Prevention of Pregnancy and STIs Flashcards
What is pregnancy?
- Estimated likelihood from unprotected sexual intercourse during the ovulation period ranges from 5-45%, with peak risk occurring the day before ovulation
- Pregnancy can occur despite contraceptive use if the product is used incorrectly, or it fails
What are STIs?
- Sexually transmitted infections
- Contracted through contact with infected genital tissues, mucous membranes, and/or body fluids
- A sexually activve person who presents with symptoms consistent with an STI is not a canddiate for self-treatment–> refer to healthcare provider
STIs affect both sexes, but women are more prone to reproductive consequences and related conditions, such as:
* Pelvic inflammatory disease, chronic pelvic pain, pregnancy complications, malignancies, and infertility.
* Likelihood possibly related to difficulties in diagnosis, lack of pt recognition of symptoms, and a higher probability of asymptomatic infection in female pts
Describe anogenital warts.
- Noncurable but vaccine preventable
- Caused by HPV
- Pathogen type: DNA virus
- The incubation period is months to years after acquiring
- Symptoms: commonly ASx, warts on external genitalia, rectum, anus, perineum, mouth, larynx, vagina, urethra, cervix.
- Treatment: Cryoablation (chemical or physical antimitotics, caustic agents, sinecatechins, immunomodulators.
- Complications: Cervical dysplasia, neoplasia, anogenital cancers, orophyrngeal cancer
Describe chlamydia
- Curable
- Caused by chlamydia trachomatis
- Bacterium
- The incubation period is several weeks
- Male symptoms: ASx to urethritis, urogenital discharge, itching, dysuria
- Female symptoms: ASx to vaginal discharge, postcoital bleeding, cervicitis
- Treatment: antibiotics
- Complications: PID, ectopic pregnancy, infertility
Describe gonorrhea.
- Curable
- Caused by neisseria gonorrhoeae
- Bacterium
- Incubation period is up to 14 days
- Symptoms: Urethritis, cervicitis, proctitis, pharyngitis
- Male: mucopurulent urethral discharge
- Female: commonly ASx
- Treatment is antibiotics
- Septic arthritis, perihepatitis, endocarditis, meningitis, PID,
infertility, ectopic pregnancy
Describe Hepatatis C.
- Curable
- Caused by Hep C virus
- Virus
- Incubation period 8-11 weeks
- Symptoms: ASx or mild clinical illness
- Can be treated by antivirals
- Complications: cirrhosis, hepatocellular cancer
Describe nongonococcal urethritis
- Curable
- Varous, including Chlamydia trachomatis, trichomonas vaginalis, mycoplasma sp.
- Bacteria
- The incubation period varies
- Symptoms: male–> nonspecific urethritis, discharge, dysuria, pruritus
- Treatment: Antibiotics
- Complications: Epididymitis, proctitis, proctocolitis, Reiter syndrome
Describe syphilis.
- Curable
- Caused by treponema pallidum
- Pathogen type: spirochete
- Types: Primary, secondary, tertiary
- Incubation periods: primary–> 21 days avg, secondary–> 4-12 weeks after initial infection, tertiary–> 10-30 years after initial infection (rare), neurosyphilis–> potentially life threating complication
- Symptoms: Primary—> a single, round, painless, usually hard sore (chancre), appearing on the genitals, anus, or elsewhere
- Treatment: antibiotics
- Complications: Secondary: skin rash, swollen lymph nodes, fever, and patchy hair loss. Tertiary: gummatous lesions and damage to multiple organs – brain,
nerves, eyes, liver, heart, blood vessels, bones, and joints. Neurosyphilis: Treponema pallidum bacterium invades the brain and/or
spinal cord–>CNS infection
Describe trichomoniasis
- Curable
- Caused by trichomoniasis vaginalis
- Protozoan
- Incubation period varies; 5-28 days
- Symptoms: Males–> commonly ASx, Females–> ~50% ASx, unpleasant smell, frothy green vaginal discharge, itching, dyspareunia, postcoital bleeding
- Treatment: antibiotics
- Complications: Pregnancy–> preterm labor, low birth weight
Describe AIDS.
- Acquired immunodeficiency syndrome
- Noncurable
- Caused by Human Immunodeficiency virus
- Virus= pathogen type
- Incubation period is up to 10 years
- Symptoms: flulike initially–> ASx until opportunitistic infections occur
- Treatment–> antivirals; prophylaxis + treatment for OIs
- Complications–> OIs, malignancies, death
Describe genital herpes.
- Noncurable
- Herpes simplex, HSV-1, HSV-2
- HSV-1: more commonly associated with oral herpes (cold sores)- passed via mouth to mouth contact
- HSV-2: more commonly associated with genital herpes- passed through sexual contact, but can be passed to other parts of the body through oral sex
- Pathogen type: virus; highly contagious
- Incubation period is 2-12 days
- Symptoms: ASx or vesicular; watery blisters on the skin and mucous membranes of the mouth, lips, nose, genitals, rectum, and eyes
- Treatment: antivirals
- Complications: spread of infection, pneumonitis, hepatitis, meningitis, encephalitis
What vaccines exist for STI prevention?
- HPV Vaccine
- Hep B Vaccine
What are the characteristics of the HPV vaccine?
- HPV infection is the most common STI in the US, with ~14 million
new cases annually - Risk of HPV infection is highest during the first few years after initiation of sexual activity
- More than 120 different subtypes of HPV have been identified
- Gardasil 9 – only HPV vaccine marketed in the US; effective against nine HPV types
- Approved for use in females and males 9-45 years old
- Vaccine works best prior to any HPV exposure from sexual contact
When is recommended to get the HPV vaccine?
- Recommends all 11 to 12 y.o. adolescents recieve applicaple HPV vax, recommending 2 dose series at 0 and 6-12 months for adolescents up to 15 y.o.
- Greater than 15 y.o.: 3 dose series recommended at 0, 1-2 months, and 6 months.
- Immunocompromisied conditions: recommends a 3-dose series at 0, 1-2 months, and 6 months
- A “catch-up immunization series is recommended for all unvaxed persons through 26 y.o.
- 27-45 y.o.–> may be appropriate with shared decision making
What are the characteristics of Hep B Vaccine?
Hepatitis B infection
○ Associated with long-term complications – hepatitis, cirrhosis,
hepatic carcinoma, death
○ Transmitted through blood and other body fluids, high-
risk sexual behaviors, usage of injectable drugs
Administration Schedules (based on the vaccine formulation)
○ Engerix-B: 3-dose series at 0, 1, and 6 months
○ Recombivax HB: 3-dose series at 0, 1, and 6 months; can be given as a 2-dose series separated by 4-6 months only for adolescents 11-15 years
○ Heplisav-B (licensed only in >18 years): 2-dose series at 0 and
1 month
○ PreHevbrio (licensed only in >18 years): 3-dose series at 0, 1,
and 6 months
