Professionlism/I&I: Sex, Drugs And Clubs Flashcards
What is chlamydia?
Chlamydia trachomitis:
- Obligate intracellular bacteria
- Gram negative
- 15 serotypes
- Causes STIs, trachoma (eye infection), conjunctivitis in newborns
In what ways does Chlamydia trachomitis exist?
- As elementary bodies (Smaller infectious forms)
- As reticulate bodies (Larger replicative forms)
Carries on as metabolically-active and dividing reticulate bodies intracellularly (i.e., inside a living host cell) and as inactive and infectious elementary bodies extracellularly (i.e., outside a living host cell)
Outline the NCSP
- Started in 2008
- 15-25 year olds annually, or if have new partner
- Give result promptly and treat immediateley
- Notify partners and treat them
- Avoid sex until antibiotics complete
- Retest in 3 months and retreat if necessary
- Now for women only
- There are concerns about this, as some argue that young men’s roles and responsibility and achieving good sexual health will be undermined
Describe the epidemiology of chlamydia
In 2023, there were 194,970 cases in England, compared to 194,244 in 2022 and 2022 was an increase of 24.3% from 2021
Accounted for 48.5% STIs in 2023
75% = under 25 years old
Test + rate in 15-24 year olds = 9.8% (varies by setting)
Incidence of chlamydia = 2-3%
Incidence of chlamydia in pregnancy = 8% approx
What is the incubation period for chlamydia? When do symptoms appear?
- 2-8 days
- Symptoms appear after 2-3 weeks
What are the symptoms of chlamydia in women?
- Midcycle bleeding
- Vaginal discharge
- Pain on passing urine
- Lower abdominal pain
70% of women have NO symptoms
What are the symptoms of chlamydia in men?
- Urethritis
- Urethral discharge
- Testicular pain
50% of men are ASYMPTOMATIC
How is chlamydia tested for?
- Charcoal swab (low vaginal swab, high vaginal swab and cervical swab)
- Chlamydia swab for females, NAAT (like a PCR)
- Viper swabs showing urine samples (men or women) or swabs (women low vaginal or endocervical)
What is the treatment and management for chlamydia?
Chlamydia can usually be treated with antibiotics
- Azithromycin - 1g single dose
- Doxycycline - 100mg bd for 7 days
Patient needs to be checked for other STIs
Contact tracing to identify partners for possible STIs
Review in 3 months to repeat the test and check they have taken the treatment
What are complications associated with chlamydia?
- Pelvic inflammatory disease
- Ectopic pregnancy
- Infertility
- Reduces sperm count in men
What are risk factors for chlamydia?
- Being under 25
- Having 2 or more partners in the last 12 months
- Having a new partner
- Not using condoms
- Men who have sex with men
What are the elements of an appropriate sexual history to assess risk for STI and pregnancy?
History:
- When did you last have sexual intercourse?
- With a man or woman?
- Were they a casual or regular partner?
- Where were they from?
- In which country did you have intercourse?
- Does your partner have symptoms?
- Have you had any other partners in the last 6 weeks?
- Did you have pain during or after intercourse?
- Have you ever had any previous STIs?
- Have you ever had a sexual health check-up before (explain and offer)?
- Have you ever had a HIV/hepatitis/ syphilis test before?
- Have you ever been vaccinated against hepatitis A/B or have you ever had hepatitis?
How can a chemist help people who are worried about having had unprotected intercourse leading to pregnancy?
- Can get morning after pill over the counter
- Can get condoms
- Can get pregnancy test
How can a chemist help people who are worried about having had unprotected intercourse leading to an STI?
- Can buy swabs
- Can get self treatment; axithromycin
Explain principles of self-care in sex and risk reduction
- Condoms reduce risk of contracting STI, but do no eliminate risk
- Condoms with CE or BSI mark meet high safety standards for condoms
- Most methods of contraception do not protect against catching or passing on an STI
- Condoms are ether only method that can protect against STIs and pregnancy
