STIs In Practice Flashcards
What is a sexually transmitted infection?
This refers to a pathogen that causes an infection through sexual contact.
What is a sexually transmitted disease?
This refers to a recognisable disease state that has developed from an infection.
How can the pathogens pass from person to person?
They pass through blood, semen, vaginal fluids and other bodily fluids.
How else can these pathogens be passed without sexual contact?
This can be from the mother to the infant during pregnancy or childbirth.
Or
From people sharing the same needles or blood transfusions.
What long term complications can be linked with STIs?
Most STIs are treated with antibiotics however the following can arise:
-pelvic inflammatory disease
-ectopic pregnancy
-infertility
-Chronic abdominal pain in women
-premature delivery of a baby
-infant blindness
-cardiovascular damage
-cancers
-arthritis
-urethral structures in men
What is the most common STI in the uk ?
The most common is CHLAMYDIA.
What is antibiotic resistance and which STI is more susceptible to it?
Increased antibiotic resistance refers to antibiotics becoming ineffective, thus leaving us with reduced treatment options.
GONORRHOEA IS THE HIGHEST RISK OF RESISTANCE.
Who offers sexual health services?
There are three levels of sexual health services:
-LEVEL 1 (asymptomatic)
-LEVEL 2 (symptomatic)
This includes GPs, pharmacies, young people services, online sexual health services etc.
-LEVEL 3 (complex and requires medical attention)
This includes genitourinary medicine (GUM services) and sexual reproductive health services.
What can general services offer ?
-sexual history taking and risk, assessments
-STI screening and treatment
-advice and supply of regular and emergency contraception
-condom distribution
-signposting to appropriate sexual health services
-HIV screening
-cervical screening
How do community pharmacies play a role in sexual health services?
They are level 1 sexual health services, thus meaning that the patient is asymptomatic and they can visit the pharmacy.
They can offer:
-sexual health advice
-emergency hormonal contraception
-ongoing contraception
- chlamydia screening and treatment from age 15-24
-pregnancy testing
-supply of erectile dysfunction treatment
-HPV vaccinations
What is the benefit of Sexual health services in the community pharmacies?
They are confident locations for many patients and they obtain flexible hours.
Which groups are at higher risk?
-adolescents -15-24
-people who have recently visited countries with high rates of HIV or other STIs
-men who have SI with men
-people with multiple partners
-alcohol or substance abuse
-IV drug use
-early onset sexual activities previous bacterial STI
What is some safe sex advice that a community pharmacist should give?
Education:
Transmission of STIs
Partner education:
-the spread of an STI depends on the rate of the change in sexual partners
Condom use
Repeat testing:
-screening for asymptomatic STIs should be recommend at least annually and 3 monthly if high risk
Vaccinations:
HPV and hepatitis
HIV pre exposure prophylaxis
What advice should be given on condom use?
-it should not be promoted as a sole means of reducing risk
-consistent and correct use of condom is the most efficient means of protecting against HIV and other STIs (98%)
What is the CDS?
CONDOM DISTRIBUTION SERVICES
They can be disturbed through a C card.
When should Fraser guidance be considered in regards to STIs?
Under 16 years of age
Under 13s:
-not legally able to consent to sexual activity
-discuss with child protection lead and record the conversation
13-16 years old:
-consider potential harm to the child
-consider informing child protection lead
16-17 years old:
-they have the right to independance
-the law however still defines them as children
-even though they are over the age of consent legally they are still treated as a child thus offer child safeguarding support if needed
How are STIs managed?
-sexual history taking
-screening
-testing
-treatment
-contact tracing
-lifestyle advice in how to prevent STIs in the future
What history is needed to be taken when preforming an STI assessment?
-reason for attendance ( is the patient symptomatic or non symptomatic)
-history of presenting complaint
-full sexual history
-revelevant past medical history
-vaccination history -Hep B ?
-drug history including illicit
-allergies
-females -menstrual, contraceptive
What does the sexual history of an asymptomatic patient consist of?
-confirm lack of symptoms
-establish competency, safeguarding children and vulnerable adults
-date of last sexual contact and number of partners found in the last three months
-gender of partners
-condom use
Any suspected infections
-infection risk
-symptoms in partner of a previous STI
-women :last menstrual period, contraceptive ands cervical cytology
-blood borne virus risk assessment
-Alcohol/illicit drugs
What does the sexual history of an ymptomatic patient consist of?
Ask additional questions in addition to the asymptotic questions:
-symptoms and reason for attendance
-pregnancy and gynaecological history
-past medical history
-medication history and history of drug allergies
-agree the methods of giving results
TEST FOR MULTIPLE STIs BECAUSE PEOPLE CAN PRESENT WITH MORE THAN 1.
What is chlamydia and how is it transmitted?
Bacteria that causes this is :CHLAMYDIA TRACHOMATIS
Transmitted through:
-through penetrative sex
-contact with infected genital secretions
-splash from genetically fluids
From mother to baby at delivery (results in conjunctivitis)
How does chlamydia infect the body?
It infects the endodermis,urethra, rectum and the conjunctiva
Infection of the urogeneital tract usually causes inflammation of the :
-urethra in males
-the cervix and or the urethra in females