Chapter 11 Flashcards
HIV stigma, is a problem for many people living with HIV as it can lead to what?
> it can lead to unfair treatment, poorer mental health, and may even contribute to the spread of HIV if people are afraid to get tested.
What has HIV stigma contributed to?
> contributed to the global spread of HIV and other sexually transmitted infections (STIs).
According to the World Health Organization (WHO), how many new cases of four curable STIs occur annually among people aged 15 to 49 years throughout the world? How many people were affected by each?
> 357 million new cases of four curable
STIs occur annually
The four STIs deemed curable are:
> chlamydia, gonorrhea, syphilis, and trichomoniasis.
What are the non curable STIs?
> human immunodeficiency virus (HIV)/acquired immuno-deficiency syndrome (AIDS)
Across the world, what factors affect / influence the susceptibility of HIV/AIDS and STI transmission among a variety of communities and populations?
> social, economic, political, and environmental factors, such as poverty, discrimination, and gender inequalities
The WHO and UNAIDS established new global HIV targets (also known as 90–90–90 HIV targets) for 2020- what were they?
> (1) 90 per cent of all people living with HIV will know their HIV status;
(2) 90 per cent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and
(3) 90 per cent of all people receiving antiretroviral therapy will have viral suppression
What happens when the 90-90-90 goal set by the WHO and UNAIDs is reached?
> at least 73 per cent of all people living with HIV worldwide will be virally suppressed (very low levels of HIV in one’s blood).
How are STIs mainly transmitted? What are other ways that they can be transmitted?
> STIs are mainly transmitted through unprotected sexual contact, but can also be transmitted through non-sexual means, such as blood transfusions, contaminated needles (used by infected individuals), and from mother to child during birth or while breastfeeding.
he pathogenic agents that cause STIs can be:
> viruses, bacteria, or parasites.
Which demographic group constitutes the highest STI rates in the US and Canada? What does this group not do according to National Survey Studies?
> Adolescents and young adults (15 to 24 years old) in the United States and Canada comprise
> report low rates of condom use during sexual intercourse + low rates of STI testing among adolescents and young adults
How can socio-economic status, gender, and ethnicity/race influence whether people are at greater risk of getting an STI?
1) Females are more likely to suffer long-term consequences of STIs due to differences in anatomy—bacteria and viruses more easily penetrate + symptoms of STIs may not be seen as quickly and easily
2) African Americans bear a disproportionate burden of STIs due to factors that relate to
- (1) higher prevalence of HIV/STIs within the African-American community;
- (2) stigma from fear of disclosing various risk behaviours or sexual orientation, which impacts health-seeking behaviours; and
- (3) socio-economic factors, which include poverty, racial discrimination, lack of access to health care, and higher rates of incarceration
The CDC highlights the distribution and trends of STIs among four population groups that are most vulnerable to help state and local health departments guide and prioritize STI prevention efforts - what are they?
> women and infants; adolescents and young adults; racial and ethnic minority groups; and gay, bisexual, and other men who have sex with men)
What is HIV and what does it cause?
> HIV is a viral infection that weakens the immune system and causes AIDS.
When is AIDS diagnosed?
> AIDS is diagnosed
when an individual has HIV and/or an opportunistic illness (such as AIDS-related cancer(s), in-cluding Kaposi’s sarcoma, non-Hodgkin lymphoma, and cervical cancer), or an opportunistic infection(s) (infections associated with severe immunodeficiency)
What is an AIDS diagnosis (also known as stage 3) is based on in the US?
> is based on the CD4+ T-lymphocyte count and the presence of opportunistic illnesses
> A person infected with HIV who is six years of age or older will receive an AIDS diagnosis if his or her CD4+ T-lymphocyte count is less than 200 cells per μL or opportunistic illnesses indicate stage 3.
What is an aids diagnosis based on in Canada?
> an AIDS diagno-sis in Canada is based on a positive test for HIV infection and the presence of one or more AIDS indicative diseases (i.e., opportunistic illnesses) (PHAC, 2009).
> CD4+ T-cells are responsible for or-chestrating the immune response, so a low number of these cells lead to the poor immune system found in people with HIV/AIDS.
Since 2000, what has the rate of HIV infection been?
> Since 2000, the rate of HIV infection among adults has been relatively stable.
In Canada, what is the most vulnerable populations for HIV infection?
> In Canada,
the most vulnerable populations are men who have sex with men (MSM), people who inject drugs, street youth, and Indigenous populations (PHAC, 2016a)
A disproportionate number of new US HIV infections are what groups?
> are men who have sex with men, African Americans, and Hispanics/Latinos (CDC, 2016d).
What are the uncommon forms of transmission for HIV?
> less commonly, through tattooing, body piercing, or transfusion of HIV-infected blood + needle stick injuries
What cells are affected by the HIV virus and how does it work?
> Once the virus enters the body, it invades the CD4+ T-cells
> The virus enters the CD4+ T-cell by first fusing with the outside surface of the cell
> CD4+ T-cells therefore become host cells for HIV and help the virus to self-replicate.
> Once new copies of the virus are produced by the host cell, they leave to enter other CD4+ T-cells.
What medications are used to treat HIV? How do they work / do they cure HIV?
> Antiretroviral medications, which are used to treat viruses such as HIV, do not cure HIV but instead reduce the ability of HIV to enter cells or replicate itself.
Highly active antiretroviral therapy is the use of what? What is it known as?
> the use of a combination of antiretroviral medications to treat HIV, which is now often called combination antiretroviral therapy (cART).
HIV/AIDS symptoms occur in how many stages?
> 3 primary stages
What is the most common STI that is transmitted in the US? How is it transmitted?
> Genital human papillomavirus (HPV) is the most common STI
transmitted in the United States
> it is mainly transmitted through genital contact and oral sex; it can be transmitted even when an infected person is asymptomatic
A number of serious health problems can arise from HPV, including:
> genital warts and various types of cancers (i.e., cancers of the head, neck, vagina, cervix, anus, and penis).
Does HPV go away?
> However, HPV usually goes away (in 90 per cent of cases) before it causes any serious complications.
How is HPV prevented?
> To prevent HPV infection, vaccines are rec-ommended for males and females between 11 and 12 years of age, which could potentially protect people from the most common types of HPV
What STIS are Viral Infections?
> HIV/AIDS
HPV
Gential Herpes
HEP A
HEP B
HEP C
What STIS are bacterial infections?
> Chlamydia
gonorrhoea
syphilis
What STIS are parasitic infections?
> Trichomoniasis
pediculosis (pubic lice)
scabies
Breakdown the Proportion of new HIV infections by exposure category (15+ years old), Canada, 2015:
1) Men who have sex with men (MSM) = 45.1%
2) Heterosexual contact =31.9%
3) Injection drug use (IDU) = 16.3%
4) Other 3.6%
5) = MSM + IDU = 3.1%
Proportion of new HIV infections by transmission category (13+ years old), United States, 2015:
1) MSM = 67%
2) Heterosexual contact = 23.7%
3) IDU = 6.1%
4) MSM/IDU = 3.15
5) Other = 0.2%
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for HIV/AIDS?
1) Human immunodeficiency virus
2) Unprotected sexual intercourse; injection drug use; mother to child
3) Not Curable - Treatment available: combination antiretroviral therapy reduces the rate at which the virus will replicate.
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for HPV?
1) Genital human papillomavirus
2) Unprotected sexual contact
3) Not Curable No specific treatment available. Treatment for the health problems that HPV can cause is available. Vaccine is also available.
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for genital herpes?
Herpes_ _ virus _?
1) Herpes simplex virus 2
2) Unprotected sexual contact
3) Not Curable Treatment available for symptom management. Antiviral medications can shorten and prevent outbreaks during period of time person takes medication.
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for HEP A?
1) Hepatitis A virus
2) Fecal–oral route
3) Curable
No specific treatment available. Recommend bed rest and adequate intake of fluids.
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for HEP B?
1) Hepatitis B virus
2) Direct blood-to-blood contact; contaminated needles; unprotected sexual intercourse; mother to child
3) Not Curable
No specific treatment available. Recommend bed rest, adequate nutrition, and intake of fluids. Some people may need to be hospitalized. Vaccine available.
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for HEP C?
1) Hepatitis C virus
2) Direct blood-to-blood contact; contaminated needles; unprotected sexual intercourse
3) Potentially Curable Treatment available. Antiviral medications are taken for as little as eight weeks
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for Chlymydia?
1) Chlamydia trachomatis
2) Unprotected sexual contact
3) Curable Preferred treatment (antibiotics): single dose of azithromycin or a week of doxycycline twice a day
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for Gonorrhea?
1) neisseria gonorrhoeae
2) Unprotected sexual contact
3) Curable Preferred treatment (antibiotics): single dose of ceftriaxone plus azithromycin or cefixime plus azithromycin
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for Syphilis?
The only one whos pathogen is nothing like it- but it is the next letter
1) Treponemapallidum
2) Direct sexual contact with sore from infected individual
3) Curable
Treatment: a single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a yea
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for Trichomoniasis?
1) Trichomonasvaginalis
2) Direct sexual contact
3) Parasitic Infections Curable
Recommended regime: a single dose of the antibiotics metronidazole or tinidazole
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for Pediculosis (pubic lice)?
1) Phthirus pubis
2) Sexual contact May also spread by close personal contact or contact with articles used by an infected person
3) Curable Treatment: a lice-killing lotion can be used to treat pubic (“crab”) lice.
What is the 1) pathogen, 2) transmission type, and 3) cure-ability + available treatment for Scabies?
1) Sarcoptesscabiei
2) Direct, prolonged, skin-to-skin contact with person infected with scabies; indirectly by sharing articles such as clothing, towels, or bedding used by an infected person
3) Curable
Treatment: products used to treat scabies are called scabicides because they kill scabies mites; some also kill eggs
What is the symptomology for genital herpes?
1. Will most experience symptoms?
2. When do they occur and when do they resolve?
3. What are symptoms during the inital episode?
> Most individuals with herpes will never have sores or will experience only very mild symptoms.
> Symptoms usually occur two weeks after transmission and resolve within two to four weeks.
> Symptoms during the initial episode may include secondary sores and flu-like symptoms (i.e., fever, swollen glands).
What is the symptomology for genital Hep A? How long do the symptoms last and what percentage relapse or have prolonged disease?
> Individuals generally experience fever, fatigue, loss of appetite, nausea, vomiting, abdom-inal pain, dark urine, clay-coloured bowel movements, joint pain, and jaundice.
> Symptoms usually last less than two months, although 10 to 15 per cent of individuals have prolonged or relapsing disease for up to six months.
What is the symptomology for Hep B?
> Some people are asymp-tomatic yet can still spread the virus.
> Symptoms during the acute phase of HBV are similar to those of hepatitis A.
> Symptoms may last from a few weeks to as long as six months.
> Chronic HBV occurs when the disease is left untreated and people may either experience ongoing symptoms or remain symptom-free for as long as 20 to 30 years.
> Approximately 15 to 25 per cent of persons with chronic HBV develop serious liver conditions such as cirrhosis (scarring of the liver) or liver cancer, and some individuals may require hospitalization.
What is the first stage of HIV infection?
1) Acute stage of HIV infection:
- Earliest stage of HIV infection where HIV multiplies in the body; many (but not all) people develop flu-like symptoms (e.g., fever, headache, rash, muscle and joint aches and pains, swollen glands, sore throat) within 2–4 weeks.
- Because of the high levels of HIV in the bloodstream, people are at high risk of transmitting HIV during this stage
What is the second stage of HIV infection?
2) Chronic HIV infection:
- second stage of HIV infection (also known as clinical latency or asymptomatic HIV) where HIV continues to multiply in the body at very low levels but without producing symptoms.
> People can still spread HIV to others.
> This stage can last up to 10 years for people who are not on antiretroviral therapy but for some people, this stage can progress faster.
> For people who are on antiretroviral therapy, this stage can last for several decades because the treatment helps to control the virus from multiplying.
What is the third stage of HIV infection?
3) AIDS:
- Final stage of HIV infection where the immune system is severely damaged.
- Since the body’s immune system has weakened, people become vulnerable to opportunistic illnesses.
- At this stage, CD4+ T-cell count is less than 200 cells per μL or one or more opportunistic illnesses are present.
- Without adequate treatment, people with AIDS typically survive about three years
What is the symptomology of hep C?
1. who can spread it?
2. What symptomolgy is it similar to?
3. How long do the symptoms last?
> Some people are asymptomatic yet can spread the virus.
> Symptoms during the acute phase of hepatitis C are similar to those of hepa-titis A and B.
> Symptoms can last indefinitely.
What is the symptomolgoy for chlamydia and how does it differentiate between men and women?
> Although most infected individuals are asymptomatic, some may experience symptoms such as painful or difficult urination, inflammation of the rectum, genital discharge, or rectal pain and bleeding.
> For men, testicular pain and swelling are other common symptoms.
> For women, additional symptoms include abnormal vaginal bleeding and lower abdominal pain.
- In rare cases, infected women may experience pelvic inflammatory dis-ease, in which infection of the uterus, fallopian tubes, and other reproductive organs causes lower abdominal pain.
What is chlamydia commonly reported as in the US and Canada?
> Chlamydia is prevalent among youth and young adults and is the most commonly reported notifiable disease in the United States and Canada
In 2015, the rate of reported cases of chlamydia was higher among what groups compared to caucasian?
> African Americans (5.9 times), American Indians/Alaska Natives (3.8 times), Native Hawaiians/Other Pacific Islanders (3.3 times), and Hispanics (2.0 times) when compared to Caucasian Americans
Since 2003, the incidence rates of chlamydia have in-creased in both countries. The increase in chlamydia cases in the last 20 years may be due to what?
This isn’t necessarily negative!
> increases in actual incidence, but also may reflect improved screening, testing, and diagnostic and reporting practices for the disease in medical and public health settings.
Describe the symptomology for Gonorrhea and the differences between men and women:
> can lead to severe complications and spread to other parts of the body, such as the eyes, if left untreated.
> Some men and most women never experience any symptoms.
> Some symptomatic men experi-ence a burning sensation when urinating; a yellow, white, or green discharge from the penis; and painful or swollen testicles.
> For women, symptoms may include increased vaginal discharge, burning sensation while urinating, and vaginal bleeding between periods, plus women with gonorrhea are at risk of developing serious complications, even if symptoms are mild or absent.
