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Sita GenitoUrinary System > Lecture 29: Sexually Transmitted Diseases > Flashcards

Lecture 29: Sexually Transmitted Diseases Flashcards

1
Q

Why is information about sexual behaviour essential?

A

Inform preventative strategies
Correct myths public perceptions
Fill gaps in knowledge (esp. asia and middle east)

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2
Q

What are some factors contributing to sexual behaviours variations and trends?

A

poverty
education
employment (1. High employment = more money to pay for sex. 2. Low employment = compounded with low education)
demographic trends : changing age structure of populations; trends towards later marriages
migration (increase) b/w and within countries
globalisation of mass media
advances in contraception + access to family planning services
public health HIV and STD strategies (local campaigns)

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3
Q

What are some trends and patterns regarding sexual behaviour?

A

Earlier sexual experiences
Less pronounced and less widespread
Later marriage –> increased premarital sex (esp. in western)
Married people have to most sex
Monogomy dominant
Men have more partners than woman esp in developed countries

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4
Q

What are some factors which influence the incidence and distribution of STIs worldwide?

A 
SES conditions (can go either way)
Birth rate
sexual behaviours
cultural practices
urbanisation (concurrent with sexual practices --> rapid spread) (increased opportunitey to meet a sexual partner)
prostitution
sex distribution (M:F)
Self medication
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5
Q

Sexual activity in younger single people

A

sporadic
greater youth sexual activity in industrialised countries
- men over report, woman under report

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6
Q

Age mixing of age structures

A

greater age mixing in countries such as Africa

- older husband, younger wife

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7
Q

General sexual activity statistics

A

Condom use increasing, but low in developing countries (as prefer anal as contracpetive act)
Married woman find it harder to negotiate condom use/safe sex harder (family planning) vs single woman
first married sexual experience can be coercive and traumatic
Not all sex is consentiual

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8
Q

Population based research surrounding Sexual activity

A

population based research provides most of the information we know about patterns of sexual behaviour
Esp. BRITISH National survey of sexual attitudes and lifestyles (1990, 2000 and 2010) –> repeated 3x on a 10yearly basis –> provides robust data on population changes
Shows: average person is quite sexually conservative

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9
Q

Patterns of Living

A 
socially conditioned
culturally embedded
economically constrained
reflect personality
have enduring consistency
- you are a product of your social and cultural environment --> your patterns in which you live are not isolated acts and neither are they under autonomous self control
- sexual lifestyle?
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10
Q

Sexual: The sexual trichotomy

A
  1. Sexual Orientation (gender attraction)
  2. Sexual Identity (internally self identify vs publicly identify)
  3. Sexual Behaviour (sexual plans proceeding actions)
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11
Q

Sexual Orientation/Identification

A

96.6% straight
1.6% gay/lesbian
0.7% bisexual
Note: KINSES data says that there is 6% gay in population, based on white, middle class, college students. Not population based

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12
Q

NATSAL UK sexual attitudes and lifestyle survey usages

A
  1. HIV prevalence and AIDS incidence
  2. Changes in behaviours over time
  3. Planning sexual health services and promotion strategies
  4. Improving STI epidemiology
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13
Q

NATSAL statistics changes is sexual lifestyles

A

Greater changes in woman sexual lifestyles in last 60 years

- same-sex acceptances + intolerance to non-exclusivity in marriage

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14
Q

STI distribution

A

heterogenously

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15
Q

Intervals in sexual growth

A

Woman: Increased time periods b/w First sexual intercourse –> cohabitation –> child bearing

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16
Q

Distribution of sexual function scores

A

increased variability in sexual function scores

  • poor sexual function = -ve health outcomes
  • poor health = decreased sexual activity = decreased satisfaction
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17
Q

Non-volition sex

A
  • occurring increasingly at younger ages

- adverse outcomes

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18
Q

Change in average number of sexual partners

A

Men: 8.6 –> 12.6 –> 11.7
Woman: 3.7 –> 6.5 –> 7.7
- compared people in age group 16-44 in each 10 year test

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19
Q

Effect of health conditions on sexual life

A

1:6 people states that poor health conditions –> lead to an effect on their sexual life
- good health status = recent sexual acitivty/active
1/4 males and 1/5 Female sought appropriate health care

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20
Q

What percentage of population have had a same-sex experience?

A

Same sex experience:
M: 4% - 5% - 5%
F: 2% - 5% - 8%

Genital contact:
M: 6% - 8% - 10%
F: 4% - 10% - 16% (increasingly common in woman)

21
Q

What is the percentage of the population that has sex prior to being 16?

A

Increased percentage of population has sex before 16

  • change seen mainly in 16-24 age group
  • less common in current older generation
  • gender disparity (M:31% F:29%)
22
Q

Number of sexual occasions in 4 weeks

A

Decreasing average 5 –> 3 sexual occasions in 4 weeks

23
Q

Methods of sex with straight partners

A

Vaginal and Oral

- less anal sex - mainly done by experimental youth

24
Q

Concern regarding sexual functional state (dryness, erection, anxious, interest)

A

Concern with sexual function: M: 42% F: 51%
- Worried about their sex life:
M:10% F:11%
- increasingly common in younger people, being concerned about their sexual function

25
Q

Comparison b/w people who have had sex in the part year vs have had no sex in the past year

A

No sex in past year:

  • DISATISFIED w. sex life
  • DISTRESSED/ worried about sex life
  • AVOIDED sex because of SEXUAL DIFFICULTIES
26
Q

Comparative levels of sexual interest within relationships

A

1/4 couples have unequal sexual interest

27
Q

Rate of experiencing sexual difficulties within relationships

A

1/5 couples have experienced sexual difficulties within their relationship

28
Q

What are some types of risks for STI transmission?

A
  1. Risk markers (indirectly causal) - far away from STI acquisition
  2. Risk factors (directly causal)
  3. Risk modifiers
    - sexual behaviour is the key determinant of incidence of viral STDs (incurable) e.g. viral HPV
    - both sexual behaviour and healthcare behaviour are important determinants of BACTERIAL STDS (curable)
29
Q

Risk Markers

A

NOT Controlled by the individual

  • demographic factors
  • causally linked to STI acquisition
  • but probably only linked to sexual behaviour and/or disease prevalance
30
Q

Risk factors

A

CAN be controlled by the individual

  • directly related to the probability of aquiring an STI
  • enhanced by risk Modiiers
31
Q

Examples of Risk Markers

A

marital status
ethnicity
rural vs urban residence
SES

32
Q

Examples of Risk markers and/or factors

A 
age
gender and gender identity
smoking
alcohol
drug abuse
other STIs
lack of circumsician
contraceptive method
non-consenting sex
33
Q

Risk Factors

A
  1. Sexual behaviours:
    - number of partners
    - rate of acquiring new partners
    - partner free interval
    - concurrency (how many partners at one time)
    - casual partners
    - gender preferences
    - sexual practices
  2. Health Care
    - no use of barrier or microbicides
    - late consultation for diagnosis, treatment
    - non-referral of partners
    - non-adherence to drug therapy
    - douching
34
Q

Non-referral of partners

A

Cycle of re-infection in intricate population: STI infections not treated –> renter population of people with similar background risk –> sex with someone who has had sex with an already infected person –> re-infected

35
Q

STI transmission Dynamics

A 
R0 = BcD
R0 = reproductive rate of infection
B = efficiency of transmission (of the infection)
c = mean rate of partner change
D = duration of infectiousness
36
Q

Changes in reproductive rate of infection

A

R0 = BcD = Infection’s reproductive rate
R0 > 1 = increase in STIs (syphylis - spreading)
R0 < 1 = decrease in STIs
R0 =1 STEADY state (chlamydia- steady presence in NZ)

37
Q

Reproductive rate of Infection in relation to gonorrhoea, chlamydia, syphillis and HIV

A

Table”

38
Q

Core groups

A
  • Small groups
  • likely to be already infected individuals
  • strongly interconnected
  • can create an increase in STI within a population
  • via infection passing from core group –> through BRIDGING group –> into wider population
    Note: Core groups vary in size for population
39
Q

Sexual Networks

A

sexual networks model the array of sexual Contacts
- different infections travel in different networks
- relates to core group or bridging population
transmission of STIs within sexual network is specific to both TIME and SPACE
- explains some demographic differences in STI rates

40
Q

Sexual networks of gonnorhea and hclamydia

A

gonorrhoea patients and chlamydia patients may NOT be in the same sexual networks, =-> even through someone may be infected with both STI’s

41
Q

What type of immunity does an already infected core group have?

A

Pr-emptive immunity

- cam recatch what you have already got

42
Q

Density of sexual networks

A

Interconnections with people when include exploratory sexual activity
- bridging person
spreads a cluster of disease to another linear chain

43
Q

Control strategies

A
44
Q

importance of DHBS

A

if know DHB, tend to know what is generating their STI rates

45
Q

Sexual function score

A

Decreased sexual function score = increased likelihood of reportion

  • relationship breakup
  • unhappy in relationship - difficult to talk about sex w. partner
  • diagnosed with STI
  • experience sex non-consentually/against their will
  • paying for sex
  • having more partners (woman only)
46
Q

Chlamydia rates

A

higher chlamydia rates with increased number of sexual partners

47
Q

Non-volitional sexual rates

A

lower than have been reported in other studies
M: 1:71 1.4%
F: 1:10 (9.8%)

48
Q

Median occurrence of non-volition sex

A

M:16
F:18
- most likely that the person responsible is known (current or former partner)

49
Q

Rates of unplanned pregnancy

A

Decreased overtime

Sita GenitoUrinary System (28 decks)

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