Public Health Impact & Prevention Of STIs & HIV

Question 1

STIs

These are infections that are transmitted predominantly by ___________ and caused by a wide range of bacterial, viral, protozoal agents and ectoparasites.

Answer 1

sexual contact

Question 2

Commonly recognized STIs include:
1. Viral & rickettsial infections
◦ _________
◦ _________

Answer 2

◦ HIV/AIDS
◦ Herpes genitalis

Question 3

Rickettsia is ??

Answer 3

Bacterial

Question 4

Commonly recognized STIs

Bacterial infections
◦ __________ __________
◦ Soft __________
◦ __________ inguinale
◦ __________
◦ __________
3. Protozoal infections
◦ __________
4. Parasitic infections
◦ __________
◦ __________

Answer 4

◦ Lymphogranuloma venereum
◦ Soft chancre
◦ Granuloma inguinale
◦ Gonorrhea
◦ Syphilis

◦ Trichomoniasis

◦ Scabies
◦ Crab louse

Question 5

Soft chancre is also called ________ and is caused by??

Answer 5

Chancroid

H.ducreyi

Question 6

Granuloma inguinale is caused by???

Answer 6

Klebsiella granulomatis

Question 7

Extent of the problem

Sexually Transmitted Infections (STI) continues to be a public health problem of major significance in most parts of the world, including Nigeria.

WHO estimates that 374 million people become ill with one of 4 STIs: _________ , _________, _________ and _________ every year

Answer 7

chlamydia, gonorrhoea, syphilis
and trichomoniasis

Question 8

The majority of STIs are present (with or without ?) symptoms.

Answer 8

Without

Question 9

_____________ is a major threat to reducing the impact of STIs worldwide

Answer 9

Drug resistance

Question 10

Highest prevailing STI in Nigeria is?

Followed by??

Then??

Answer 10

Non-gonococcal urethritis

Gonorrhea

Trichomoniasis

Question 11

Non-gonococcal urethritis includes ??

Answer 11

Chlamydia

Ureaplasma

Mycoplasma

Question 12

Infective agents

__________ gonorrhoeae– Gonorrhoea

__________ __________– Syphilis

__________ __________– Chancroid

__________ __________– LGV

Answer 12

Neisseria gonorrhoeae– Gonorrhoea
 Treponema pallidum– Syphilis
 Haemophilus ducreyi– Chancroid
 Chlamydia trachomatis– LGV

Question 13

Infective Agents

 ____________ ____________– granuloma
inguinale

 ____________________ – genital warts

 ____________ ________– trichomoniasis

Answer 13

Calymmatobacterium granulomatis–

Human papillomaviruses–

Trichomonas vaginalis

Question 14

Infective agents

 __________ __________– scabies
 __________ __________ – crab louse

Answer 14

Sarcoptes scabbier

Phthirius pubis

Question 15

Epidemiology triad?

Answer 15

Host
Environment
Agent

Question 16

Host factors

Age:
_________ and ___________ are at higher risk of contracting STI.
 _______ years which has the highest STI prevalence, is entering the period of sexual activity, resulting in higher incidence of STI cases.

Answer 16

Adolescents and young adults

15-24

Question 17

Reasons why adolescents are more at risk of STIs

 They are more likely to have a __________ relationship
 They have more difficulty with using __________ methods
 They have less access to STI care due to lack of __________, lack of __________ or __________ policies of clinics.

Answer 17

less stable

barrier ; awareness,

money ; restrictive

Question 18

In adolescents less than 19 years, (males or females?) appear to be
more at risk.

Reasons include:
________ sexual debut
 More likely to have higher-risk, _______ partners
 Prone to __________

Answer 18

Females ; Earlier

older; sexual abuse.

Question 19

Host factors

Sex
Poverty and gender inequalities force some women to turn to __________ as a means of survival.
 cultural practices (i.e. abstinence by pregnant female partners) tend to encourage ____________________ in males

Answer 19

commercial sex

multiple sexual partnerships

Question 20

Hosts

Marital status:
 The frequency of STI is higher among _________ , _________ and _________ persons than among married couples

Answer 20

single

divorced

separated

Question 21

Host factors

Occupation

Certain occupations tend to reinforce high-risk sexual behaviour:
 Mobile workers (___________, professionals, etc)
 _________ workers (oil workers)
 _________ workers

Socio-economic status:
 Individuals from the lowest socioeconomic groups have the highest morbidity rate.

Answer 21

long distance ; Migrant

Sex workers

Question 22

Urbanization and migrant labour favours transmission of STI by ???

Answer 22

increasing demand for
commercial sex

Question 23

Demographic factors that increase risk for STIs

Population __________ and marked increase in the number of ________ people
 ___________ migration
 Increasing educational opportunities for women _________ their marriage and
increasing STI risks

Answer 23

explosion ; young people

Rural-urban ;? delaying

Question 24

Cultural factors that increase risk of STIs

________
________ marriages
High rates of ________
Multiple partners by ______
Wife ————-
Wife ————-
Widow ————

Answer 24

Polygamy
Forced marriages
High rates of prostitution
Multiple partners by men
Wife hospitality
Wife inheritance
Widow cleansing

Question 25

Forced marriages – When ___________ are forced into marriage usually with __________ who have had ___________ and so run higher risks of having an STI

Answer 25

young girls older men multiple sexual partners

Question 26

Wife hospitality – In some cultures, the woman is ________________ as a _______________ . This gesture shows the amount of respect the host has for his guest. Wife inheritance – In some cultures when a man _______, his __________ inherits his property including his _______.

Answer 26

given to a male visitor as a welcome package dies; immediate younger brother; wife

Question 27

Widow cleansing – Some cultures require the new widow to ____________________________ . The number of men is decided by the family of the deceased. This act is though to cleanse the widow of the spirit of the dead husband. Cultural beliefs and perceptions of STI: that a man with STI can be cured if he ______________

Answer 27

have sexual intercourse with her husband male relations had sex with a virgin.

Question 28

Religious factors that affect risk of STIs _______ _________ sex _________ before marriage _________ in Marriage

Answer 28

Polygamy Pre-marital Chastity Fidelity

Question 29

Religious factors that affect risk of STIs Non-acceptance of _________ _____________ to adolescents – Certain religions, because of the problems associated with HIV, are beginning to embrace sexuality education to adolescents. _________– This would help to inhibit transmission of STI

Answer 29

condoms Sexually education Abstinence

Question 30

General symptoms of STIs •Abnormal —————— • __________ (or leakage) from the penis. • ______ or ______ near the vagina, penis or anus. • ______ or ______ around the vagina, penis or anus. • ______ or ______ feeling when you pass urine. • Passing urine very ______ or more often than usual. • ______ when you have intercourse. • ______ symptoms.

Answer 30

vaginal discharge ; Discharge Sore ; blister ; Rash ; irritation Pain ; burning ; frequently Pain ; No symptoms.

Question 31

Some people can have an infection without noticing any symptoms at all. In fact, _____ out of 10 women with gonorrhea do not get any symptoms; and a (small or large?) proportion of men with ________ don’t get sores.

Answer 31

9 Large; herpes

Question 32

Background on HIV Two types: HIV _____ and ____  HIV 2 was discovered in ________ in _______  HIV ____ is more virulent, more infective, and is the cause of the majority of HIV infections globally.

Answer 32

HIV 1 and 2 West Africa ; 1986 HIV 1

Question 33

Human Immunodeficiency Virus (HIV) is a retrovirus that was first discovered among ___________ in _______ in ________  Nigeria’s first two AIDS cases were diagnosed in ______ in Lagos and reported at the international AIDS conference in _______

Answer 33

homosexuals 1981 ; USA 1985 ; 1986

Question 34

HIV-2 is largely confined to west Africa T/F

Answer 34

T

Question 35

Burden of HIV __________ status  AIDS killed more than 40million people since the beginning of the epidemic  More than 85 million people have been infected  As at the end of 2022, about 39m persons were estimated to be infected with HIV globally  Sub-Saharan Africa accounted for 43% of deaths, 45% of new infections in 2021 and where 67% of people living with HIV are

Answer 35

Pandemic status

Question 36

(Men or Women?) are more than twice as likely to be living with HIV than (men or women?) (1.9% versus 0.9%.) The difference in HIV prevalence between women and men is greatest among ___________, with young ______ aged 20–24 years more than three times as likely to be living with HIV as young _____ in the same age group.  Prevalence among children aged 0–14 years is 0.2%

Answer 36

Women; Men younger adults women; men

Question 37

The _________ zone of Nigeria has the highest HIV prevalence, at 3.1% HIV prevalence is also high in the North Central zone (2.0%) and in the South East zone (1.9%) HIV prevalence is lower in the South West zone (1.1%), the North East zone (1.1%) and the North West zone (0.6%).

Answer 37

South-South

Question 38

HIV: agent factors Retrovirus that replicates in actively dividing _______________ and eventually _________ them Found in greatest concentration in _______ , _______ & _______ Lower concentrations in _______, _______, _______, _______, cervical & _______ secretions

Answer 38

CD4 lymphocytes ; destroys blood, semen & CSF tears, saliva, breast milk, urine, cervical & vaginal secretions

Question 39

HIV: Host factors AGE: ___________ persons aged 20 - 49 yrs SEX: in America & Europe, higher incidence among __________ & __________ men. MOST AT RISK POPULATION: _____, ________, __________, ___________ drivers, uniformed personnel OTHER HIGH RISK GRPS: recipients of ____________________ , clients with STIs

Answer 39

Sexually active homosexual ; bisexual men. Men who have sex with men infectious disease unit workers commercial sex workers long distance blood & blood products

Question 40

In Africa, there is a feminization of the disease. This means?

Answer 40

Women get it more that men

Question 41

Mode of transmission of HIV ______________ with an infected person _______ contact – contaminated sharps and transfusion with infected blood and blood products From an infected mother to child during __________ , __________ or while __________

Answer 41

Sexual intercourse Blood pregnancy ; delivery breastfeeding

Question 42

Control of STIs INFECTIVE AGENT  Eliminate the reservoir of infection ◦ Regular medical ___________ and __________ of known CSWs, inhabitants of brothels, and other places where promiscuous sexual behaviour occurs ◦ For HIV, ________ is used to identify infected persons who may be guided on how to prevent infecting others & offered ________ where applicable

Answer 42

examination ; treatment HCT ; ART

Question 43

HCT ??

Answer 43

HIV confidential counseling & testing)

Question 44

Transmission control of HIV Discourage ____________  Local protection ◦ Male & female _______ HIV: ___________________ for HIV after accidental exposure  ________________ for high-risk population e.g ___________ couples and MSM  PMTCT  Prophylaxis against __________ infections

Answer 44

sexual promiscuity condoms Post-exposure prophylaxis Pre-exposure prophylaxis serodiscordant; opportunistic