Lecture 27: Sexually Transmitted Diseases Flashcards

1
Q

Chlamydia in NZ

A
  • Most common STI in 2014
  • 629/100, 000 people (83% between 15 and 29)
  • The has remained steadily prevalent (endemic in NZ)
  • 83 infants reported
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2
Q

Ethnic Differences of chlaymydia

A

Europeans at the tops of the stats (healthcare access)

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3
Q

Gonorrhoea in NZ

A
  • 70/100, 000 people
  • 73% between 15-29
  • 1 infant reported
  • Bulk of disease in Europeans
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4
Q

It looks like female rates are going down in NZ for gonorrhoea, but if you look at specimen sites?

A
  • High in urethral screening, less urine screening
  • Rates of anorectal or throat screening have a slight bias towards males, and are increasing.

Whereas in females most testing is done from the vagina.

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5
Q

Drug resistance to Gonorrhea

A

Ciprafloxacin Resistance: recently become a massive issue in the early 2000’s (was already above the 5-10% cutoff for first-line treatment) and has changed the way we do treatment. Now over 50% resistances

Penicillin resistance: remained relatively stable.

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6
Q

Infectious Syphilis in NZ

A

Numbers have taken off in NZ, a significant outbreak predominantly in males (40+ years).

We can conclude from this that the spread is predominantly in older man-to-man encounters

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7
Q

Genital Warts in NZ

A

A decrease in the case counts of genital warts, genital herpes and NSU

  • 5 year trend (2010-2014) showed a 36.8% decrease in the case counts of genital warts.
  • The MAIN reason: women are vaccinating themselves
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8
Q

Why do we wan’t to know about sexual behaviour?

A
  • To inform preventitive strategies
  • To correct myths in public perceptions
  • To fill gaps in knowledge (esp in asia and the middle east)/
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9
Q

What are the factors contributing to variations and trends in sexual behaviour.

A
  • -Poverty
  • Education
  • Employment
  • Demographic Trends: changing age structure of populations, trends towards later marriage
  • Increased migration with and between countries
  • Advances in contraception and access to a family-planning services
  • Public Health HIV and STD prevention strategies*
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10
Q

What are the current trends and patterns towards sexual behaviour?

A
  • Trends towards earlier sexual behavious (not as pronounced are you would think)
  • Trend towards later marriage → increase in the prevalence of premarital sex
  • Married people have the most sex
  • Monogomy the most dominant pattern
  • Men report multiple partnerships more then women
  • Sexual activity in young single people tends to be sporadic and more in industrialised countries. (men over-report and women under-report)
  • Condom use is increasing but rates of use remain low in many developing countries.
  • First sexual experiance often forced
  • Married women find negotiation of safer sex hard.
  • Very early sexual experiance within marriage can be coercice and traumatic
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11
Q

What key factors influence the incidence and distribution of STI’s

A
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12
Q

Where do we get most of our knowledge about the distribution and patterns of sexual behaviour

A

From population based research of broadly similar countries to NZ

Best research: from UK studies

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13
Q

Lifestyle is?

A

NOT random and relatively fixed over time. You are not entirely in control and are a product of your environment.

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14
Q

The Sexual Trichotomy

A
  1. Sexual Orientation
    - the gender(s) an individual is attracted to
  2. Sexual Identity
    - How individuals self-identify
    - how individuals publicly identify
  3. Sexual Behaviour
    - Sexual plans and actions
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15
Q

Key findings within British Data (Natsal-3)

A
  • Shows huge changes in behaviour (especially in women) in terms of acceptance of same-sex marriage and intolerance to non-exclusive marriage
  • Increase in # sexual partners in women, as well as the number of same-sex partners (societal aspects and anonomous asking)
  • STI’s distributed heterogenously
  • Increasing intervals between 1st sexual intercourse, cohabitation and childbearing for women.
  • Poor health associated with decreased sexual activity and satisfaction.
  • Non-volitional sex is mainly an experiance of young age and is associated with a range of adverse outcomes
  • Young sex is increasing
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16
Q

What are the different types of sex with people of the opposite sex?

A

High rates of vaginal and oral sex (in every age group)

Really low rates of anal sex in heterogenic couple (older= contraception, younger= experimentation)

17
Q

Those with poor health status don’t tend to be _______

A

Those with poor health status don’t tend to be as sexually active

18
Q

What are the statistics involved in good sexual function

A

in both men and women ~50% have experianced one or more sexual difficulties. But it was less common for people to say that they were distressed about it

19
Q

Sexual mis-match between couples in a relationship

A

1/4 men/women don’t share the same sexual interest as their partner.

1/5 men/women said their partner experiance sexual difficulties in the past year

20
Q

Non-volitional sex

A

1/10 women (median age 18)

1/71 men (median age 16)

21
Q

Types of risk for STI transmission

A
22
Q

What’s the difference between risk markers vs risk factors in terms of STI acquisition?

A

Risk Markers: tend to be indirectly causal, and just something broad about the person.

Risk Factors: Directly casual, close to the point of STI acquisition. (Risk reduction techniques very important here!)

23
Q

What is the Equation of STI transmission Dynamics

A

Ro = ßcD

Ro = reproductive rate of infection

ß = efficiency of transmission of the infection

c = mean rate of partner change

D = duration of infectiousness

24
Q

Ro

A

Ro > 1 the incidence of STI increases

Ro <1 the incidence decreases

Ro = 1 steady state (auckland chlaymydia)

25
Q

What are ‘core groups’?

A

Small groups of individuals who can create an increase in an STI within a population through the passage of the infection from the core group through bridging group members into the wider population

Vary in size for each infection

26
Q

The Sexual Networks

A

How the array of sexual contacts can be modelled.

  • Different infections travel through different networks
  • Network Transmission is specific both in time and in space and explains some apparent demographic differences in STI rates (eg; gonorrhea and chlamydia patients may not be in the same networks)
27
Q

Control strategies

A