STIs

Question 1

define STI

Answer 1

A STI is an infection by a pathogen which is sexually transmissible, and which is unlikely to be transmitted by non-sexual means e.g. Neisseria gonorrhoeae.

Question 2

define STD

Answer 2

A STD is a disease caused by an STI e.g. pelvic inflammatory disease or genital warts.

Question 3

Sexually transmitted organisms in the UK: bacteria

Answer 3

chlamydia trachomatis
Klebsiella granulomatis
mycoplasma genitalium

Question 4

Sexually transmitted organisms in the UK: viruses

Answer 4

HSV
HIV
HPV
molluscum contagiosum virus

Question 5

Sexually transmitted organisms in the UK: parasites

Answer 5

pthirus pubis
sarcoptes scabei
trichomonas vaginalis

Question 6

examples of sexual contact

Answer 6

1. Fisting/other potentially traumatic sex
2. Group sex
3. Anal sex
4. Vaginal sex
5. Oral sex
6. Touching someone else’s genitals with your genitals
7. Mutual masturbation

Question 7

activity required for transmission: genital contact only

Answer 7

pubic lice (pthirus pubis)
scabies (sarcoptes scabeii)
warts (HPV 6 + 11)
herpes (HPV 1 + 2_

Question 8

activity required for transmission: blood transmission or group sex

Answer 8

hep b
hep c
HIV

Question 9

why are STIs important?

Answer 9

They cause morbidity and they can kill. They cause unpleasant symptoms and psychological distress.
Systemic symptoms include fever, rash, lymphadenopathy, malaise and infertility.
They are a drain on resources. Managing infertility due to chlamydia/cost of IVF. The cost of HIV
medication and management of HIV related health conditions is massive. The time taken off work to
get warts frozen.

Question 10

why do diagnoses of STIs change over time?

Answer 10

a true change in numbers

a change in diagnoses but no actual change in numbers

Question 11

how does a change in no of diagnoses but no change in cases occur? STIs

Answer 11

A greater awareness of STIs means that more people will be tested. More doctors are considering STIs
and therefore testing for them. Additionally, better tests result in more cases being diagnoses. For
example, nucleic acid amplification tests vs enzyme immunoassays for chlamydia.

Question 12

the sexual Hx

Answer 12

• Determine possible cause of symptoms
• Detect high risk behaviour and advice re reducing future risk
• Trace contacts
1. When did you last have sexual contact?
2. Casual contact vs regular partner?
a. How long were you going out with them for?
3. Were they male or female?
4. Asking about nature of sex act sometimes useful
a. Anxiety about a specific incident
b. If it’s going to alter where you swab from e.g. MSM
5. Did you use condoms?
6. Other contraception used
7. Nationality of contact

Question 13

male risk assessment

Answer 13

• Have you ever had sexual contact with a man?
• Have you ever injected drugs?
• Sexual contact with:
o Anyone who’s injected drugs?
o Someone from outside the UK? (Clarify)
• Medical treatment outside UK? (Clarify)
• Involvement with sex industry (prostitute)

Question 14

health promotion in regards to STIs

Answer 14

• Condoms prevent transmission of some STIs
o HIV, chlamydia, gonorrhoea
• Condoms aren’t very good at preventing transmission of other STIs
o Herpes and warts
• Oral sex carries risks too
o Not as great as vaginal or anal sex
o Fellatio more than cunnilingus
• Alcohol and other drugs