Chapter 8 - Sexually Transmitted Infections Flashcards
Pathogens
- Bacteria, parasites, fungi, or viruses that cause infection or disease
History of syphilis
- Columbus and his explorers brought it here from Europe
- Was treated with mercury compounds, then condoms, arsenic, and antibiotics starting in the 1940s
Tuskegee, Alabama study
- Between 1932 and 1972
- Recruited black men who were wrongfully informed
- 399 with syphilis and 201 without
- Given food, health care, and burial insurance
- Basically over 100 people’s died because even once they found a treatment they stopped giving them the cure to see the long term events
The history of herpes
- 1980s
- Sores on genitals
- Leading edge of what came to be known as the sexually transmitted viruses which can’t be cured with antibiotics
History of AIDS
- Acquired immunodeficiency syndrome (AIDS)
- Thought it was a gay issue, but it was actually caused by infection with HIV that had been spreading for a while, probably comes from primates
- During the 80s and 90s AIDS-related deaths were really high and was the number one cause of death in men younger than 50
- Many protests were happening for drug research to start
- First drugs came out in 1996: They could stop HIV from becoming AIDS
- Treatment as prevention is now the focus
Antiretrovial (ARV) Drugs
- Halt replication of HIV and stop the progression from becoming AIDS
- Can make HIV into a chronic condition that we can live a long and healthy life with
Indigenous persons and STI prevalence in Canada
- Estimated to be higher than the overall population
- Chlamydia is 7x higher
- HIV and AIDS are 3.5x higher
Chlamydia
Prevelance
- Highest rate, especially in people between 20 and 24
Transmission
- Intercourse (vaginal or anal)
- Oral
- Infant during childbirth
Symptoms
- Often asymptomatic
- Discharge
- Burning pee
- Itching
- Vaginal bleeding
- Infection of the cervix and uterus
Consequences
- Spreading to other reproductive parts
- Pelvic inflammatory disease
- Infertility
- Male issues: inflammation of the urethra or the epididymis leading to infertility and pain
Diagnosis
- Swab
- Urine
Treatment
- Antibiotics
Gonorrhea
Canadian Prevelance
- Canadian MSM
- People who have sex with people from abroad
Transmission
- Intercourse
- Oral
- Birth
Symptoms
- Pus yellow to green discharge from vagina, urethra, or anus
- Often Asymptomatic
Consequences
- Women: uterus and fallopian tubes and cause PID, affecting fertility
- Men: Less severe may impact fertility
Diagnosis
- Swab
- Urine
Treatment
- Oral or injectable antibiotics
- Coinfection with chlamydia
Syphilis
Prevelance
- Not common
- Highest in MSM
- Sex with those abroad
Transmission
- Intercourse
- Oral
- Injections
- Birth
Symptoms
- Different symptoms at different stages
- Primary syphilis: swelling of lymph nodes near the site and painless ulcers
- Secondary syphilis: Rash, warts, patches of erosions, whitish skin, fever, malaise, jaundice, muscle/joint aches, patchy hair loss
Consequences
- Tertiary stage: Affects blood vessels, heart, eyes, sensory, or brain damage
- May impact bones or internal organs
- May be at a higher risk of HIV especially when lesions are present
Diagnosis
- Blood test
- May have to be repeated 3 weeks later
Treatment
- Injectable antibiotics (oral meds are less reliable)
Herpes
Prevalence
- Not reportable disease in Canada so we don’t really know
- 13.6%
Transmission
- Genital to genital
- Oral
- Anal
Birth
Symptoms
- Lesions
- Swollen lymph nodes
- Numbness or pins and needles in affected area
- Red patch of skin
- Tiny watery or pus-filled vesicles will develop which will transform into pustules
- Lasts a few days, we have it for life, outbreaks can happen whenever
Consequences
- Scarring
- Urinary tract symptoms
- Higher HIV risk
- Infants who get it may experience major neuro and other impairments and even death
Diagnosis
- Swapping lessions
- Tests aren’t 100% accurate
Treatment
- Antiviral drugs (either when you feel symptoms or every day)
- Local antiviral
HSV1 vs HSV2
- HSV1: Lips
- HSV2: Genital
- Outbreaks in 2 are more common than in 1
Human Papillomavirus (HPV)
Prevalence
- Not reportable in Canada
- Estimated as the most prevalent STI
- Up to 75% of Canadians will be infected by one of the HPV types in their life
- High in university aged women and men
Transmission
- Skin to Skin
- Oral
Symptoms
- Most people don’t know
- Warts
- Abnormal pap tests
- Genital conditions or cancers long after infection
Consequences
- Will clear this most of the time
- Won’t get immunity typically
- Genital conditions or cancers
Diagnosis
- Visual exam
- Pap smear
- Biopsy
- Scraping the inside of the cervical canal
Treatment
- Warts can be treated at home with different kinds of drugs which are applied locally
- More toxic drugs at the Dr
- Surgery
- Chemo
- Radiation
Prevention
- Vaccines
Human Immunodeficiency Virus (HIV)
Prevalence
- More than 63,000 Canadians living with it
- MSM
- Drug users
- People who come from places where outbreaks are
Transmission
- Blood/Bodily fluids come into contact with oral, genital, or anal
- Intercourse
Symptoms
- Flu like symptoms
- Enlarged lymph nodes
- Later on will have a lot of immunity
Consequences
- HIV progresses to AIDS
- Severe damage of the immune system
- Cancers
- Neurologic and cardiac disease
- Physical wasting
- Death
Diagnosis
- Blood tests that detect antibodies to HIV
Treatment
- ARV therapy
Viral Hepatitis
Prevalence
- Hep A: Food issues, MSM
- Hep B: MSM, drug users , where the disease is prevalent
- Hep C: Drug uses, poor infection control, HIV positive MSM
Transmission
- Hep A: Fecal-oral route, oral-anal sex, ingestion of food or water contaminated with feces
- Hep B: Transmitted through sexual contact, the sharing of contaminated drug-injection or drug-preparation equipment, or the sharing of sex toys.
- Hep C: Blood contact, drug injection, drug prep equipment, and sexual activities that cause trauma at the sites of sexual contact
Symptoms
- Jaundice
- Flu like symptoms
- Abdominal pain
Diagnosis
- Blood test
Treatment
- Hep A: Symptom specific
- Hep B and C: Antiviral drugs
Trichomoniasis
Prevalence
- uncommon
- Prevalent in Africa and other areas
- Women with multiple sex partners
Transmission
- Protozoa that causes the infection
- Most commonly spread through sexual contact
Symptoms
- Profuse yellowish discharge in women
- Pain when peeing
- Itching
- May be asymptomatic (usually is in men)
Consequences
- Can lead to infertility
- Increased risk of cervical cancer
- Inflammation of the uterus, endometritis, premature delivery
Diagnosis
- Swab of the vagina or urethra
Treatment
- Oral drug
Pubic Lice and Scabies
Prevalence
- Uncommon in Canada
Transmission
- Direct sexual or nonsexual contact
- Bed sheets or towels
Symptoms
- Itchiness
- Visible on the skin
- Rash
Consequences
- Itchiness
- Bacterial infection
Diagnosis
- Visual inspection
- Skin biopsy (scabies)
Treatment
- Creams or shampoos
Moniliasis/Trush
Transmission
- Not really sexually transmitted
- Yeast infection
- Can also come from things like diabetes
Symptoms
- Pain during intercourse
- Itchiness
- Odour
- White and clumpy discharge
Consequences
- Eczema like reaction in the genital area
- Pain during sex
- Pain during peeing
Diagnosis
- Visual inspection
- Recurrent cases should be sent to the lab
Treatment
- Oral and topical drugs
- Suppositories, capsules, oral fluconazole
Bacterial Vaginosis
Prevalence
- Overgrowth of bacteria that usually lives in the vagina
- Not considered an STI
Symptoms
- Fishy odour
- Vaginal discharge
- Itching around
- Dyspareunia
Consequences
- Preg complications
- Increase chances of getting HIV or the clap or gonorrhoea, herpes, or HPV
Diagnosis
- Higher than usual pH
- Absence of lactobacilli bacteria in vaginal secretions
Treatment
- Oral meds
- Inserting cream or gel
- Boric acid or lactic acid gel
Dental Dams
- Effective barriers for use in any instance of oral sex
Canadian sexual pattern for new sexual relationships is they will use a condom until
- They have “gotten to know” their partner well enough
- Then they transition to oral contraceptive or nonbarrier methods
Risk factors to STI
- Prevalence
- How contagious
- Sexual behaviours
- Partners of behaviour
