An intro to STIs Flashcards
Sub-clinical vs clinical infection?
Sub-clinical - no symptoms
Clinical - symptoms
Sexually transmissible infection definition
An infection by a pathogen which is sexually transmissible and which is unlikely to be transmitted by non-sexual means
Sexually transmitted disease definition
A disorder of structure or function caused by a sexually transmitted pathogen
e.g Pelvic inflammatory disease or Genital warts
Name some bacteria that are considered to be sexually transmissible organisms within the UK
Chlamydia trachomatis
Klebsiella granulomatis
Mycoplasma genitalium
Name some viruses that are considered to be sexually transmissible organisms within the UK
HSV
HIV
HPV
Molluscum contagiosum virus
Name some parasites that are considered to be sexually transmissible organisms within the UK
Pthirus pubis
Sarcoptes scabei
Trichomonas vaginalis
Common characteristics of STIs
They’re contagious
Asymptomatic most of the time
Unpredictable minority suffer significant complications
Totally avoidable
What are the most high risk forms of sexual contact?
From most high risk to least. Group sex Anal sex Vaginal sex Oral sex - cunnilingus Oral sex - fellatio Touching someone else’s genitals with your genitals. Mutual masturbation
What conditions can be spread by skin contact only?
Pubic lice (Pthirus pubis) Scabies (Sarcoptes scabeii) Warts (human papilloma virus types 6 &11) Herpes (Herpes Simplex Virus types 1 & 2)
What infection is the main concern for someone who participates in group sex?
Hep C - anal sex where a 3rd person moves from one man to another
What sorts of things might you see on examination of a patient with an STI?
Ulceration - syphilis, herpes simplex
Lumps - genital warts, molluscum contagiosum
Genital discharge - Gonorrhoea, chlamydia or mycoplasma genitalium
Non-genital discharge - gonorrhoea or chlamydia in the eyes
Rashes - scabies, syphilis and HIV.
What systemic symptoms may be present with STI? and which STIs are more likely to show systemic involvement?
Fever Rash Lymphadenopathy Malaise Arthralgia and arthritis
HIV or syphilis
Give examples of some late complications associated with common STIs
Infertility - chlamydia
Cancer - HPV
Adverse pregnancy outcomes - syphilis
How can STIs be costly?
Managing infertility due to chlamydia - IVF cost
Cost of HIV medication/ long term management of HIV related health conditions
Taking time off work to get your warts frozen etc
What is the R number?
The reproductive number - applies to every communicable disease.
It is the average number of secondary infections produced by a single infected person. Shows the spread of a disease.
What factors influence the R number in relation to STI spread?
Likelihood of transmission per encounter
Rate of acquiring new partners
Duration of infectivity
What is the best way to prevent transmission of an organism/disease?
Vaccinations
What is the biggest factor in clinic attendees and the reason for their sexual activity?
Alcohol
In terms of sexual network analysis what is a ‘core’?
Theory that some people likely to have sex with people who are like them in some way – similar lifestyle, ethnicity etc this can lead to a particularly high prevalence in a small population i.e the ‘core’..
e.g syphilis in people who exchange sex for drugs and HCV in gay men
That core can branch out wider though if say a man who has sex with men also then has sex with a woman.
What is considered good management of someone with symptoms suggestive of an STI?
A good history
HIV testing - if high risk
Partner notification
Health promotion - condoms, risk of oral sex, HIV prep etc
Why might you need to know a patient’s sexual history?
Determining possible cause of symptoms
Detecting high-risk behaviour and advising on risk reduction.
Tracing contacts
What would you ask to find out more about their sexual history?
When did you last have sexual contact? Was it casual or with a ‘regular’ partner?
How long were you going out with them for?
Were they male or female?
Asking about nature of sex act sometimes useful i.e if they have anxiety about a specific incident? or if it’s going to alter where you swab from
Did you use condoms?
Other contraception used
Nationality of contact
High risk assessment
Have you ever had sexual contact with another man?
Have you ever injected drugs? – both genders
Sexual contact with anyone who’s injected drugs? Or someone from outside the UK? (clarify)
Medical treatment outside UK? (clarify)
Paid for sex or been paid?
