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Year 2 Medicine > Sexual Health > Flashcards

Sexual Health Flashcards

1
Q

Define ‘health’

A

a state of complete physical, mental, spiritual and social well-being and not merely the absence of disease or infirmity

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2
Q

Define ‘Sexual health’ (WHO)

A
  • a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.
  • Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence
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3
Q

Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as…

A

the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence

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4
Q

Why is “sexual health” preferable to “reproductive health”?

A

Sex is not just about reproduction (E.g same sex couples, postmenopausal women)

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5
Q

20,037 respondents in Australian Study of Health & Relationships:

  • Sexual identity and sexual … is important (idenity and … are not identical)
A
  • Sexual identity and sexual experience is important (idenity and … are not identical)
  • Majority - sexual identity is heterosexual
  • BUT almost 10% say they have had sexual experiences with same gender and different gender, so experience does not match identity
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6
Q

should we refer to STDs? or STIs? or RTIs? - why does it matter (Sexual health)

  • much medical research focuses on … (HIV and other STIs) and sexual …
    • (+ unplanned …)
  • less attention is given to non-disease / dysfunction
  • but it is important to consider sexual well-being in more broad terms
    • sexual s..
    • sexual d..
    • sexual c…
    • sexually transmitted …
A
  • much medical research focuses on disease (HIV and other STIs) and sexual dysfunction
    • (+ unplanned pregnancy)
  • less attention is given to non-disease / dysfunction
  • but it is important to consider sexual well-being in more broad terms
    • sexual satisfaction
    • sexual difficulties
    • sexual coercion
    • sexually transmitted infections
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7
Q

Sexual satisfaction

  • …% of men and …% of women agree that “An active sex life is important for your sense of well-being”
    • (de Visser et al., 2014)
  • overall … satisfaction is strongly related to sexual satisfaction
  • In national surveys (USA and Australia) satisfaction with … aspects of … is significantly related to greater physical satisfaction and more frequent sex
A
  • 87% of men and 79% of women agree that “An active sex life is important for your sense of well-being”
    • (de Visser et al., 2014)
  • overall relationship satisfaction is strongly related to sexual satisfaction
  • in national surveys (USA and Australia) satisfaction with emotional aspects of relationships is significantly related to greater physical satisfaction and more frequent sex
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8
Q

Frequency of Sex

  • men have higher ideal frequency but large male/female overlap
  • … frequency is similar for men and women, and … than ideal
  • only 15% of men and 26% of women report a match between their ideal and actual frequency of sex
    • most men and women want …
  • mean frequency in relationships is … times per week
A
  • men have higher ideal frequency but large male/female overlap
  • actual frequency is similar for men and women, and lower than ideal
  • only 15% of men and 26% of men report a match between their ideal and actual frequency of sex
  • most men and women want more
  • mean frequency in relationships is 1.5 times per week
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9
Q

only …% of men and …% of women report a match between their ideal and actual frequency of sex

A

only 15% of men and 26% of women report a match between their ideal and actual frequency of sex

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10
Q

Mean frequency of sex in relationships is … times per week

A

Mean frequency of sex in relationships is 1.5 times per week

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11
Q

Sexual difficulties

A
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12
Q

Lower Sexual function is also related to:

  • … age *
  • d…
  • poor … health
  • lower … satisfaction
  • … to … about sex with partners
A
  • greater age *
  • depression
  • poor physical health
  • lower relationship satisfaction
  • inability to talk about sex with partners
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13
Q

Sexual Difficulties:

  • lacked interest in sex ->…% of men & …% of women
A

lacked interest in sex ->25% of men & 55% of women

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14
Q

Sexual Difficulties:

  • orgasm too quickly …% of men & …% of women
A

orgasm too quickly 24% of men & 12% of women

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15
Q

Sexual Difficulties:

  • unable to orgasm …% of men and …% of women
A

unable to orgasm 6% of men and 29% of women

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16
Q

Sexual Difficulties:

  • anxious about ability to perform …% of men and …% of women
A

anxious about ability to perform 16% of men and 17% of women

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17
Q

Sexual Difficulties:

  • sex not pleasurable …% of men and …% of women
A

sex not pleasurable 6% of men and 27% of women

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18
Q

Sexual Difficulties:

  • pain during intercourse …% of men and …% of women
A

pain during intercourse 2% of men and 20% of women

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19
Q

Sexual Difficulties:

  • vaginal dryness in …% of women
A

vaginal dryness in 24% of women

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20
Q

Sexual Difficulties:

  • unable to keep erection …% of men
A

unable to keep erection 10% of men

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21
Q

poor physical health has -ve effect on sexual … and …

A

poor physical health has -ve effect on sexual frequency and satisfaction

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22
Q

poor … health has -ve effect on sexual frequency and satisfaction

A

poor physical health has -ve effect on sexual frequency and satisfaction

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23
Q
  • around …% of men and …% of women have ever been sexually coerced
  • = forced or frightened into unwanted sexual activity
A
  • around 5% of men and 20% of women have ever been sexually coerced
  • = forced or frightened into unwanted sexual activity
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24
Q

Define sexual coercion

A

= forced or frightened into unwanted sexual activity

25
Q

sexual coercion has potentially long lasting effects on:

  • psychological well-being
    • e.g., higher prevalence of … and …
    • physical well-being
      • e.g., lower …-being, greater …/…/… use
    • sexual well-being
      • e.g., more …, more … attitudes
A
  • psychological well-being
    • e.g., higher prevalence of depression and anxiety
    • physical well-being
      • e.g., lower well-being, greater cigarette/drug/alcohol use
    • sexual well-being
      • e.g., more STIs, more negative attitudes
26
Q

any sexual … has these detrimental effects (psychological weel-being, physical well-being, sexual well-being)

A

any sexual coercion has these detrimental effects (psychological weel-being, physical well-being, sexual well-being)

27
Q

Sexual health across the lifespan

  • sexual health concerns vary over time
    • e.g. youth:
      • avoiding unintended …
      • avoiding …
      • treating … to protect … health
    • e.g. adulthood:
      • optimising … health
      • optimising sexual …
    • e.g. older age:
      • optimising sexual …
      • limiting impact of … health on sexual health
  • ? less lifespan variation in sexual health needs of homosexual people
  • age and/or cohort effects -> society more …
  • sexual health more …
A
  • sexual health concerns vary over time
    • e.g. youth:
      • avoiding unintended pregancy
      • avoiding STIS
      • treating STIS to protect reproductive health
    • e.g. adulthood:
      • optimising reproductive health
      • optimising sexual satisfaction
    • e.g. older age:
      • optimising sexual function
      • limiting impact of physical health on sexual health
  • ? less lifespan variation in sexual health needs of homosexual people
  • age and/or cohort effects society more sexualised
  • sexual health more valued
28
Q

Sexual health across the lifespan:

  • age and/or cohort effects society more …
  • sexual health more …
A
  • age and/or cohort effects society more sexualised
  • sexual health more valued
29
Q

people are sexually active at younger ages = earlier potential … exposure / … … risk + people are sexually active … in life = longer potential … exposure

  • (Rissel et al., 2003; Wellings et al., 2001)
A

people are sexually active at younger ages = earlier potential STI exposure / unplanned pregnancy risk + people are sexually active later in life = longer potential STI exposure

30
Q

What does being sexually active for longer (during your lifestime) mean for you?

A

earlier STI exposure and unplanned pregnancy (younger) and longer STI exposure (older)

31
Q

prevalence of sexual difficulties varies with age - but not simply more problems with age

A
  • sexual function not simply physical
    • = also related to relationship satisfaction, and ability to talk about sex with partners
      • (de Visser et al., 2017; Mitchell et al., 2013)
32
Q

Promoting preventive behaviour

  • major focus in sexual health is prevention
  • absence of …, … or … treatment increases importance of behaviour
  • high and increasing rates of …, particularly among young people
A
  • major focus in sexual health is prevention
  • absence of vaccines, cures or effective treatment increases importance of behaviour
  • high and increasing rates of STIs, particularly among young people
33
Q

Condom use

  • …% of men and women have ever used condoms
    • but only …% used one last time they had vaginal sex
  • and …% said the condom was put on late
A
  • 90% of men and women have ever used condoms
    • but only 23% used one last time they had vaginal sex
  • and 15% said the condom was put on late
34
Q

…% of men and women have ever used condoms

A

90% of men and women have ever used condoms

35
Q

90% of men and women have ever used condoms but only …% used one last time they had vaginal sex

A

90% of men and women have ever used condoms but only 23% used one last time they had vaginal sex

36
Q
  • 90% of men and women have ever used condoms but only …% used one last time they had vaginal sex and …% said the condom was put on late
  • need to promote condom use and correct condom use
A
  • 90% of men and women have ever used condoms but only 23% used one last time they had vaginal sex and 15% said the condom was put on late
  • need to promote condom use and correct condom use
37
Q

Sexual Difficulties

A
  • no clear association between sexual difficulties and whether people seek treatment
  • issue with seeking treatment - degree of problem is more likely than duration of problem.
  • Everyone should know they can seek treatment for common problems
38
Q

There is a need to promote … use and … … use

A

There is a need to promote condom use and correct condom use

39
Q

What affects condom use? - The IMB Model - the key to effective safe sexual promotion

A
40
Q

The … Model is the key to effective safe sexual promotion

A

The IMB Model is the key to effective safe sexual promotion

41
Q

The IMB Model is the key to effective safe … promotion

A

The IMB Model is the key to effective safe sexual promotion

42
Q

What model is this?

A

IMB model - information, motivation, behaviour

43
Q

Weighted average correlations with condom use (Albarracín et al., 2001; ; Sheeran et al., 1999)

  • ​… regarding condom use has the strongest influence on condom use behaviour - knowledge and susceptibility not so much
A
  • ​Communication regarding condom use has the strongest influence on condom use behaviour - knowledge and susceptibility not so much
44
Q
  • Sexual health - > scare campaigns may be ineffective if:
    • people do not have the necessary …
    • and …
    • can be …-…
A
  • Sexual health - > scare campaigns may be ineffective if
    • people do not have the necessary skills
    • and confidence
    • can be counter-productive
45
Q

Sexual Health - Interventions

  • interventions that include a …. component are the most effective (Carey et al. 2000)
    • but few … promotion materials focus on … (Abraham et al., 2001)
  • heterosexual condom use is influenced more by concerns about … than …
    • dual use is … (de Visser, 2007; Ott et al., 2002)
  • access to contraception and post-coital contraception
    • (… after pill) may mean greater STI risk
    • is it responsible to prescribe the pill without also giving condoms to protect against STIs?
A
  • interventions that include a skills component are the most effective (Carey et al. 2000)
    • but few condom promotion materials focus on skills (Abraham et al., 2001)
  • heterosexual condom use is influenced more by concerns about pregnancy than STIs
    • dual use is uncommon (de Visser, 2007; Ott et al., 2002)
  • access to contraception and post-coital contraception
    • (morning after pill) may mean greater STI risk
    • is it responsible to prescribe the pill without also giving condoms to protect against STIs?
46
Q

Sexual health interventions that include a … component are the most effective (Carey et al. 2000)

A

Sexual health interventions that include a skills component are the most effective (Carey et al. 2000)

47
Q

heterosexual condom use is influenced more by concerns about … than …

A

heterosexual condom use is influenced more by concerns about pregnancy than STIs

48
Q
  • heterosexual condom use is influenced more by concerns about pregnancy than STIs
    • … dual use is … (de Visser, 2007; Ott et al., 2002)
A
  • heterosexual condom use is influenced more by concerns about pregnancy than STIs
    • … dual use is uncommon (de Visser, 2007; Ott et al., 2002)
49
Q

access to contraception and post-coital contraception (morning after pill) may mean greater … risk

A
  • access to contraception and post-coital contraception (morning after pill) may mean greater STI risk
50
Q

PEP and PrEP

  • Anti-… therapy drugs can be used to prevent sexual transmission of HIV through
    • …-exposure … (PEP) immediately after high-risk events
    • …-exposure … (PrEP)
  • (Krakower et al., 2015; Traeger et al., 2018)
  • … but is it responsible to prescribe PrEP without condoms for other STIs?
A
  • Anti-retroviral therapy drugs can be used to prevent sexual transmission of HIV through
    • post-exposure prophylaxis (PEP) immediately after high-risk events
    • pre-exposure prophylaxis (PrEP)
  • (Krakower et al., 2015; Traeger et al., 2018)
  • … but is it responsible to prescribe PrEP without condoms for other STIs?
51
Q

What is PEP and PrEP?

A
  • Anti-retroviral therapy drugs can be used to prevent sexual transmission of HIV through
    • post-exposure prophylaxis (PEP) immediately after high-risk events
    • pre-exposure prophylaxis (PrEP)
52
Q

Promoting screening and testing

  • diagnoses are not decreasing for many STIs - artefact?
    • more … tests
    • more … getting …
  • real increase
    • more … people sexually active
    • … condom use
    • lack of … about HIV affects STI concern
    • belief that STIs are not …
A
  • diagnoses are not decreasing for many STIs - artefact?
    • more sensitive tests
    • more people getting tested
  • real increase
    • more young people sexually active
    • inconsistent condom use
    • lack of concern about HIV affects STI concern
    • belief that STIs are not serious
53
Q

diagnoses are not decreasing for many …

A

diagnoses are not decreasing for many STIs

54
Q

National Chlamydia Screening Programme (NCSP)

  • opportunistic Chlamydia screening - under …s
    • i.e. testing at places other than GUM clinics
  • all people aged under … attending healthcare facilities not providing specialist sexual health services
    • outreach (e.g. “pee in a pot”)
      • testing via urine sample (all men, …% of women)
      • or self-collected vulvo-vaginal swabs (…% of women)
  • how many people had undiagnosed chlamydia? …%
A
  • opportunistic Chlamydia screening - under 25s
    • i.e. testing at places other than GUM clinics
  • all people aged under 25 attending healthcare facilities not providing specialist sexual health services
    • outreach (e.g. “pee in a pot”)
      • testing via urine sample (all men, 70% of women)
      • or self-collected vulvo-vaginal swabs (30% of women)
  • how many people had undiagnosed chlamydia? - ~10% of men and women aged 16-24 not seeking STI testing tested positive for chlamydia
55
Q

In opportunistic Chlamydia screening - under 25s - what % of men and women aged 16-24 not seeking STI testing tested positive for chlamydia?

A

~10% of men and women aged 16-24 not seeking STI testing tested positive for chlamydia

56
Q

Purpose of National Chlamydia Screening Programme (NCSP) (opportunistic screening)

  • collect …
  • raise …
  • … people
  • … partners
A
  • collect data
  • raise awareness
  • treat people
  • notify partners
57
Q
  • prevalence of Human Papilloma Virus was …-…% of 20-24yo women
    • … so, introduction of HPV vaccination
    • …% of eligible women have had 2-dose vaccination
    • prevalence of HPV16 and HPV18 in 18-20yo women is now …%
      • (PHE, 2020; Sonnenberg et al., 2014)
A
  • prevalence of Human Papilloma Virus was 20-40% of 20-24yo women
    • … so, introduction of HPV vaccination
    • 84% of eligible women have had 2-dose vaccination
    • prevalence of HPV16 and HPV18 in 18-20yo women is now 6%
      • (PHE, 2020; Sonnenberg et al., 2014)
58
Q
  • …% of eligible women have had 2-dose vaccination (HPV) and prevalence of HPV16 and HPV18 in 18-20yo women is now …%
    • (PHE, 2020; Sonnenberg et al., 2014)
A
  • 84% of eligible women have had 2-dose vaccination (HPV) and prevalence of HPV16 and HPV18 in 18-20yo women is now 6%
    • (PHE, 2020; Sonnenberg et al., 2014)
59
Q

How are older people protected? (Sexual health)

A

some catch up vaccination of over 13 but older - hope there is no mixing with age too much and if HPV goes down in general population risk is decreased overall

Year 2 Medicine (162 decks)

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