Transcript Document

Preventive Care and Sexual
Health Information for
Tweens and Teens
Developed by:
ACOG District XII
Health Care for Underserved Women Committee
General Risk Factors for
Tweens and Teens
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Poor Diet
Lack of Exercise
Smoking/Drugs/Alcohol
Early initiations of Sexual Activity
When Should You See an
Ob/Gyn?
• Ideally BEFORE there is a problem
• The American College of Obstetricians
Gynecologists (ACOG) recommends young
women see a obstetrician/gynecologist (Ob/Gyn)
between the ages of 13-15 years
What to Expect from an
Initial Visit?
• History and Physical
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History on menstrual (period) cycle
Examine physical development
Screen for emotional and behavioral conditions
Discuss/obtain immunizations
• Generally does not involve a Pelvic Exam
• All females aged 10-18 should receive annual
screening
• Annual screening should focus on:
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Healthy eating habits
Regular exercise
Tobacco/drug use
Sexual activity
What is a Pap Smear????
• It is not a pelvic exam
• Use of a speculum to look at the cervix to screen for precancer and cancer cells
• Exams should begin at age 21
Just the Facts……..
2002 Center for Disease Control (CDC) National
Survey of Family Growth
•11% of girls sexually active by age 13
•24% of girls sexually active by age 15
•40% of girls sexually active by age 16
•70% of girls sexually active by age 18
•Every 10 seconds, a teen loses their virginity
Every 10 seconds
a teen loses their
virginity!
CDC Trends in Sexual
Début Girls, Ages 15-19
More facts…….
• 12 million NEW Sexually
Transmitted Infections (STIs) cases
per YEAR
• 3 million of them are TEENS
• 9,000 teen STIs per DAY
STI Facts
• Herpes Simplex Virus (HSV) 20 million active cases
• Human Papilloma Virus (HPV) 24 million active cases
• Human Immunodeficiency Virus (HIV)
 More than 1 million active cases
HIV in Florida
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Florida #3 nationwide
1999: 5,424 new cases
22% of new cases are female
12 % ages 15-24
Chlamydia in Florida
(2008 Data)
• Total cases= 75,000 people
• 389.1 cases/100,000 people
Gonorrhea in Florida
(2000 Data)
• Total cases: 25,000 people
• 127.8 cases/100,000 people
Teen Pregnancy
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1997-183,324 births to 15-17 year olds in USA
1997-305,886 births to 18-19 year olds in USA
35% of all teen pregnancies are aborted
ADD TEEN PREGNANCY RATES IN
FLORIDA
Teen Pregnancy
• 8 out of 10 teen moms live below
the poverty level for 10 years
• 9 out of 10 teen moms never finish
college
Consequences of Our
Choices……
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Emotional affects
Physical affects
Future Fertility (pregnancy)
Possibility of Cancer (HPV)
Consequences and affects on loved
ones
Pregnancy Prevention
• Communicate with parents, counselors,
trusted adults, partner
• Daily involvement
• Commit to your decision
• Date those that share your views
• Avoid alcohol
• Safe sex?
• Think of YOUR future
Invasive Cervical Cancer
• 12,360 cases in the USA/year
• 4,020 deaths in the USA/year
• 16% of reproductive tract cancers
Cervical Cancer is
caused by HPV
Risk Factors for Contacting HPV the cause of
Cervical Cancer
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#1 Highest Risk=HPV
Number of partners
Age at loss of virginity
Smoking
HIV infection
Prevalence of HPV
• Sexually active female college students
baseline 26% positive for HPV
• Check every 6 months 60% positive at
least once over 3 years.
Sexual Debut
• 62% 12th graders sexually active…
• ½ their mothers are unaware
Role of the Pap Smear in
Cervical Cancer Prevention
• Age 21
• Responsible for 70% decrease in
cervical cancer deaths.
• Results 3% Low grade
• 1% High grade
• 0.1% Cancer
When Should My
Daughter see a Ob/Gyn?
• Recommended first visit age 13-15
• Annually to check for STIs (gonorrhea and
chlamydia) testing if sexually active
• Problems with period
• Discussions about sexual activity
What is the HPV
Vacccine?
Quadrivalent HPV Vaccine
• Protects against four strains of the virus
o 6,11,16,18
• Approved by CDC in 2006
• CDC/ACIP in mid-2006 after FDA approval
• Recommended for females ages 11-26
o Vaccine may be given to females as young as 9 years old
How Safe is the HPV vaccine?
• Vaccine was studied for a period of over 10
years
• Included 25,000 people
• 1,124 adolescent girls age 9-14
• Vaccine against a virus particle
• Rare complications noted from 5 year
Scandinavian study
How Do I Get the
Vaccine?
• Vaccine is dispensed in 3 doses
o 1st-dose at visit,
o 2nd dose at two months
o 3rd dose at six months
• Through the Florida Department of
Health- Vaccine for Children (VFC)
Program
Is the Vaccine Effective?
• HPV 16 and 18 responsible for 70% of
cervical cancers
• State of Florida- 10 cases cervical cancer
per 100,000 women
New Developments
• Gardasil was FDA approved for
young men ages 9-26 in October 2009
• Cervarix is an additional FDA
approved HPV vaccine FDA approved
for ages 9-25
o Only covers HPV strains 16 and 18
o Does NOT prevent HPV associated warts
New Developments
• New vaccine in development
that covers 9 different HPV
types
What we have done..
With only a 33% vaccination in US girls,
and 10% vaccination rate in US boys,
rate we have decreased the incidence
of HPV by 56% in girls ages14-19!!!
We can do better…
• 80% adolescent girls vaccinated in Rwanda
• 33% US girls vaccinated
• 25.3% eligible Florida adolescent girls vaccinated
We can prevent close to
33,000 cases of HPV linked
cancer cases annually with
the HPV vaccine
QUESTIONS?
Resources
• ACOG Pamphlet AP073 Human Papillomavirus (HPV) Infection
Jan 13
• ACOG Pamphlet AP167 Human Papillomavirus Vaccines Feb
2014
• cdc.gov/vaccines/teens
• cancer.gov/cancertopics/factsheet/Prevention/HPV-vaccine
• The initial reproductive health visit. Committee Opinion No.
598. American College of Obstetricians and Gynecologists.
Obstet Gynecol 2014;123:1143–7.
• Human papillomavirus vaccination. Committee Opinion No.
588. American College of Obstetricians and Gynecologists.
Obstet Gynecol 2014;123:712–8
• www.ImmunizationforWomen.org/HPV
References
CDC. Human papillomavirus vaccination coverage among adolescent girls,
2007–2012, and postlicensure vaccine safety monitoring, 2006–2013—United
States. MMWR 2013;62:591–5.
CDC. Quadrivalent human papillomavirus vaccine: recommendations of the
Advisory Committee on Immunization Practices. MMWR 2007;56(No. RR-2):1–24.
Markowitz, L. Hariri,S .Lin.C.,Dunnel,E. Steinau,E. McQuillan,G and Unge,E.
Education in Human Papillomavirus (HPV) Prevalence Among Young Women
Following HPV Vaccine Introduction in the United States, National Health and
Nutrition Examination Surveys, 2006–2010J Infect Dis. June 2013.
ACOG pratice Bulleton Number 131, November 2012 Screening for Cervical
Cancer.