It was just once! STDs/HIV/AIDS and Reproductive Life Planning

1. It was just once! STDs/HIV/AIDS and Reproductive Life Planning Judy Herrman, PhD, RN, ANEF Associate Professor University of Delaware September 29, 2012

3. At the end of this session Preconception Peer Educators will be able to: 1. Define Preconception health and Preconception care.2. Explain the importance of a reproductive life plan in promoting preconception health.3. Discuss prevention of STD's as a key concept in reproductive life planning.4. Identify STDs that affect maternal and infant health.

4. Preconception HealthOptimal health throughout the lifespan, benefiting healthy pregnancies and lives.Preconception CareA set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management.

5. Why have a plan? • A reproductive life plan is important for your personal well-being, whether or not you plan to have children.  • Planning if and when to have children helps you think about how you want to live your life and achieve your goals.  • Almost half of pregnancies are unplanned and could happen at a time when a woman’s health or social situation is not ideal.   • Making a reproductive life plan can help ensure that you are healthy and ready if you choose to get pregnant. 

6. Reproductive Life Plan • A reproductive life plan is a set of personal goals about having or not having children. • It also states how to achieve those goals. • Everyone needs to make a reproductive life plan based on their own values, goals, and resources

7. Develop a Reproductive Life Plan • “I’m not ready to have children now because I want to finish school first. I’ll make sure I don’t get pregnant. Either I won’t have sex, or I’ll use birth control, every time!” • “I want to have children when my relationship feels secure and I’ve saved enough money. I have diabetes so, when it’s time, I’ll go see my doctor to make sure my body is ready for pregnancy. In the meantime, I’m taking really good care of myself just for me.” • “I am in a stable relationship and am taking good care of my health.  I am ready to stop using birth control and will try to get pregnant.”  • “I’ve had two kids, and they were only a year apart. Both times, it just happened. I want to have another kid, but I want to wait at least two years. I’ll talk to my doctor about timing between pregnancies. This time, I’m going to make sure I only get pregnant when I want to.

8. Reproductive Life Plan • “I’m just going to let pregnancy happen whenever it happens. Since I don’t know when that will be, I’m making sure that I’m in the best health now, just in case!” • “My partner and I are ready to have a child, but we’ll need to use a sperm bank or fertility service to get pregnant. I’ll make sure I’m in good health before we use those services.”  • “I’ve decided that I don’t want to have any children. I will find a good birth control method, or I will talk to my doctor about permanent birth control methods.” 

9. REFRAMED-PLUSComponents of a Reproductive Life Plan • Reproductive Awareness • Environmental toxins and teratogens • Folic Acid • Review of Genetic History • Alcohol, tobacco, and other substance use • Medical Care and medications • Evaluate immunizations and infectious disease risk • Domestic violence and Psychosocial issues • Pregnancy • Labor • Understanding • Self-empowerment

10. STI’s and HIV • HIV • 1.2 million live with HIV • 48,000 diagnosed each year • Highest risk—MSM, young/minority females, ethnic disparities • 39% of all newly diagnosed—women ages 13-29 • Much more prominently spread through sexual activity than IDU

11. STI’s and HIV • STI’s • 1000 teens in DE each year Dx with STI • ? untested carriers • Bacterial • Bacterial vaginosa • Syphilis • Gonorrhea • Chlamydia • Trichomoniasis • Viral • Herpes • HPV

13. Impact on the mother/baby • Vertical transmission-mother to baby • HIV-birth, placental circulation, breastmilk (200 cases/year)—early testing/AZT • Syphilis-placental circulation-congenital syphilis • Transmission at birth • Herpes-herpetic lesions, brain damage • Gonorrhea-conjunctivitis, opthalmianeonatorum • HPV-cervical cancer • HBV-Hepatic damage/cirrhosis/hepatitis • STI’s increase risk of: • Fetal demise/LBW • Neurological damage • Neonatal sepsis/pneumonia • PID/infertility

14. Prevention • CONDOMS • Every time • Throughout sexual activity • Applied and used correctly • In good condition/check expiration date/don’t open with teeth or rip open pack • Abstain/monogamy with non-infected partners

15. Prevention • HPV vaccine • HBV vaccine • Testing in new relationships • PAP smears • EDUCATION!!

16. With teens and young adults… • Fear tactics do not work! • Focus on logical, immediate, and certain consequences (rather than delayed and uncertain) • Enhance teens perceptions of vulnerability and the role of risk behaviors

17. Techniques to help • Safe in the City videos • Contact Risks Game • Hi/Med/Lo Risk Activity • Introspective exercise • How would you feel if someone told you that you had an STI? • How would you feel if a sexual partner told you had an STI? • Communication skills • Negotiation skills-Invented Dialogs

18. Invented dialogs… • I want to have sex with you but I won’t use a condom • If you trusted me, we wouldn’t need to use a condom • I won’t get tested for HIV…don’t I look clean to you? • You are on the pill…why do we need the condom too? • If you loved me you would know I don’t have anything!

19. ConclusionsProtection from STDs/HIV is a important component of reproductive life planningQuestions?