Sexual health

Question 1

key populations

Answer 1

-disproportionately affected by HIV and other STIs
-men who have sex with men
-people who inject drugs
-transgender people
-people in sex trade
-people who have been incarcerated
-barriers to accessing sexual health services, stigma and discrimination, may require targeted interventions to reduce risk of HIV and other STIs
-15-19yo is highest rate of reported STIs in NY**
- note: 30-50% of practicioners are uncomfy with talking about sexual health w pts

Question 2

sexual history - what are the 5 ps

Answer 2

-partners- # and gender
-practices
-protection- STD tests in non-monogamous
-past hx of STD- greater risk for others now
-prevention of pregnancy

Question 3

know ur rights: you dont need permission from anyone for:

Answer 3

-OCP
-condoms
-morning after pill
-pregnancy tests and prenatal care
-STI tests
-HIV tests and tx
-PreP and PEP
-HPV vaccine
-abortion
-sexual assualt care

Question 4

sexual dysfunction

Answer 4

-difficulty with arousal, desire, orgasm, and resolution
-females- most likely caused by diabetes
-males MC- erectile dysfunction from other chronic diseases (DM)
-premature ejaculation

Question 5

infertility

Answer 5

-40-50% are due to males
-causes MC lifestyle factors: smoking, alcohol, drug use
-MCC for males is low sperm count
-MCC is ovulation disorder in women
-2nd MCC is tubal blockage and age

Question 6

low libido

Answer 6

males: MC- decrease TESTOSTERONE
-age
-SNRI, SSRI
-OSA
-stress
-increased alcohol, drugs, smoke

women: MC- STRESS in younger women -> 30-50 is PERIMENOPAUSE
-dyspareunia, surgery
-menopause
-stress
-fatigue

Question 7

decrease in STIs reported. Why?

Answer 7

-reduced screening
-limited resources
-stay at home orders

so: we need to update STI screening

Question 8

syphilis

Answer 8

-on the rise
-only screen women exposed - CDC
-only screen women who are high risk - USPSTF

Question 9

chlamydia tx

Answer 9

-adults/adolescents- doxy 100mg 2x day for 7 days
-pregnant- azithro 1gm 1x
-infants and children- erythro 50mg/kg 4x/day for 14 days OR ethylsuccinate 50mg/kg 4x/day for 14 days
-children who weight >45kg but at <8- azithro 1gm 1x

Question 10

gonococcal tx

Answer 10

Question 11

epididymitis tx

Answer 11

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Question 12

syphilis tx

Answer 12

Question 13

STI-PEP

Answer 13

-retest 3-6 months after tx, you cant have unprotected sex until after youre cleared and you have finished meds
-post prophylaxis for sex workers