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Sexual Health > Epidemiology and public health > Flashcards

Epidemiology and public health Flashcards

1
Q

Epidemiology

A

the study of the distribution and occurrence of disease states and determinants of health

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2
Q

Distribution

A

where did the disease occur; when did it occur and who has the disease

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3
Q

Determinants

A

risk factors, risk markers- associated with social, biological, psychological elements of health

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4
Q

Epidemic

A

The occurrence of disease in greater numbers than normally expected or accepted for that population

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5
Q

Endemic

A

Describes diseases that are usually present in a certain population or location

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6
Q

Incidence

A

Number of new cases arising in a given period of time in a given population

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7
Q

Prevalence

A

The number of cases in a defined population at a specific point in time

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8
Q

Blood borne virus (BBV)

A

A virus that is transmitted through blood to blood contact. These include HIV, Hepatitis B and C.

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9
Q

Transmission: Sexual contact

A

skin to skin

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10
Q

Transmission: Sexual intercourse

A

oral, vaginal, anal, sex toys

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11
Q

Transmission: Direct

A

blood to blood contact

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12
Q

Transmission: Occupational Contact

A

splash injuries; needle stick injury

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13
Q

Transmission: Blood

A

transfusions and related blood products

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14
Q

Transmission: Mother to baby (known as Vertical transmission)

A

Intrauterine; Delivery (may also be mother to baby post delivery via lactation)

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15
Q

Transmission: Percutaneous

A

sharing injecting equipment; tattooing, body piercing

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16
Q

Transmission: Traditional practices

A

scarification, circumcision, female genital mutilation (FGM)

17
Q

The probability of an individual acquiring an STI is determined by a number of specific factors. These can be divided into categories and include:

A

Behaviour, Partners and Infectiousness

18
Q

Behaviour

A
  1. 1 Sexual behaviour: Type, frequency, repetition, condom use
  2. 2 Injecting drug use: Clean equipments verses sharing
  3. 3 Occupational: risk of exposure to bodily fluids
19
Q

Partners

A
  1. 1 Rate of partner change

2. 2 Number of partners.

20
Q

Infectiousness

A
  1. 1 Prevalence of infections in the population from which partners are chosen
  2. 2 Duration of infectiousness of STI- longer for chronic viral STIs
  3. 3 Curability versus chronicity of infections
  4. 4 Transmissibility, virulence
21
Q

The basic epidemiological equation used to calculate or determine risk is the rose bud equation: R0 = BuD

A 
R0 = the number of new infections produced by an infected individual during the duration of the infection
B = infectiousness
u = rate of partner change
D = duration of infection
22
Q

Ro

A

Number of new infections or the pool of infection will only increase if the host infects other susceptible hosts therefore to reduce Ro you have to influence the other factors of this equation so

23
Q

B

A

The infectivity of pathogens varies between the causative pathogen and each STI. It can also be stated in terms of risk of transmission (ROT).
Infectiousness is increased by:
Repeated exposure of a susceptible contact to the infection Antibiotic resistance that causes persistence of the infection in spite of treatment,Co-infectionsGenital inflammation from another STI in either partner.
Infectiousness is decreased by:

Condom use

Treatment.

24
Q

U

A

Rate of partner change can be influenced by:
Education aimed at enabling the client to adopt safer behaviour patterns will decrease U
Peer pressure may either increase or decrease U
There has also been a reported reduction in the rate of partner change as a result of the AIDS epidemic. Why did this happen? Does fear have an effect?

25
Q

D

A

Duration of infection is influenced by:
Access to services
Availability of treatment

26
Q

Risk markers reflect higher or lower occurrences of STIs, but have no direct causal connection.

A 
Age
Cultural background
Marital status
Occupation
Residence
Socio-economic status.
27
Q

Risk factors for STIs have a direct causal connection to the occurrence and transmission of STIs.

A

The individuals sexual practices
The number and duration of sexual partnerships
Extent of overlapping partnerships.
Prevalence of STIs in partner population also needs to be considered.
Drug usage that is, alcohol, tobacco, injecting drug use,
Choice of contraception, that is, barrier, chemical, or oral contraception.

28
Q

Risk behaviours - the following may be considered as risk behaviours:

A

Vaginal intercourse, that is, insertive, receptive
Anal intercourse, that is, insertive, receptive
Oral intercourse, that is, insertive, receptive: cunnilingus, fellatio
Other forms of sexual intercourse
Injecting drug use, that is, sharing injection equipment
Occupational and nosocomial
Pregnancy, childbirth and breast-feeding, risk to the foetus/baby.

29
Q

Index

A

Original person identified with infection

30
Q

Contact

A

Person who has been exposed to index

31
Q

Source

A

Person who index acquired infection

32
Q

Post Exposure Prophylaxis (PEP)

A

offered to a person exposed to a significant risk of HIV infection through either occupational or non-occupational (NPEP) exposure. The aim of PEP is to reduce the risk of HIV transmission for persons exposed to significant risk of HIV infection through occupational exposure (eg. deep needle stick injury) or non-occupational exposure (eg. Unprotected receptive or insertive anal or vaginal intercourse, or needle sharing) with a person known to have (or suspected to have) HIV infection.
PEP consists of a regime of one or more antiretroviral drugs and must commence within 72hours of the exposure occurring. Its mode of action is to prevent the initial cellular infection and subsequent replication of HIV therefore allowing the host immune defences to eliminate the virus (ASHM 2009). It involves the ongoing administration of combination antiretroviral therapy for one month after the risk exposure.
While evidence indicates that PEP may be effective, feasible and cost effective as an HIV prevention method there are currently no data from randomised controlled trials of the use of NPEP. Indirect epidemiological and animal model evidence exists that supports the effectiveness of PEP and there is ongoing research in progress to further determine the effectiveness.

33
Q

Pre Exposure Prophylaxis (PrEP)

A

PrEp is the use of HIV antiretroviral treatment (ART) as pre-exposure prophylaxis in HIV uninfected individuals who are at high risk of becoming HIV infected. It is an important new prevention option to add to the existing suite of prevention measures including correct and consistent condom use; safe injecting practices; early ART in people with HIV infection to reduce infectiousness; and other harm reduction approaches

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