STI Flashcards
What are commensal micro-organisms?
A micro-organism that derives food or other benefits from another organism without hurting or helping it
What is a sexually transmitted microbe?
- A virus, bacteria or protozoan which can be spread by sexual contact
- Commensal
- Pathogen
What is a sexually transmitted infection?
An infection by a pathogen which is sexually transmissible and which is unlikely to be transmitted by non-sexual means
What is sexually transmitted disease?
A disorder of structure or function caused by a sexually transmitted pathogen
What is on the current list of sexually transmitted organisms? (bacteria, viruses, parasites)
- Bacteria
- Chlamydia trachomatis
- Klebsiella granulomatis
- Mycoplasma genitalium
- Viruses
- HSV
- HIV
- HPV
- Molluscum contagiosum virus
- Parasites
- Pthirus pubis
- Sarcoptes scabei
- Trichomonas vaginalis
How can STIs impact on home life? Is an STI diagnosis or a being temporarily colonised by a commensal organism worse?
Effect the relationship.
STI diagnosis is worse so reasuring someone that they are just colonised is v important sometimes.
What are some sexually transmissible microbial pathogens that are not classified as STIs?
- Ebola
- Zika virus
What are characteristics of STIs and the implications that these characteristics carry?
- Transmissable: need to tell partner
- Asymptomatic majority of time: hard to eradicate from population
- All manageable but not always curable: treat and prevent complications
- Avoidable: primary prevention is education
List sexual contact from low risk to high risk.
- mutual masturbation
- Touching anothers genitals with your own genitals
- oral sex
- vaginal sex
- anal sex
- group sex
What can spread via genital contact only?
What can spread via group sex?
- pubic lice (Pthirus pubis)
- Scabies (Sarcoptes scabeii)
- Warts (human papilloma virus types 6 &11)
- Herpes (Herpes Simplex Virus types 1 & 2)
- Hep C
What are some systemic symptoms and adverse outcomes?
- Fever
- Rash
- Lymphadenopathy
- Malaise
- Infertility
- Cancer. 250,000+ deaths globally from cervical cancer.
- 300,000 adverse pregnancy outcomes from syphilis per year (globally)
Why have we had a change in number of cases of STIs?
- Increased numbers of partners/person
- Increased concurrent partners
- More people having anal sex
- More men reporting sex with men
Has there been a change in the number of diagnoses?
- There has but this does not necessarily mean there has been a rise in incidence.
- Likely rise in diagnoses because there is increased awareness.
How can we model the spread of STIs over an area?
Sexual network analysis
What does assortive mixing mean?
What are the implications of assortive mixing?
When people within a certain population only have sex with each other.
Leads to high prevalence within a subpopulation (core) but limited spread through the wider community.
What are the implications of a small ‘core’ or a large ‘chain’ when discussing assortive mixing?
- Small core: high incidence of infection
- Large chain: infection can spread further
What are the 4 key management factors for someone complaining of STI symptoms?
- Good history
- HIV testing
- Partner notification
- Health promotion
What is needed along with the basic history for an STI history?
- Gynae history
- Direct questions such as “discharge from the penis/pain in abdomen?”
What is the sexual history necessary for?
- determining possible cause of symptoms
- detecting high-risk behaviour and advising re reducing future risk
- tracing contacts
What are some of the questions required in a sexual history?
- When did you last have sexual contact?
- Casual contact vs ‘regular’ partner?
- How long were you going out with them for?
- Were they male or female?
- Asking about nature of sex act sometimes useful
- anxiety about a specific incident
- If it’s going to alter where you swab from eg MSM
- Did you use condoms?
- Other contraception used
- Nationality of contact
What need’s to be asked in a risk assessment for a man?
- Have you ever had sex with a man?
- Have you ever injected drugs?
- Sexual contact with
- anyone who’s injected drugs
- someone from outside UK
- Medical treatment outside the UK? [those fenians got nothin on the NHS]
- Involvement in sex industry
How can we notify the partner of an STI?
- Patient tells: ‘client referral’
- NHS tells: ‘provider referral’
What do we offer and why during an STI consultation?
- Recommend further testing for things such as HIV.
- Health promotion: Allows the patient to know benefits/risks of condoms, the risk of oral sex and drugs/alcohol
