2: STIs Flashcards
A variety of clinical syndromes caused by pathogens that can be acquired and transmitted through sexual activity.
STIs
This older term primarily described gonorrhea and syphilis.
Venereal disease
Risk factors for STIs.
- Previous or current sexually transmitted infection
- Sex with multiple or new partners
- Initiating sex at a young age
- Unprotected sex
- Sex with high-risk partners
- Sex with an partner who has HIV
- Sex in exchange for money or drugs
- Sex while intoxicated
- Illegal drug use
- Injection drug use
- Mental illness
- Age < 25 years
- Living in an area with high sexually transmitted infection/HIV prevalence
- Residing in a detention or correctional facility
T/F Women are biologically more likely to become infected with STIs than men. Women are also more likely than men to acquire an STI from a single heterosexual sexual encounter.
True
T/F Women are 2-3x more likely to transmit HIV to men.
False. MEN are 2-3x more likely to transmit HIV to WOMEN.
Why are women more likely to get STIs?
- The vagina has a larger amount of genital mucous membranes exposed and is an environment more conducive to development of infections than the penis.
- Risk for trauma is greater during vaginal intercourse for women than for men
T/F Women are more likely to have asymptomatic STIs.
True. Often results in delayed treatment.
Besides problems with fewer symptoms, why might it be more difficult to diagnose women with STIs?
The anatomy of a woman makes a physical exam more difficult.
Why are adolescents more likely to get STIs?
- Lack of immunity and biologic susceptibility.
- More immature cervix. These cells recede into the cervix as a woman ages.
T/F Risk for PID can increase both with vaginal douching and greater frequency of douching.
True
Why do anal intercourse, sex during menses, and dry sex increase risk of STIs?
The bleeding and tissue trauma facilitates invasion by pathogens.
The central (endocervical) columnar epithelium protrudes out through the external os of the cervix and onto the vaginal portion of the cervix, undergoes squamous metaplasia, and transforms to stratified squamous epithelium.
Cervical ectropion
Poverty, lack of education, immigration status, and inadequate access to health care are examples of what kind of factors for STI transmission?
Social factors
T/F Women who are abused are at higher risk of STIs.
True. This may be due to lack of ability to exercise control in the situation (negotiating condom use).
Why are women who have sex with women at risk for STIs?
They may have had intercourse with a man by choice, by force, or by necessity. Their female partners may also have other STI risk factors, such as injection drug use.
What is a key factor of STI spread within geographic areas?
Sex partner mixing
How do drugs and alcohol increase risk for HIV?
- They undermine cognitive and social skills, making it more difficult to engage in protective actions.
- Decreased functioning also makes it difficult to clean drug equipment.
What education is necessary for diagnosis of STIs?
Men and women must know how to recognize the s/s of STIs or they won’t seek help.
Who should be screened for STIs?
All women who are sexually active. Through history, physical exam, and lab studies based on risk factors.
What are the 5 Ps of sexual health?
- Partners: Do you have sex with men, women, both? In the past 2 months, how many partners? In the past 12 months, how many partners? Is it possible that any partners in past 12 months had sex with someone else at the same time?
- Practices: Have you had vaginal sex? Do you use condoms? Have you had anal sex? Do you use condoms? Have you had oral sex?
- Prevention of Pregnancy: What are you doing to prevent pregnancy?
- Protection from STIs: What do you do to protect yourself?
- Past History of STIs: Have you ever had an STI? Have any of your partners ever had an STI?
Which of these are risk factors for STIs?
- Frequent vaginal infections
- Unusual vaginal discharge or odor
- Vaginal itching, burning, sores, or warts
- Sexually transmitted infections (ask about individual infections)
- Abdominal pain
- Pelvic inflammatory disease/infection of the uterus, tubes, ovaries
- Sexual assault/rape
- Physical, emotional, sexual abuse
- Abnormal Pap test
- Pain or bleeding with intercourse
- Severe menstrual cramps occurring at end of period
- Ectopic pregnancy
All of them.
When assessing for STIs, what is the first step?
Generally, a history should be taken while fully dressed.
When discussing STIs, the clinician must make sure the woman understands what about her infection?
- Which infection.
- How it is transmitted.
- Why it must be treated.
When describing a patient’s STI, what should the clinician include?
- Modes of transmission
- Incubation period
- Symptoms
- Infectious period
- Potential complications
T/F Women with HIV are likely more infectious during menses.
True
Which STIs are mandatory for reporting?
- Chancroid
- Chlamydia
- Gonorrhea
- Hepatitis
- HIV
- Syphilis
Which STIs are most common in sexually assaulted women?
- Gonorrhea
- Chlamydia
- Trichomoniasis
Which age group has the lowest rates of STIs?
Peri- and postmenopausal women
What is a possible risk for STI transmission in older women?
In older women, the dry, friable vaginal tissue that results from vulvovaginal atrophy associated with declining estrogen levels in menopause may increase microabrasions with intercourse and increase the risk for STI transmission.
Which strains of HPV cause 90% of genital warts?
- 6
- 11
Which strains of HPV that occasionally found in genital warts are associated with cervical intraepithelial neoplasia?
- 16
- 18
- 31
- 33
- 35
70% of all cervical cancer is caused by these 2 strains of HPV.
- 16
- 18
