STI Flashcards
State 5 risk factors for STI contraction
- young age (<20 years) - low age at 1st intercourse - coitarche
- frequent partner change, high no. lifetime partners, concurrency (simultaneous partners)
- sexual orientation
- ethnicity for some STIs
- use of non barrier contraception
- residence in inner city/ deprivation
- history of previous STI
What are the effects of having sex at an early age?
- Poor subsequent sexual health status
- higher numbers of sexual partners / partners change
- greater numbers of concurrent partners
- yet to develop skills and confidence to use condoms, negotiate safe sex,
- more risk-taking behaviour/ experimentation
- poor contraception awareness
- Physiological changes increase susceptibility to pathology
What is tthe correlation between consent and age?
The earlier intercourse occurs, the more people express regret and rport being more/less willing than their partner
20% men
42% women wish they waited
Rx factors for young people having poor sexual health/ early coitarche
- leaving home / not living with parents before 16 years
- leaving school early
- family disruption & disadvantage
- lack of nurturing relationships
- those whose main source of information on sex was not school / parents
Where do young people get sexual information from?
- Parents
- School
- Books
- Internet (porn)
Internet is free, unrestricted and UNCENSORED. Its unrealistic and raises expectations
State 5 negative aspects of porn
- Unrealistic nature & expectations
- Self-image / performance anxiety
- Lack of censorship / boundaries – hardcore material becomes addictive / normalised
- Ethical issues e.g. exploitation of women
- Sexual consent blurred
- Lack of condom use = reduced risk perception / perceived need to practice safe sex
What should we be telling young people about sex?
- Don’t rush, avoid peer pressure
- Use a condom with all new partners, continue until both screened
- Sort out contraception
- Avoid overlapping sexual relationships
- Get screened for chlamydia/gonorrhoea when you have a new partner
- MSM should have regular sexual health screens, including HIV, get vaccinated for hepatitis A/B and HPV & consider PrEP for HIV prevention
What is the definition of a “core group”
Why are these relevant?
- sub-group of the population, high turnover
- not a static entity
- highly sexually active individuals
- high prevalence of infection
- reservoirs of infection
- high frequency of transmission
Effective control at the population level based on targeting core groups
What is GMC guidelines regarding a genital examination?
- OFFER a chaperone
- Explain to patient why examination is necessary & what it will involve
- Give patient privacy to undress & dress
- Obtain patient’s permission before the examination - discontinue if patient asks you to
- Keep discussion relevant - avoid unnecessary comments
How would you conduct a female genital examination?
- Inspect pubic area, labia majora & minora & perianal area
- Inspect & palpate inguinal region
- Use leg rests - allow better visualisation
- Speculum examination (use water as lubricant - gels can interfere with tests)
- Bimanual examination (if indicated)
How would you conduct a male genital examination?
- Inspect pubic area, inguinal region
- Inspect scrotum & perianal area
- Palpate scrotal contents – note presence of testes, any lumps/ tenderness
- Inspect penis - record whether circumcised - if not inspect under foreskin
- Particular attention to coronal sulcus, frenulum & meatus
- Note presence of urethral discharge
What are pearly penile papules?
What is the female equivalent?
- Normal variation in penis
- Vulval papules / papillomatosis
How can normal subaceous glands become pathological
- Subaceuous glands can turn into subaceous cysts (these are not always pathological
How does psoriasis appear in the moist genital areas?
If you suspect psoriasis what else would you ask/check
Red
- FHx,
- Asthma
- Check elbows
How does scabbies present?
Is scabbies exclusively a STI?
Pruritic papules (red spots on penis)
- Lesions and burrows in finger webs and wrist
No