Health

Sexually transmitted diseases (also called STDs, or STIs for sexually transmitted infections) are infections that can be transferred from one person to another through sexual contact.

• Chlamydia
• Genital Herpes
• Gonorrhoea
• HIV/AIDS
• Human Papillomavirus (HPV)
• Lymphogranuloma venereum (LGV)
• Syphilis

Some people with an STI have few or no symptoms at all; others have very obvious symptoms. Be aware of any changes in your health, or symptoms such as:

• different or heavier discharge from the vagina
• discharge from the penis
• a burning feeling when urinating (peeing)
• sores, particularly in the genital or anal areas
• itchy feeling around the sex organs or anus
• appearance of a rash
• swollen glands in the groin.

These symptoms might appear alone, or in combination. Having a symptom doesn't mean you do have an STI but if you are having sex and taking chances, you should see a health professional for a check-up.

STIs or sexually transmitted infections can be spread in several ways.

STIs are usually spread through sex because the bacteria or viruses travel in semen, vaginal fluids, and blood. Saliva (or spit) can spread some STIs if you have a tiny cut in or around your mouth.

STIs can be spread through direct contact with an infected area.

Infected blood on needles and syringes can spread certain STIs.

Infected women can pass some STIs to their babies during pregnancy, at childbirth or during breastfeeding.

You can catch some STIs more than once. And, you can have more than one STI at a time.

If you are HIV positive and have another of the sexually transmitted infections, you increase your chances of GIVING HIV to your partner.

If you don't have HIV but have another sexually transmitted infection, you increase your chances of GETTING HIV from an HIV positive partner.

Many STIs are easily treated, but all can be dangerous if ignored.

To reduce the possibility of spreading STIs or reinfection, sexually activity should be postponed until treatment has been completed.

For some STIs, like HIV, there is no cure to date.

Following these suggestions may help you to protect yourself from contracting an STI:

Learn about safer sex methods - see Smarter Sex.

Make informed decisions and talk to your partner(s) about their STI status and the use of protection;

Use condoms consistently and correctly;

Get tested for STIs if you are sexually active; and

And if you are diagnosed and treated for an STI, be sure to follow your health care provider's treatment and follow-up recommendations. You can easily be reinfected if your partner is not treated as well.

For more information about sexually transmitted diseases go to:

Canadian Resources:
Public Health Agency of Canada
American Resources:
Centers for Disease Control and Prevention
For numbers to call for information go to:
Public Health Agency of Canada

If you think your substance use may be causing problems in your life, try the following questionnaire, called the CAGE (each letter stands for a key word in the four questions):

• Have you ever tried to cut down on your drinking or other drug use?
• Have you ever felt angry at or annoyed by someone else's comments about your drinking or other drug use?
• Have you ever felt guilty about your drinking or other drug use?
• Have you ever used alcohol or other drugs as an eye-opener-that is, have you used first thing in the morning?

If you answer yes to two or more of these questions, you may have a substance use problem. Even a "yes" answer to one question might be a cause for concern and worth investigating further.

In some cities some youth services provide sterile equipment (e.g., needles, stems). You should ask a worker at a local service/drop in where this can be found in your city. See CitiWide Harm Reduction for an example of such a program.

If you have problems such as bleeding gums, loose teeth, aching teeth, or your teeth that cause a lot of pain in response to hot or cold, pressure or sweetness, you probably have to see a dentist. Like most medical problems, dental problems will usually only get worse until you get it treated. Here are a couple of suggestions:

• In many cities there are youth services that hold free dental clinics. You should ask a worker at a service about how and where you could get access to such a clinic.
• You can ask a doctor (see above) about where you might find free dental clinics.
• You can go to an emergency room where you might be able to access emergency dental treatment.

The best thing to do is to try to brush your teeth and floss regularly. This is especially important if you can't get to the dentist for checkups on a regular basis. For instructions about brushing and flossing go to: Canadian Dental Association

If you think you are pregnant (e.g., have missed a one or more periods, getting sick in the mornings), there are a couple of things you can do to see if you really are pregnant. You can ask a medical professional to test you (see info on medical care). Free pregnancy tests are done at many clinics, such as Planned Parenthood. You can also purchase a pregnancy testing kit from a drug store.

Being pregnant and without adequate housing can be stressful. Issues that often come up include whether or not to have the baby, how to keep the fetus healthy, and what to do when the baby is born.

Deciding to keep or not keep the baby: Some women have clearly decided to have their baby. Some firmly decide not to have the baby. Some go through a difficult process trying to decide whether or not to have the baby. Regardless, it is suggested that you speak with a health professional or counsellor about your decision and make sure that you decide based on all of the important facts/information. This can be a counsellor at a youth agency, or a counsellor at a pregnancy clinic. Many hospitals have women's clinics that can be helpful. There are also counsellors available at organizations such as Planned Parenthood U.S. and Canada Canadian Federation for Sexual Health. If you choose to have an abortion, such counsellors can be helpful in supporting you in that process. Another option is carrying your baby to term and having him/her adopted. Planned Parenthood can discuss this with you.

Healthy Pregnancy: Lacking adequate housing and being street-involved can make a healthy pregnancy difficult. Factors such as high levels of chronic stress and malnutrition can have a major impact on the health of your baby. Also, anything that you take into your body goes into the body of your baby. Smoking cigarettes, using drugs and alcohol all can have a major impact on your baby's health and long term development. Problems linked to drug and alcohol use include miscarriage, brain damage, premature delivery, and low birth weight. Unsafe sex during pregnancy can also cause transmission of a sexually transmitted disease (e.g., AIDS) to the baby. You should speak with a counsellor as soon as you find out that you are pregnant about steps you can take to keep healthy while you are pregnant and find housing. There are also shelters that are specifically for mothers without housing and their babies. You should be aware that Child Protection Services/Children's Aid Society would likely regard keeping a baby on the streets to be a significant risk to the child and take custody of the baby until some form of safe and stable housing can be provided. There are a number of things you will need to do to make sure your baby is healthy during pregnancy. This includes:

• Not using drugs, alcohol, or smoking
• Eat nutritious foods
• Take vitamins
• Don't over exert yourself
• If you have sex, take precautions (e.g., condoms)
• Take folic acid
• Reduce your stress levels
• See a doctor or OBGYN regularly
• Do not take any medications, over the counter or prescription, that you haven't cleared with a health professional about how it might affect the baby
• For more info, go to: Public Health Agency of Canada
• For information on drugs and procedures as they might affect the fetus (e.g., what over the counter medication you can safely take), call 1-877-327-4636 in Canada (MotherRisk).
• For information on post partum (after birth) anxiety and depression, go to Kids Health.

Being without a regular house and on the streets can be very stressful. Many youth, due to both stress and bad experiences on the streets and bad experiences in childhood, struggle with mental health issues. This includes feeling down and depressed, feeling very anxious and worried all of the time, hearing things that other people can't hear and thinking that everyone wants to hurt you, and having a hard time with memories about very bad past experiences. Having these kinds of difficulties can make it harder to cope with problems, can get in the way of important relationships, and can take away parts of life that are fun or make you happy.

It is important to know that there is help available if you are feeling this way. There are people you can talk with privately who will not judge you for something that has happened to you or is happening in your life. It can be a huge relief to talk to someone. Here are some things you could do to get some help with this:

• Youth agencies have staff who are very experienced with counselling and who can help you get access to other forms of help as well.
• You can also call someone for help. In Canada you can call the Kid's Help Phone Kids Help Phone any day and at any time of day (1-800-668-6868), you can call in the U.S. the National Runaway Switchboard at 1-800-621-4000 or the Covenant House Nineline at 800-999-9999.
  For a list of numbers around the world go to Email Santa.
• For more information and ideas about getting help and helping yourself, go to Kids Health.
• If things get so bad that you feel like you can't go on or can't look after yourself, you can go to a hospital emergency room for help. If this includes thinking about suicide and planning to hurt yourself, see the section on suicide for help.

For more information about mental illness and the kinds of treatments available, and locations where you could get help, see Canadian Mental Health Association in Canada and National Institute of Mental Health in the U.S.

Sexual assault and rape have been experienced by many street involved youths. These are extremely difficult experiences and it can be hard to know what to do after it happens. Here is some information and suggestions that might help. Kids Health

You're not alone. Many youth think about suicide. Thinking about suicide doesn't always mean that there's a problem, as long as it doesn't last very long and it isn't a powerful thought.

Why do I feel this way?

There are many reasons why you might be thinking about suicide or feeling emotional pain, including things like:

• major life changes
• stress
• loss or death
• the end of a relationship
• suffering from a chronic illness
• having problems with alcohol or drug use
• being assaulted
• feeling unable to get off the streets

What should I do?

If you're stressed out and feeling overwhelmed, try to simplify. If you have too many things going on and can't keep up, decide what's important or what can be put on the back burner, and then try to just concentrate on the important things. If you're feeling sad or depressed, you can try some of these things to help you feel better:

• Talk to and spend time with friends.
• Start a new activity or hobby.
• Try to get some exercise
• Write about your feelings in a journal or diary.
• Use art to express your feelings.

If none of these activities make you feel any better, you might want to talk to a counsellor at an agency or another health professional.

When is it a problem?

Your suicidal thoughts may be a real problem if you:

• are writing about suicide
• have a specific suicide plan
• have a family history of suicide
• are showing signs of depression or other mental illness
• have increased your use of alcohol or other drugs
• are feeling hopeless, helpless and trapped
• are losing interest in friends and usual activities
• have suffered a recent loss (such as the death of a loved one).

Where do I get help?

If suicide is on your mind often or every day, if it's a powerful feeling or if you really feel it's the only solution to your problems, then you have to do something about it and get some help and support. There are other ways of dealing with your pain.

• Tell someone how you're feeling and ask for help.
• Call Kids Help Phone at 1-800-668-6868 in Canada or call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) in the United States.
• If you can't get help by trying the ideas and numbers above, go to a hospital emergency room or call 911.