they are still in the system. We know that the 566 00:31:39,430 --> 00:31:43,300 virus itself remains in the system. And we talked 567 00:31:43,300 --> 00:31:46,030 about shedding without an outbreak. In terms of 568 00:31:46,030 --> 00:31:49,930 testing and treatment, examination is probably one 569 00:31:49,930 --> 00:31:53,680 of the best. A trained eye can really identify, "Wow, 570 00:31:53,710 --> 00:31:56,290 this looks like a herpes lesion. 571 00:31:56,320 --> 00:31:58,870 Let's get some more information. And we can do a 572 00:31:58,870 --> 00:32:01,450 culture where we actually take a little Q-tip, touch 573 00:32:01,450 --> 00:32:05,470 that lesion and send it off to the lab where they 574 00:32:05,470 --> 00:32:07,510 can grow it out and tell us exactly what it is. 575 00:32:07,990 --> 00:32:10,690 There is also a blood test on the market. Not the 576 00:32:10,690 --> 00:32:14,740 most reliable test. We use it occasionally to kind 577 00:32:14,740 --> 00:32:18,040 of confirm diagnosis of something we're not quite 578 00:32:18,040 --> 00:32:20,560 sure of. Or sometimes somebody will come in and 579 00:32:20,560 --> 00:32:23,680 say, "Oh I think I was exposed. I just need to know. 580 00:32:23,680 --> 00:32:26,470 I have to know." We'll run a blood test with the 581 00:32:26,470 --> 00:32:29,770 caveat that it's not the most reliable. It doesn't give us a 582 00:32:29,770 --> 00:32:33,310 whole lot of information because it can 583 00:32:33,310 --> 00:32:36,820 change really quickly. So these lesions tend to be 584 00:32:36,820 --> 00:32:39,580 very painful especially in the first outbreak, so 585 00:32:39,580 --> 00:32:41,050 people are kind of miserable and kind of 586 00:32:41,050 --> 00:32:43,240 uncomfortable. They want something done about 587 00:32:43,240 --> 00:32:47,200 them. We do use oral medication to decrease the 588 00:32:47,200 --> 00:32:50,080 number of outbreaks. Some people have outbreaks 589 00:32:50,110 --> 00:32:52,570 more than once month. Some people have one 590 00:32:52,570 --> 00:32:54,100 outbreak and never have another one in their 591 00:32:54,100 --> 00:32:57,490 lifetime. And we also know that oral medications 592 00:32:57,490 --> 00:32:59,980 can reduce the transmission--that shedding that 593 00:32:59,980 --> 00:33:06,260 goes on even when there're no lesions present. 594 00:33:06,260 --> 00:33:08,560 This isn't curable but we do know that we can 595 00:33:08,560 --> 00:33:11,020 manage it and treat it and people can go on and 596 00:33:11,020 --> 00:33:12,760 live normal and healthy lives. 597 00:33:15,110 --> 00:33:18,040 What about telling your partner? That's a hard thing. 598 00:33:18,040 --> 00:33:20,380 You find out you have an STI, and you feel bad 599 00:33:20,380 --> 00:33:23,440 enough and you go, "This really sucks." But 600 00:33:23,620 --> 00:33:26,200 the reality is that you really do need to let 601 00:33:26,200 --> 00:33:28,390 your partner know because you would want somebody 602 00:33:28,390 --> 00:33:31,390 to let you know. We want them to get tested and 603 00:33:31,390 --> 00:33:33,790 treated to make sure that A, they're not spreading 604 00:33:33,790 --> 00:33:36,370 it any further and to prevent any long term 605 00:33:36,370 --> 00:33:37,060 effects. 606 00:33:42,910 --> 00:33:46,270 Who does a partner include? Anyone you're having 607 00:33:46,270 --> 00:33:49,450 sex with and that includes oral, virginal, anal sex. 608 00:33:49,870 --> 00:33:52,330 And anybody that you might be sharing I.V. drugs 609 00:33:52,330 --> 00:33:55,930 with sharing needles, syringes, or other injectable 610 00:33:55,930 --> 00:33:58,930 equipment. So it's really important that all those 611 00:33:58,930 --> 00:34:02,380 people get tested and get that treatment so that 612 00:34:02,380 --> 00:34:04,450 we don't have long term problems and we can start 613 00:34:04,450 --> 00:34:05,960 to bring those numbers back down. 614 00:34:08,090 --> 00:34:09,920 How do you tell your partner? That's a good 615 00:34:09,920 --> 00:34:12,620 question. Some of us are pretty good 616 00:34:12,620 --> 00:34:14,960 at communicating and are able to call up and say, 617 00:34:14,990 --> 00:34:17,900 "Hey, look at you know what--know we haven't had sex 618 00:34:17,900 --> 00:34:20,390 in the last week, but I want to let you know that 619 00:34:20,390 --> 00:34:23,810 today I tested positive for whatever the STD is. 620 00:34:24,920 --> 00:34:29,010 There's also a couple of e-mail sites, STDs.com 621 00:34:29,060 --> 00:34:31,700 which will send an anonymous e-mail. But 622 00:34:31,700 --> 00:34:35,390 you gotta know their email. tellyourpartner.org 623 00:34:35,420 --> 00:34:38,240 Dontspreadit.com. And there are a 624 00:34:38,240 --> 00:34:41,720 couple of apps that came out. I think it's really 625 00:34:41,720 --> 00:34:45,230 fascinating. I actually I was playing with one and 626 00:34:45,680 --> 00:34:47,480 you'll only get like three months for free and 627 00:34:47,480 --> 00:34:49,550 then you have to pay like five dollars a month for 628 00:34:49,550 --> 00:34:52,280 it. So you're gonna get your STD get it in the 629 00:34:52,280 --> 00:34:54,500 first three months, get it out of your system, 630 00:34:54,770 --> 00:34:56,720 because then you have to pay every time you want 631 00:34:56,720 --> 00:34:59,240 to use your app. Anyway, I thought that was 632 00:34:59,240 --> 00:35:03,410 fascinating. Times have changed. These are great 633 00:35:03,410 --> 00:35:06,830 resources, if you know somebody's email address. 634 00:35:06,920 --> 00:35:07,490 Otherwise, 635 00:35:09,590 --> 00:35:12,710 if somebody was diagnosed with an STD and they 636 00:35:12,710 --> 00:35:15,770 were a victim of assault or rape, some type of 637 00:35:15,770 --> 00:35:19,880 abuse, both the college and Ventura County Public 638 00:35:19,880 --> 00:35:23,900 Health will help in those circumstances. We would 639 00:35:23,900 --> 00:35:27,470 never want somebody who was in a dangerous or 640 00:35:27,500 --> 00:35:30,170 unethical position to have to tell somebody that 641 00:35:30,520 --> 00:35:33,320 that they have an STD, so there are exceptions 642 00:35:33,320 --> 00:35:36,380 to that rule. But in general, we want you guys 643 00:35:36,380 --> 00:35:41,030 to be responsible and do that yourself. So, you've 644 00:35:41,030 --> 00:35:43,490 heard a gazillion times, you know condoms are 645 00:35:43,490 --> 00:35:46,310 the only thing that stop bodily fluids. The 646 00:35:46,370 --> 00:35:49,070 only contraception that reduces both the 647 00:35:49,070 --> 00:35:52,820 transmission of HIV, STIs, and pregnancy. No other 648 00:35:52,850 --> 00:35:56,420 contraception can 649 00:35:56,420 --> 00:35:59,300 make that statement, so it's a really great resource. 650 00:35:59,600 --> 00:36:03,710 We know that latex condoms are the best. And this 651 00:36:03,710 --> 00:36:06,530 is primarily because the pores in the latex condom are 652 00:36:06,530 --> 00:36:11,540 smaller than the pores in things like lambskin or 653 00:36:12,290 --> 00:36:16,550 any type of man-made vinyl, anything like that. 654 00:36:17,270 --> 00:36:19,610 However, if you have an allergy to latex 655 00:36:19,880 --> 00:36:22,430 something's better than nothing, so just keep that 656 00:36:22,430 --> 00:36:26,670 in mind. Polyurethane condoms are generally a 657 00:36:26,720 --> 00:36:29,090 female condom and you can see the picture. 658 00:36:29,340 --> 00:36:31,310 It shows you this is what the packaging 659 00:36:31,310 --> 00:36:33,860 looks like when you take it out for a female 660 00:36:33,860 --> 00:36:36,230 condom, this is what it looks like. That's 661 00:36:36,230 --> 00:36:39,050 like a huge condom, so guys if you're can't 662 00:36:39,050 --> 00:36:43,010 fit in regular condom ask your girl to get a 663 00:36:43,010 --> 00:36:48,740 female condom and that will fit handily. I 664 00:36:48,740 --> 00:36:52,190 don't recommend these in gay sex and anal sex. 665 00:36:52,460 --> 00:36:53,840 That's not what these are designed for. And you 666 00:36:53,900 --> 00:36:57,350 certainly don't want to get this stuck. 667 00:36:57,740 --> 00:36:59,930 The bottom right hand corner is what it looks 668 00:36:59,930 --> 00:37:02,710 like from the vagina, looking at the vagina 669 00:37:02,950 --> 00:37:05,090 (somebody's hand, obviously), but that's what it would 670 00:37:05,090 --> 00:37:08,990 look like. And then you'd have sex. It is an 671 00:37:09,020 --> 00:37:12,230 option. You never want to use this with a male 672 00:37:12,230 --> 00:37:14,930 condom at the same time. But this is a great way 673 00:37:14,930 --> 00:37:18,020 for women to to always have that backup for 674 00:37:18,020 --> 00:37:20,860 themselves and say hey you know what sex. But do 675 00:37:20,860 --> 00:37:22,940 know this is polyurethane. It's not as 676 00:37:22,940 --> 00:37:27,350 protective as a latex condom. But like we said-- 677 00:37:27,620 --> 00:37:31,670 this is the safest we can do sometimes. Dental 678 00:37:31,670 --> 00:37:36,110 dams are generally a small square of latex or 679 00:37:36,110 --> 00:37:37,310 vinyl or 680 00:37:39,440 --> 00:37:41,900 even saran wrap that are laid over the vagina or 681 00:37:41,900 --> 00:37:46,670 the anus to give oral sex or rimming. It's just a 682 00:37:46,670 --> 00:37:49,250 barrier method. It's kind of like a condom but 683 00:37:49,400 --> 00:37:53,870 it's flat. So you can see how it's nice and easily 684 00:37:54,280 --> 00:37:56,660 just the piece of plastic. You can cut a condom 685 00:37:56,750 --> 00:38:00,170 and make a piece. You can use Saran Wrap. Dollar 686 00:38:00,170 --> 00:38:03,410 Store Saran Wrap: 600 yards for 687 00:38:03,410 --> 00:38:06,200 a buck that will last you a while. And if you 688 00:38:06,530 --> 00:38:08,810 want it for Halloween they're special colors to 689 00:38:08,810 --> 00:38:11,840 match your outfit or whatever. Just don't get 690 00:38:11,880 --> 00:38:14,120 the the microwave type because the pores are 691 00:38:14,120 --> 00:38:16,670 different in a microwave type and can actually 692 00:38:17,030 --> 00:38:20,000 increase the risk of STIs. Lots of options 693 00:38:20,000 --> 00:38:24,400 there. In the student health center we do run 694 00:38:24,400 --> 00:38:26,620 a program called Family Pact. It is a State 695 00:38:26,620 --> 00:38:31,330 program related to family planning. If you qualify, 696 00:38:31,360 --> 00:38:34,870 and it is financial-based, you can get SDI 697 00:38:34,870 --> 00:38:38,500 testing, birth control, condoms, STI treatment, 698 00:38:38,500 --> 00:38:40,720 PAPs, and anything related to family planning 699 00:38:40,720 --> 00:38:44,770 medical needs, all taken care of at no cost. If 700 00:38:44,770 --> 00:38:46,480 you have questions about that you can certainly 701 00:38:46,480 --> 00:38:49,540 call the student health center at 702 00:38:49,540 --> 00:38:53,260 (805) 378-1413, and we're happy to 703 00:38:53,260 --> 00:38:55,600 discuss how that program works for you and how it 704 00:38:55,600 --> 00:38:59,110 might benefit you. It's a great 705 00:38:59,110 --> 00:39:03,880 program and really helps out our students. Just some little 706 00:39:03,880 --> 00:39:06,730 reminders here: Spooning leads to forking, so use 707 00:39:06,730 --> 00:39:10,930 common sense. Condoms are not 100 percent safe: my 708 00:39:10,930 --> 00:39:12,940 friend was wearing one and he got hit by a bus. 709 00:39:13,240 --> 00:39:16,780 Hate when that happens. What a bummer. Just 710 00:39:16,780 --> 00:39:18,430 think about that when you're thinking about 711 00:39:18,430 --> 00:39:21,730 catching the bus. We do have condoms in the 712 00:39:21,730 --> 00:39:23,650 student health center which doesn't do a whole lot 713 00:39:23,650 --> 00:39:25,450 of good right now because the student health 714 00:39:25,450 --> 00:39:29,230 center is only available through telehealth, but 715 00:39:29,230 --> 00:39:33,520 we are there. And when when we get back on campus 716 00:39:33,520 --> 00:39:36,160 you're welcome to come on up and get condoms from 717 00:39:36,160 --> 00:39:41,070 us at any time. Please let us know if there's 718 00:39:41,070 --> 00:39:43,920 something we can do to help you get tested. We do 719 00:39:43,920 --> 00:39:47,070 do testing even via telehealth right now, so 720 00:39:47,070 --> 00:39:49,140 you're welcome to give our office a call and make 721 00:39:49,140 --> 00:39:51,420 that appointment. We will set you up and get you 722 00:39:51,930 --> 00:39:54,120 tested if you have any questions or concerns. 723 00:39:54,370 --> 00:39:56,490 Again call our office. Make an appointment. We're 724 00:39:56,490 --> 00:40:00,120 happy to talk to you. And stay safe out there.