76 Screening and prevention of STI Flashcards
Blood tests check for which sexual disease?
• HIV 1+2 antibodies and p24
antigen
• Hepatitis B antigen
• Syphilis
Swabs and urine tests check for which sexual disease?
- Chlamydia
- Gonorrhoea
- Mycoplasma
- Ureaplasma
- Candida (thrush)
- Streptococci
- Staphylococci
- Haemophilus
- NSU (non-specific urethritis)
- Bacterial vaginosis (BV)
- Trichomonas
- Cystitis
- Genital wart and HPV
- HIV
Chlamydia causative agent?
Chlamydia tachomatis
Effect of chlamydia?
- Damage to woman’s reproductive organs e.g. irreversible infertility
- Discharge from the penis of infected man
Incidence of chlamydia?
• In Europe: 10 million new cases per year
• Typical developed country prevalence rate for 15-25 yr olds:
– 9% for females
– Slightly less for males
Transmission of chylamydia?
- Vaginal, anal or oral sex
* Infected mother to baby during vaginal childbirth
What are teenage girls and young women at particularly high risk for infection if sexually active?
Because their cervix is not fully matured
Symptoms of chlamydia?
• Silent disease
Symptoms tend to only occur 1-3 weeks after exposure
• Female symptoms:
- Abnormal vaginal discharge
- Burning sensation when urinating
- Lower abdominal pain
- Low back pain
- Fever
- Pain during intercourse
- Bleeding between menstrual periods
• Male symptoms:
- Discharge from penis
- Burning sensation when urinating
- Burning / itching around opening of the penis
- Pain and swelling in the testicles are uncommon
Serious complications of chlamydia in women?
PID:
• Untreated infection can spread into the uterus or fallopian tubes
=> pelvic inflammatory disease (PID)
• 40% of untreated female cases
• Leads to: Permanent damage to the fallopian tubes, uterus and surrounding tissues
• Damage leads to chronic pelvic pain, infertility and dangerous ectopic pregnancy
• 5 x more likely to be infected with HIV
Serious complications of chlamydia in men?
- Rare
- Infection sometimes spreads to the epididymis
- Causes pain, fever and rarely sterility
Testing for chlamydia?
- Traditional method: physical examination for collection of samples from urethra
- Urine tests using immunoassays e.g. Home testing kits
What is the importance of partner notification?
- More than half of the partners of +ve patients are themselves +ve
- Found that partner notification was important to notify partners for testing. Huge saving in treatment costs if both partners are tested
- GPs prefer specialist partner notification
What are the different approaches to behaviour change?
- Motivational interviewing
• Process of increasing motivation when people are not thinking of change - Problem-focused counselling
• Identifies causes of problems that prevent change - Modelling and rehearsal of change
• Improves skills and self-efficacy to achieve change
What are the Prochaska and DiClemente Stages of Change?
- Pre-contemplation
- Contemplation
- Preparation - determination, decision
- Action
- Maintenance
Correlates of patient change talk?
Change talk
- -> Clinical listen or
- -> Clinical reframe
