risky sexual bx Flashcards by Matthew Fasano

Will risky sexual bx usually be the primary presenting concern?

No; typically useful adjunct (info or intervention) to primary concern

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Highest risk groups?

adolescents and young adults

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At this stage of my training what is my goal re: risky sex bx?

know the right questions to ask
get comforabtle with the questions
be able to ID high risk groups

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in 2011 how many babies were born to women aged 15-19? According to who?

approx 330,000; CDC

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Why does CDC focus on ppl aged 15-19

tend to be the highest risk group

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Rates if births among women 15-19 dropped ___% from 2011 to 2010; is this significant?

8%; yes we don’t usually see such large drops in public health research year to year

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Why the drop?

increased use of abortions
increased access/use of contraceptions
increased use of morning after pill

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As of 2012, what is annual rate of new STI?

approx 20 million/year

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As of 2012 how many new cases of chlamydia?

approx 1,423,000; rate of approx 450 per 100,000 people (generally a stable statistic)

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As of 2012 how many new cases of syphillis?

16,000 cases; a rate of 5 per 100,000 people

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Rates of syphilis in 2012 represents an increase of ____% since 2011; mainly among ____?

11.1% increase; mainly men - gay, bi, and MSM

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As of 201 how many new cases of gonorrhea?

approx 335,000; rate of 108 per 100,000

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Rates of gonorrhea in 2012 represent an increase of ____% since 2011?

4.1%

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In general, rates of STI are_____?

increasing

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What # of adolescents and adults are living with HIV?

1.1 million

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What % of females dx’ed with HPV?

approx 25%

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Despite increasing rates and danger of STI most ppl don’t get services… why?

Financial 
Some things are asymptomatic (e.g. HPV)
Lack of knowledge
Stigma/shame/guilt/fear
Transportation (especially young people)
Psychosocial factors (e.g., How will I tell my partner?)

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What are point-of-service intervention?

responding to low rates of help seeking/follow through re: STI/risky sex bx; provide interventions at the point of testing

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Different kinds of failed follow through?

don’t get tested at all
get tested but don’t find out results
get results but don’t get tx

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Acronym for demo risk factors re: risky sex bx?

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RAGS
Race/ethnicity; age; gender; SES
also, these factors interact

Describe RAGS in a nutshell

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Race/ethnicity - blacks/hispanics
Age - adolescents
Gender - women and MSM
SES - low SES

Acronym for adolescent risk factors re: risky sex bx?

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FADS-O

Family; Access; Developmental; Social; other

Adolescents: family risk factors re: risky sex bx?

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Mother’s history of sexual behaviors
– Initiation of sexual activity early on
– Pregnancy at young age
– Having numerous partners
Supervision
– Overcrowding in the home (people sharing rooms)
– Degree of parental supervision about behavior
– Had conversations with mother about sex?

What kinds of questions can/should you ask to assess adolescent risk factors re: risky sex bx? (Not just asking the teen either)

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How old was your mother when she got pregnant for the first time?
Mom, how old were you initiated sexual activity?
Mom, have you had numerous partners? Has your mother had numerous partners?
What’s the sleeping situation like in the home? Do people share rooms?
Hav you had conversations with your parents about sex? What kinds of conversations have you had?
If you’re having sex, do your parents know? How much do you think your parents know about your sex life?
Parents, how much do you know about your kids sex life?

Adolescents: access-related risk factors re: risky sex bx?

Transportation (to a clinic for testing/contraceptives) Less likely to receive information? (nowadays, health classes? receiving the right information, i.e from peers?) Poverty/affording condoms

Adolescents: developmental risk factors re: risky sex bx?

``` Poor impulse control sensation control deficits in EF Deficits in abstract thinking (e.g. weighing longterm consequences vs. short term benefits) Experimentation Identity development ```

Adolescents: social risk factors re: risky sex bx?

Peer exposure Peer pressure Has become the norm faulty information

Adolescents: other risk factors re: risky sex bx?

``` homelessness deliquency/legal issues substance use hx of trauma lower IQ greater levels of daily burdens/stressors ```

As measured in 2007: ___% of HS students had had ever had sex; ___% of sexually active HS'ers did not use a condom during last sexual intercourse; ___% HS'ers had four or more sexual partners during their life

50%; 40%; 15%

Race/ethnicity X age interaction re: risky sex bx... when we say "race" we really mean who?

black and hispanic kids

In general describe the race/ethnicity X age interaction re: risky sex bx

higher rates of sexual activity in HS higher rates of pregnancy more likely to have multiple partners initiate sexual activity at an earlier age

Race/ethnicity X Age (adolescence), rates of sexual activity in HS

teens in general - 50% white - 45% hispanic - 54% AA - 70%

Race X age (teens), rates of pregnancy

AA/Hispanic approx 130 births vs. white approx 45 births (per 1000 females)

Race X age (teens), age of initiation

ranges from 15-17 on average | AA at most risk, start the youngest

Race X age (teens), having multiple partners

``` Teens in general - 16% whites - 12.5% hispanics - 17% AA - 35% Teens in general, four or more - 15% ```

Chlamydia - rates (2012), race X gender

relatively even split between genders (leans more female) three groups with highest rates: black women, NA/AN women, NHOPI women

Gonorrhea - rates (2012), race X gender

nearly even split between genders | Overwhelmingly, black men and black women highest risk

Syphilis - rates (2012), race X gender

overwhelmingly male three groups with highest rates: black men, NHOPI men, hispanic men

HIV/AIDS, ___% of those living with AIDS/HIV are AA, but account for ___% of the US population

50%; 13%

HIV/AIDS, ___% of those living with AIDS/HIV are white

31%

HIV/AIDS, ___% of those living with AIDS/HIV are Hispanic, but account for ___% of the US population

18%; 15%

Why are women at increased risk for STI?

STI's typically transmitted male to female Asymptomatic/undetected --> untreated More likely to be victims of domestic violence/rape

MSM includes ______; and are at risk for______

gay, bi, and hetero men who have sex with men | hep, HIV, anal cancer

in 2005, MSM made up what proportion of all men living with HIV/AIDS

more than 2/3rds (68%)

What percent of men report having sex with men?

5-7%

(2012) What % of men attending STI clinic in Philly have gonorrhea? chlamydia?

g - approx. 60% | c -approx. 20%

(2012) What % of men attending STI clinic in Philly for syphilis (prim. and sec.) are co-infected with HIV?

approx 60%

Who does knowing that my client is in a relationship affect how I assess for risky sex bx?

Knowing that will make me less likely to assess it (but relationship many not mean less risk)

risky sexual bx Flashcards

(48 cards)