REPRODUCTIVE

04/10/2024
HEALTH

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 REPRODUCTIVE
HEALTH
Session ONE

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What is adolescent sexual &
reproductive health (ASRH)?

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 What isREPRODUCTIVE
Adolescence?
Period from 10 – 19 yearsHEALTH
of age:

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• Very Young Adolescence: 10-14 years

• Middle Adolescence: 15-16 years

• Older Adolescence: 17- 19 years

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 What isREPRODUCTIVE
Adolescence?
• Period between childhood and
adulthood HEALTH

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• Visible physical, behavioral and
psychological change

• Increase feeling of independence

especially independence from
adults
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 REPRODUCTIVE
Adolescents are not a homogenous group!
Certain adolescents are always at HEALTH

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high risk, regardless of the
situation:
• Pregnant adolescents
• Orphaned adolescents
• Adolescent heads of household
• Marginalized adolescents:
• Adolescents living with HIV
• Adolescents
5 with disabilities
• Adolescents who identify as
LGBTI
• Adolescents belonging to
indigenous or migrant groups
 REPRODUCTIVE
HEALTH

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What is sexual & reproductive health?

Health as defined by WHO is a state of

complete physical, mental and social well
being and not the mere absence of disease and
infirmity.
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 REPRODUCTIVE
Reproductive health (synonymousHEALTH
with sexual and

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reproductive health) is a state of complete physical,
mental and social well being pertaining to sexual and
reproductive health of individuals and not the mere
absence of disease or infirmity pertaining to sexual
and reproductive functions of individuals.

Reproductive health is one of the major focus of

pubic7health endeavors.
 REPRODUCTIVE
HEALTH
Importance of Sexual and Reproductive Health

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 Reproduction and sexuality is an important part of
life
 90% of women and couples achieve pregnancy at
least once during their life time
 40% of pregnancies sustain some complication of
which 15% are life threatening complications
possibly leading to maternal and perinatal
mortality
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if untreated
 REPRODUCTIVE
Importance of Sexual and Reproductive Health
 Due to the universality of pregnancy, the
HEALTH
magnitude of maternal and perinatal mortality can

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be enormous in parts of the world where
pregnancy care is suboptimal
 The reproductive tract is an important origin of
precancerous and cancerous lesions of men as
well as women
 Non-malignant illnesses of the reproductive tract
also constitute major public health problems
affecting
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millions of reproductive age individuals
every year
 REPRODUCTIVE
Importance of Sexual and Reproductive Health
Every Day…HEALTH

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 100 million sexual acts occur
 10,000 conceptions follow
 50% of which are unplanned; 25% unwanted
 80 million abortions annually;1/3 unsafe
 356,000 sexually transmitted infections occur
 1370 maternal deaths; 580,000 maternal deaths
annually in the world
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 REPRODUCTIVE
HEALTH
Importance of Sexual and Reproductive Health

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Every Day…
 300 million couples have no access to
contraception
 Sexual and reproductive health issues are thus of
major public health concerns

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 REPRODUCTIVE
HEALTH
Importance of Sexual and Reproductive Health

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Every Day…
 300 million couples have no access to
contraception
 Sexual and reproductive health issues are thus of
major public health concerns

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 ASRH Rights are Human
Rights
Freedom from Education &
Harmful Practices Health Information

Equality in Adolescent Freedom

Marriage Sexual & from
Reproductive violence
Health
Privacy
Consent to
Marriage
Decide Freedom
Number & from
Spacing of Discriminati
Children on

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 REPRODUCTIVE
HEALTH
Importance of Sexual and Reproductive Health

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Every Day…
 300 million couples have no access to
contraception
 Sexual and reproductive health issues are thus of
major public health concerns

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 Important Reproductive Health problems
RH problem Description

Maternal 40% of pregnancies suffer some complications out of which

mortality/morbidity 15% are life threatening if not managed promptly. Maternal
mortality is a major public health problem in low resource
countries where pregnancy care is suboptimal or absent.

Sexually transmitted STIs are a slow epidemic increasing steadily for the last several
infections decades. They lead to numerous complications including PID,
preterm labor, PROM, perinatal infections, neonatal sepsis,
infertility, ectopic pregnancy and chronic pelvic pain. 356,000
new cases of STIs occur every 24 hours.

Gender based Women are the primary victims of gender based violence
violence including rape due to their low socioeconomic status in society.
GBV leads to physical, social and psychological injury to women
and girls including unwanted pregnancy, unsafe abortion, STIs,
HIV/AIDS, poor pregnancy outcome and death.

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 Important Reproductive Health problems
RH problem Description

Maternal 40% of pregnancies suffer some complications out of which

mortality/morbidity 15% are life threatening if not managed promptly. Maternal
mortality is a major public health problem in low resource
countries where pregnancy care is suboptimal or absent.

Sexually transmitted STIs are a slow epidemic increasing steadily for the last several
infections decades. They lead to numerous complications including PID,
preterm labor, PROM, perinatal infections, neonatal sepsis,
infertility, ectopic pregnancy and chronic pelvic pain. 356,000
new cases of STIs occur every 24 hours.

Gender based Women are the primary victims of gender based violence
violence including rape due to their low socioeconomic status in society.
GBV leads to physical, social and psychological injury to women
and girls including unwanted pregnancy, unsafe abortion, STIs,
HIV/AIDS, poor pregnancy outcome and death.

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 Important Reproductive Health problems
RH problem Description

Harmful In societies with low status of women, several harmful traditional

traditional practices are inflicted on women victims that lead to detrimental
practices of their SRH status. These practices include female circumcision,
abduction marriage, early or child marriage etc

Reproductive Cervical cancer is the number one killer genital malignancy in sub
tract cancers Saharan Africa killing around 200,000 women annually. This is due
to the lack of pap screening and preponderance of its risk factors
such as early coitus and multiparity.

Unsafe abortion In societies where access to contraception is low and availability of

information and services to adolescents is poor prevalence of
unsafe abortion and resultant death and morbidity are very high.
Globally every year, 80,000 young women die from unsafe
abortion.

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 Important Reproductive Health problems

RH problem Description

Menopausal and The menopause leads to some health risks that require follow up
postmenopausal and management. These include postmenopausal osteoporosis and
problems increased cardiovascular atherosclerotic risks. In developed
societies women are now spending an average of 30 years or one
thirds of their life time in the menopause.

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 Global strategies for addressing SRH problems
RH problem Strategies

Sexually transmitted •Community sensitization and health education

infections •Improved access to facilities for screening and treatment
•Increased condom use and safe sex practices
•Gender rights advocacy
•Screening and treatment during antenatal and family
planning services

Gender based •Community sensitization with increased male involvement

violence •Legal provisions and enhanced implementation
•Health education to women about their legal rights
•Life skills education for young men and women

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 Global strategies for addressing SRH problems
RH problem Strategies

Sexually transmitted •Community sensitization and health education

infections •Improved access to facilities for screening and treatment
•Increased condom use and safe sex practices
•Gender rights advocacy
•Screening and treatment during antenatal and family
planning services

Gender based •Community sensitization with increased male involvement

violence •Legal provisions and enhanced implementation
•Health education to women about their legal rights
•Life skills education for young men and women

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 Global strategies for addressing SRH problems
RH problem Strategies

Harmful traditional •Legal provisions for prevention

practices •Community mobilization by using community leaders
•Advocacy via the media
•Girls education and women's empowerment

Reproductive tract •Increased access to screening and treatment

cancers •Vaccination against HPV- advocate for increased access
•Community health education on the importance of screening
•Reduction of its risk factors such as early marriage and
multiparity
•HIV prevention

Unsafe abortion •Improved access to contraception for vulnerable groups

•Health education and community sensitization on the causes
and dangers of unsafe abortion
•Safe abortion provision as permitted by the law
•Improved access to SRH services to adolescents

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 Global strategies for addressing SRH problems
RH problems Strategies

Gender rights for women •Legal provisions for equal political, social and
economic rights for women
•Advocacy at all levels for improvement of women’s
rights
•Improved girls and women’s education
•Increased partnership of men in gender advocacy and
improvements in women’s status
•Improvements in women’s economic situation
•Overall economic developments

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 REPRODUCTIVE
SRH Needs of Very Young Adolescents
HEALTH

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o Very young adolescents need accurate, unbiased
information about sexuality and reproductive
health from their service providers and parents.
Overall, young people have limited access to
comprehensive sexuality education or other
sources of reliable information about their sexual
and reproductive health, and this is particularly
true
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for adolescents aged 10-14, girls who are
married before age 15
 REPRODUCTIVE
SRH Needs of Very YoungHEALTH
Adolescents

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 Very young adolescents are exploring their values
and beliefs around their emerging sexuality,
including what it means to be a man or a woman.
 It is during this period of life that young people
adopt and establish their gender roles and
identities.
 They
24 are very receptive to information about the
following topics:
 REPRODUCTIVE
SRH Needs of Very Young Adolescents
HEALTH

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 What changes to expect during puberty, including
information about menstruation and nocturnal
emissions.
 Gender roles, gender norms, and expressions of
gender.
 Relationships.

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 REPRODUCTIVE
SRH Needs of Very YoungHEALTH
Adolescents

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 Violence, consent, and bodily autonomy.
 Sexuality, body image, personal values, tolerance,
respect, and inclusion.
 For girls who are married, contraception, healthy
timing and spacing of pregnancy, and healthy
pregnancies.
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 REPRODUCTIVE
HEALTH

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Termination of Pregnancy

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 Termination of Pregnancy

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 Termination of Pregnancy

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 Outline

• Definition of termination of pregnancy

• Indications for termination of pregnancy
• Methods of pregnancy termination
• Complications of pregnancy termination
procedures

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 Outline

• Definition of termination of pregnancy

• Indications for termination of pregnancy
• Methods of pregnancy termination
• Complications of pregnancy termination
procedures

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 Definition of Termination of Pregnancy

• Termination of pregnancy is the artificial

interruption of pregnancy before fetal viability
• It could be because of clear dangers to maternal or
fetal health and life ( Medical indications) or
• Safe abortion conducted as per the provisions of a
particular country’s law based on indications other
than purely medical ( Non-medical
indications)

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 Unintended Pregnancy

• Health considerations
• Socioeconomic concerns
• Cultural reasons
• End childbearing or space births
• Rape, incest
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• Other personal reasons 04/10/2024
 Unintended Pregnancy

• 222 million
 women who do not want to become
pregnant but are using no
contraceptive method or a traditional
method

• 33 million
 accidental pregnancies among
34 contraceptive users 04/10/2024
 Public Health Context

• 85 million
 unintended pregnancies
annually in the developing
world

• 40 million
 end in abortion

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 Public Health Context

Unsafe Abortions

Developing
Countries: 98%

Developed
Countries:
2%

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 Public Health Context

Induced Abortions
in Developing Countries

Unsafe Safe

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Public Health Context

Unsafe Abortion in
Developing Countries

Over age
20

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 Proportion of abortions
that are unsafe

Africa 97

Latin America 95

Asia 40 Unsafe
Safe

Eastern Europe 13

Developed Countries 0.5

39 0% 20% 40% 60% 80% 100% 04/10/2024

 Consequences of unsafe abortion

• 47,000
related
deaths

• 5 million
women with
disabilities

• 220,000
children
motherless
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Complications of abortion

 Haemorrhage
 Septicaemia
 Bacteraemia shock with rigors, nausea,

vomiting, diarrhoea, hypotension,

confusion, delirium and coma
 Renal failure
 Secondary

infertility
 Death

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 Legal grounds for abortion

• When there is threat to a woman’s life

• When there is threat to a woman’s health
• When pregnancy is the result of rape or
incest
• Where there is fetal impairment
• For economic and social reasons
• On request

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 Legal grounds for abortion

• When there is threat to a woman’s life

• When there is threat to a woman’s health
• When pregnancy is the result of rape or
incest
• Where there is fetal impairment
• For economic and social reasons
• On request

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 REPRODUCTIVE
HEALTH

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What does
STI
stand for?

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 REPRODUCTIVE
Sexually Transmitted Infection
(STI) HEALTH

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•Most STIs have no symptoms
•A person can have an STI and not know it

Why would you be at greater risk of getting an STI that doesn't cause any
symptoms?

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 How can someone
REPRODUCTIVE
get an STI?
HEALTH

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• Vaginal sex
• Anal sex
• Oral sex
• Transmission from mother to baby during childbirth
• Skin to Skin contact
• Sharing equipment
• Exchange
47 of bodily fluids
 There are
REPRODUCTIVE
3 types of HEALTH
STIs

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Bacterial
Parasitic
Viral

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 Bacterial STIs
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HEALTH

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Chlamydia

Gonorrhea

Syphilis
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 Chlamydia
REPRODUCTIVE
HEALTH

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• Among the most common bacterial STIs in the world
• Passed by having unprotected oral, anal or vaginal sex
• Condoms can help prevent the spread of chlamydia during
vaginal/anal sex
• Condoms or dental dams can be used for protection during
oral sex

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 Chlamydia
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HEALTH

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• Most people have no symptoms
• The infection can be cured with a single dose of antibiotics
• A person can get the infection again, so their partners
should also be tested

Remember chlamydia is CURABLE!

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 Chlamydia
REPRODUCTIVE
HEALTH

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 Gonorrhea
REPRODUCTIVE
• Sexually transmitted bacterialHEALTH
infection

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• Passed along by having unprotected oral, anal or
vaginal sex
• Condoms can help prevent the spread of
gonorrhea during vaginal or anal sex
• Condoms or dental dams can be used for
protection during oral sex
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 Gonorrhea
REPRODUCTIVE
• Most people have no symptoms HEALTH

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• The infection can be cured with antibiotics
• A person can get the infection again, so their
partners should also be tested

Remember gonorrhea is CURABLE!

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 Gonorrhea
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HEALTH

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 Syphilis
REPRODUCTIVE
• HEALTH
Rare sexually transmitted bacterial infection

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• Can cause serious damage to the body if not
cured, including death
• Passed along by having unprotected oral, anal or
vaginal sex
• Condoms can help prevent the spread of syphilis
during vaginal or anal sex
• Condoms
56 or dental dams can be used for
protection during oral sex
 Syphilis
REPRODUCTIVE
• Syphilis produces a wide range HEALTH
of symptoms that

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are often confused with other illnesses
• Some people have no symptoms at all
• The infection can be cured antibiotics
• A person can get the infection again, so their
partners should also be tested

Remember
57 syphilis is CURABLE!
 Syphilis
REPRODUCTIVE
HEALTH

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 Trichomoniasis
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HEALTH

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Caused
59 by a parasite that is usually sexually
transmitted, but it can survive 24 hours on wet towels
and bathing suits
 REPRODUCTIVE
HEALTH
Trichomoniasis

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Signs and symptoms of a parasitic
STI
•Intense itchiness
•Reddish rash
•Pain during sex or urination
•60Vaginal discharge
 REPRODUCTIVE
HEALTH

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Human Immunodeficiency Virus (HIV) and
Acquired Immunodeficiency Syndrome (AIDS)

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 HIV and AIDS
REPRODUCTIVE
•HIV is the initial infection HEALTH

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•AIDS is the advanced stage of the disease
•Over a period of time, the virus attacks and damages
the body’s immune and nervous system

How is HIV/AIDS spread?

•The virus is spread through bodily fluids
•Decrease risk with condom use
•There
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is no cure for HIV infection
•Once infected, you have HIV for life
 REPRODUCTIVE
HEALTH

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What is the only 100 % effective
way of preventing STIs and
pregnancy?

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 REPRODUCTIVE
HEALTH

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Abstinence!
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 REPRODUCTIVE
What does abstinence mean?
HEALTH
•Abstinence means to not do something

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•Sexual abstinence means to abstain from
different levels of sexual activity
•Possible choices for sexual abstinence
between two people could be:
• Avoiding vaginal and anal intercourse
• Avoiding oral-genital contact
• Avoiding
65 genital contact
 REPRODUCTIVE
Preventing STIs and pregnancy
HEALTH

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•Delay sexual activity until you are older
•If you choose to be sexually active, use
protective barriers (condoms, dental dams)
and birth control

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 REPRODUCTIVE
Summary
HEALTH

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•Keep informed about STIs and how to protect
yourself

•Talk to a parent, teacher, or a trusted adult

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 REPRODUCTIVE
HEALTH

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QUESTIONS?

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