SEXUALITY, HIV/AIDS and STDs

by Ssemujju Stephen Dip Clin. Med. , BCH, MPH on going

SEXUALITY

Is a broad area of study related to an individuals sex, gender identity and expression, and sexual orientation. This is an expression of who we are as humans. It involves a persons thoughts, feelings, sexual expression, and relationship It encompasses;
The person you feel you are Your body How you feel as a man or as a woman The way you dress, move and speak The way you act How you feel about other people

Rationale for sexuality

Sexuality impacts us deeply as humans. It is an important expression of our culture and impacts us in many ways;
Physically:- how we understand the changes that occur within our bodies, how we choose to share our bodies with others in a sexual and non sexual settings. Our attitudes, values, and social norms:- how we come to feel and think about ourselves informs our identity as Christians, Baganda, and Luo etc. Mentally:- there is a strong connection between what we think and our character.

Rationale cont.
Spiritually:- our spiritual health influences our behavior key to note is that sex is Gods gift to a married man and woman However we have broken Gods gift by

Having casual sex Living in traditional marriages not recognized by God. Engaging in homosexuality. Prostitution

..The main temptations

Satisfy the urge. Entertainment (or, playing sex.) Comfort a friend. Favors - sugar daddies, mommies; Cs Prove ourselves sophisticated Show we are powerful or in control Myth: I am going to DIE if I do not have sex. (Nobut you CAN die from HAVING sex)

Men and Women may differ

Men derive pleasure from physical act, sight, and touch Women value the intimacy and caring What are the implications for how we behave, dress, and get along with coworkers and friends?

Example!

Remove Temptations
Dont look at pornography Be careful of what movies you watch; talk with others about the morals they show Casual sex is the goal at clubs simply dont go to them Avoid being alone with the opposite sex (stay vertical and public!) Choose tasteful literature

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Dont let this happen to you!

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Sexually Transmitted Infection

Infections that are commonly transmitted through sexual contact HIV/AIDS is a well known STI but many others are even far more common.

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Common STIs
Symptoms Genital Herpes Genital Warts Chlamydia Painful blisters in genital areas; possible swollen glands, headache and fever Small, firm, dark warts in Genitals Male: Painful urination Female: Increased vaginal discharge, irritation Male: burning pain with urination, penis discharge Female: increased vaginal discharge, abdominal pain, or no symptoms Painful inflammatory swelling Extra genital lesion Consequence Painful sores 14x/year Linked to cervical cancer Serious infections, sterility Arthritis, heart problems, serious infections, sterility Treatment No cure

Remove Medication

Gonorrhoea

Medication

Chancroid

Medication
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Genital Herpes

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Gonorrhea
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Notice the big beefy ulcer

Chancroid

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Syphilis

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Genital Warts

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Herpes simplex in a male

In a female

Genital herpes

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What do you think these are?

Teaching-aids at low cost

OPTHALMIA NEONATARUM

CONGENITAL SYPHILIS

What did these babies do to deserve this?

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Avoid STIs
Condoms can help but are not perfect. Having STIs can increase risk of contacting HIV too. Seek medical attention early Use the ABC where C in this case means Christ

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Definition of HIV and AIDS

HIV refers to the virus that causes AIDS. The letters stand for: H - Human I - Immunodeficiency V - Virus AIDS is the most advanced stage of HIV infection. The letters stand for: A - Acquired (Something you get) I - Immune (Protection against disease) D - Deficiency (Lack of) S - Syndrome (A group of different signs and symptoms) HIV weakens the immune system, the bodys defence against infections. As the immune system weakens, the body loses its ability to resist infections and certain cancers. There are two types of HIV, HIV-1 and HIV-2. HIV-1 sub types are A, B, C, D, E, F, G, H and O. HIV-2 has no known subtypes

Adults and children with HIV (2005)

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Global changes in the incidence of HIV between 2001 to 2009 selected countries

increasing >25% Stable Decreasing >25% Not included in analysis

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AIDS in Africa

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What HIV does

Attacks and kills white blood cells which are responsible for our immunity from disease and infection HIV grows so fast, the body cannot replace white blood cells fast enough Opportunistic Infections begin to make people sick

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How AIDS kills

AIDS weakens the immune system so that a person no longer has strength to fight off other diseases. The secondary infections that are acquired, like pneumonia, meningitis, or some cancers are often the actual cause of death.

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Spread of HIV

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HIV is spread by:

Contact with human tissue, liquid

Contact with blood, semen, vaginal fluids NOT tears, sweat, saliva, hugging

Therefore:
Sexual intercourse Transfusions Infections during child birth Breast feeding Accidents with sharp instruments
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Women

75% of people who contract HIV between 15-24! Larger mucosal surface exposed in intercourse Victims of sexual abuse May need blood transfusions during childbirth Girls often engage in sex at a younger age Feel unable to negotiate sex Exposed to cultural practices like wife inheritance Take charge Protect yourself!
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Signs and sympt oms

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How HIV is spread in Uganda

Heterosexual 84%

MotherChild 14% Other 2%

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Stages of HIV/AIDS
Stage 1: Asymptomatic Stage 2: Weight loss < 10%, fungal infections, herpes zoster, recurrent respiratory infections, oral ulcers Stage 3: Weight loss > 10%, diarrhoea > 1 month, fever > 1 month, pneumonias, TB, oral fungus, opportunistic infections Stage 4: Wasting, affect on brain, affect on organs, cancers like Kaposis sarcoma, serious infectious diseases

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How doctors monitor HIV

Viral load: how much virus CD4: how many t-cells (white blood cells) there are. Usually you have 850 per ml blood, AIDS drops the count to below 500 and serious infections begin below 200.

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Stigma is a threat to health!

Shame and fear of labels leads people to hide and not get help Stigma shows up as:

Assigning fault Death Sentence Fear of getting sick

Overcoming stigma requires education and awareness

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People with HIV can live many years even without ARVs
New anti-retrovirals only apply to people with low CD4 counts (<350cells/ml) Many people can protect their immune system and live long with diet, vitamins, and care to protect self from illnesses There is never an excuse for a person to not seek help they need in Uganda.

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Control your Future

People with HIV may not know that they have been infected Get tested, plan for a smart, safe, future and prevent the spread of HIV Testing is available at the Allan Galpin Centre as well as through the clinics that come periodically to the campus such as the health awareness week. The results of your test are 100% confidential and it is up to you what you want to do with them 41

Prevention

Say no to sex Remain faithful to your partner, go and get tested together before being intimate for the first time Remember you dont have to have sex to get HIV/AIDS Prevent direct contact with blood by using gloves or another barrier Be aware of the risks of HIV transmission when pregnant.

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Get tested.

Looks for antibodies to HIV 99.5% accurate New Rapid Test is being developed False Positives may occur if your mother has HIV/AIDS and passed antibodies to you (for babies below 18 months but still a DBS confirms status ). False Negatives can occur if you were recently infected but your body has not had time to make antibodies

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Test Results

Positive - seek counseling either from a professional, family, friends, God etc.
Many HIV patients live long, healthy lives Protect othersyour responsibility to stop spread Not the end of the world life will change and your faith will guide you

Negative continue to protect yourself from HIV/AIDS by following prevention methods!

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Care for those who are ill, dying, or left behind

Understand AIDS; help family Get a support group Income generating projects When someone confides in you: maintain trust, keep information confidential Communicate effectively with terminally ill patients make sure they dont feel alone
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The Whole Truth

1 Corinthians 6:19 Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God? You are not your own; 20 you were bought at a price. Therefore honour God with your body.
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