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Public Health 150 > 16. Sexually Transmitted Diseases 11/27 > Flashcards

16. Sexually Transmitted Diseases 11/27 Flashcards

1
Q

Herpes

A

The most prevalent STI in the USA

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2
Q

The most 5 prevalent STI in the USA

A
  1. Herpes
  2. Genital HPV
  3. Chlamydia
  4. HIV
  5. Hepatitis B
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3
Q

Reprotable STDs in Californai

A

Chlamydia, Gonorrhea, Syphilis, HIV/Aids, Hepatitis B, Chancroid, Pelvic Inflammatory Disease (PID)

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4
Q

Non-reportable STDS-Viral/Parasitic

A

Hepes simples virus (HSV)
Human papillomavirus (HPV)
Trichomonas vaginalis

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5
Q

Reported STDS adn HIV.Aids in 2010 top 4

A
  1. Chlamydia 73%
  2. Gonorrhea 16%
  3. Syphilis 5%
  4. HIV/AIDS 6%
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6
Q

Chlamydia trachomatis

A

Most common bacterial STD in US. Chlamdial infections can cause PID, ectopic pregnanacy, infertility adn pregnancy complications. Upt o 70% of sexually active women have asymptomatic chlamydial infections. 14-30 % women re-infected by 6-12 months. Asymotmatic oral adn rectal infections in MSM.

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7
Q

Chlamydia rates in females with race/ethnicity are highes amont

A

Black in 15-19–>Blacks in 20-24
Hispanics 20-24–>Hispanics 15-19
White
Other

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8
Q

Chlamydia rates in males with race/ethnicity are highes amont

A

Black 20-24, 15-19, 25-29

Hispanics

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9
Q

Chlamyia rate by sex in the united states

A

are high among men. bisexual or gay men.

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10
Q

Chlamydia-summary points

A

Epidemic paricularly among young women in Los Angeles County. Often asymptomatic, Serious sequelae, particularly with repeat infections

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11
Q

Gonorrhea

A

second most commn becterial STD in US. Usually symptomatic in males, often asymptomatic in women. Can cause PID, infertility, ectopic pregnancy, and complications in pregnancy in women. High infection rate reproted from non-gential sites amon MSM. Anitbiotic resistance common and has developed rapidly

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12
Q

Gonorrhea Rate females

A

Highest among black females

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13
Q

Gonorrhea rate males

A

highest among black males

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14
Q

Second district accounts for GC?

A

for 40% of GC cases in LA county. GC burden primarly among 2nd district reisdents, Females (disease rate), Youth <25 yrs old, African-Americans

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15
Q

GC transmission

A

Efficently trasmitted bby male to female via semen, Vagina to male urethra, Rectal intercourse, Fellatio(pharyngeal infection), Perinatal transmision (mother to infant). Gonorrhea associated with increased transmission of adn susceptibility to HIV infection

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16
Q

Microbiology/ Pathology

A

Etiologic agent: Neisseria gonorrhoeae, Gram-negatice intracellular diplococcus, infects mucus-secreting epithelial cells, evades host response through alteration of surface structures

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17
Q

Genital Infection in Men

A

Urethritis-inflammation of urethra

Epididymitis-inflammation of the epididymis

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18
Q

MAle Urethritis symptoms

A

Typically purulent or mucopurulent urethral discharge. Often accompanied by dysuria. Discharge may be clear or cloudy. Asymptomatic in a minority of cases. Incubation perido:usually 1-14 days for symptomatic disease, but may be longer

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19
Q

Epididymitis

A

Sysptoms: Unilateral testicular pain and swelling. Infrewuent, but mose common local complication in males. Usually assoicated with overt or subclinical urethritis

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20
Q

Genital Infection in Women

A

Most infections are asymptomatic. cervicitis-inflammation of the cervix. Urthritis-inflammation of the urethra

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21
Q

cervicitis

A

non-specific sysmptoms: abnormal vaginal discharge, intermenstrual bleeding, dysuria, lower abdominal pain, or dyspareunia.
Clinical findings: mucopurulent or purulent cervical discharge, easily induced cervical bleeding. At least 50 % of women with clinical cervicitis have no symptoms. Incubation perios unclear, bot symptoms may occur within 10 days of infection.

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22
Q

Complications in women

A

Pelvic Inflammatory Disease (PID)
May be asymptomatic, may present with lower abdominal pain, discharge, syspareunia, irregular menstrual bleeding and fever. Tubal scarrign and ectopic pregnancy

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23
Q

Syphilis (Treponema Pallidum)

A

high for all male and men who have sex with men

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24
Q

early syphilis-summary points

A

The syphilis epidemic has been concentrated in the Hollywood-Wilshire Healht District (SPA 4, metro) Mosy syphilid is among MSM: WHite adn LAtino MSM predominately affected. Approximately 6 in 10 MSM syphilis cases also HIV infected

25
Q

Sexual Transmission of HIV depends on

A

The infectiousness of the index case:plasma viral load, Genital viral load.
The susceptibility of the unifected partner: presence of STDs. genital inflammation, Innate host factors

26
Q

The susceptibility of the unifected partner of HIV:

A

presence of STDs. genital inflammation, Innate host factors

27
Q

The infectiousness of the index case of HIV:

A

plasma viral load, Genital viral load.

28
Q

STDs as cofactors of HIV infection

A

HIV and other STD are linked by common behaviors as well as biological mechanisms. STDs increase gential HIV RNA concentration in the HIV + partner-independent of plasma viral load.

29
Q

STDs as Cofactors of HIV infection

A

Intermittent STD increases the probability of HIV acquisition/transmission. Ulcerative STDS(e.g., syphilis, gential herpes, chancroid,): 10-50 times.
Non-ulcerative STDs (e.g., Chlamydia and gonorrhea): 2-4 times

30
Q

Trends in bumber of HIV co infection early eyphilis, gonorrhea, and chlamydia 2005-2010

A
  1. syphilis/HIV
  2. Gonorrhea/HIV
  3. Chlamydia/HIV
31
Q

In 2006, an estimated how many new HIV infections occured in the United States?

A

56,300

32
Q

Estimated percentage of New HIV infections, by sex, 2006

A

Men 73%

Women 27%

33
Q

Estimated percentage of New HIV infections, by transmission category 2006

A

Men who have sex with men 53%
Heterosexual contact 31%
Injection drug users

34
Q

Sexual Networks & HIV/ STD transmission

A

Infections come from unambiguoug relations (person-to-person)
Core transmitters are easily idenitified
“Bridges” readily apparent
Challenge to interrupt

35
Q

Priority for PS

A

Acute HIV infection. Syphilid case or serology per reactor grid. Pregnant w/ any STD. NEw HIV. HIV w/ STD

36
Q

Sexual Network:Internet

A

1 person wiht syphilis with 66 partners b/w July and August 2007 (2 prior syphilis infections).
Field staff investigation led to 319 partners (280 anonymous) Met future sex partners online. Limited sata on demographics, drug use. Average age=37.4 (n=29). Syphilis history (n=22) average 2.2 previous syphilis infections. 17 “Bridges”.

37
Q

New PS approaches

A

Internet-based. Public Helaht (DIS) notification of internet partners w/ or w/o prior index notification via internet and/or text. Self notification of internet partners.

38
Q

www.inSPOTLA.org

A

Potentially means to interrupt transmission. Promotes STD and HIV testing and treatment. Promotes connection to community agencies and services. More than 60 clinics and other agencies listed as testing adn resource referrals.

39
Q

HPV

A

Major Capsid Protein(L1)

Viral Nucleic Acid(DNA)

40
Q

HPV-summary

A

HPV vaccination will help lead to an eventural reduction in cervical cancer morbidity and mortality. The populations most in need of the vaccine may have the greatest barriers to recieving it. Need to address HPV knowledge gaps, concerns surrounding acceptance of the vaccine, adn barriers to vaccination, especially among vulnerabel populations.

41
Q

Herpes simplex virus type 1

A 
Mostly orolabial (cold sores, fever blisters).
An increasing proportion of cases of primary gential herpes are caused by HSV-1 (15-30%). Highest incidence in childhood. 73% infected by age 12
42
Q

Hepres simple virus Type 2

A

Almost entirely genital; oral infection 95% of recurrent genital herpes.
Prevalence: 16% of US sexually active adults 81% are undiagnosed.

43
Q

Genital Herpes

A

In USA, estimated incidence: 600,000 to 1 million cases/ year. Significant morbidity and psychological distress. Co-factor for HIV acquisition/ transmission. Neonatal hepes.

44
Q

> 100 HPV Types

A

High-risk types. Low grade cervical abnormalities, cnacer precursors, gential cancers.
Low-risk types. Low grade cervical abnormalities, genital warts, respiratory papillomatosis.
Common warts-hands/feet

45
Q

HPV age

A

nearly half are under age 25

46
Q

Natural History of HPV infection

A

THe body’s immune system usually eliminates HPV infection.

47
Q

Cervical cancer morbidity in the US

A

9th most common cancer in US accounting for 1.7% of deaths among US women.

48
Q

HPV related to

A

Multiple sexual parrtners. Early age od first intercourse, partner’s partners

49
Q

Risk factors for HPV

A

Younger age(peak 16-21, male peak closer ot 25-29).
Sexual behavior-young age of sexual initiation, number sex partners, partner’s sex partners
Immune status
Lack of circumcision in men

50
Q

Risk factors for HSV-2 infection

A

independent predictos for HSV-2 were: Lifetime number of sex partners, female gender, african american, older age

51
Q

Transmission for HSV-2

A

Major routes: sexual adn vertical. Most sexual transmission when index case is asymptomatic. efficiency is greater from men to women than women to men. All infected persons have episodes of asymptoatic viral shedding.

52
Q

Progression of Herpes Lesions

A

Crusting, Scabbing, Healed Skin

53
Q

Primary Genital Herpes

A

FIrst infection ever with either HSV-1 or 2
No serum ntibody is present initially
Incubation period-4 days (2-14 day range)
Sysptoms are usually more severe than in non-primary or recurrent disease
Systemic symptoms in up to 80% (fever, headache, malaise, myalgia)

54
Q

Primary Genital Herpes

A

Local symptoms: pain, itching, dysuria, discharge, inguinal adenopathy.
Multiple painful lesions develop bilaterally
New lesions may appear for up to 10 days, with mean duration of lesions 18 days

55
Q

Recurrent Genital Herpes

A

Milder clinical illness.

56
Q

Subclinical/ Asymptomatic infection

A

Serum anitbody is present. Patient has never noticed symptoms. Most has never noticed symptoms. Most probably have mild, unrecognized disease. Probably all shed virus from the genital area intermittenly.

57
Q

Aymptomatic Viral shedding

A

Most people with genitla HSV-2 shed virus asymptomatically. ncommon in HSV-1 gential infection. May shed from cervis, vulva, urethera, rectum, penis. Frequency of asymptomatic shedding in high first year after acwuistion, then stabilizes.

58
Q

Discordant gential herpes transmission may occur during asymptomaticb

A

up to 70% of Transmission may occur during asymptomatic viral shedding
Up to 30% transmission during symptomatic outbreaks.

59
Q

www.DOntThinkKnow.org

A

on interior bus cards, bus kings, 8-sheets outdoor, bus kings, interior bus cards, postcards, collateral materials for outreach

Public Health 150 (19 decks)

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