Human Sexuality

• Diseases spread through sexual contract:
• -Vaginal
• -Anal
• -Oral
• 65 Million in the U.S. have an STD
• 15 Million new cases per year

• Direct sexual contact or sexual contact with someone's infected semen, vaginal secretions, blood or body fluids.
• Maternal transfer
• Sharing contaminated needles through injectable drug use.

• Source
• -Bacterium
• Incubation Period
• -1-30 days
• Signs and Symptoms
• -Males: watery (milky, white) discharge, pain upon urination
• -Females: watery (mikly white) discharge, PID
• -50% of men and women do not have any symptoms.
• Diagnosis
• -Culture discharge
• Treatment
• -Antibiotics
• Epidemiology
• -Most prevealent sexually transmitted bacterial pathogen in the U.S.
• -3 million cases annually

• Source
• -Bacterium
• Incubation Period
• -1-30 days
• Signs and Symptoms
• -Males: pus discharge, pain upon urination, can lead to sterility
• -Females: usually asymptomatice, PID, can lead to sterility.
• Diagnosis
• -Culture discharge
• Treatment
• -Antibiotics
• -Not curable in late stages
• Epidemiology
• -350,000 cases reported annually in U.S.

• Source
• -Virus
• Incubation Period
• -2-12 days
• -Can be transmitted to newborn during delivery
• Signs and Symptoms
• -Vesicles
• -Vesicles break down, crust over and form painful ulcers.
• -Entire first episode takes 15-20 days
• -Flu-like symptoms
• Recurrence
• -5 to 8 times per year
• -10 days per episode
• -Frequency and severity diminish with time
• Treatment
• -No cure
• -Antiviral therapies
• Epidemiology
• -45 million in U.S. infected

• Source:
• -Bacterium
• -infection in urethra of males caused by chlamydia bacteria
• Signs and Symptoms:
• -Discharge
• -Pain upon urination
• Treatment:
• -Antibiotics
• Epidemiology:
• -3 Million cases annually

• Source:
• -Virus
• Incubation Period:
• -3 Months
• Signs and Symptoms:
• -Cauliflower-like growths in genital and rectal areas
• -Some individuals do not have any symptoms
• Diagnosis:
• -Presence of lesions
• Cervical Cancer:
• -HPV is indicated in 80% of all cervical cancer cases
• Treatment:
• -Removal of lesions by laser surgery or chemical
• -Not curable
• Epidemiology:
• -20 million Americans
• -Routine testing at 4 locations yielded the following results:
• --9% of women seeking routine Pap smears at OB/GYN offices tested positive.
• --9-45% of women attending health services in a university health center had positive results
• --23% of women attending a family planning clinc were positive.
• --82% of street prostitues in a select study were positive.

• Source:
• -Bacterium
• Incubation Period:
• -3 to 4 weeks
• Signs and Symptoms:
• -Primary
• --Chancre
• ---A painless indurated primary lesion of early syphilis
• ---Internal, vagina or anus
• ---Disappears within 1-5 weeks
• -Secondary
• --Rash, 6 weeks later
• --Appears on trunk, or mild on hands, or feet
• --Disappears without treatment 2-6 weeks
• -Latency
• --Damage to central nervous system
• --Can transmit by donating blood
• --Congenital syphilis
• Diagnosis:
• -Blood Test
• Treatment:
• -Penicillin or other antibiotic
• Epidemiology:
• -Reduced numbers due to penicillin
• -Mini epidemics in major metropolitan areas

• Source:
• -Bacterium
• Incubation Period:
• -4-10 days
• Signs and Symptoms:
• -Chancre
• --Granular, painful erosions
• --Painful, swollen lymph glands in the groin
• Treatment:
• -Antibiotics
• Epidemiology:
• -Not common in U.S.
• -Epidemics in developing countries
• -Predominance in black and Hispanic males; prostitution

• Source:
• -Virus
• --Disease of the immune systems
• Transmission:
• -Person-to-person
• --Sexual contact-anal or vaginal
• --Sharing contaminated needles-IDU
• --Maternal-to-fetal transmission
• Diagnosis:
• -Incubation period (window period)
• --8 weeks to 6 months
• -Blood test- detect HIV antibodies
• --ELISA
• --Western Blot- confirmatory test
• -Oral test-detect HIV antibodies
• --Saliva
• Signs and Symptoms:
• -Asymptomatic at first
• -Early Symptoms
• --fatigue, diarrhea, fever, night sweats, skin rashes, sudden weight loss, dry cough, swollen lypmh glands, vaginal or oral yeast infections
• -Opportunistic Infections:
• --Infections that individuals get due to a weakened immune system
• Treatment- No Cure
• -Some medications available to lesson symptoms and opportunistic infections
• -AZT, other antiviral medication
• --Prevents and slow replication of HIV
• -Protease Inhibitors
• --Acts as an enzyme to prevent replication of HIV-infected cells
• -HAART (Highly Active Antiroviral Therapy)
• -Halts the spread of the virus
• -Reducing viral loads
• -HIV infected individuals living longer, better quality of life.
• Epidemiology:
• -AIDS is reportable by law in U.S.
• -Majority of cases among males
• -57% of AIDS patients have died
• -Since 1996, there has been dramatic decline in the number of AIDS caese
• -Slight increase among heterosexual contact from 1998-2001

• Source:
• -Virus
• -Attacks the liver
• --Can cause extreme illness and death
• Diagnosis:
• -Blood test
• Signs and Symptoms:
• -Jaundice
• -Dark urine
• -Fever
• -Malaise
• -Moderate liver enlargement and tenderness
• Treatment:
• -No cure
• -Boost the immune system
• -Vaccine available
• Epidemiology:
• -5% of U.S. population has HBV
• --Risks
• ---Heterosexual males and gay men
• ---Sexual transmission most common

• Transmission:
• -Sexually
• -Clothing, bedding, towels
• -Nits, eggs, attach to shaft of hair
• Signs and Symptoms:
• -Visual confirmation of lice
• -Intense itching
• -Skin irritation
• -Sore from scratching
• Treatment:
• -Shampoos to kill nits
• -Bedding and other clothing must be washed

• Diagnosis:
• -Infestation with mite
• -Burrow under skin
• Treatment
• -Special lotion that is left on skin 8-24 hours
• -May need more than one application

• Sexual Behavior
• Sexual Relationships
• Sexual/Medical History
• Demographic variables

• More cases among 15-25 year olds
• -earlier onset
• -mutliple partners
• -unprotected
• -cervical tissue more susceptible

• Women are at a greater risk of acquiring STDs:
• -Heterosexual women are receptive sexually
• -Asymptomatic in women
• -Menstruation facilitates movement of pathogens
• -Transmission to fetus or newborns

• Heterosexual women
• Gay and bisexual men
• Heterosexual men least at risk
• Lesbians have lowest rates of infection

• Use of pscyhoactive drugs impair ability to make good decisions
• --Sex and drug use
• Sharing needles
• --Crack cocaine, heroin
• --Steroid
• Infections remain in syringe

STDs and HIV are higher in urban areas

• People of lower SES tend to lack enabling factors related to prevention and treatment
• People of lower SES do not perceive themselves to be at risk for STD/HIV
• Poverty contributes to higher levels of drug use which is a risk factor for STD/HIV

• African Americans and Hispanics have highest rates
• Social class and poverty contribute to risk

• Lifetime number of sexual partners
• Contraceptive use
• History of injected drug use
• Prior STD history

Know the person before you have sex with them

Both must agree that the relationship is monogamous

• Noninsertive
• No exchange of body fluids

• Insertive and protected sex
• Insertive and not protected

Insertive and not protected including ejaculation

• More effective against: gonorrhea, chlamydia, trich, and HIV
• Prevents transmission from mucosal surfaces
• Not reliable for prevention of transmission by skin-to-skin contact
• -HPV, Herpes, Syphilis

• Sponge, diaphragm, spermicides:
• -Reduced STD infection rate among barrier users
• -Lower STD infection rate for women who attend STD clinics and use barrier methods
• -Up to 70% effective against gonorrhea when using barriers
• -Up to 40% effective against chlamydia when using barrriers

Union of the sperm and ovum

Release of ovum from on ovary

• Cervical mucous
• Body Temperature
• Ovulation kits

• Release of ovum
• Allurin

Fertilization occurs

• Ejaculation contains 250-500 million sperm
• Only a few hundred get close to ovum
• Fertilin

• Implantation
• -The attachment of a fertilized egg to lining of uterus

Fertilized egg up to 8 weeks

Fertilized egg from 8 weeks to birth

• Human Chorionic Gonadotropin (HGC)
• Home pregnancy tests are 85-95% accurate
• Medical confirmation necessary

• Averaging 40 weeks
• Premature delivery prior to 38 weeks
• Due Date: First day of last menstrual period, subtract 3 months, then add 7 days

• Amniotic Fluid
• -Transparent liquid contained in the amniotic sac
• Placenta
• -An organ that attachs to the uterine wall and serves as a conduit for oxygen and nutrients to pass to the developing fetus
• At the end of 3 months:
• -Fetus has arms, legs, feet, toes, fingers, and vital organs for body systems.
• -Most vulnerable time for fetal development
• --teratogenic effects

• By the end of 5 months:
• -Fetal movement is active enough for mother to feel
• -Sex organs have developed
• -Eyebrows and eyelashes have developed
• Some babies can survive if delivered at the end of 6 months
• -NICUs

• Respiratory system is last to develop
• -Could cause damage to fetus if delivered early
• --Medication available to help mature the lungs and also prevent bronchiospasms in preemies

• Physical: Prenatal Care
• Psychological: Mothers and Fathers
• Social: Families

• May experience a progressive decline in sexual desire
• Personal reactions vary
• Sexual activities

• Balanced Diet
• Prenatal Vitamins
• More folic acid
• Appropriate weight gain

• Association with fewer c-sections
• Do not begin a new, strenuous, exercise program
• 15 minute rule
• Body temperature at 100F or lower
• Heart rate at 140 or lower
• Myth: If you exercise too much, you can have a miscarriage
• Benefits

• Do not take any medication without consulting a physician
• NO cigarrette use

• Effects:
• -Facial abnormalities
• -Mental retardation
• -Nervous system damage
• Some states can terminate parental rights

• Uterine measurement
• Blood pressure
• Weight check
• Chorionic villus sampling
• -screening for genetic abnormalities
• Ultrasound

• Blood sample
• High level indicates neural tube defects
• -Anencephaly: brain is underdeveloped
• -Spina Bifida: spinal cord is exposed

• HIV
• CBC

Gestational diabetes

• Hospital Births (traditional delivery)
• Home births

• 12-14 hour process
• Beginning of Labor Signs
• -uterus begins to contract
• -mucous plug covering cervix is dislodged
• -rupture of amniotic membrane

• Longest Stage
• Dilation of cervix to 10 cm
• Effacement
• Pain management- epidural

• Birth of baby
• -pushing stage
• Episiotomy
• -surgical cutting of the perineum to facilitate childbirth

• Delivery of the Afterbirth
• -The placenta, umbilical cord, and membranes expelled after the birth of the child
• -Take approx. 15 minutes

• Breech Position
• Baby's head too large to pass through pelvic region
• Fetal distress
• Prolonged labor
• Problems with placenta

• The time after birth
• Hormones
• Emotional Concerns
• Lack of Sleep
• Recovering from physcial aspects of pregnancy, labor, and delivery

• Numerous health benefits
• -Immunity
• -Encourages better mouth and tooth development
• -Reduces chances of obesity in children
• Convenient and economical

Inability to conceive after one year of unprotected intercourse.

• Purposeful action-vasectomy or tubal ligation
• Disease
• Cancer treatments
• Removal of uterus or ovaries

• Lack of ovulation
• Hormonal imbalances
• Scar tissues in uterus or fallopian tubes
• Habitual miscarriages
• Production of antisperm antibodies
• Advanced age
• Cigarette smoking
• Drug use
• Excessive dieting and exercising

• Sperm productino
• Hormone deficiencies
• Drug use

• Physical assessments
• Medical and sexual history
• Charting menstrual cycle
• Basal body temperature
• Blood work
• Endometrial biopsies
• Hysterosalpingogram
• Postcoital cervical mucous test

• Physcial assessment
• Medical and sexual history
• Check sperm

• Absence of ovulation
• --Hormones
• Pelvic Surgery
• --Removal of endometrial tissue
• --Myomectomy

• Sperm production
• --Lifestyle changes
• --Hormone treatment
• --Surgery to remove varicocele

• Ova are removed from the woman's body and fertilized with sperm in a lab
• The embryo is surgically implanted into her uterus
• Success rates decline as woman ages

• Safe and effective
• Adverse health conditions
• Affect sexual lifestyle
• Religious considerations
• Cultural considerations
• The best method is one that is used consistently and correctly

• Actual-use effectiveness: 65-70%
• Causes pregnancy due to human error and sex during peak fertility
• No STD protection

• Avoiding unprotected intercourse during peak fertility
• Determine ovulation:
• -Calendar
• -Basal Body Temperature
• -Cervical mucous
• -Combination of all the above

• Estimate future ovulation
• Need to track menstrual cycle for at least 8 months to determine average ovulation time
• Deteremine the "safe zone"
• Avoid unprotected vaginal intercourse during unsafe days

• Changes in cervical mucous to determine ovulation
• Combine method with calendar for maximum effectiveness

• Basal Body Thermometer
• Chart temperature for 3 months
• Record temperature on a grid
• Normally, 12 to 24 hours prior to ovulation, the BBT will drop
• Next subsequent rise in temperature will indicate ovulation
• Combine with mucous and calendar methods for maximum prediction of ovulation

Mechanical, chemical, or combination barrier between sperm and egg

• Condoms (male and female)
• Diaphragm
• Sponge
• Cervical Cap

Spermicidal barriers

• Latex
• Polyurethane
• Natural lamb membrane

• How it works:
• Covers penis and trapping ejaculate
• Pregnancy prevention
• Some STD prevention

• Variety of shapes, colors, and sizes
• Theroretical use: 98%
• Actual Use: 88%

• Made from intestines of lambs
• Fit more loosely than latex
• With or without spermicides
• Effective for pregnancy prevention
• Not effective for STD prevention

• Polyurethane
• Lose-fitting pouch, one size
• Pregnancy and STD protection
• Non-prescription
• Theoretical Use: 95%
• Actual Use: 79%

• Rubber dome inserted into the vagine and placed over the cervix
• Use with spermicide
• Limited protectoin against STDs
• Must be fitted by health care professional
• Theoretical Use: 94%
• Actual Use: 84%

• Small, thimblle-shaped rubber cap
• Fits snugly on cervix by suction
• Must be fitted by health care professional
• Limited protection against STDs
• Different than diaphragm
• Theoretical Use: 94%
• Actual Use: 40%

• Sexual intercourse without the consent of the man/woman and effected by force, duress, intimidation or deception as to the nature of the act.
• 95% of rapes are committed by men against women

• Rape is about violence
• Women do not want to be raped
• Rapists are not mentally ill
• Everyone is responsible for preventing rape

• A syndrome developing after exposure to an extremely traumatic event
• Victim or the witness to the event

• Date Rape
• -Forced sexual intercourse by a person whom the victim knows
• Most common and least reported of all forms of rape

• Get to a safe place
• Call someone you trust to stay with you
• Go to a hospital emergency room immediately
• Call local police
• Write down as much as you can remember
• Talk with a counselor

Persuasive or forcing someone into something

Doing anything sexually aggressive to another person without their consent

• The National College Women Sexual Victimization Study (NCWSV)
• -Estimate the incidence of sexual victimization of college women
• Comprehensive representative sample of college women in U.S.
• Questioned if subject had experienced a sexual victimization event

• 2.8% had experienced a completed rape or attempted rape
• Some women were raped by definition but did not personally feel they were raped
• 9 out of 10 women knew the perpetrator
• Overall, 15% of the women had been sexually victimized

• Frequently drinking to get drunk
• Being unmarried
• Having a history of previous sexual assaults
• Living on campus

• Unplanned and unsafe sexual activity
• Physical and sexual assault
• Criminal violations
• Physical injury
• Interpersonal problems
• Academic Perfromance

• Rohypnol
• GHB

Depressant that cause a loss of memory and make women vulnerable to uninvited sexual intercourse

Depressant that causes amnesia, euphoria, loss of consciousness making women vulnerable to sexual assault

• Forced intercourse by a person who is unknown to the victim
• The assailant typically targets the victim
• Most likely to involve guns, knives, other weapons

• Plan travel in advance
• Avoid dark and isolated areas
• Take a self-defense course
• Don't list your telephone name in the phone book or on mailbox
• Locks on all doors and windows
• Leave a light on near the entrance
• Get a dog

• 13% of married women have been raped by husbands
• 84% of husbands used force
• Peronality traits of husbands

• Sexual intercourse between a person older than the legal age of consent with a partner who is younger than the legal age of consent.
• The legal age of consent varies by state between 12 to 21 years old.

• Statistics from FBI and Bureau of Justice's National Crime Victimization Survey
• -Definition of rape as a crime:
• --The carnal knowledge of a female forcibly and against her will.
• Rape is one of the least reportable crimes in the U.S.
• Rate is 32 per 100,000 women

• Relationship between victim and rapist
• How the two came together
• Threat of force
• Use of force
• Extent of injury
• Use of medical treatment

• Hostility toward women
• Hostile home environment
• History of delinquency
• Sexual promiscuity

• Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature in the workplace
• Men and women tend to interpret sexual harassment differently.

• A powerful differential in the relationship
• Inappropriate approach
• Pressure after expression of disinterest

• At parties
• After midnight
• At their residence
• At a frat house

• Any sexual contact between an adult and a child who is under 18 years of age
• Begins as normal behaviors
• Perpetrator tells child that they are doing nothing wrong and don't tell anyone
• Child Molestation
• Incest

Sexual abuse of a child by non-family members

Sexual abuse involving genetically related family members

• Child Molesters-profile
• Movitation to Abuse
• Internal Inhibitions Against Abuse
• External Inhibitions Against Abuse
• Children's Resistance

• Emotional congruence
• Sexual arousal
• Blockage of alternative forms of sexual arousal

• Prey on weaknesses
• Use coercion, threats, punishment, and force
• Prime targets
• Education and support

• Having a stepfather
• Ever lived with mother alone
• Not close to mother
• Mother never finishing high school
• Sex-punitive mother
• No physical affection from Father
• Income under $10,000 a year
• Two friends or fewer in childhood

• Unreported
• Number of reported cases have declined 2-11% since 1998

• Relationship between the victim and perpetrator
• Time span of abuse
• Violent contact
• Intrusive

• Have difficulty forming intimate relationships
• Lack trust
• Have revulsion of being touched
• Often alcohol and drug abusers
• Some are characterized by a lack of emotion and sexual interest

• Registration and Community Notification Laws
• -Convicted sexual offenders must register with law enforcement authorities
• -Provide community notification
• --Registered letters
• --Posting of pictures
• --Mailings to families, community, groups, and organizations
• --National Sex Offender Registry
• --Arkansas Crime Information Center

• Provide sex education
• Become an approachable parent
• Discuss inappropriate sexual behavior with your children
• Let your children know they can can decide how, when, and by whome they want to be touched
• Discuss refusal skills
• Discuss escape skills
• Discuss telling