risky sexual bx Flashcards
Will risky sexual bx usually be the primary presenting concern?
No; typically useful adjunct (info or intervention) to primary concern
Highest risk groups?
adolescents and young adults
At this stage of my training what is my goal re: risky sex bx?
know the right questions to ask
get comforabtle with the questions
be able to ID high risk groups
in 2011 how many babies were born to women aged 15-19? According to who?
approx 330,000; CDC
Why does CDC focus on ppl aged 15-19
tend to be the highest risk group
Rates if births among women 15-19 dropped ___% from 2011 to 2010; is this significant?
8%; yes we don’t usually see such large drops in public health research year to year
Why the drop?
increased use of abortions
increased access/use of contraceptions
increased use of morning after pill
As of 2012, what is annual rate of new STI?
approx 20 million/year
As of 2012 how many new cases of chlamydia?
approx 1,423,000; rate of approx 450 per 100,000 people (generally a stable statistic)
As of 2012 how many new cases of syphillis?
16,000 cases; a rate of 5 per 100,000 people
Rates of syphilis in 2012 represents an increase of ____% since 2011; mainly among ____?
11.1% increase; mainly men - gay, bi, and MSM
As of 201 how many new cases of gonorrhea?
approx 335,000; rate of 108 per 100,000
Rates of gonorrhea in 2012 represent an increase of ____% since 2011?
4.1%
In general, rates of STI are_____?
increasing
What # of adolescents and adults are living with HIV?
1.1 million
What % of females dx’ed with HPV?
approx 25%
Despite increasing rates and danger of STI most ppl don’t get services… why?
Financial Some things are asymptomatic (e.g. HPV) Lack of knowledge Stigma/shame/guilt/fear Transportation (especially young people) Psychosocial factors (e.g., How will I tell my partner?)
What are point-of-service intervention?
responding to low rates of help seeking/follow through re: STI/risky sex bx; provide interventions at the point of testing
Different kinds of failed follow through?
don’t get tested at all
get tested but don’t find out results
get results but don’t get tx
Acronym for demo risk factors re: risky sex bx?
RAGS
Race/ethnicity; age; gender; SES
also, these factors interact
Describe RAGS in a nutshell
Race/ethnicity - blacks/hispanics
Age - adolescents
Gender - women and MSM
SES - low SES
Acronym for adolescent risk factors re: risky sex bx?
FADS-O
Family; Access; Developmental; Social; other
Adolescents: family risk factors re: risky sex bx?
Mother’s history of sexual behaviors
– Initiation of sexual activity early on
– Pregnancy at young age
– Having numerous partners
Supervision
– Overcrowding in the home (people sharing rooms)
– Degree of parental supervision about behavior
– Had conversations with mother about sex?
What kinds of questions can/should you ask to assess adolescent risk factors re: risky sex bx? (Not just asking the teen either)
How old was your mother when she got pregnant for the first time?
Mom, how old were you initiated sexual activity?
Mom, have you had numerous partners? Has your mother had numerous partners?
What’s the sleeping situation like in the home? Do people share rooms?
Hav you had conversations with your parents about sex? What kinds of conversations have you had?
If you’re having sex, do your parents know? How much do you think your parents know about your sex life?
Parents, how much do you know about your kids sex life?
Adolescents: access-related risk factors re: risky sex bx?
Transportation (to a clinic for testing/contraceptives)
Less likely to receive information? (nowadays, health classes? receiving the right information, i.e from peers?)
Poverty/affording condoms
Adolescents: developmental risk factors re: risky sex bx?
Poor impulse control sensation control deficits in EF Deficits in abstract thinking (e.g. weighing longterm consequences vs. short term benefits) Experimentation Identity development
Adolescents: social risk factors re: risky sex bx?
Peer exposure
Peer pressure
Has become the norm
faulty information
Adolescents: other risk factors re: risky sex bx?
homelessness deliquency/legal issues substance use hx of trauma lower IQ greater levels of daily burdens/stressors
As measured in 2007: ___% of HS students had had ever had sex; ___% of sexually active HS’ers did not use a condom during last sexual intercourse; ___% HS’ers had four or more sexual partners during their life
50%; 40%; 15%
Race/ethnicity X age interaction re: risky sex bx… when we say “race” we really mean who?
black and hispanic kids
In general describe the race/ethnicity X age interaction re: risky sex bx
higher rates of sexual activity in HS
higher rates of pregnancy
more likely to have multiple partners
initiate sexual activity at an earlier age
Race/ethnicity X Age (adolescence), rates of sexual activity in HS
teens in general - 50%
white - 45%
hispanic - 54%
AA - 70%
Race X age (teens), rates of pregnancy
AA/Hispanic approx 130 births vs. white approx 45 births (per 1000 females)
Race X age (teens), age of initiation
ranges from 15-17 on average
AA at most risk, start the youngest
Race X age (teens), having multiple partners
Teens in general - 16% whites - 12.5% hispanics - 17% AA - 35% Teens in general, four or more - 15%
Chlamydia - rates (2012), race X gender
relatively even split between genders (leans more female)
three groups with highest rates:
black women, NA/AN women, NHOPI women
Gonorrhea - rates (2012), race X gender
nearly even split between genders
Overwhelmingly, black men and black women highest risk
Syphilis - rates (2012), race X gender
overwhelmingly male
three groups with highest rates:
black men, NHOPI men, hispanic men
HIV/AIDS, ___% of those living with AIDS/HIV are AA, but account for ___% of the US population
50%; 13%
HIV/AIDS, ___% of those living with AIDS/HIV are white
31%
HIV/AIDS, ___% of those living with AIDS/HIV are Hispanic, but account for ___% of the US population
18%; 15%
Why are women at increased risk for STI?
STI’s typically transmitted male to female
Asymptomatic/undetected –> untreated
More likely to be victims of domestic violence/rape
MSM includes ______; and are at risk for______
gay, bi, and hetero men who have sex with men
hep, HIV, anal cancer
in 2005, MSM made up what proportion of all men living with HIV/AIDS
more than 2/3rds (68%)
What percent of men report having sex with men?
5-7%
(2012) What % of men attending STI clinic in Philly have gonorrhea? chlamydia?
g - approx. 60%
c -approx. 20%
(2012) What % of men attending STI clinic in Philly for syphilis (prim. and sec.) are co-infected with HIV?
approx 60%
Who does knowing that my client is in a relationship affect how I assess for risky sex bx?
Knowing that will make me less likely to assess it (but relationship many not mean less risk)
