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S1u C8Cu 8C!

LC1 vluLC SC8l1



SLarLs wlLh a 8reaklng news" screen
Ieremy 8reaklng news! We have 8reaklng news here people! Shhh LlsLen! 1he CuC has [usL
reporLed a dramaLlc rlse ln Lhe number of S1u cases reporLed each year l don'L know whaL Lhe heck
you people are dolng ouL Lhere buL lock lL up! Serlously Lhough leL's Lalk abouL Lhls We have seL up
Leam coverage Lo help you undersLand some of Lhese S1u's and whaL Lo do lf you have or Lhlnk you
have one
LeL's begln wlLh Chlamydla as lL ls Lhe mosL frequenLly reporLed bacLerlal sexually LransmlLLed dlsease ln
Lhe unlLed SLaLes An esLlmaLed 28 mllllon lnfecLlons occur annually ln Lhe uS 8reLL ls sLandlng by Lo
brlng you more on Lhls lncredlbly nasLy dlsease 8reLL"

8rett 1hank you !eremy And mlghL l add LhaL ls a very manly musLache you have Lhere Wver
wonder how you can geL a smelly puss Lo come from your penls? Pave LhaL burnlng deslre" Lo urlnaLe?
Well look no furLher frlends Chlamydia is the most common bacterial based sexually transmitted
disease in the United States, with over 2.8 million aIIected individuals each year. Among adults,
about 5 oI the population is estimated to be inIected.However, those darn scandalous
sexually active adolescent Iemales have a inIection rate oI over 10. Chlamydia is an inIection
caused by the bacterium Chlamydia trachomatis. No, that wasn`t a sneeze, it is the buggy bug
name.. The inIection is transmitted in 2 ways: Through sexual contact (oral, anal, or vaginal) or
Irom mom to baby during birth. Chlamydia can cause pneumonia or serious eye inIections in a
newborn, especially among children born to inIected mothers in developing countries.
Though none oI you dirty birdies show symptoms, you are probably still inIected you just
don`t KNOW you are. II symptoms do occur, they usually appear within 1 to 3 weeks aIter
exposure. In women, the bacteria initially inIect the cervix and the urethra, which is where you
get the burn... Women who have symptoms might also have an abnormal vaginal discharge.
The inIection spreads Irom the cervix to the Iallopian tubes, yet some women still have no signs
or symptoms. Others have lower abdominal pain, low back pain, nausea, Iever, pain during
intercourse, or bleeding between menstrual periods. Chlamydial inIection oI the cervix can
spread to the rectum, yes, I said rectum... Men with signs or symptoms might have a discharge
Irom their penis or a burning sensation when urinating. Men might also have burning and
itching around the opening oI the penis. Pain and swelling in the testicles are uncommon, so
sorry guys, nothing to look Iorward to. Men or women who have receptive anal intercourse (the
receiver, not the QB) may acquire Chlamydia inIection in the rectum, which can cause rectal
pain, discharge, or bleeding. Chlamydia can also be Iound in the throats oI women and men
having oral sex with an inIected partner.
Your doc may prescribe a single-dose antibiotic and up to 95 oI people will be cured
aIter one course oI antibiotics.
Are there complications iI not treated? Why yes, there are. 10- 40 oI women will
develop pelvic inIlammatory disease and 5 oI women with pelvic inIlammatory disease will
develop a Iorm oI liver disease (perihepatitis). Women may develop chronic pelvic pain and
become sterile due to blockage oI the Fallopian tubes. More common in men, some may develop
sexually acquired reactive arthritis or 'Reiter syndrome" and experience painIul swelling oI the
testicles.
To determine iI you are inIected with Chlamydia your doc will conduct the Iollowing
exams and tests. Physical examination tenderness Ior women in the area oI the sex organs,
detection oI pus Irom the vagina or penis, and Iever are indications oI inIection. Diagnostic tests
may be ordered that may include looking at samples oI the discharge under a microscope or
obtaining cultures to identiIy the disease-causing bacteria. You may also be tested Ior other
sexually transmitted diseases because many patients with Chlamydia also have other inIections
such as gonorrhea or trichomoniasls. II you are diagnosed with Chlamydia, Iinish the entire
course oI antibiotics your doctor prescribes, even iI you're Ieeling Iine and symptoms go away.
Do not sell your prescription to your buddy.. NotiIy any and all sexual partners oI inIection,
yes, even iI it takes days. They should be treated or tested so the inIection is not passed back and
Iorth. Get retested iI your symptoms continue or you think you have been re-inIected. Having
the inIection once does not mean immunity to repeat inIection. Avoid sexual contact with high-
risk partners. And please, en[oy a wonderful 1ro[an condoms (for your pleasure) during sex, (yes,
that was a shameless sponsor plug). Jeremy, Back to you..
1eremy: 'Well, that was.. InIormative.. Thank you, Brett. We had a Iew phone calls during
that segment Irom people with the same symptoms, but diagnosed with Syphilis. Shockingly, no
one would agree to speak on air. hmm. strange.moving right along. Let`s go to Brandon
who is standing by with Syphilis. (turns to someone oII screen 'Poor guy..).
Brandon: ~I don`t have, wait, I do, wait... oh Iorget it..Syphllls ls a sexually LransmlLLed
dlsease caused by Lhe bacLerlum 1reponema pallldum lL ls hard Lo dlagnose because so many
of Lhe slgns and sympLoms are lndlsLlngulshable from Lhose of oLher dlseases PealLh offlclals
reporLed over 36000 cases of syphllls ln 2006 lncludlng 9736 cases of prlmary and secondary
syphllls ln Lhe uS alone Palf of all syphllls cases were reporLed from 20 counLles and 2 clLles
and mosL cases occurred ln persons 20 Lo 39 years of age 1haL remlnds me l need Lo look for a
new place
1he lncldence of syphllls was hlghesL ln women 20 Lo 24 years of age and ln men 33 Lo 39 years
of age and cases of congenlLal syphllls ln newborns lncreased by 20 Syphllls ls passed from
person Lo person Lhrough dlrecL conLacL wlLh an open sore (gross) Sores occur malnly on Lhe
exLernal genlLals vaglna anus or ln Lhe recLum Sores also can occur on Lhe llps and ln Lhe
mouLh Why you would have sex wlLh someLhlng LhaL looks llke LhaL l don'L know lL's
grosss l've seenplcLures 1ransmlsslon of Lhe organlsm occurs durlng vaglnal anal or oral
sex regnanL women wlLh Lhe dlsease can pass lL Lo Lhe bables Lhey are carrylng Syphllls
cannoL be spread Lhrough conLacL wlLh LolleL seaLs doorknobs swlmmlng pools hoL Lubs
baLhLubs shared cloLhlng or eaLlng uLenslls so go nuLs
Many people lnfecLed wlLh syphllls do noL have any sympLoms for years yeL remaln aL
rlsk for laLe compllcaLlons lf Lhey are noL LreaLed AlLhough Lransmlsslon occurs from persons
wlLh sores who are ln Lhe prlmary or secondary sLage many of Lhese sores are unrecognlzed
Lhus Lransmlsslon may occur from persons who are unaware of Lhelr lnfecLlon
1he prlmary sLage of syphllls ls usually marked by Lhe appearance of a slngle sore LhaL lasLs 3 Lo
6 weeks and lL heals wlLhouL LreaLmenL Powever lf adequaLe LreaLmenL ls noL admlnlsLered
Lhe lnfecLlon progresses Lo Lhe secondary sLage Skln rash and mucous membrane leslons
characLerlze Lhe secondary sLage 1hls sLage Lyplcally sLarLs wlLh Lhe developmenL of a rash on
one or more areas of Lhe body 1he slgns and sympLoms of secondary syphllls wlll resolve wlLh
or wlLhouL LreaLmenL buL wlLhouL LreaLmenL Lhe lnfecLlon wlll progress Lo Lhe laLenL and
posslbly laLe sLages of dlsease 1he laLenL (hldden) sLage of syphllls beglns when prlmary and
secondary sympLoms dlsappear WlLhouL LreaLmenL Lhe lnfecLed person wlll conLlnue Lo have
syphllls even Lhough Lhere are no slgns or sympLoms lnfecLlon remalns ln Lhe body 1hls laLenL
sLage can lasL for years 1he laLe sLages of syphllls can develop ln abouL 13 of people who
have noL been LreaLed for syphllls and can appear 1020 years afLer lnfecLlon was flrsL
acqulred ln Lhe laLe sLages of syphllls Lhe dlsease may subsequenLly damage Lhe lnLernal
organs lncludlng Lhe braln nerves eyes hearL blood vessels llver bones and [olnLs Slgns and
sympLoms of Lhe laLe sLage of syphllls lnclude dlfflculLy coordlnaLlng muscle movemenLs
paralysls numbness gradual bllndness and demenLla 1hls damage may be serlous enough Lo
cause deaLh Some healLh care provlders can dlagnose syphllls by examlnlng maLerlal from a
chancre (lnfecLlous sore A blood LesL ls anoLher way Lo deLermlne wheLher someone has
syphllls Syphllls ls easy Lo cure ln lLs early sLages
lf your Llp ls drlppln' don'L be Lrlppln' Lhere lS a cure!
A slngle lnLramuscular ln[ecLlon of penlclllln an anLlbloLlc wlll cure a person who has had
syphllls for less Lhan a year AddlLlonal doses are needed Lo LreaL someone who has had syphllls
for longer Lhan a year lor people who are allerglc Lo penlclllln oLher anLlbloLlcs are avallable Lo
LreaL syphllls 1here are no home remedles or overLhecounLer drugs LhaL wlll cure syphllls
1reaLmenL wlll klll Lhe syphllls bacLerlum and prevenL furLher damage buL lL wlll noL repalr
damage already done 8ecause effecLlve LreaLmenL ls avallable lL ls lmporLanL LhaL persons be
screened for syphllls on an ongolng basls lf Lhelr sexual behavlors puL Lhem aL rlsk for S1us
ersons who recelve syphllls LreaLmenL musL absLaln from sexual conLacL wlLh new parLners
unLll Lhe syphllls sores are compleLely healed ersons wlLh syphllls musL noLlfy Lhelr sex
parLners so LhaL Lhey also can be LesLed and recelve LreaLmenL lf necessary Pavlng syphllls
once does noL proLecL a person from geLLlng lL agaln lollowlng successful LreaLmenL people
can sLlll be suscepLlble Lo relnfecLlon 1he suresL way Lo avold Lransmlsslon of sexually
LransmlLLed dlseases lncludlng syphllls ls Lo absLaln from sexual conLacL or Lo be ln a longLerm
muLually monogamous relaLlonshlp wlLh a parLner who has been LesLed and ls known Lo be
unlnfecLed Avoldlng alcohol and drug use may also help prevenL Lransmlsslon of syphllls
because Lhese acLlvlLles may lead Lo rlsky sexual behavlor lL ls lmporLanL LhaL sex parLners Lalk
Lo each oLher abouL Lhelr Plv sLaLus and hlsLory of oLher S1us so LhaL prevenLlve acLlon can be
Laken Condoms wlll proLecL agalnsL Lhls nasLyness !eremy"
Ieremy 1haL sounds llke a good Llme for a word from our sponsors Lhe flne people aL
1ro[an
ommercial: hLLp//wwwyouLubecom/waLch?vk!dM3[WvSg
1eremy: 'Gotta love the holidays.Damn egg nog haha. Which reminds me, I need to run and
get. why don`t we cut to our station nurse Chandni Ior a minute to get the Nurse`s role in all
this hanky panky mahem.Heeelllloooo NURSE!
andni: 'Hi, Jeremy. Thanks Ior the intro, I think..
There are many things a Nurse does STI prevention.
Two well known things include:
O educating patients and the public about testing and treatment options as well as
O educating the public about STIs and STI transmission.
Educating patients and the public about testing and treatment options simply requires the nurse to
make the patients as well as the public:
O aware oI what sorts oI STI tests are available
O aware oI what sorts oI STI treatments are available
O and aware oI what an STI test entails
Educating the public about STIs and STI transmission includes:
O Education about what sorts oI STIs are out there
O And How STIs are spread
4 How STIs are spread is an important concept because it is a misconception that
STIs are simply transmitted by being sexually active. However, there are many
other modes oI transmission as well, including:
Oral sex
Needles, IV
Blood transIusions
Child birth (through the birthing canal)
And Breast Ieeding (via the breast milk)
In addition, an article Irom NursingTimes.net mentioned that is vital that a Nurse recognized at
risk groups Ior STIs as well as what inIluences risky sexual behavior.
This article mentioned that a Iew inIluences on risky sexual behavior include:
Low selI-esteem
Lack oI skills
4 An example oI this is being unable to use or put on a condom
Lack oI negotiation skills
4 An example oI this would be having an individual who is unable to say
'no to sex without condoms
Lack oI knowledge about the risks that come with diIIerent sexual behaviors
The lack oI resources available
4 For example, not being able to buy condoms due to Iinancial reasons
And Being sucked into peer pressure
While educating patients as well as the public is important in STI prevention, it is also signiIicant
that the Nurse be approachable and comIorting enough Ior patients. This important role Ior
Nurses tends to be helpIul when a patient Ieels too embarrassed or hesitant to ask Ior advice or
even help.
Many patients complaining oI a possible STI are simply embarrassed patients:
Imagine being a 23 year old male, complaining oI itching and burning as well as painIul
urination.
Not only would the patient be in discomIort, but it is a shot at his male ego to even admit
that he might have an STI. In order Ior the patient to Ieel more at ease and calm enough
to give you, the nurse, the patient`s history as well as chieI complaints, the nurse needs to
maintain a proIessional yet nurturing attitude.
This simple gesture would not only make you, the nurse, a better patient advocate, but it
would greatly beneIit the patient in receiving any and all treatment and testing needed.
Under age (16 year old patients) are becoming more and more prevalent when it comes to STIs:
Young people are beginning to become sexually active even earlier. Their oItentimes lack
oI education about protecting themselves and lack oI prophylactic use sometimes makes
them more prone to Sexually Transmitted InIections. Also, there is a relationship between
premature and early sexual contact and an ampliIied number oI sexual partners with
regards to STIs.
We all remember having the birds and the bees talk as well as the very blunt and to the
point Sex Education courses we took in Middle School. While these talks were
inIormative about what sex is and how to have sex and how to use a condom, the lack oI
educating the younger generation, who is sexually active, about HPV and other diseases
is only giving the under aged sexually active kids a lack in education about how harmIul
unprotected sex can be.
Imagine a 16 year old girl coming into a doctor`s oIIice. Not only is she worried about
her painIul urination and redness in the area, but she is the oIIice with her mother. This
makes it diIIicult to have the patient, who is under age, be honest with you, the nurse.
Not only is she unable to actually admit that she is sexually active, but having her mother
present in the appointment creates a barrier.
As a nurse, it would greatly help the child be aware oI conIidential oIIices such as
Planned Parenthood which have STI testing and treatments available. However, in order
to make the child Ieel even remotely comIortable requires the nurse to give oII a
comIorting and non-judgmental vibe.
All in all, it is important that the Nurse keep in mind that they are the patient advocate, and to
always have the patient`s best interest in mind. And in order to create a saIe and non-judgmental
environment Ior the patients, it is vital that Nurses be aware oI the reasons Ior risky sexual
behavior.
1eremy: 'Thank you, Chandni. Let`s go to Andrew who has Iull coverage oI the 'Herp-a-
licious outbreak in the community...
Andrew: #Pello lm Andrew Merch and lm lLchlng Lo unload an ouLbreak of lnformaLlon on you
Lver wake up from a passlonaLe nlghL wlLh an unknown lover Lo flnd a couple cold sores ln your mouLh
or around your llps? you could be Lhe proud carrler of PL8LS SlMLLx vl8uS 1 more commonly
know as Cral Perpes! Pow could l be so lucky you ask? Well lll Lell youCral Perpes ls LransmlLLed
from one person Lo Lhe nexL Lhrough conLacL wlLh an lnfecLed person lL ls more common LhaL Lhe
dlsease wlll spread only when Lhere ls an ouLbreak of sores presenL buL lL can be spread aL any Llme
Cral herpes ls mosL commonly spread Lhrough oral secreLlons or sores of Lhe skln lL can be spread by
klsslng or sharlng oral uLlnslls

ln rare cases dlsease can lead Lo a bonus round called Perpes Slmplex 2 or CenlLal Perpes! !usL when
you LhoughL lL couldnL geL any beLLer8AM!! lLchy rash on Lhe gennys!! 1here are Lwo sLages ln whlch
Lhls dlsease goes Lhrough boLh of whlch revolve as Lhe dlsease ls never fully removed from Lhe body
llrsL Lhere ls a herpes rash 1he rash lnvolves small bumps on Lhe skln LhaL ls lnfecLed 1he bumps wlll
laLer Lurn lnLo bllsLers LhaL are fllled wlLh a mllky whlLe fluld 8ecause Lhese llLLle Lhlngs are so lLchy
Lhey wlll break open AL Lhls Llme Lhey form open palnful sores on Lhe skln AfLer a few days Lhey wlll
heal over wlLh scabs and Lhe dlsease enLers Lhe second sLage 1hls sLage ls slmply when Lhe PSv vlrus ls
dormanL ln Lhe body where Lhere are noL slgns or sympLoms of Lhe condlLlon on Lhe skln

1o Lop lL all off Lhere ls no cure for Perpes lf you have herpes lL ls up Lo you Lo leL your sexual
parLners know Lhls Secondly lL ls up Lo you Lo do all LhaL you can Loward genlLal herpes prevenLlon
CenlLal herpes medlcaLlon can help Lhough 1he easlesL way Lo pass Lhe condlLlon Lo anoLher person ls
Lhrough and durlng an ouLbreak MedlcaLlons help Lo keep ouLbreaks from happenlng 8y reduclng Lhe
number of ouLbreaks Lhere ls a sllmmer chance LhaL you would pass Lhe vlrus on Spreadlng herpes ls
posslble many docLors belleve wlLhouL an ouLbreak buL lL ls greaLly reduced

AnoLher fun fllled resulL from rldlng dlrLy ls Pv or CenlLal human paplllomavlrus 1hls wonderful
blesslng boLh males and females and ls Lhe mosL common sexually LransmlLLed lnfecLlon 1here are
more Lhan 40 Lypes of Pv LhaL lnfecL Lhe genlLal area of boLh sexes Some good news ls LhaL mosL
people wlLh Pv do noL develop sympLoms or healLh problems from lL ln facL ln 90 of cases Lhe bodys
lmmune sysLem clears Pv naLurally wlLhln Lwo years 8uL for Lhe oLher lucky people lLs a bumpy and
lumpy rlde SomeLlmes cerLaln Lypes of Pv can cause genlLal warLs ln males and females 8arely Lhese
Lypes can also cause warLs ln Lhe LhroaL yummy! 1hls condlLlon ls called recurrenL resplraLory
paplllomaLosls or 88 CLher Pv Lypes can cause cervlcal cancer 1hese Lypes can also cause oLher less
common buL serlous cancers lncludlng cancers of Lhe vulva vaglna penls anus and head and neck
(Longue Lonslls and LhroaL)

lf Pv sounds llke someLhlng you wouldnL be lnLeresLed ln Lhen here are some Llps on prevenLlon
vacclnes for women lnclude Cervarlx and Cardasll whlch are recommended for ages 11 Lo 36 lor males
Cardasll works for ages 9 Lo 26 ln boLh cases Cardasll helps prevenL mosL Lypes of genlLal warLs as well
Also belng falLhful Lo one parLner and condoms help lower Lhe rlsk of lnfecLlon

So remember people don'L be so free and easy 1hls lsn'L Lhls 60's8ag lL before you shag lL"

Ieremy ugh Lhanks Andrew lnformaLlve as always LeL's Lake a qulck break Lo recover"

Commerc|a| hLLp//wwwyouLubecom/waLch?vLcva6?xClw
eremy: sLares blankly aL screen for abouL 10 seconds

ndsay: Cbvlously we are havlng some Lechnlcal dlfflculLy !eremy ls never LhaL quleL As you
all know we here aL kCSu wanL Lo ensure you all have a fun and safe summer so we have puL
LogeLher a few S1u LesLlng and prevenLlon Llps Lo help you ouL We llke Lo call Lhls llLLle segmenL
Wrap lL 8efore you 1ap lL

llrsL and foremosL absLlnence ls as always Lhe besL posslble prevenLlon for Lransfer of S1u's
so all you ugly l mean asLheLlcally challenged people have a head sLarL AbsLalnlng from all forms of sex
ls Lhe only 100 sure way Lo noL conLracL an S1u lf you make Lhe declslon noL Lo absLaln Lry Lo keep
you number of sexual parLners Lo a mlnlmum Lo llmlL your exposure Lo Lhls growlng epldemlc 1he
CenLer for ulsease ConLrol suggesLs obLalnlng a sexual hlsLory from your parLner ln Lheory Lhls ls greaL
advlce buL human naLure suggesLs a lack of honesLy ln Lhls regard due Lo embarrassmenL or belng really
horney ln reallLy Lhe only one you can counL on Lo keep you safe ls you lnslsL on condom use and
LesLlng before lnLercourse

arenLs Lalk Lo your Leens abouL Lhe dangers LhaL accompany sexual acLlvlLy WlLh Lhe sLaLlsLlcs
of adolescenLs conLracLlng S1u's on Lhe rlse lL ls lmporLanL Leens undersLand how Lo prevenL S1u's and
how Lo cope wlLh dlfflculL slLuaLlons and sexual declslons lf you are havlng Lrouble communlcaLlng wlLh
your Leen feel uncomforLable or [usL don'L know how Lo approach Lhe sub[ecL Lhere are numerous
webslLes you can access for advlce Some of Lhe mosL effecLlve and user frlendly slLes are
wwwLalkabouLsLdscom wwwllfe123com/parenLlng and wwwplannedparenLhoodorg leedback
from parenLs and Leens allke show LhaL Lhese slLes are helpful lnformaLlve and can Leach boLh parenL
and Leen how Lo deal wlLh sexual cholces

Also avold sex wlLh lv drug users as S1u's are passed Lhrough bodlly flulds 1hls ls a vasLly
overlooked form of S1u Lransmlsslon and mosL lnfecLed persons don'L Lhlnk Lo lnform Lhelr drug
parLners of Lhelr affllcLlon probably due Lo Lhe facL LhaL Lhey are oh l dunno PlCP [usL sayln'
1ry re and osL Lxposure prophylaxls lf you have many parLners AnLlreLrovlral Lherapy has
Lhe poLenLlal Lo lnhlblL Lransmlsslon and acqulslLlon of Plv Also use of Lenofovlr gel slgnlflcanLly
reduce Lhe spread of Plv and Perpes Slmplex 2 vlrus AlLhough sLlll ln Lhe LesLlng phase Lhe gel shows
lmmense poLenLlal As far as osL Lxposure douchlng ls lneffecLlve ln proLecLlng agalnsL Plv and S1u's
1hough once LhoughL of as safe and effecLlve posL lnLercourse douchlng acLually lncreases rlsk of
lnfecLlon So ladles you can sklp Lhe afLer sex baLhroom Lrlp AlLhough urlnaLlon afLer sex ls an
effecLlve meLhod for prevenLlng urlnary LracL lnfecLlons [usL l?l

arLner ManagemenL ls also an effecLlve conLrol/prevenLlon meLhod 1hls lnvolves cllnlcalcare
provlders belng noLlfled of lnfecLed paLlenLs and Lhelr parLners elLher sexual or needlesharlng ln
naLure 1he careprovlders assess and lnLervlew Lhe paLlenL Lhen conLacL Lhe paLlenL's parLners and
arrange for evaluaLlon and LreaLmenL 1hese LreaLmenLs lnclude healLh counsellng as well as LreaLmenLs
and/or medlcaLlons approprlaLe Lo Lhelr exposure 1hese can lnclude penlclllln for Syphllls odofllox
LrlchloroaceLlc acld or cryoLherapy wlLh llquld nlLrogen for genlLal warLs and LryLhromycln or
AzlLhromycln for Chlamydla
1he mosL common affllcLlon LhaL boLh women Anu men are belng LreaLed for ls vaglnal
Lrlchmonlasls whlch ls an S1u caused by a paraslLe (a bad bug") and ls LreaLed by meLronlzadole
Powever Lhe CenLer for ulsease ConLrol reporLs LhaL Lhere ls a shorLage of MeLronlzadole so new
LreaLmenLs may be forLhcomlng and of course we wlll keep you updaLed as Lhey become avallable
Cause we knCW you need Lhem

1here are several S1u cllnlcs across San ulego counLy where you can go for LesLlng LreaLmenL
vacclnes and lnformaLlon 1he cllnlcs are sLaffed wlLh physlclans nurse pracLlLloners and reglsLered
nurses and are walkln based cllnlcs 1here ls a nomlnal $13 fee Lo be seen whlch can be walved for
cllenLs unable Lo pay 1hls fee covers physlcal exam lab LesLs LreaLmenL vacclnes and a 30 day follow
up aymenL ls by cash or check only and lnsurance ls noL accepLed Some locaLlons also offer rapld Plv
LesLlng 1he cllnlcs are locaLed ln San ulego on 8osecrans and on unlverslLy ln Cceanslde on SouLh
8arnes and ln Chula vlsLa on Cxford lor a more compleLe llsLlng of addresses conLacL lnformaLlon
and cllnlc hours please vlslL www SdcounLycagov
llnally Lhe flne folks aL 1ro[an would llke Lo remlnd you lf you are golng Lo parLlclpaLe ln Lhe
[oys of sex do lL safely and for your pleasure Wrap lL before you Lap lL
lor kCSu l'm Llndsay vall SLay Classy San ulego !eremy"
Ieremy 1hank you Lo ouL news Leam for puLLlng yourselves ouL Lhere ln Lhe S1u world and lnfecLlng
us wlLh your lnformaLlon We know Lhe rlsks you Look Lo brlng us Lhe mosL honesL and up Lo daLe lnfo
now lf you'll excuse me l have Lo go geL proLecLlon before l go ouL lnLo Lhe nlghLllfe of Saan
uleaagowhlch ls Spanlsh for Whale's vaglnafrom kCSuCood nlghL and good luck!"

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