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Reproductive Health of Young Adults: Contraception, Pregnancy and Sexually Transmitted Infections/H PowerPoint Presentation

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Description : Check out this medical presentation on sexual health titled "Reproductive Health of Young Adults: Contraception, Pregnancy and Sexually Transmitted Infections/HIV" to know about the reproductive health risks and consequences in the young adults. This medical PPT also talks about STI/HIV risks and consequences.

Tags : medical presentation, sexual health, medical ppt, contraceptive methods, contraception, family planning, benefits, reproductive health, young adults, pregnancy, sexually transmitted infections, hiv, sti

Published on : Jun 20, 2022 | Views : 1664 | Downloads : 5

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Slide 1-

Reproductive Health of Young Adults: Contraception, Pregnancy and Sexually Transmitted Infections/HIV Reproductive Health Series
Slide 2-

Reproductive Health Issues of Young Adults Topics to be covered Why focus on young adults Defining young adults Characteristics of young adults Reproductive health risks and consequences STI/HIV risks and consequences
Slide 3-

Why Focus on the Reproductive Health of Young Adults? More than 1 of every 4 persons worldwide is between ages 10 and 24 years
Slide 4-

Youth Are Assets Youth are a great potential resource
Slide 5-

Reproductive Health Risks and Consequences for Young Adults Risks: Unintended and too-early pregnancy STIs, including HIV/AIDS Unsafe abortion Sexual violence and unwanted sexual activity Consequences: Medical Psychological Social Economic
Slide 6-

HIV/AIDS Risk for Youth HIV/AIDS epidemic among youth remains largely invisible to adults Stopping HIV/AIDS requires working with youth in a comprehensive way Young women are several times more likely to get infected than young men Today’s young people are the AIDS generation About half of all new HIV infections are among youth
Slide 7-

Transition from Childhood to Adulthood Universal process that varies by individual and culture Involves physiological, psychological, cognitive, social and economic changes
Slide 8-

Defining Young Adults Terms used: adolescents, young people, young adults, teenagers, youth Age Range: 10-24 years
Slide 9-

Factors Affecting the Reproductive Health Needs of Young Adults Age Marital status Gender norms Sexual activity School status Childbearing status Economic/social status Rural/urban Peer pressure Political/cultural
Slide 10-

Married and Unmarried Youth Common Characteristics: Biological Need for accurate information Differences: Access to services Contraceptive needs
Slide 11-

Gender Affects the Reproductive Health of Youth Expectations of sexual activity of boys and girls Views regarding responsibility for contraception Social consequences of pregnancy Degree of risk for HIV/AIDS infection Cultural acceptance of harmful behaviors and practices Client-provider interactions Gender involves roles and relationships that are determined by society and culture. Gender affects:
Slide 12-

Gender Affects HIV/AIDS, Other Risks Males have more ability to use a condom than females, for cultural reasons Culture accepts harmful behaviors and practices against females
Slide 13-

Fertile Years Prior to Marriage Increasing 1890 14.8 14.8 30 10 1988 Age Menarche Marriage 7.2 years 11.8 years Menarche Marriage 22.0 22.0 Source: U.S. data: adapted from Alan Guttmacher Institute, 1995. 30 10 Age 12.5 24.3
Slide 14-

Average Age at First Intercourse for Unmarried, Sexually Active Youth Source: CDC Surveys; WHO, 1997; AGI, 1995.
Slide 15-

Young Adults and Contraceptive Use Few married youth use contraceptives before first birth After becoming sexually active, unmarried youth delay use of contraceptives about a year Common reasons for non-use of contraceptives among unmarried youth: did not expect to have sex lacked information about contraception lacked access to contraceptives
Slide 16-

Limited Contraceptive Use: Characteristics of Youth Tend not to plan ahead or anticipate consequences Think they are not at risk Feel invulnerable Lack confidence or motivation to use Embarrassed or not assertive Lack power and skill to negotiate use Social or cultural expectations or beliefs
Slide 17-

Limited Contraceptive Use: Barriers to Access Lack of access to services or methods: Clinics not designed to be inviting to youth Providers reluctant to serve unmarried youth Laws/policy may prohibit provision to unmarried youth Youth may: Lack transportation to clinic or money for contraceptives or services Fear judgment or discovery Be concerned about having pelvic exam
Slide 18-

High Proportion of Births are Unintended Sub-Saharan Africa Latin America 3 out of 6 2 out of 6 Source: Adapted from Population Reports, 1995. Percent of last births that were unintended to all women under age 20, average for regions
Slide 19-

Psychological and Social Consequencesof Pregnancy for Unmarried Youth Social stigmas for unmarried mothers and children Limited education Fewer career or job opportunities Heavy economic burden Depression, loss of self-confidence and lack of hope Consequences more severe for young women than men Children of young parents may face psychological, social and economic obstacles
Slide 20-

Maternal Mortality Higher for Young Women 0 4 8 12 16 20 24 28 Nigeria Bangladesh Ethiopia Source: Studies in Family Planning, 1986; British Journal of Ob/Gyn, 1985. Maternal mortality rate per 1000 live births  15 years 20-24 years 30-34 years 30-34 years
Slide 21-

Under age 16: May result in: Small pelvis Obstructed or prolonged labor First births: Hypertensive disorders of Hemorrhage, eclampsia pregnancy Medical Risks of Pregnancy in Young Women Can be fatal for both mother and child
Slide 22-

Maternity Care Prenatal Care: To educate young women on proper pregnancy care and assess risk for complications Delivery: To monitor for possible complications Prenatal and postpartum: To provide information on contraception, breastfeeding, child-care skills and child health
Slide 23-

Risk of Unsafe Abortion Each year at least 2 million young women worldwide have unsafe abortions mainly due to: Inaccessibility or costs of safe services Self-induced methods Unskilled or non-medical providers Delay in seeking procedure past first 3 months of pregnancy Family planning can reduce unsafe abortion
Slide 24-

Consequences of Unsafe Abortion 3 out of 5 women seeking hospital care for unsafe abortion complications in Africa, Asia and Latin America are under age 20 Complications: Infection Hemorrhage Injury to reproductive organs Intestinal perforations Toxic reactions to drugs Can result in: Infertility Death Psychological trauma Negative social reactions
Slide 25-

Youth at High Risk for STIs/HIV Primary factors are behavioral: Non-use or incorrect use of condoms Little knowledge of STIs Failure to seek treatment Multiple partners or partners with multiple partners High STI risk
Slide 26-

Consequences of STIs, Including HIV Incurable STIs: Viral Can lead to chronic disease or death (HIV/AIDS) Harmful medical, psychological, and social consequences Curable STIs: Mostly bacterial Can lead to PID and infertility
Slide 27-

Risks and Consequences of Sexual Abuse Rape, sexual assault, involuntary prostitution can result in: Physical injury Unintended pregnancy STIs Psychological trauma Increased likelihood of high-risk sexual behavior
Slide 28-

Summary and Next Steps To address this: Young adults need information, skills, and access to services Policy-makers and providers need to know how and where to reach youth, and what contraceptive and STI/HIV services are needed Young adults face high risks of pregnancy and STIs
Slide 29-

How to Reach Young Adults Who provides information and services to young adults What reproductive health information is needed by young adults Where services for young adults are best provided Topics to be covered Who provides information and services to young adults What reproductive health information is needed by young adults Where services for young adults are best provided
Slide 30-

Youth Involvement Is Critical Youth “should be involved from the start as full partners….” World Health Organization, 2001 Involve perspective of target audience Work with youth, rather than for youth Draw on youth’s energy, hope, eagerness to learn and resilience
Slide 31-

Who Provides Information and Services to Youth? To offer a range of services, various providers need to be involved Teachers Nurses Peer Educators Community Workers Doctors
Slide 32-

Provider Attitudes Often Negative Toward Young Adults
Slide 33-

Sexuality: Open DiscussionsAre Important Difficult topic to discuss openly for both youth and adults Includes a wide range of issues, such as peer pressure, sexual identity, sexual orientation, sexual capability, sexual coercion Helps youth understand and express their feelings Promotes responsible sexual behavior, helps prevent unintended pregnancy and STIs
Slide 34-

Communication Skills Needed by Providers Reflective listening Open-ended questions Positive body language Characteristics that help communication: sincerity, honesty, non-judgment, respect, sense of humor Confidentiality is critical in serving youth
Slide 35-

Provider Training Needed Technical knowledge Knowledge of issues facing young adults Gender awareness Counseling skills For some: how to train young people in communication skills
Slide 36-

What Reproductive Health Information and Education Do Youth Need? Young adults need information and skills to be able to take responsibility for their sexuality. Risks and consequences of sexual activity Contraceptives and STIs Sex education Fertility issues for men and women Gender issues Information and education should be age-specific
Slide 37-

Research Shows Sex Education Helps Sex education: Does not lead to earlier or increased sexual activity Can give young people skills to delay sexual activity Can increase contraceptive use Source: WHO, 1993. It is important to begin sex education early
Slide 38-

Teaching methods/ program design: Provides modeling and practice of communication and negotiation skills Trains instructors Involves students in teaching methods Lasts at least 14 hours or has intensive small-group work Content: Provides basic, accurate information Focuses on reducing sexual risk-taking Addresses peer pressures Strengthens individual and group values against unprotected intercourse Effective Programs Elements of Effective Sex Education Programs Source: U.S. National Technical Information Services, 1995.
Slide 39-

Sexuality: What Youth Need to Know Includes issues of identity, societal roles, human relationships, biological development Youth need to learn: How their bodies, minds and feelings are changing How to communicate about sexuality How to handle societal and peer pressures How to make responsible decisions about sexual activity, including abstinence
Slide 40-

Ways of Expressing Sexuality Young people need to knowalternatives to risky sexual behavior Holding hands Hugging Dry kissing Body rubbing Masturbation Mutual masturbation Sexual intercourse with a condom
Slide 41-

Fertility Awareness Involves education about: The reproductive system Fertility The menstrual cycle How pregnancy occurs Attitudes and cultural norms about fertility, the use of contraception and childbearing Important for both males and females
Slide 42-

Fertility of Men and Women Males are fertile all the time after beginning sperm production Females are fertile for a period of time during each cycle Menstrual cycle: begins with menstrual bleeding ovulation occurs if egg is not fertilized, cycle begins again in about 2 weeks Fertile time can begin about 6 days before ovulation
Slide 43-

Gender Awareness for Youth Important to emphasize communication and shared responsibility between boys and girls
Slide 44-

Where Can Information and Services for Youth Be Provided? Home Health clinics School-based programs Community-based youth organizations Mass media
Slide 45-

Effective Programs for Young Adults Incorporate evaluation Identify target group, analyze assets and needs Involve youth Work with community, including family members Use materials designed by and for youth Make services accessible, as identified by youth
Slide 46-

Youth-Adult Partnerships Elements of good partnerships: Organizational commitment and capacity Attitude shifts among adults and youth Selection, recruitment and retention of youth Substantive levels of youth participation
Slide 47-

Family Involvement Many youth want to talk to family members about sexuality Crucial elements: availability of family members attitudes and knowledge communications skills Programs needed to help parents learn necessary skills and information Family members can support youth in seeking services and information
Slide 48-

Health Clinics Designed for Youth Separate units for youth Outreach clinics with specially trained staff Mobile clinics Special hours Convenient and safe locations Youth-to-youth promotion Low or no-cost services
Slide 49-

Traditional Health Clinics: An Opportunity to Reach Youth Providers can take advantage of existing opportunities for providing information to young adults With every client, the provider should ask: Referrals to other services and providers “If you are sexually active, what are you doing to prevent pregnancy and STIs?”
Slide 50-

Elements of School-Based Programs Large numbers of youth can be reached efficiently at schools Family life education curricula School-based or linked clinical services Training of instructors and administrators Involvement of families and community
Slide 51-

Community-Based Youth Organizations Multi-service organizations: recreation, sports teams, vocational training, tutoring Workplace and religious groups: information and services Peer promoters or educators: information, counseling and condoms Youth centers for pregnant and parenting teens: continuing education and skills training
Slide 52-

Mass Media and Other Creative Outreach Mass media: radio, television, film, comic books Telephone hotlines Entertainment: drama groups, puppet shows, concerts Computer technology: Web sites, CD ROMS, distance learning Social marketing
Slide 53-

Lessons learned: Sex education is valuable for young adults Education needs to focus on skills and attitudes as well as information Programs need to involve youth in the design Forming effective youth-adult partnerships influences attitude changes Summary
Slide 54-

Contraceptive Options for Young Adults Topics to be covered Contraceptive methods Emergency contraception Dual method use Postpartum and postabortion contraception
Slide 55-

Contraceptive Issues for Young Adults Non-medical issues: High-risk behavior Lack of accurate information May not use methods consistently and correctly Have unplanned and sporadic sexual activity Lack of knowledge or access to emergency contraception
Slide 56-

Complete Abstinence Most effective way to prevent pregnancy and STIs No sexual intercourse May include other forms of sexual expression Option for all youth, including those who have begun sexual activity Requires high motivation, self-control, communication and social support
Slide 57-

Barrier Methods Includes male and female condoms, spermicides, diaphragms and cervical caps Are most effective when used consistently and correctly Pregnancy rates in typical use range from 12 percent for condoms to 21 percent for spermicides Safe, with no systemic effects
Slide 58-

Barrier Methods: Advantages Male condom is the most effective method for STI/HIV prevention Female condom is an alternative to male condom Most methods are accessible and available Good for infrequent sexual activity User-controlled Easily initiated and discontinued
Slide 59-

Barrier Methods: Counseling Successful use requires: Partner participation and negotiation skills High level of motivation, self-confidence, self-control Key messages: Always carry with you, so barrier methods are available when needed Communication and shared responsibility are vital Consistent and correct use are key to effectiveness
Slide 60-

Male Condom Use for pregnancy protection and if at risk for STIs Use with other methods for STI protection Incorporate into sexual activities Use can result in delayed ejaculation
Slide 61-

Male Condom: Use When using: Open package carefully Do not unroll before putting it on Hold rim of condom during withdrawal Use only water-based lubricants
Slide 62-

Oral Contraceptives Very safe and effective when used consistently and correctly Many non-contraceptive health benefits Rapid return to fertility Use independent of sexual intercourse Can be used without partner’s knowledge Usually requires visit to clinic or other trained provider No STI protection
Slide 63-

Oral Contraceptives: Counseling Contraceptive benefit wears off quickly Pills must be taken daily Possible side effects include nausea or breakthrough bleeding Link pill-taking to a daily routine Encourage use of condoms for backup if pills not taken correctly or if at risk for STIs
Slide 64-

Injectables and Implants Very effective against pregnancy Non-contraceptive health benefits No daily action required or supplies needed at home Use independent of sexual intercourse and can be used without partner knowledge Require clinic visit No STI protection
Slide 65-

Injectables and Implants: Counseling Progestin-only injectables and implants: Bleeding irregularities likely Return to fertility delayed with injectables immediate upon removal of implants Use condoms if at risk for STIs Implants: Appropriate for those wanting long-term method
Slide 66-

Intrauterine Devices (IUDs) Very effective at pregnancy prevention Use independent of intercourse Quick return to fertility Requires clinic visit for insertion and removal No STI protection
Slide 67-

Intrauterine Devices (IUDs): Counseling Eligibility: Not usually recommended for young women at increased risk for STIs Not recommended for those with recent or current STIs Under age 20 and nulliparous women may have increase risk of expulsion Counseling messages: IUDs are not appropriate for those with high-risk behavior Important to check for signs of expulsion
Slide 68-

Lactational Amenorrhea Method (LAM) Temporary and effective method for breastfeeding women For LAM to be effective the woman must be: Fully or nearly fully breastfeeding Amenorrheic Within the first six months postpartum LAM provides no protection against STIs
Slide 69-

Traditional Methods Periodic abstinence and withdrawal: Always available Can promote reproductive health awareness High pregnancy rates in typical use No STI protection Require considerable motivation Periodic abstinence is difficult for young women with irregular menstrual cycles Training about fertility awareness essential
Slide 70-

Sterilization Generally not an appropriate method for young adults
Slide 71-

Emergency Contraception Prevents pregnancy after unprotected intercourse Not meant to be a regular method After use, a regular method should be initiated or resumed Can be used at any time during cycle Does not protect against STIs Most effective when used early after unprotected intercourse Method options: combined oral contraceptive pills progestin-only contraceptive pills
Slide 72-

Emergency Contraception: Combined Oral Contraceptives Prevents 75% of expected pregnancies Requires 2 doses, 12 hours apart Each dose contains at least 100 mcg of ethinyl estradiol and 500 mcg of levonorgestrel May cause nausea and vomiting
Slide 73-

Emergency Contraception:Progestin-Only Oral Contraceptives More effective than combined pills for emergency contraception Requires 2 doses, 12 hours apart Each dose contains 750 mcg levonorgestrel Much less likely to cause nausea and vomiting than combined pills
Slide 74-

Dual Protection: Pregnancy and STIs Dual method use: Other option for dual protection: Primary method for pregnancy prevention Condoms added for STI prevention Condom as primary method for pregnancy and STI prevention Emergency contraceptive pills if condoms not used, or if they break or slip
Slide 75-

Condoms/Spermicides Diaphragm/cervical cap IUD Combined Estrogen-Progestin Progestin-only Methods/Natural Family Planning Lactational Amenorrhea Method Progestin-only Methods Combined Estrogen-Progestin Methods/Natural Family Planning Postpartum Contraceptive Options Breastfeeding women All women 6 months onward Delivery 3 weeks 6 weeks Non-breastfeeding women
Slide 76-

First trimester procedure Diaphragm/cervical cap 6 weeks Second trimester procedure 6 weeks IUD Combined Estrogen-Progestin/Natural Family Postabortion Contraceptive Options Any method Condoms/Spermicides/ Planning/Progestin-only
Slide 77-

Summary of Contraceptive Options for Youth Source: WHO, 2004.
Slide 78-

STI/HIV Prevention and Treatment: Priority for Young Adults Topics to be covered STI/HIV risks and consequences Most common STIs, including HIV STI/HIV prevention STI/HIV counseling Voluntary counseling and testing Risk assessment STI/HIV management and treatment
Slide 79-

STI/HIV Risk Higher in Young Adults Biological susceptibility in young women: Cervical ectopy Behavioral susceptibility: Youth feel invulnerable, don’t believe it could happen to them Condoms not used consistently or correctly Have multiple partners, or partners with multiple partners Other factors such as drug and alcohol use
Slide 80-

STI Consequences for Young Adults Symptoms: vaginal or penile discharge, painful urination, abdominal pain or genital sores Can be transmitted from mother to infant during pregnancy, delivery or breastfeeding Untreated, can lead to chronic disease, infertility or death Psychological, social and economic impact
Slide 81-

Most Common STIs Most Common Providers need to know STI prevalence in their areas Curable (mostly bacterial) Trichomoniasis, chlamydia, gonorrhea, syphilis Incurable (viral)HIV/AIDS, human papilloma virus (HPV), hepatitis B, herpes
Slide 82-

Curable STIs Curable with antibiotics Access to treatment services important opportunity Often asymptomatic and hard to diagnose Can lead to PID and infertility Some can be transmitted during childbirth or result in adverse pregnancy outcomes Increases risk of HIV transmission
Slide 83-

Most Common Curable STIs Trichomoniasis: Estimated to be most common STI globally Associated with adverse pregnancy outcomes Chlamydia and gonorrhea: High rates in young adults May lead to PID Can infect newborn during childbirth Syphilis: High risk of congenital infection
Slide 84-

HIV: High Risk for Young Adults Half of all infections worldwide are in people under 25 years of age New infections concentrated in young women HIV can be transmitted through semen, vaginal fluids, blood, breastmilk or in utero No vaccine exists Prevention strategies are essential
Slide 85-

Other Viral STIs Human papilloma virus (HPV): Causes genital warts Highly associated with cervical cancer Hepatitis B: Causes liver damage Vaccine available Herpes: Symptomatic or asymptomatic Widespread among young adults
Slide 86-

Addressing the HIV Epidemic:Youth Central to Strategies Build support among leaders to speak out Use education and communication Address cultural, social and gender norms Promote condoms Make services youth-friendly Reach out to vulnerable youth
Slide 87-

Orphans and Vulnerable Children (OVC) By 2010, more than 25 million children will have lost one or both parents to AIDS Needs to address: Whether orphans should know their serostatus Increased risk of sexual exploitation Stable family structure, educational opportunities Mental health supports, such as memory books Reproductive health and HIV prevention
Slide 88-

STI Prevention Should be part of all reproductive health programs Provide information on STIs Counsel clients about safe sexual behaviors Assess risk for STIs Promote and distribute condoms
Slide 89-

STI Counseling Messages for youth: All sexual activity puts them at risk for STIs/HIV Safest sexual behavior is abstinence For those sexually active, safe sexual behaviors include: Assessing if partner is infected Mutual monogamy Reducing number of sexual partners Using condoms
Slide 90-

Voluntary Counseling and Testing (VCT) Where HIV prevalence is high, young people want to know their status VCT can help young adults use safer sexual practices and reduce rates of STIs VCT presents challenges: Recruitment Preservation of confidentiality Stigma
Slide 91-

What is the VCT model? HIV-positive News given Risk-reduction plan made Discussion about disclosure of HIV status NO YES Posttest counseling HIV-negative News given Risk-reduction plan made Discussion about disclosure of HIV status Preventive Counseling Decision to seek testing Decision to test Pretest counseling The test process The implications of testing Risk assessments and risk prevention Coping strategies Social Support Medical care Emotional Support Follow-up counseling and support
Slide 92-

Assessment of STI Risk STI symptoms include: Vaginal or penile discharge, painful urination, abdominal pain, or genital sores Risk factors include: Number of sexual partners Client’s age Recent new partner Previous STI infection Partner has other partners or STI symptoms
Slide 93-

STI Management: Diagnosis and Treatment Using laboratory tests: Expensive and require client to return to clinic Using syndromic approach: Based on a person’s symptoms and signs and the local epidemiology Works well for ulcers and male urethral discharge; does not work as well for vaginal discharge syndrome During treatment, counseling should emphasize partner notification
Slide 94-

Summary STI prevention and treatment – a priority for those working with youth Young women in particular need attention since HIV rates are increasing most rapidly among this group Good counseling can help all youth avoid STI infection
Slide 95-

Youth Are Our Future