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      "body": "Diseases & Conditions\nSTD Diagnosis, Images, Symptoms, Treatment\nReviewed By Charles Patrick Davis, MD, PhD on 8/7/2016\nFacebook Twitter Email\nGenital Warts (HPV)\nPhoto of Genital Warts.\n\nIt's not necessary to have sexual intercourse to get a sexually-transmitted disease (STD). The human papillomavirus (HPV) that causes genital warts can be transmitted by close skin-to-skin contact. Some types of HPVs cause cervical or anal cancer, and vaccines are available to protect against the most dangerous types. Other HPV types cause genital warts, which can be raised, flat, or cauliflower-shaped. HPV infection can occur in people who have no symptoms or visible warts.\n\nHPV Symptoms\n\n    Genital warts can be big or small, flat or raised. They generally appear as a small bump or group of bumps in the genital region, and may be shaped like a cauliflower.\n\n\nHPV Vaccine\n\n    A vaccine to prevent HPV is given in three shots. The second shot is given a month or two after the first shot. The third shot comes six months after the first shot.\n    The Centers for Disease Control recommends boys and girls be vaccinated at ages 11 or 12.\n    If they did not get the HPV vaccine as children, women can get the HPV vaccine through age 26. Men can get it through age 21. The CDC recommends HPV vaccination for men through age 26 for men who have sex with men or men with compromised immune systems, including HIV.\n\nPubic Lice (Crabs STD)\nPhoto of Pubic Lice.\n\nPubic lice are colloquially known as \"crabs.\" This name refers to the shape of these parasites, which is different from that of body lice. Pubic lice live in pubic hair and are spread among people during close contact. Pubic lice can be treated with over-the-counter lice-killing medications.\n\nPubic Lice (Crabs) Symptoms\n\n    Severe itching\n    Visible crawling lice or eggs attached to pubic hair \n\nScabies\nPhoto of Scabies.\n\nScabies is another disease caused by lice infestation. It is not necessarily an STD, since it can affect any area of the skin. However, it is often spread during sexual contact.\n\nScabies Symptoms\n\n    Extreme itching that is worse at night.\n    The skin appears to have a pimple-like rash, as shown in this photo.\n    Both the itching and rash may be across the body or limited to the wrist, elbow, armpit, webbing between fingers, nipple, penis, waist, belt-line or buttocks.\n    Tiny blisters (vesicles) and scales may appear.\n    Tiny burrows left by the tunneling of female scabies mites may be visible on the skin.\n    They appear as tiny raised and crooked grayish-white or skin-colored lines.\n\nPrescription creams can cure a scabies infestation.\nGonorrhea (The Clap)\nPhoto of Gonorrhea.\n\nGonorrhea is an easily transmissible STD that affects both men and women. It can cause infertility in men and women when untreated. There may be no early symptoms of the infection.\n\nGonorrhea Symptoms\n\n    Burning during urination\n    Vaginal or urethral discharge\n    Pelvic pain in women\n    Men may experience swelling of the testes and discharge from the penis\n\nIn some cases, the symptoms are mild and the condition is mistaken for a urinary tract infection or yeast infection.\nSyphilis\nPhoto of Syphilis infections.\n\nSyphilis can be cured with antibiotics, but many people don't notice the early symptoms. It can lead to nerve damage, blindness, paralysis, and even death overtime if not treated.\n\nSyphilis Symptoms\n\n    A round, firm, painless sore on the genitals or anal area (often the first sign)\n    A rash can develop later on the soles of the feet, palms, or other parts of the body\n    Enlarged lymph nodes\n    Fatigue\n    Hair loss\n    Late-stage syphilis can cause damage to many different organ systems\n\nChlamydia\nPhoto of Chlamydia bacteria.\n\nChlamydia is a very common infection transmitted by sexual contact. It can cause infertility if not treated. The symptoms may not be noticed, or they may be vague and nonspecific. Some people have no symptoms at all.\n\nChlamydia Symptoms\n\n    Burning or itching of the genitals\n    Discharge\n    Painful urination\n\nChlamydia infections can also develop in the rectum and throat.\nHerpes Simplex 1 Virus (Oral Herpes)\nPhoto of Herpes Simplex Virus Type 1 (oral herpes).\n\nCold sores or \"fever blisters\" on the lips are a sign of herpes virus infection, usually caused by the type of herpes virus known as human herpes virus 1, or HHV-1. HHV-1 is usually not considered to be an STD; however, it can be spread through kissing or household contact. It can also spread to the genitals. There is no cure for herpes infection, but medications can reduce the severity and duration of outbreaks.\n\nHerpes Simplex 1 (Oral Herpes) Symptoms\n\n    Itching of the lips or skin around the mouth\n    Burning near the lips or mouth area\n    Tingling near the lips or mouth area\n    Sore throat\n    Swollen glands\n    Painful swallowing\n    A rash may form on your gums, lips, mouth or throat\n\nSymptoms usually appear 1-3 weeks after first infection. When symptoms return, they are typically milder.\nHerpes Simplex 2 Virus (Genital Herpes)\nPhoto of Herpes Simplex Virus Type 2 (genital herpes)\n\nIn contrast to HHV-1, most genital herpes infections are caused by a different virus known as HHV-2. It is spread through direct contact and is considered to be an STD. More than 87 percent of those infected with genital herpes are unaware of their infection due to very mild or nonexistent symptoms.\n\nHerpes Simplex 2 (Genital Herpes) Symptoms\n\n    Painful, fluid-filled blisters and crusted sores on the genital area, buttocks, thighs, or anus.\n    Mild tingling or shooting pain in the legs, hips, or buttocks may occur hours to days before a genital herpes outbreak.\n    After the first infection, less severe outbreaks are common in the first year. Outbreaks tend to decrease over time, though the infection may stay in the body indefinitely.\n\nThe infection can spread to the lips through oral contact. As with HHV-1, medications can reduce the severity of the condition, but there is no cure.\nHepatitis B\nPhoto of Hepatitis B Virus.\n\nHepatitis B is a virus that spreads through contact with body fluids and blood, so it can be transmitted through sexual intercourse. Hepatitis B infection is also possible through sharing of needles, razors, and toothbrushes. Babies can become infected at birth from an infected mother. It's possible to go for years without symptoms of the infection.\n\nHepatitis B Symptoms\n\n    Nausea\n    Abdominal pain\n    Jaundice (yellowing of the skin and whites of the eyes)\n    Over time, scarring of the liver (cirrhosis) and liver cancer can develop\n\nAlthough there is no cure, there is a vaccine to prevent hepatitis B infection.\nHIV/AIDS\nPhoto of HIV infections.\n\nThe HIV virus (AIDS virus) weakens the body's immune system. It is spread through sexual contact, needle sharing, or from an infected mother to baby. There may be no symptoms for years, but a blood test can tell if you have been infected. With appropriate treatment, many serious illnesses can be prevented.\n\nHIV Symptoms\n\n    Flu-like symptoms 1 to 2 months after first infection, including like swollen lymph nodes, fever, and headaches\n    Chills\n    Rash\n    Night sweats\n    Muscle Aches\n    Sore throat\n    Swollen lymph nodes\n    Mouth ulcers\n\n\nAIDS Symptoms\n\n    Rapid weight loss\n    Recurring fever or profuse night sweats\n    Extreme and unexplained tiredness\n    Prolonged swelling of the lymph glands in the armpits, groin, or neck\n    Diarrhea that lasts for more than a week\n    Sores of the mouth, anus, or genitals\n    Pneumonia\n    Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids\n    Memory loss, depression, and other neurologic disorders\n\nHIV Testing\nPhoto of doctor with blood samples used to test for HIV.\n\nThere are accurate tests to identify whether or not you have been infected with the HIV virus. These can be done in the clinic or at home with the FDA-approved Home Access test kit. The test can be performed anonymously, with only a number to identify you. However, sometimes people may not test positive in the initial 6 months after infection. This time period is referred to as the \"window period\" in which antibodies may not have developed enough for a positive test. You can still transmit the virus to others during this time.\nHIV/AIDS Treatment Options\nPhoto of pills in man's hand, used to prevent infection in HIV/AIDS patient.\n\nWhile there is no cure for HIV, there are medications that can suppress the amount of virus multiplying inside the body. People take a combination of antiviral drugs in hopes of preventing the infection from advancing to AIDS. Additional treatments can help prevent or fight off serious infections, if the immune system has weakened.\nTrichomoniasis\nPhoto of Trichomoniasis parasite.\n\nTrichomoniasis is a parasitic infection (caused by Trichomonas vaginalis) that is spread during sexual contact. It affects both men and women and can be cured with medications. Most affected men have no specific symptoms.\n\nTrichomoniasis Symptoms\n\n    Men: minor discharge or burning with urination\n    Women: yellowish-green vaginal discharge with a prominent odor, itching of the vaginal area, or painful sex or urination \n\nSymptoms can develop anywhere from 5 to 28 days after contracting the infection.\nChancroid\nPhoto of Chancroid infections.\n\nChancroid is an STD that is rarely seen in the U.S. It is more common in Africa and Asia. It causes painful lumps in the genital area that can progress to open sores. Antibiotics can cure the infection; chancroid is caused by bacterial infection with Haemophilus ducreyi.\n\nChancroid Symptoms\n\n    One or more sores or raised bumps on the genitals. A narrow, red border surrounds the sores. The sores become filled with pus and eventually rupture into a painful open sore.\n    About half the time when untreated, the chancroid bacterial infection spreads to the groin's lymph glands, causing the groin to enlarge and become hard and painful.\n\nLymphogranuloma venereum (LGV)\nPhoto of Lymphogranuloma venereum (LGV) infection.\n\nLymphogranuloma venereum (LGV) is a type of chlamydial infection, but it is caused by a different type of chlamydia (Chlamydia trachomatis) than the usual chlamydial STD. Like other chlamydial infections, it can be cured by antibiotic treatment.\n\nEarly Lymphogranuloma venereum Symptoms (3-12 Days After Exposure)\n\n    Soft red, painless sores on or near the genitals or anus\n    Similar sores in the throat or mouth following oral sex\n\n\nLater Lymphogranuloma venereum Symptoms (2-6 Weeks After Exposure)\n\n    Open sores in the genitals\n    Swollen lymph nodes in the groin\n    Headache\n    Anal sores and rectal discharge or bleeding if the infection was acquired through anal sex\n    Painful urination\n    Constipation\n    Rectal bleeding\n    Pain in lower back/abdomen\n    Pus-filled or bloody diarrhea\n    Fever, chills, joint pain, decreased appetite and fatigue\n\nPelvic Inflammatory Disease\nPhoto of Pelvic Inflammatory Disease.\n\nPelvic inflammatory disease (PID) is not a specific STD. Rather, it is a complication that can develop following multiple different STDs, particularly gonorrhea and chlamydia. In PID, bacteria spread to the uterus and female reproductive tract. Infertility may result if the condition is not treated right away.\n\nPelvic Inflammatory Disease Symptoms\n\n    Fever\n    Pelvic or low abdominal pain\n    Painful urination\n    Discharge\n    Painful intercourse\n    Light bleeding\n\nWho's at Risk for STDs?\nPhoto of teenage couple on the couch, at risk for STDs.\n\nIt's estimated that half of sexually active young adults acquire an STD by age 25. In fact, STDs are the most common type of infection in America. While STDs are more common in teens and young adults, anyone who is sexually active is at risk. The risk is raised by having multiple sex partners. The incidence of some STDs, including LGV and syphilis, is rising in men who have sex with men.\nCan Virgins Get STDs?\nPhoto of couple kissing in car, still at risk for STDs.\n\nMany STDs can spread through any type of sexual activity. This includes skin-to-skin contact and oral sex. This means that people who have not yet had sexual intercourse can still get STDs.\nSTD Prevention\nPhoto of gloved hands.\n\nAbstinence from any sexual contact is the only absolute way to prevent getting an STD. Being in a long-term, monogamous relationship also is a good way to avoid STDs. There are also steps you can take to decrease the chance of getting an STD if you are sexually active, including:\n\n    Asking partners if they have ever had an STD\n    Using condoms\n    Avoiding sexual activity with a partner who has signs of an STD\n    Asking partners to be tested before having sex\n    Being aware of symptoms and signs of STDs\n\nThe Limits of Condoms\nPhoto of condom.\n\nCondoms can prevent the spread of some STDs, but they aren't 100% effective. They are less effective at protecting against herpes, syphilis, and genital warts, since these STDs can be transmitted by contact with skin lesions that are not covered by a condom. Condoms also do not protect against crabs and scabies infestations.\nHow to Tell Your Partner You Have an STD\nPhoto of couple talking about STDs.\n\nIt may be difficult, but it is important to tell your partner as soon as possible if you believe you may have an STD. Even if you are being treated, you may still be able to spread the infection. For some STDs, it's recommended that both partners be treated at the same time. It can be difficult to share this information, so some people find that preparing a script in advance can be helpful. Here are some facts that can help the conversation go more smoothly:\n\n    Discovering an STD is not evidence of cheating. It may very well have come from one of yours or your partner's past relationships.\n    An estimated one in two sexually active people will contract an STD by the time they reach age 25. Most of these don't know they have an STD. Many STDs show few or no symptoms when contracted and may be discovered much later.\n\nIt's normal to be nervous about this topic. But by being bold and taking action, you can actively promote better health for you and your partner.\nSTDs and Pregnancy\nPhoto of ultrasound of baby.\n\nSTDs can cause premature labor in pregnant women, and many STDs can be passed to the baby either during pregnancy or childbirth. So all pregnant women should be checked for STDs. STDs can cause numerous problems in babies, like low birth weight, stillbirth, nerve problems, blindness, serious infections, and liver problems. Treatment during pregnancy can reduce the risks of these complications and can cure many types of infections.\nCan STDs Come Back?\nPhoto of people playing volleyball.\n\nIn most cases, new exposures to STDs that you have had in the past can cause you to get the infection again. Most treatments don't protect you from developing the STD at a future time. If your partner has not been treated, you may pass the infection back and forth. Without the right precautions, you could acquire a second STD or a recurrence of the same infection. In addition, genital herpes virus infections can be recurrent after a single exposure.\n\nSome experts prefer to term STD's as STIs (sexually transmitted infections). STIs include all infections that can be transmitted sexually. For example, scabies and most recently, Zika virus infections are better classified as STIs.\nWebMD does not provide medical advice, diagnosis or treatment. See additional information\n© 2005-2018 WebMD, LLC. All rights reserved.\nDiseases & Conditions\nFemale Sexual Dysfunction\nBy Wayne Blocker, MD on 6/1/2016\nFacebook Twitter Email\nSexual Dysfunction is Common\nslide.ImageAlt\n\nSexual dysfunction is a common concern shared by many women. Problems may occur during any phase of the sexual response cycle (excitement, plateau, orgasm, and resolution) that prevent a woman from experiencing sexual satisfaction. Many women are reluctant or embarrassed to discuss their sexual problems, but it's important to tell your doctor what you are experiencing since most cases of sexual dysfunction can be treated.\nWhat Causes Female Sexual Problems?\nslide.ImageAlt\n\nSexual dysfunction can have physical or psychological causes. Physical causes include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause, chronic diseases such as kidney disease or liver failure, alcoholism, drug abuse, and side effects of medications, including antidepressant drugs. Psychological causes of sexual dysfunction can include stress, anxiety, concerns about sexual performance, relationship problems, depression, feelings of guilt, and effects of a past sexual trauma.\nWho Is Affected by Sexual Problems?\nslide.ImageAlt\n\nMen and women can be affected by sexual dysfunction. Seniors may be affected more often, possibly due to health-related declines associated with aging.\nHow Do Sexual Problems Affect Women?\nslide.ImageAlt\n\nCommon types of sexual dysfunction in women include:\n\n    Inhibited sexual desire\n    Inability to become aroused\n    Lack of orgasm (anorgasmia)\n    Painful intercourse\n\nThese will be discussed on the following slides.\nInhibited Sexual Desire\nslide.ImageAlt\n\nLack of sexual desire or lack of interest in sex is inhibited sexual desire. This can have many causes, including hormonal changes, certain medical conditions and treatments, depression, pregnancy, stress, fatigue, lifestyle influences such as work stress or child care, and even boredom with regular sexual routines.\nInability to Become Aroused\nslide.ImageAlt\n\nInsufficient vaginal lubrication in women may trigger the inability to become physically aroused during sexual activity. An inability to be aroused may also result from anxiety, or inadequate sexual stimulation. Blood flow problems to the vagina and clitoris may also affect lubrication and arousal.\nLack of Orgasm (Anorgasmia)\nslide.ImageAlt\n\nThe absence of sexual climax (orgasm) is called anorgasmia. Many factors can contribute to anorgasmia, including sexual inhibition, inexperience, or lack of knowledge. Psychological contributors to anorgasmia may include guilt, anxiety, or a past sexual trauma or abuse. Insufficient stimulation, drugs or medications, and chronic diseases can also result in lack of orgasm.\nPainful Intercourse\nslide.ImageAlt\n\nPainful intercourse can be a result of a number of conditions such as endometriosis, a pelvic mass, ovarian cysts, vaginitis, poor lubrication, vaginal dryness, the presence of scar tissue from surgery, or a sexually transmitted disease. A painful, involuntary spasm of the muscles that surround the vaginal entrance is a condition called vaginismus that may occur in women who fear penetration will be painful, have sexual phobias, or previous traumatic or painful sexual experiences.\nHow Is a Female Sexual Problem Diagnosed?\nslide.ImageAlt\n\nSexual dysfunction in women is diagnosed by a physical exam and symptom history. The doctor will probably perform a pelvic exam with a Pap smear to check for cancer. Other tests may be ordered to rule out medical conditions that may cause sexual dysfunction. You may also be asked about attitudes toward sex, past sexual trauma or abuse, problems in your relationship, or alcohol and drug abuse to help determine if these psychological factors contribute to the dysfunction.\nHow Are Female Sexual Problems Treated?\nslide.ImageAlt\n\nMany types of sexual problems can be treated by addressing the underlying physical or psychological problems. Usually it involves cooperation between the woman, her doctors, and therapists.\n\nTreatment strategies are discussed on the following slides.\nProviding Education\nslide.ImageAlt\n\nPatient education is important to help women overcome anxiety about sexual function and performance. Learning about sexual behaviors and normal responses may ease anxiety.\nEnhancing Sexual Stimulation\nslide.ImageAlt\n\nIt may be necessary to enhance sexual stimulation to help a woman overcome some sexual dysfunction. Masturbation, changing your sexual routine, or use of erotic videos or books may help.\nProviding Distraction Techniques\nslide.ImageAlt\n\nAnxiety may be alleviated with distraction. Erotic or non-erotic fantasies can be useful. Music, videos, or television can also distract and help women relax.\nEncouraging Non-Coital Behaviors\nslide.ImageAlt\n\nOther behaviors that do not involve intercourse such as sensual massage may help a women feel more comfortable with her sexuality and with intercourse, and feel less pressure and anxiety surrounding sexual activity.\nMinimizing Pain\nslide.ImageAlt\n\nIf sexual dysfunction is due to pain, sometimes changing sexual positions may help minimize or eliminate the pain. Vaginal lubricants may relieve pain caused by friction, and relaxation before intercourse (warm bath, meditation) may decrease pain responses.\nCan Sexual Problems Be Cured?\nslide.ImageAlt\n\nThe prognosis for treating sexual dysfunction in women depends on whether the underlying cause can be treated. If sexual dysfunction is related to a treatable physical condition, the outcome is often positive. When dysfunction is due to psychological causes, it can often be treated successfully with counseling, education, and improved communication between partners.\nHow Do Hormones Affect Sexual Function?\nslide.ImageAlt\n\nHormones play a large role in sexual function in women. As women age, the hormone estrogen decreases, which can lead to poor vaginal lubrication and decreased genital sensation. Low levels of the male hormone testosterone in women may also contribute to less sexual arousal, genital sensation, and orgasm.\nWhat Effect Does a Hysterectomy Have on Sexual Function?\nslide.ImageAlt\n\nA hysterectomy (surgical removal of the uterus) may cause sexual dysfunction in many women. Hormonal changes associated with removal of the ovaries may result in loss of desire, decreased vaginal lubrication, and genital sensation. Nerves and blood vessels integral to sexual functioning may also be damaged during the surgery. Finally, some women may become depressed or feel a loss of self-esteem from their uterus being removed that may make it hard for them to engage sexually following the procedure.\nHow Does Menopause Affect a Woman's Sexual Function?\nslide.ImageAlt\n\nMenopause and the associated loss of estrogen can affect women's sexual function such as a loss of vaginal lubrication and genital sensation. Other emotional aspects of menopause may contribute to a loss of interest in sex or an inability to become aroused.\n\nHowever, many postmenopausal women have increased sexual satisfaction. This is thought to be due to less anxiety about getting pregnant, or having the time to relax and enjoy being intimate with their partners.\nWhen Should I Call my Doctor About Sexual Problems?\nslide.ImageAlt\n\nSexual problems in women are common, and nearly every woman will experience them on occasion. If the problems persist, they can be very upsetting for a woman and can affect her relationship with her partner. If you experience any sexual problems on a regular basis, talk to your doctor. Help is available!\nWebMD does not provide medical advice, diagnosis or treatment. See additional information\n\n© 2005-2018 WebMD, LLC. All rights reserved.",
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      "body": "Congratulations @bayer1989! You have completed the following achievement on Steemit and have been rewarded with new badge(s) :\n\n[![](https://steemitimages.com/70x80/http://steemitboard.com/notifications/votes.png)](http://steemitboard.com/@bayer1989) Award for the number of upvotes\n[![](https://steemitimages.com/70x80/http://steemitboard.com/notifications/posts.png)](http://steemitboard.com/@bayer1989) Award for the number of posts published\n[![](https://steemitimages.com/70x80/http://steemitboard.com/notifications/voted.png)](http://steemitboard.com/@bayer1989) Award for the number of upvotes received\n\n<sub>_Click on the badge to view your Board of Honor._</sub>\n<sub>_If you no longer want to receive notifications, reply to this comment with the word_ `STOP`</sub>\n\n\n\n**Do not miss the last post from @steemitboard:**\n[SteemitBoard World Cup Contest - Quarter Finals - Day 2](https://steemit.com/steemitboard/@steemitboard/steemitboard-world-cup-contest-quarter-finals-day-2)\n\n---\n**Participate in the [SteemitBoard World Cup Contest](https://steemit.com/steemitboard/@steemitboard/steemitboard-world-cup-contest-collect-badges-and-win-free-sbd)!**\nCollect World Cup badges and win free SBD\nSupport the Gold Sponsors of the contest: [@good-karma](https://v2.steemconnect.com/sign/account-witness-vote?witness=good-karma&approve=1) and [@lukestokes](https://v2.steemconnect.com/sign/account-witness-vote?witness=lukestokes.mhth&approve=1)\n\n---\n\n> Do you like [SteemitBoard's project](https://steemit.com/@steemitboard)? Then **[Vote for its witness](https://v2.steemconnect.com/sign/account-witness-vote?witness=steemitboard&approve=1)** and **get one more award**!",
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      "body": "Hi! I am a robot. I just upvoted you! I found similar content that readers might be interested in:\nhttp://www.who.int/reproductivehealth/topics/violence/clinical-response-csa/en/",
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      "title": "Rate Of Sexual Abuse on Adolescent age",
      "body": "Responding to children and adolescents who have been sexually abused\nWHO publishes new guidelines\n19 October 2017 Millions of children and adolescents across the globe are subjected to sexual abuse, including sexual assault or rape. A 2011 study estimates that 18% of girls, and 8% of boys worldwide have experienced sexual abuse. This abuse is a major public health problem and a grave violation of human rights. Health care providers have an important role in identifying abuse and providing child or adolescent-centred care to disclosure of abuse. They also have an important role in connecting survivors to other services that they may need.\n\nA 7-year-old girl who was sexually abused by an 18 year old boy at a police station, Sierra Leone\nUNICEF/Asselin\nFor the first time, WHO has published guidelines to help (primarily) front-line healthcare providers give high-quality, compassionate, and respectful care to children and adolescents (up to age 18) who have or may have experienced sexual abuse, including sexual assault or rape.\n\nImage of front cover\nAccess the guidelines\nAbout the guidelines\nThe new WHO Clinical Guidelines for responding to children and adolescents who have been sexually abused are grounded in human rights standards and ethical principles. They recommend that healthcare providers put the best interests of children and adolescents first by assessing and promoting their safety; ensuring confidentiality and privacy; offering choices in provision of care; respecting their autonomy and wishes; and addressing the specific needs of boys and girls with additional vulnerabilities, such as LGBTI adolescents, children and adolescents with disabilities, and those from low socio-economic groups and indigenous populations, and ensuring provision of care to them without discrimination.\n\nConsequences of sexual abuse\nStreet child in Pakistan UNICEF/Noorani\nGirls and boys who experience abuse often face a number of short and long term negative consequences for their mental, physical, sexual, and reproductive health and well-being. Boys and girls who are sexually abused face higher risks of lifetime diagnoses of post-traumatic stress disorder, anxiety, depression, externalizing symptoms, sleep disorders, and having thoughts of suicide and self-harm. They are more likely to engage in unsafe-sex, abuse of drugs and misuse of alcohol, placing them at higher risk for STIs and HIV and for other negative health outcomes that last into adulthood. For girls there is also increased risk of pregnancy and gynaecological disorders.\n\nAdolescents and children at the centre\nThe new guidelines address an important gap in providing quality and trauma-informed care to survivors by placing emphasis on the safety, wishes, autonomy of children and adolescents.\n\nHealth care providers are recommended to:\n\nProvide first line support that is child or adolescent-centred and gender sensitive in response to disclosure of sexual abuse.\nMinimize additional trauma and distress while taking medical history, conducting the examination and documenting the findings.\nOffer HIV post-exposure prophylaxis and adherence support to those who have been raped and who present within 72 hours.\nOffer emergency contraception to girls who have been raped and who present within 120 hours/ 5 days.\nConsider STI presumptive treatment or prophylaxis in settings where laboratory testing is not feasible.\nOffer Hepatitis B and HPV vaccination as per national guidance.\nConsider cognitive behavioural therapy (CBT) with a trauma focus for those have PTSD symptoms and diagnosis and where safe and appropriate to do so involve at least 1 non-offending caregiver.\nWhere required to report child sexual abuse to designated authorities, health care providers should inform the child or adolescent and their non-offending caregivers about the obligation to report the abuse and the limits of confidentiality before interviewing them.\nHelping countries worldwide\nThe new guidelines will assist WHO Member States to ensure the health and wellbeing of children and adolescents and implement the Global Plan of Action on strengthening the health systems response to violence against women and girls and against children, endorsed by the World Health Assembly in May 2016.",
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      "title": "Adolescents and Life",
      "body": "Adolescents: health risks and solutions\n5 February 2018\nالعربية 中文 Français Русский Español\nKey facts\nEstimated 1.2 million adolescents died in 2015, over 3000 every day, mostly from preventable or treatable causes.\nRoad traffic injuries were the leading cause of death in 2015. Other major causes of adolescent deaths include lower respiratory infections, suicide, diarrhoeal diseases, and drowning.\nGlobally, there are 44 births per 1000 to girls aged 15 to 19 per year.\nHalf of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated.\nAround 1.2 billion people, or 1 in 6 of the world’s population, are adolescents aged 10 to 19.\n\nMost are healthy, but there is still substantial premature death, illness, and injury among adolescents. Illnesses can hinder their ability to grow and develop to their full potential. Alcohol or tobacco use, lack of physical activity, unprotected sex and/or exposure to violence can jeopardize not only their current health, but also their health as adults, and even the health of their future children.\n\nPromoting healthy behaviours during adolescence, and taking steps to better protect young people from health risks are critical for the prevention of health problems in adulthood, and for countries’ future health and ability to develop and thrive.\n\nMain health issues include:\nEarly pregnancy and childbirth\nThe leading cause of death for 15– 19-year-old girls globally is complications from pregnancy and childbirth.\n\nSome 11% of all births worldwide are to girls aged 15–19 years, and the vast majority of these births are in low- and middle-income countries. The UN Population Division puts the global adolescent birth rate in 2015 at 44 births per 1000 girls this age – country rates range from 1 to over 200 births per 1000 girls (1). This indicates a marked decrease since 1990. This decrease is reflected in a similar decline in maternal mortality rates among 15–19 year olds.\n\nOne of the specific targets of the health Sustainable Development Goal (SDG 3) is that by 2030, the world should ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes. To support this, a proposed indicator for the Global strategy for women’s, children’s and adolescents’ health is the adolescent birth rate.\n\nBetter access to contraceptive information and services can reduce the number of girls becoming pregnant and giving birth at too young an age. Laws that specify a minimum age of marriage at 18 and which are enforced can help.\n\nGirls who do become pregnant need access to quality antenatal care. Where permitted by law, adolescents who opt to terminate their pregnancies should have access to safe abortion.\n\nHIV\nMore than 2 million adolescents are living with HIV. Although the overall number of HIV-related deaths is down 30% since the peak in 2006 estimates suggest that HIV deaths among adolescents are rising. This increase, which has been predominantly in the WHO African Region, may reflect the fact that although more children with HIV survive into adolescence, they do not all then get the care and support they need to remain in good health and prevent transmission. In sub-Saharan Africa only 10% of young men and 15% of young women aged 15 to 24 are aware of their HIV status.\n\nOne of the specific targets of the health Sustainable Development Goal (SDG 3) is that by 2030 there should be an end to the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases, hepatitis, water-borne diseases and other communicable diseases. Given the high prevalence of HIV in many countries, to achieve this, adolescents will need to be central to control efforts.\n\nYoung people need to know how to protect themselves and must have the means to do so. This includes being able to obtain condoms to prevent sexual transmission of the virus and clean needles and syringes for those who inject drugs. Better access to HIV testing and counselling, and stronger subsequent links to HIV treatment services for those who test HIV positive, are also needed.\n\nOther infectious diseases\nThanks to improved childhood vaccination, adolescent deaths and disability from measles have fallen markedly – for example, by 90% in the African Region between 2000 and 2012. Diarrhoea and lower respiratory tract infections are estimated to be among the top 5 causes of death for 10–19 year olds. These two diseases, together with meningitis, are the top three causes of adolescent death in African low and middle-income countries (LMICs).\n\nMental health\nDepression is the third leading cause of illness and disability among adolescents, and suicide is the third leading cause of death in older adolescents (15–19 years). Violence, poverty, humiliation and feeling devalued can increase the risk of developing mental health problems.\n\nBuilding life skills in children and adolescents and providing them with psychosocial support in schools and other community settings can help promote good mental health. Programmes to help strengthen the ties between adolescents and their families are also important. If problems arise, they should be detected and managed by competent and caring health workers.\n\nViolence\nViolence is a leading cause of death in older adolescent males. Interpersonal violence represents 43% of all adolescent male deaths in LMICs in the WHO Americas Region. Globally, 1 in 10 girls under the age of 20 years report experiencing sexual violence.\n\nPromoting nurturing relationships between parents and children early in life, providing training in life skills, and reducing access to alcohol and firearms can help to prevent injuries and deaths due to violence. Effective and empathetic care for adolescent survivors of violence and ongoing support can help deal with the physical and psychological consequences.\n\nAlcohol and drugs\nHarmful drinking among adolescents is a major concern in many countries. It reduces self-control and increases risky behaviours, such as unsafe sex or dangerous driving. It is a primary cause of injuries (including those due to road traffic accidents), violence (especially by a partner) and premature deaths. It can also lead to health problems in later life and affect life expectancy. Setting a minimum age for buying and consuming alcohol and regulating how alcoholic drinks are targeted at the younger market are among the strategies for reducing harmful drinking.\n\nDrug use among 15–19 year olds is also an important global concern. Drug control may focus on reducing drug demand, drug supply, or both, and successful programmes usually include structural, community, and individual-level interventions.\n\nInjuries\nUnintentional injuries are the leading cause of death and disability among adolescents. In 2015, over 115 000 adolescents died as a result of road traffic accidents. Young drivers need advice on driving safely, while laws that prohibit driving under the influence of alcohol and drugs need to be strictly enforced. Blood alcohol levels need to be set lower for teenage drivers. Graduated licences for novice drivers with zero-tolerance for drink-driving are recommended.\n\nDrowning is also a major cause of death among adolescents – 57 000 adolescents, two-thirds of them boys, are estimated to have drowned in 2015, and teaching children and adolescents to swim is an essential intervention to prevent these deaths.\n\nMalnutrition and obesity\nMany boys and girls in developing countries enter adolescence undernourished, making them more vulnerable to disease and early death. At the other end of the spectrum, the number of adolescents who are overweight or obese is increasing in low, middle and high-income countries.\n\nExercise and nutrition\nIron deficiency anaemia is the leading cause of years lost to death and disability in 2015. Iron and folic acid supplements are a solution that also helps to promote health before adolescents become parents. Regular deworming in areas where intestinal helminths such as hookworm are common is recommended to prevent micronutrient (including iron) deficiencies.\n\nDeveloping healthy eating and exercise habits in adolescence are foundations for good health in adulthood. Reducing the marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt and providing access to healthy foods and opportunities to engage in physical activity are important for all but especially children and adolescents. Yet available survey data indicate that fewer than 1 in every 4 adolescents meets the recommended guidelines for physical activity: 60 minutes of moderate to vigorous physical activity daily.\n\nTobacco use\nThe vast majority of people using tobacco today began doing so when they were adolescents. Prohibiting the sale of tobacco products to minors and increasing the price of tobacco products through higher taxes, banning tobacco advertising and ensuring smoke-free environments are crucial. Globally, at least 1 in 10 adolescents aged 13 to 15 years uses tobacco, although there are areas where this figure is much higher. Cigarette smoking seems to be decreasing among younger adolescents in some high-income countries.\n\nRights of adolescents\nThe rights of children (people under 18 years of age) to survive, grow and develop are enshrined in international legal documents. In 2013, the Committee on the Rights of the Child (CRC), which oversees the child rights convention, published guidelines on the right of children and adolescents to the enjoyment of the highest attainable standard of health, and a General Comment on realizing the rights of children during adolescence was published in 2016. It highlights states’ obligations to recognise the special health and development needs and rights of adolescents and young people.\n\nThe Convention on the Elimination of Discrimination Against Women (CEDAW) also sets out the rights of women and girls to health and adequate health care.\n\nWHO response\nIn May 2017, WHO published a major report: Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to support country implementation. The AA-HA! Guidance has drawn on inputs received during extensive consultations with Member States, United Nations agencies, adolescents and young people, civil society and other partners. It aims to assist governments in deciding what they plan to do and how they plan to do it as they respond to the health needs of adolescents in their countries. This reference document targets national-level policy-makers and programme managers to assist them in planning, implementing , monitoring and evaluation of adolescent health programmes.\n\nOverall, WHO carries out a range of functions to improve the health of young people, including:\n\nproduction of evidence-based guidelines to support health services and other sectors;\nmaking recommendations to governments on adolescent health and the provision of high quality, age-appropriate health services for adolescents;\ndocumenting progress in adolescent health and development; and\nraising awareness of health issues for young people among the general public and other interested stakeholders.\nReferences\n(1) SDG Indicators, Global Database\nhttps://unstats.un.org/sdgs/indicators/database/?indicator=3.7.2",
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