Chapter 8: STIs Flashcards by Nikola Yee

STI % rate in women/men in Canada (2013)

19% and 12%

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highest rate of STIs amongst which age group?

yound adults

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3 most common STIs in Uni students

chlamydia
HPV
herpes

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3 reasons rates of STIs are increasing

better testing
decreased condom use
increased rate of drug use

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most prevalent bacterial STI in Canada

Chlamydia

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rates of this STI have been rising since 1997

Chlamydia

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Symptoms: Chlamydia

Penis: thin/clear discharge, mild discomfort on urination
Vagina: abnormal discharge, burning/itching/pain with urination

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How to diagnose chlamydia

Men: urine sample
women: urine sample/vaginal swab

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untreated chlamydia leads to what in men?

epididymitis
- scrotal pain/swelling
- infertility

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untreated chlamydia leads to what in women?

PID (pelvic inflammatory disease)
- pain with/without intercourse
-chronic pelvic pain
-infertility

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Oldest STI

gonorrhea

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What is a venereal disease?

In hippocrates time: a disease thought to result from excessive pleasure of the vagina

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symptoms of gonorrhea in men vs women

men: white puslike discharge
women: no symptoms

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how to diagnose gonorrhea in men?

Urine test

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how to diagnose gonorrhea in women?

Urine test + Pelvic exam

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treatment for gonorrhea?

antibiotics

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what part of the body does gonorrhea usually affect in women?

Cervix –> uterus/fallopian tubes –> PID

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what other parts of the body does gonorrhea affect, other than the reproductive system (4)?

-eyes
-mouth
-bladder
-rectum

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What STI can damage the nervous system and lead to death?

syphilis

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Is syphilis common now?

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Describe syphilis stage 1

Stage 1: Painless chancre, 3 weeks after exposure, usually on the mucous membranes, or hand

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Describe syphilis stage 2

Body rash (not painful)

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Describe syphilis stage 3

Latent syphilis
- bacteria are burrowing into the body
- no longer infectious but syphilis can be passed to the fetus
- 50% of patients stay in this latent stage for the rest of their life; 50% go on to develop late syphilis

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Describe syphilis stage 4

occurs 10-40 years later
major cardiovascular problems or neurological problems causing insanity, paralysis

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what are the 3 outcomes of a baby born with congenital syphilis?

1. miscarriage 2. baby is born very ill 3. baby is asymptomatic until years later

Which bacterial STI is difficult to diagnose?

Syphilis

How is syphilis diagnosed (4)?

1. genital exam 2. pelvic exam 3. full body exam 4. blood test

Treatment for Syphilis

2 shots of penicillin

Name 3 bacterial STIs

Chlamydia Gonorrhea Syphillis

What is the most common STI in sexually active Canadians?

HPV

What percentage of Canadians will be infected with HPV at least once?

75%

There are at least how many types of HPV causing genital warts and cancer?

Which types of HPV cause genital warts?

Type 6 Type 11

Which viral STI is NON-reportable in Canada

HPV

Symptoms of HPV?

1. genital warts 2. 90% asymptomatic

How to diagnose HPV?

Inspect genital warts

HPV treatment

- creams, freezing

Does HPV ever go away?

Yes, can be undetectable in 1-2 years ( but it is easy to get another of the 40+ strains)

Can you get warts in your mouth from HPV?

Yes, from oral sex Can cause throat/mouth cancers

What can prevenet HPV?

Gardasil

How many strains of HPV does Gardasil protect against?

9 types

Gardasil protects what age group (women vs men)?

women: 9-45 men: 9-26

How many strains of Herpes simplex are there?

Which strain of Herpes (1 or 2) prefers the mouth?

HSV-1

Which strain of Herpes (1 or 2) prefers the genitals>

HSV-2

What is the most common strain of Herpes?

HSV-1

What percentage of people carry HSV-1?

~50%

Can both Herpes strains can appear orally and genitally?

Yes

Is herpes reportable in Canada?

Symptoms of Herpes

Small, painful blisters on the genitals/anus/thighs

When is someone most contagious with Herpes?

During an active outbreak

Are people with asymptomatic herpes infectious?

Yes

How often does someone with Herpes have outbreaks?

It depends on the person. Some people only have 1 outbreak in their entire life, some people have several, unpredictable outbreaks

Is there a cure for Herpes?

What is the treatment for Herpes?

Valtrex to reduce the frequency of outbreaks

Describe the 2 range of responses to Herpes

1. STI-related stigma: awareness of negative societal judgments 2. STI-related shame: one's own negative feelings

In which continents are HIV1 and HIV 2 most prominent?

HIV1: North America HIV2: Africa

Mechanism of action of HIV/AIDS?

HIV attacks the immune system --> Acquired immunodeficiency syndrome --> patient is asymptomatic until infected by something else

Origin of HIV/AIDS?

Mysterious; thought to have arose from butchering primates for meat

When was HIV/AIDS identified in the USA?

1981

When was HIV/AIDS identified in Canada?

1982

When was HIV/AIDS actually conceptualized?

1984

What STI is currently a global pandemic?

HIV/AIDS

How many people worldwide are infected with HIV/AIDS?

33 million

How many people in Canada are infected with HIV/AIDS?

71 000

What percentage of new HIV/AIDS infections happen in africa?

72%

How many cases of HIV/AIDS in Africa?

25.5 million

How many cases of HIV/AIDS in Eastern Europe/Central Asia?

1.5 million

How many cases of HIV/AIDS in the middle east/West Africa?

230 000

How many cases of HIV/AIDS in Asia?

2 million

How many cases of HIV/AIDS in Europe/America?

2.5 million

How is HIV/AIDS transmitted?

Exchange of bodily fluids - semen - vaginal secretions - blood - breast milk*

What percentage of new STI/AIDS cases is due to heterosexual transmission?

70%

In Canada, what percentage of new cases are in the following group: men on men

~50%

In Canada, what percentage of new cases are in the following group: heterosexual + infected person

~20%

In Canada, what percentage of new cases are in the following group: heterosexuals from an AIDS epidemic country

~14%

In Canada, what percentage of new cases are in the following group: drug injectors

~13%

2 highest risk behaviors for HIV/AIDS?

1. Anal intercourse 2. Vaginal intercourge

4 stages of HIV infection: Stage 1

1. Primary: 2-4 weeks after exposure Nonspecific symptoms/Asymptomatic *asymptomatic: fever, diarrhea, fatigue, swollen lymph nodes, persistent yeast infection

4 stages of HIV infection: Stage 2

2. Chronic asymptomatic infection: Virus replication Nonspecific/Asymptomatic *asymptomatic: fever, diarrhea, fatigue, swollen lymph nodes, persistent yeast infection

4 stages of HIV infection: Stage 3

3. Chronic Symptomatic HIV infection: Nonspecific symptoms Reduced T4 cells inability to fight off infections Shingles Weight loss

4 stages of HIV infection: Stage 4

4. AIDS-defining conditions Life-threatening, opportunistic infections - pneumonia - Kaposi's sarcoma (rare skin cancer)

How to diagnose HIV/AIDS?

Blood test - ELISA 98.9% accurate, some false +ve - Western blot - Rapid test - Home test kit

HIV/AIDS treatment

No cure HAART: antiviral cocktail: virus becomes undetectable, but there are a lot of side effects to adherence is challenging

Name 3 psychological impacts of HIV/AIDS

1. Social stigma/isolation 2. Depression 3. Poor sex life

What's the challenge in developing an HIV/AIDS vaccine?

Viral mutations

What is PrEP?

Preexposure Prophylaxis - the uninfected partner is given a cocktail of antivirals

Describe HIV/AIDS genetic resistance

2 mutated copies of the CCR5 receptor on cells= resistance - 10% of Europeans carry this double mutation, and there is a connection to surviving the bubonic plague

What is Trichomoniasis?

A (rare*)parasite that lives on surfaces, but is usually transmitted via sex

Symptoms of trichomoniasis

Vaginal discharge Penile discharge, urethral irritation

How to diagnose trichomoniasis

urine sample vaginal swab

treatment for trichomoniasis

metronidazole/tinidazole

Symptoms of public lice

intense itching

slang for "public lice"

crabs

How to diagnose pubic lice

Find lice/eggs

Treatment for crabs

same as headlice (Nix, Rid)

What are the 4 reportable STIs in Canada? Why do these need to be reported?

Chlamydia Gonorrhea Syphilis HIV These can cause PID/Infertility

What are 2 non-reportable STIs in Canada

HPV Herpes

What are 2 non-reportable STIs in Canada?

HPV Herpes