Screening and Prevention of STI

Question 1

What is Screening?

Answer 1

Process of identifying apparently healthy people who may be at increased risk of a disease or condition. They can be offered information, further tests and appropriate treatment to reduce their risk and/or any complications arising from the disease or condition.

Question 2

Wilson & Jungner Screening Criteria

Answer 2

• The condition being screened for should be an important health problem
• The natural history of the condition should be well understood.
• There should be a detectable early stage.
• Treatment at an early stage should be of more benefit than at a later stage.
• A suitable test should be devised for the early stage.
• The test should be acceptable.
• Intervals for repeating the test should be determined.
• Adequate health service provision should be made for the extra clinical workload resulting from screening.
• The risks, both physical and psychological, should be less than the benefits.
• The costs should be balanced against the benefits.

Question 3

WHO Revised Screening Criteria

Answer 3

• Response to a recognised need
• Objectives defined and evaluation planned at outset
• Defined target population
• Scientific evidence of effectiveness
• Programme should be comprehensive and integrated
• Quality assured, with systematic mitigation of risks
• Informed choice, confidentiality, and respect for autonomy
• Programme should promote equity and access to screening
• The overall benefits of screening should outweigh the harm

Question 4

Possible Outcomes of Screening

Answer 4

• Not screened - refused/did not get opportunity
• True positive
• True negative
• False positive
• False negative

Question 5

COM-B Model

Answer 5

Capability <
\/
Motivation  <    Behaviour
/\
Opportunity <

• Capability - an individual’s psychological and physical capacity to engage in the activity concerned.
• Motivation - all those brain processes that energise and direct behaviour, not just goals and conscious decision-making.
• Opportunity - all the factors that lie outside the individual that make the behaviour possible or prompt it.

Question 6

Social Cognitive Theory

Answer 6

Environemental Factors (social norms, access in the community, influence on others and environment) /\
/\/ I
Behavioural Factors (skills, self-efficacy, practice) I
/\/ \/
Cognitive Factors (knowledge, expectations and attitudes)

Question 7

Fishbone/ Ishikawa Diagra in relation to STI screening

Answer 7

go look at screenshot on iPad

Question 8

Chlamydia Test and Epidemiology

Answer 8

Urine/swab test

- In 2019, increase of 17,000 cases

Question 9

Gonorrhoea Test and Epidemiology

Answer 9

Swab/urine test - in 2019, increase in 3000 cases

Question 10

Genital Warts Test

Answer 10

Visual inspection

Question 11

Syphilis Test and Epidemiology

Answer 11

Blood/swab test - in 2019, decrease by 300 cases

Question 12

Genital Herpes Test and Epidemiology

Answer 12

Blood/urine/swab - in 2014, increase in 3000 cases

Question 13

HIV/AIDs Test and Epidemiology

Answer 13

Self blood test - in 2019, cases increased by 6000.

Question 14

Hepatitis B Test and Epidemiology

Answer 14

Blood test - in 2015, cases decreased by 18

Question 15

What are the individual consequences of STIs?

Answer 15

• NO SEX
• Impotence
• Infertility
• cancer
• cause impact on pregnancy - vertical transmission

Question 16

STI stigma

Answer 16

• stops people from being screened
• scared about contact tracing and losing confidentiality
• false positives
• scared about how they will be perceived

Question 17

What STIs can you get anonymous and postal tests for?

Answer 17

• chlamydia, gonorrhoea, HIV

Question 18

True or False: Males are more likely to be screened than females.

Answer 18

False

Question 19

What informs sense of risk?

Answer 19

• Personal acceptable level of risk
• Sense of control
• Type of sexual contact

Question 20

Social Norms which can affect a person’s likeliness to get tested

Answer 20

• Attitudes to sex/sexuality
• Attitudes to STIs
• Attitudes to screening

When we say attitudes we mean those of the family, community, partner(s) and social group

Question 21

What should STI screening look like?

Answer 21

• Services offered: prevention, treatment, supportive relationship, specialised information
• Themes to be addressed: sexuality, diet, weight, interpersonal relationships, leisure activities, dependencies, safety, career.
• Who: Doctors, nurses, psychologists, nutritionist, sexologist
• How: mix of bookable and emergency appointments, should be able to come alone or accompanied
• Where: school or health centre