test 3 Flashcards
(189 cards)
1
Q
What is the prevalence of autism in children?
A
1 in 50 children will be diagnosed with autism.
2
Q
How many hours a day does the average child spend on social media?
A
About 3–4 hours per day.
3
Q
How many hours daily on social media doubles the risk for anxiety and depression?
A
2 or more hours per day.
4
Q
Fertility and reproductive health: 1 in ? men face reduced fertility; sperm production takes an average of ___ months; ?
A
- 1 in 6 men face reduced fertility
- Sperm production takes an average of 2.5 months
5
Q
percent of women will experience perinatal mental health issues.
A
25% of women will experience perinatal mental health issue
6
Q
What is the current fertility rate in Canada and how does this relate to the a) cohort replacement value and b) “low fertility trap” threshold value?
A
1.4 births per woman
* a) Cohort replacement value: 2.1
* b) “Low fertility trap” threshold value: 1.5
7
Q
By what age should egg and sperm be frozen in order to ensure viability and a health pregnancy (i.e. before age ___?)
A
Before age 35
8
Q
At what age does a woman’s fertility significantly decline? Age for a man?
A
Around 35
Around 40–45, when fertility starts to decline gradually
9
Q
In Canada, 1 in ? people living with HIV are unaware of their status?
A
1 in 10 people living with HIV in Canada are unaware of their status.
10
Q
How frequently should you test for STIs?
A
At least once a year.
If you’re sexually active with multiple or new partners, testing every 3 to 6 months is recommended. Always test sooner if symptoms appear or after unprotected sex.
11
Q
What are the guidelines for aerobic exercise for improving erectile dysfunction (ED) in men?
A
160 minutes per week of moderate-to-vigorous aerobic exercise (e.g., brisk walking, cycling, jogging) has been shown to significantly improve ED.
That’s about 30 minutes, 5–6 days a week.
12
Q
What are the 9 guiding principles for honouring the child?
A
- A Covenant for Honouring Children
- Respectful Love
- Diversity
- Caring Community
- Conscious Parenting
- Emotional Intelligence
- Nonviolence
- Safe Environments
- Sustainability
- Ethical Commerce
13
Q
What is the difference between permissive vs gentle parenting
A
- Permissive Parenting:
- Minimal boundaries and rules; parents often give in to children’s demands.
- Prioritizes children’s freedom but may lack structure, resulting in unclear limits.
- Can lead to children struggling with self-regulation and responsibility.
- Gentle Parenting:
- Emphasizes respect, empathy, and emotional support.
- Maintains clear and consistent boundaries but does so with compassion and understanding.
- Seeks to guide rather than control, fostering secure attachment, emotional intelligence, and independence.
14
Q
What are the 4 S’s of parenting?
A
- Safe: Child feels physically and emotionally safe.
- Seen: Child knows their feelings and experiences are acknowledged.
- Soothed: Child receives comfort and guidance to manage emotions.
- Secure: Consistent application of the above three creates a lasting sense of security and attachment, enabling resilience and trust.
15
Q
As a parent, what are risk factors, signs/symptoms to look out for in your children, that they may be at risk or suffering from a mental health issue?
A
Risk Factors:
* Family history of mental illness
* Stressful or traumatic experiences (e.g., bullying, loss of relationships, discrimination)
* Difficulty managing emotions or stress
* Social isolation or exclusion
Signs and Symptoms:
* Noticeable changes in eating or sleeping habits
* Declining academic performance or loss of interest in previously enjoyable activities
* Mood swings, increased anxiety, agitation, or personality changes
* Withdrawal from family and friends
* Reckless behavior or substance use
* Talking about feelings of hopelessness, worthlessness, or expressing suicidal thoughts
16
Q
Lifestyle behaviours that impact child mental health, impact of social media on child health
A
- Nutrition: Affects brain health, body image, and self-esteem.
- Social Media Use: Leads to stress responses (HPA axis activation), social disconnection, cyberbullying, self-doubt, and low self-esteem.
- Gut-Brain Health: Linked to emotional and mental well-being.
- Sleep: Crucial for emotional regulation, academic performance, and overall mental health.
17
Q
Impacts of social media on child health:
A
- Increased anxiety and depression among youth, particularly those spending excessive hours daily online.
- Over one-third of girls aged 11-15 report feeling addicted to certain social media platforms.
- Exposure to harmful content, including bullying, body-image pressures, and hate-based content, contributes significantly to declining mental health.
- Social media use reduces face-to-face interactions, disrupts sleep patterns, and increases feelings of isolation.
During the COVID-19 pandemic, emergency room visits for mental health crises among youth increased dramatically (e.g., ER visits for ages 10-17 in Ontario rose 121% above expected rates). Hospitalizations for eating disorders also increased notably (54%).
Despite these negative impacts, social media can have some perceived benefits, including: - Increased feelings of social acceptance.
- Support during difficult times.
- Creative expression and staying connected socially.
18
Q
Why are the first 3 years of childhood development so important to the trajectory of a child’s long-term emotional wellness?
A
- The first three years are crucial because early childhood experiences significantly shape the developing brain.
- Exposure to trauma or chronic stress in these early years can negatively affect emotional regulation and attachment, impacting lifelong mental health.
- A safe, nurturing, trauma-free environment helps form a stable emotional foundation, supporting long-term emotional wellness
19
Q
Why is it important to “hold space” for children and allow them to experience all emotions?
A
- Holding space means providing an environment where children feel safe to express and explore all emotions without judgment or repression.
- Allowing access to all emotions validates their experiences, fosters emotional intelligence, and helps prevent negative impacts from emotional suppression.
- Experiencing the full emotional spectrum helps children develop self-awareness, resilience, and emotional regulation skills.
20
Q
How can caregivers help support emotional regulation?
A
- Practice mindful emotional coaching: help children recognize, name, and separate themselves from their emotions (e.g., saying, “Do you notice you have a big feeling inside?” instead of labeling the child as their emotion).
- Comfort and affection, providing a safe and calming presence.
- Allowing space for emotional expression and modeling emotional regulation through calm, consistent behavior.
- Incorporating playfulness or silliness to ease emotional intensity.
21
Q
What are ways in which caregivers can guide children to express anger in a health way?
A
- Modeling healthy anger: Caregivers should demonstrate calm, controlled expression of anger.
- Teaching self-regulation skills: Guide children through recognizing triggers, problem-solving, and calming strategies.
- Praise when children effectively manage or express anger constructively.
- Help children recognize anger as a natural, healthy emotion useful for setting boundaries rather than something inherently negative.
- Avoid correcting behavior in the heat of the moment; wait until emotions have settled.
22
Q
How can we help youth build resilience (emotional, physical, social, etc.)?
A
- Foster supportive relationships: Provide a reliable adult presence and encourage communication of feelings and needs.
- Encourage problem-solving and optimism: Support youth in facing challenges, reframing disappointments, and finding positive outcomes.
- Promote healthy lifestyle habits: Establish routines, ensure adequate sleep, proper nutrition, regular physical activity, and balanced technology use.
- Connect youth with nature: Outdoor experiences promote emotional calm and resilience.
- Allow youth to experience failure (F.A.I.L.) safely: Encourage youth to face fears, learn from mistakes, and build coping skills.
- Cultivate spirituality or awe: Encourage a sense of connection to something bigger, which strengthens resilience and provides meaning and purpose.
23
Q
How can spirituality be fostered in youth?
A
Spirituality, existing independent of religion, can be nurtured in children and youth by:
* Celebrating and participating in family and community activities.
* Encouraging practices that cultivate a connection to their inner self, such as mindfulness, meditation, or physical movement.
* Promoting curiosity and appreciation for nature, through gardening, outdoor exploration, and observing natural phenomena.
* Encouraging creative expression through writing, art, music, and movement.
* Utilizing reflective practices like journaling and vision boards.
* Creating opportunities for connection with animals.
* Cultivating values of altruism (love of service) and inclusion (love of neighbour).
24
Q
How can development of the “spiritual core” support/protect child health?
A
Developing the spiritual core supports child health by:
* Fostering an awakened mind, promoting a deeper awareness, connectedness, and a clearer sense of purpose.
* Building resilience, emotional regulation, and empathy, which protect against mental health challenges.
* Significantly reducing risks associated with addiction, self-harm, and other mental health issues.
* Helping youth cultivate meaning, hope, and optimism, which enhances emotional well-being and overall resilience.
25
How to support and educate youth on body diversity, body image, sexual identity
* Role Modeling: Parents should regularly check-in with their own body image and model positive self-talk and healthy behaviors around their bodies.
* Language and Actions: Be conscious of your words, focusing on body neutrality and positivity rather than appearance-based judgments.
* Celebrate Diversity: Actively celebrate body and cultural diversity, teaching youth to honor different body shapes, sizes, and appearances.
* Social Media Literacy: Educate youth on navigating social media critically, emphasizing realistic and diverse representations.
* Understanding Development: Help children understand and accept natural body changes, especially during puberty and adolescence.
* Encourage Healthy Habits: Promote intuitive eating, respect for body limits, physical activity for wellness (not appearance), and avoid weight-focused metrics.
* Body Image Activism: Encourage following role models and movements that promote diverse, realistic body images and self-acceptance.
26
Body positivity vs body neutrality
* Body Positivity: Encourages acceptance, love, and celebration of one’s physical appearance.
* Body Neutrality: Emphasizes appreciating the body's abilities and functions rather than appearance, especially helpful when body positivity feels challenging.
* Both perspectives can coexist, supporting mental health by reducing body-related anxieties and pressures.
27
How to support and educate youth on sexual identity:
* Create Safe Spaces: Foster open, non-judgmental environments for ongoing discussions about gender and sexuality from an early age.
* Education Through Literature: Read diverse books that represent varied gender identities and expressions.
* Community Celebration: Expose youth to inclusive communities that affirm diverse sexual identities, reinforcing a sense of belonging and acceptance.
* Awareness and Advocacy: Stay informed about school policies, media representation, and peer interactions; advocate for supportive and inclusive environments.
* Recognize Signs of Struggle: Be attentive to emotional signs such as anxiety, depression, or social withdrawal, especially if youth struggle with sexual identity.
* Self-Reflection: Parents and caregivers should actively challenge their own biases, educate themselves, and speak respectfully and compassionately about sexuality and gender identity.
28
Don’t need to memorize stats; recognize to recognize systemic barriers and health outcomes for LGBTQ2+ youth
* Stigma and Discrimination: LGBTQ2+ youth often face systemic stigma, prejudice, and discrimination, which significantly impacts their mental health and overall well-being.
* Social Rejection and Violence: Experiences of rejection from families and communities, along with violence and harassment, contribute to severe emotional distress.
* Limited Access to Safe Housing: LGBTQ2+ youth disproportionately face homelessness due to rejection or discrimination at home, compounded by a lack of safe, inclusive shelters.
* Employment and Education Barriers: LGBTQ2+ youth encounter challenges in accessing inclusive education, securing employment, and finding supportive work environments.
* Healthcare Barriers: Limited access to inclusive, affirming health services and support networks, especially for transgender and gender-diverse youth.
29
Characteristics of Autism:
* Autism is a neurodevelopmental condition affecting communication, social interactions, and behaviors, influencing how individuals experience and relate to the world.
* Autism is a form of neurodiversity, meaning autistic brains process information differently from neurotypical brains.
* Autism exists on a spectrum; each autistic person's experiences, strengths, and challenges vary widely.
* Autism does not discriminate and exists across all cultural and socioeconomic groups.
* Many autistic individuals prefer terms like neurological "difference" or "condition" rather than "disorder."
* Early childhood is typically when autism is first identified, but support and accommodations are beneficial at any age.
30
Challenges faced by parents raising a child with lifelong disabilities or neurodiversity:
* Navigating complex medical and educational systems: Parents often face challenges advocating for appropriate support, accommodations, and therapies.
* Social Isolation and stigma: Families may experience judgment or misunderstanding from community or peers.
* Emotional and financial strain: Accessing specialized care, therapy, and adaptive equipment can be expensive and emotionally taxing.
* Behavioral challenges: Managing behaviors related to sensory sensitivities, communication barriers, and emotional regulation requires patience, support, and specialized strategies.
* Caregiver burnout: Continuous care demands, appointments, and advocacy efforts can lead to stress and exhaustion without proper support.
* Future uncertainties: Parents often worry about long-term independence, quality of life, and ongoing support for their child.
31
Positive aspects and celebrations:
* Strengthened family resilience and adaptability through navigating and overcoming challenges together.
* Celebration of unique achievements, strengths, and milestones specific to their child’s journey.
* Increased empathy and advocacy in both parents and siblings, fostering a compassionate worldview.
* Building supportive communities and connections with other families and professionals sharing similar experiences.
32
what is ableism?
Treating people unfairly or negatively because they have disabilities, leading to exclusion or disadvantage.
33
Internalized ableism?
When a person with a disability believes the negative things society says about disabilities, causing them to feel bad about themselves.
34
Universal design?
Creating places, products, or systems that are easy and accessible for everyone to use, without needing special adaptations.
35
what are community examples of inclusion and support for youth living with disability/neurodiverse?
Community examples of inclusion and support:
1. Role modeling inclusive behavior: Adults demonstrating respect, compassion, and speaking against discrimination.
2. Creating compassionate environments: Schools and communities ensuring no child feels excluded (e.g., during recess).
3. Celebrating differences: Teaching youth about diversity through stories, books, media, and real-life examples.
4. Supporting inclusive businesses: Choosing companies and businesses that actively employ and support individuals with disabilities or neurodiverse individuals.
5. Community projects and groups: Examples include inclusive choirs like "Just As I Am - The Shira Choir," and organizations like "Friendship Revolution" and businesses that provide job opportunities and vocational training for neurodiverse youth.
36
what the cohort replacement level?
* This is the fertility rate needed to maintain a stable population size from one generation to the next.
* The standard replacement fertility rate is 2.1 children per woman.
37
What is the “low fertility trap” threshold?
* Defined as a fertility rate below 1.3.
* When fertility drops below this level, it's extremely difficult for a country to return to the cohort replacement level of 2.1, potentially leading to long-term population decline.
38
How do these relate to the current fertility rate and population growth in Canada?
* Canada's fertility rate is currently 1.26, making it among the "lowest-low" fertility countries in the world.
* This places Canada below the low fertility trap threshold, which risks permanent population decline without immigration.
39
What is the main predictor of fertility in women?
* Age is the strongest predictor of female fertility.
40
How is level of fertility determined?
* Fertility is largely determined by the number and quality of eggs available in a woman's ovaries.
* As a woman ages, both egg quantity and quality naturally decrease.
41
At what age, on average, does fertility start to significantly decline?
* Fertility begins to gradually decline after age 30.
* A more rapid decline typically occurs around age 35.
* By age 40, fertility sharply decreases, and pregnancy becomes much more difficult naturally, often requiring assisted reproductive technology (ART).
42
What is endometriosis?
What is it?
* A condition where tissue similar to the lining of the uterus grows outside the uterus, causing pain and inflammation.
Symptoms:
* Severe pelvic pain (especially during menstruation)
* Painful intercourse
* Chronic fatigue
* Heavy periods
* Digestive problems (e.g., nausea, diarrhea, constipation)
* Infertility
Prevalence:
* Affects about 1 in 10 reproductive-age women
43
What is PCOS?
Polycystic Ovary Syndrome (PCOS)
What is it?
* A hormonal disorder causing the ovaries to produce excess male hormones (androgens), leading to health and reproductive issues.
Symptoms:
* Irregular or missed periods
* Excess body or facial hair (hirsutism)
* Acne
* Weight gain or difficulty losing weight
* Mood changes (anxiety, depression)
* Insulin resistance (risk for diabetes)
* Infertility
Prevalence:
* Affects 7–10% of women of reproductive age (up to 70% undiagnosed).
44
What qualities determine sperm health?
* Quantity (number of sperm)
* Motility (movement, ability to swim effectively)
* Morphology (shape and structure, which affects ability to fertilize an egg)
45
How long does sperm production take?
Sperm production (spermatogenesis) takes about 64 days (approximately two months).
46
At what age, on average, does fertility start to decline?
Male fertility starts declining gradually around age 40, with more noticeable declines after age 45–50.
47
What is fragile fertility?
Refers to the significant global decline in sperm count and sperm quality observed over recent decades, making fertility increasingly vulnerable.
48
What factors might be contributing to the decline in sperm health worldwide?
* Environmental toxins and pollutants (chemicals in plastics, pesticides)
* Lifestyle factors such as smoking, alcohol use, poor diet, lack of physical activity
* Chronic stress and mental health issues
* Obesity and related health complications
* Exposure to heat (e.g., hot tubs, tight clothing)
* Medication and drug use
49
T or F: Infertility issues is not just about the woman’s fertility health – it is a shared issue with both genders (and is about equitable)
TRUE
50
Causes of infertility
Lifestyle Factors:
o Age (advanced age)
o Weight extremes (obesity or underweight)
o Physical inactivity or excessive exercise
o Stress
o Tobacco use
o Poor diet and nutrition
o Alcohol consumption
o Caffeine intake
o Drug use
o Sexually transmitted infections (STIs)
* Environmental Factors:
o Exposure to pollution and toxins
o Radiation (e.g., from mobile phones, Wi-Fi)
o Chemicals and pesticides
o Endocrine disruptors (chemicals affecting hormone balance)
Medical Factors:
o Hormonal imbalances (e.g., insulin resistance, PCOS)
o Chronic health conditions (hypertension, diabetes)
o Disorders like endometriosis, PCOS, or varicocele
o Psychological stress and mental health issues
Other Factors:
o Occupational exposure (heat, chemicals)
o Socioeconomic factors (limited healthcare access, poor nutrition)
o Genetic factors and idiopathic causes (unknown reasons)
51
Lifestyle factors that support fertility
Youth Mental Health:
* Sleep, social media, nutrition, outdoor time impact mental health.
Early Childhood Importance:
* First 3 years shape lifelong emotional health.
Emotional Regulation:
* Allow emotions, comfort, validate feelings.
Healthy Anger Expression:
* Model calm behavior; teach triggers and coping skills.
Building Resilience:
* Encourage supportive relationships, routines, activity, and optimism.
Spirituality for Youth:
* Connection, community, mindfulness support resilience.
Body Image Support:
* Positive role models, body positivity and neutrality.
Sexual Identity Support:
* Safe conversations, inclusion, advocacy.
LGBTQ2+ Youth:
* High risk for mental health issues, need supportive environments.
Autism & Neurodiversity:
* Autism affects communication/social skills, difference not disorder.
Ableism & Universal Design:
* Ableism = disability discrimination; universal design includes everyone.
Infertility Causes:
* Lifestyle (diet, stress), health conditions (endometriosis, PCOS).
Fertility Support:
* Balanced exercise, good nutrition, stress management, sleep quality.
Female Fertility:
* Main factor: age (fertility declines significantly after 35).
Male Fertility:
* Depends on sperm count and quality; declines around age 40.
52
heat exposure and sperm health
* Increased heat around the testicles (such as from wearing tight underwear) significantly decreases sperm count and viability.
* Studies show tight underwear reduces sperm quantity by half and motility by a third compared to loose-fitting underwear.
* Keeping testicles cooler supports healthier sperm production and fertility.
53
Tips for maximizing fertility in both men and women
Timing:
* Intercourse should be timed 2-3 days before and during ovulation to increase likelihood of conception.
* Track ovulation through basal body temperature or ovulation kits.
* Lifestyle Changes:
* Discontinue birth control ahead of time to allow hormonal adjustment.
* Regular health check-ups to rule out sexually transmitted infections (STIs).
* Maintain a healthy lifestyle (balanced diet, exercise, avoid smoking, alcohol, excessive caffeine).
* Avoid lubricants that can hinder sperm motility, or use fertility-friendly lubricants.
* Sperm Health:
* Men should reduce alcohol consumption, smoking, and heat exposure (e.g., avoid tight underwear or prolonged heat exposure to the scrotum).
* Allow approximately 3 months for changes in lifestyle to improve sperm health, as this is the typical sperm-production cycle duration.
* General Advice:
* Stress reduction and patience are key; conception can take time.
* Seek professional help or advice if pregnancy is not achieved after prolonged efforts.
54
Assisted reproductive therapy: the only thing you need to know is the age by which sperm/eggs should be frozen to help ensure viability/healthy pregnancy)
* Women: ideally freeze eggs before age 36 (preferably by age 25-35).
* Men: freeze sperm ideally before age 36 to maintain quality.
55
What is epigenetics and be able to recognize examples of how environment/lifestyle impact childhood development
* Epigenetics: How environment and lifestyle change gene expression without changing DNA itself.
* Examples:
* Smoking or stress during pregnancy can affect child's brain, emotions, and physical health.
* Father’s lifestyle (stress, nutrition) before conception impacts child's mental and physical development.
* Regular maternal exercise during pregnancy enhances baby’s heart health and motor skills.
56
Perinatal (right after or last stages of pregnancy) mental health – triggers for depression, signs and symptoms
Triggers for Depression:
* Past trauma or abuse
* Relationship stress
* Previous pregnancy loss
* Young pregnancy (<20)
* Lack of social support
* Family history of depression
* Infertility treatments
* Stressful life events
Signs and Symptoms:
* Persistent sadness, anxiety, hopelessness
* Difficulty concentrating
* Sleeping too much/little
* Loss of interest in activities
* Negative intrusive thoughts, guilt, worthlessness
* Anger, irritability
* Difficulty bonding with baby
* Thoughts of suicide
57
Pregnancy loss – causes, things to say (or not to say) to someone who has experienced pregnancy loss
Pregnancy Loss (Miscarriage)
* Terminology: "Miscarriage" → "Pregnancy loss" (more sensitive term)
* Common Causes:
o Genetics
o Uterine abnormalities (e.g., septate uterus—divided uterus)
o Autoimmune conditions
o Infections
o Metabolic disorders
* Reducing Risk:
o Avoid tobacco and drugs
* Cultural Factors:
o Often kept private (cultural norm: share pregnancy after 13 weeks)
o Most losses occur before 12 weeks (1st trimester)
58
Things to say and NOT to say to someone who has experienced pregnancy loss:
To say:
1. I am sorry for your loss
2. Whatever happened was unfortunate. It was not your fault
3. Be gentle with yourself, and let me know if there is anything I can do to help
4. Grief does not follow a timeline. Take as much time as you need. Whenever you want to talk about your loss, I’m there for you
5. Whatever you are feeling is only natural. Do not force yourself to feel something else
Do NOT say:
1. You are young. You can have another baby
2. At least you have other children
3. Probably it was not meant to be
4. At least you know you can get pregnant
5. Look on the brighter side of things. It could have been worse if it had happened later in pregnancy
59
What is “sympathetic pregnancy”? What are signs and symptoms?
* Definition:
* Men experience pregnancy symptoms when their partner is pregnant.
* Signs and Symptoms:
* Nausea
* Heartburn
* Abdominal pain or bloating
* Changes in appetite
* Respiratory problems
* Toothaches
* Leg cramps
* Backaches
* Urinary or genital irritations
* Anxiety or depression
* Reduced libido
* Restlessness
60
What is ageism?
Ageism is discrimination based on age.
* It can lead to marginalization, social exclusion, isolation, violence, and stereotypes against older adults.
61
Where to we see ageism in society?
* Workplace (older adults being passed over for promotions or forced into retirement)
* Healthcare (biases in treatment and caregiving)
* Media (negative stereotypes, jokes about older adults)
* Relationships (judgment around older women partnering with younger men)
62
What are the societal impacts of ageism?
* For older people:
* Shorter lifespan
* Poorer physical and mental health
* Slower recovery from illnesses and disabilities
* Increased loneliness and social isolation
* Higher risk of abuse and violence
* For younger people:
* Reduced loyalty and commitment to organizations
* Impact on mental and emotional wellbeing
* Overall societal costs:
* Financial insecurity and poverty
* Billions of dollars in economic loss (e.g., healthcare costs, lost productivity)
* Reduced quality of life and wellbeing across the lifespan
*
63
Do age-related changes in hormones impact visceral stores, irrespective of calorie intake?
Yes, aging-related hormonal changes increase visceral fat storage independent of calorie intake.
64
What is the physiological explanation for why fat storage location impacts health risks?
* Fat storage in the abdomen ("apple shape") places you at higher risk for metabolic syndrome.
* Known as central obesity or visceral adipose tissue (VAT)—fat stored deeply around organs.
65
What are adipokines?
Chemicals released by visceral adipose tissue (fat cells).
66
How do adipokines affect our health?
Adipokines cause two main issues:
* Hormone imbalance: impacts reproductive health and increases cancer risk.
* Chronic cellular inflammation: leads to insulin resistance and endothelial dysfunction.
67
Health conditions linked to adipokines:
* Insulin resistance, Type 2 diabetes
* Dyslipidemia (high LDL, low HDL)
* Heart disease, hypertension
* Certain cancers
* Autoimmune diseases (fibromyalgia)
* Alzheimer’s, dementia
* Kidney disease
* NAFLD (fatty liver disease)
* PCOS (polycystic ovary syndrome)
68
Can we prevent the development and/or progression of dementia through lifestyle choices? If so, what factors play a role?
* Is dementia preventable?
o Yes. Almost half of dementia cases can be prevented or delayed through lifestyle choices.
* Factors that play a role (modifiable risks):
o Early life: Less education.
o Midlife: Hearing loss, traumatic brain injury, hypertension, alcohol, obesity.
o Late life: Smoking, depression, social isolation, physical inactivity, air pollution, diabetes, high cholesterol, poor sleep.
* Lifestyle habits to reduce dementia risk:
o Preserve hearing, education, cognitive training (increase brain reserve).
o Exercise, adhere to Mediterranean diet, manage obesity, stop smoking.
o Reduce depression, improve social network.
o Manage diabetes, hypertension, cholesterol to reduce brain damage.
69
Why is deep sleep so important for brain health?
* Deep sleep is vital because:
o It clears toxic waste (amyloid plaques) from brain cells.
o Poor sleep allows plaque buildup, impairing memory and brain function.
o Even slight reductions in deep sleep significantly raise dementia risk (27% increased risk per each percentage decrease in deep sleep).
* Diet and dementia:
o MIND diet (Mediterranean-DASH): reduces inflammation, oxidative stress, beta-amyloid plaques, and improves brain circulation.
o Avoid ultra-processed foods; they increase dementia risk.
70
What is the leading cause of injury-related hospitalization and death in those over 65 years?
* Falls are the leading cause of injury-related hospitalization and death in those over 65 years.
* 10–20% of falls result in serious injury (e.g. head trauma, fractures) and extended hospitalization.
* In Canada, the mortality rate due to falls in people 65+ increased by 111% between 2001–2019.
71
What lifestyle and nutritional factors can help in the preservation of muscle and bone health (and therefore reduce risk of osteoporosis, sarcopenia, falls, fractures, hospitalization and injury-related death)?
Lifestyle Factors:
* Functional movement training (e.g., judo courses teaching older people how to fall safely)
* Ability to sit and rise from the floor without support is linked to longer life expectancy
* Structuring your daily environment for movement (e.g., cultures that encourage sitting on the floor, gardening, playing with children)
Nutritional Factors:
* Creatine supplementation (especially combined with resistance exercise):
o Supports muscle density and strength
o Improves lean tissue mass
o Maintains bone strength
o Enhances cognitive function and memory
o Reduces risk of disability and falls
72
What are the trends of heterosexual relationships in aging population?
Sexual Activity by Age:
* 46% of adults aged 65–70 report being sexually active
* 39% of adults aged 71–75
* 25% of adults aged 76–80
* This shows a decline in sexual activity with age
Interest in Sex:
* 50% of older men say they are very interested in sex
* Only 12% of older women report the same level of interest
* This shows a gender difference in interest
Sexual Satisfaction:
* 43% of older women are satisfied with their sex lives
* Only 31% of older men report being satisfied
* Despite lower interest, women report higher satisfaction
73
(Peri)Menopause. What is perimenopause?
* Perimenopause is the transitional time leading up to menopause where hormone levels begin to fluctuate.
* Menopause is defined as the cessation of menstruation for at least 12 months (no more egg release).
74
How does this differ from menopause?
* Average age of menopause: 48 (with large variability).
* Menopausal transition typically occurs between ages 45–55.
75
How long can the transition to menopause last?
* The average age of menopause is around 48, but there’s large variability.
* The menopausal transition typically happens between ages 45–55.
* Menopause is defined as cessation of menstruation for at least 12 months.
* Recent recommendations suggest that menopause should be defined as cessation of ovarian function (no more egg release).
76
How would you describe the hormonal transition during perimenopause?
* There are major hormonal fluctuations, especially a decline in estrogen and progesterone.
* Hormone levels become erratic, which can cause a wide range of symptoms (see below).
* This transition is complex and not linear; it includes fluctuating cycles that affect both body and brain.
77
What are the main hormones impacted?
* Estrogen:
* Affects endometrial lining
* Regulates menstrual cycle
* Crucial for brain function, cardiovascular function, urinary tract health
* Impacts every organ system (all have estrogen receptors!)
* Progesterone:
* Prepares uterine lining for pregnancy
* Influences mood, inflammation, cell reproduction, adrenal hormones, and cognition
78
How can the menopausal transition impact the health of person experience it (physical, emotional, social, economic, occupational…)?
* Physical:
* Hot flashes, night sweats, vaginal dryness, joint/muscle pain
* Bone loss, sarcopenia, cardiovascular risk, urinary incontinence
* Fatigue, weight gain, dry skin, headaches
* Emotional & Cognitive:
* Mood swings, anxiety, depression, memory issues, “brain fog”
* Difficulty concentrating
* Social & Relationship:
* Decreased libido
* Pain during intercourse
* Reduced sexual activity
* Decreased confidence in personal relationships
* Economic & Occupational:
* Increased sick leave
* Decreased workplace confidence
* Reduced physical ability affecting work and daily life
* Lower quality of life and satisfaction
* Other long-term consequences:
* Increased risk of certain cancers
* Low-grade chronic inflammation
* Neurodegenerative diseases
* Mental health issues
79
What lifestyle strategies can help with managing the symptoms of the transition?
* Exercise – supports mental and physical health
* Healthy diet – supports hormone balance (e.g. Mediterranean diet)
* Sleep hygiene – improves mood and memory
* Limit alcohol – reduces hot flashes and sleep disruption
* Supplements – based on individual needs (e.g. calcium, vitamin D, omega-3s)
* Hormone Replacement Therapy (HRT) – recommended treatment option for many
* Talk therapy / social support – reduces emotional distress
80
False Statement: That Hormone Replacement Therapy (HRT) causes breast cancer.
"Telling women to avoid HRT because it causes breast cancer may have been the biggest error in modern medicine. Women deserve an apology." — Dr. Marty Makary
The WHI (Women's Health Initiative) investigators have rescinded those claims.
81
The Guidelines of the Menopause Society currently recommend HRT for management of which health issues?
* Hot flashes and night sweats
* Prevention of osteoporosis
* Vaginal symptoms including dryness, atrophy, recurrent UTIs, and painful sex
o This includes topical vaginal estrogen
82
What are other potential health protective benefits of HRT currently under scientific investigation?
Though not yet officially recommended, there is emerging evidence that HRT may help with:
* Brain fog, depression, mood disorders
* Dementia (some recent data is promising)
* Cardiovascular disease (CVD)
* Joint pain
* Type 2 diabetes
* Weight loss
83
What is topical vaginal estrogen – how does it help with genitourinary syndrome of menopause? Is it safe?
* Topical vaginal estrogen is used for vaginal symptoms such as:
o Dryness
o Atrophy
o Recurrent urinary tract infections (UTIs)
o Painful sex
* It is part of the current official recommendations from the Menopause Society.
* It is considered safe for use to treat genitourinary syndrome of menopause.
84
Male health: How does their hormonal shift with aging differ from that in women?
* Around 30 years old, testosterone levels start to decrease at about 2% per year.
* Testosterone levels below 300 ng/dL = hypogonadism.
* In contrast to women, who experience a sharp hormonal drop at menopause, men experience a gradual hormonal decline.
85
Symptoms of andropause:
Symptoms:
* Sexual dysfunction
* Low motivation / vitality
* Poor concentration / memory
* Hot flushes / sweating
* Infertility
Signs:
* Reduced body hair
* Gynecomastia (breast tissue development)
* Reduced testicular volume
* Obesity
* Reduced muscle mass
* Anemia
* Reduced bone density
86
What is hypogonadism?
* Condition diagnosed when testosterone levels < 300 ng/dL.
* Associated with cardiovascular risk (myocardial infarction, stroke).
* Cardiometabolic implications: inflammation, insulin resistance, dyslipidemia, atherosclerosis.
87
For TRT, what is the current research on safety and effectiveness of low-dose TRT; exercise v.s. Viagra in treating erectile dysfunction; what amount of aerobic exercise can help with management of ED?
Benefits of TRT for hypogonadism:
* Improves libido, erectile dysfunction (ED)
* Increases energy levels, mood
* Maintains/increases lean body mass, muscle strength
Risks to cardiovascular health (MI, stroke, heart failure):
* 2022 meta-analysis of 17 studies (3400 subjects): No significant increase in CV event risk (short-term, 9.5 months average).
* TRAVERSE trial (2022): Over 60 months, 5000 men (45–80 years old) with hypogonadism at high CVD risk — results just released!
* Meta-analysis of 11 RCTs, 1100 men (30–60 min of aerobic exercise, 3–5x/week).
* Compared ED outcomes with those on Viagra.
Outcomes:
* Exercise just as effective as Viagra in improving ED.
* Greatest improvements in severe ED cases.
* Biological rationale: exercise supports vascular health, hormone balance, and circulation.
88
What percentage of working Canadians aged 50+ can afford to retire when they want to?
Only 35% can afford to retire when they want to, leading to financial insecurity and delayed retirement.
89
What financial challenges do many seniors face in Canada?
Many seniors struggle with housing costs, rent increases, and limited affordable accommodations—especially those renting or on fixed incomes.
90
What are common social concerns for older adults related to living conditions?
Isolation, housing insecurity, limited access to long-term care, and elder abuse in care facilities are major issues.
91
What percentage of Canadian seniors live alone, and why is this concerning?
27.9% live alone—double the general population—raising concerns for isolation, mental health decline, and lack of support.
92
What percentage of older adults in the community experience depression?
10–15% of adults over 65 living in the community suffer from depression.
93
What are five key factors affecting seniors’ mental health and well-being?
Discrimination, lack of participation in meaningful activities, poor relationships, physical health decline, and poverty.
94
What percentage of seniors experience elder abuse, and where does it usually occur?
At least 10% of seniors (65+) experience abuse, mostly within the community (where over 90% live).
95
What are the five main types of elder abuse?
Caregiver neglect, financial fraud & exploitation, psychological abuse, physical abuse, and sexual abuse.
96
What is sexual consent?
Consent is a clear, mutual, and voluntary "yes" to sexual activity. It must be informed, enthusiastic, and can be withdrawn at any time.
97
What are examples of healthy communication between partners on sex?
Discussing desires, boundaries, STI testing, protection methods, and checking in during sex.
98
What are several safer sex practices? What are tips for proper condom use?
Using condoms/dental dams, regular STI testing, vaccination (HPV, Hep B), honest communication, avoiding sex under influence.
99
How have STI rates in Canada changed over the past 10 years?
STI rates have increased, especially among youth (2014–2022).
100
What are some factors contributing to this change?
Less condom use, poor sex ed, stigma, lack of public health messaging.
101
classify them: viruses, bacteria or parasite
* Viruses: HIV, HPV, herpes, Hep B
* Bacteria: Chlamydia, gonorrhea, syphilis
* Parasite: Trichomoniasis
102
Which STIs are vaccine-preventable?
HPV, Hepatitis B
103
Which STIs are curable with antibiotics?
Bacterial STIs (chlamydia, gonorrhea, syphilis), trichomoniasis
104
General symptoms of STIs?
Discharge, burning when peeing, lumps/blisters, pain during sex, or no symptoms at all
105
In a heterosexual relationship, ways in which men can share responsibility for birth control with their female partner?
Use condoms, support partner’s birth control, share costs, talk openly, get tested, learn about contraception.
106
Gender Identity
* Definition: One’s internal understanding and experience of their gender (e.g., woman, man, non-binary, gender fluid).
* Examples from the image:
o Hitori: Gender fluid (any/all pronouns)
o Mikey: Transgender
o Jasper: Non-binary
o Simone: Woman
107
Gender Expression
* Definition: How a person outwardly expresses their gender (e.g., clothing, hairstyle, behavior), which may or may not align with societal expectations.
* Examples from the image:
o Hitori: Androgynous
o Mikey: Masculine
o Jasper: Masculine
o Simone: Feminine / Androgynous
108
Sexual Orientation
* Definition: Who someone is emotionally, romantically, or sexually attracted to.
* Examples from the image:
o Hitori: Lesbian
o Mikey: Pansexual
o Jasper: Bisexual
o Simone: Bisexual
109
What is queer erasure?
Queer erasure is a heteronormative practice where queer people are removed, ignored, or falsified from cultural and historical narratives, either consciously or unconsciously. It includes the downplaying, silencing, or elimination of identity
110
Cisnormativity?
Cisnormativity is the assumption that everyone is cisgender, meaning their gender identity matches the sex they were assigned at birth. This is shown in the slide as a moment where someone says, "Sometimes I forget you're transgender", revealing internalized assumptions about gender identity.
111
Heteronormativity?
Heteronormativity is the belief that heterosexuality is the default or superior sexual orientation. It marginalizes all other orientations and identities.
112
Fetishization?
Fetishization is sexual fascination based on a personal or physical trait that is not inherently sexual, such as race, ethnicity, body type, or gender identity.
113
How is fetishization oppressive?
* It reduces people to objects of sexual desire.
* It dehumanizes and sexualizes marginalized identities, like transgender and nonbinary individuals.
Example: “Being talked to like I was a sex toy, like being transgender was simply for the enjoyment of someone else.”
114
In what “spaces and places” is discrimination towards LGBTQ2+ evident?
According to the material, discrimination is evident in:
* Healthcare
* Education
* Access to public spaces
* Employment
* Housing
* Other??? (leaves space for further thought or discussion)
115
How is fetishization oppressive?
* It treats transgender and nonbinary people as objects for someone else’s pleasure, not as full human beings.
* It contributes to broader systems of racism, misogyny, and transphobia.
116
What is Two-Spirit identity?
Two-Spirit is a modern, pan-Indigenous term used by some Indigenous people to describe a person who embodies both masculine and feminine spirits. It refers to gender and sexual diversity that is specific to Indigenous cultures and worldviews.
117
What is the historical root of heteronormative privilege?
* The content suggests exploring how these norms developed over time, particularly through societal and institutional structures.
118
When and where was the term coined?
The term "Two-Spirit" was coined in 1990 at an Indigenous lesbian and gay gathering in Winnipeg, Canada. It was created to replace the colonial term that misrepresented Indigenous understandings of gender and sexuality.
119
Before Two-Spirit, the term _______ (which means _______) was used by colonizers who were offended by Two-Spirit customs.
Before Two-Spirit, the term berdache (which means "kept boy") was used by colonizers.
* This term is inaccurate and derogatory and does not reflect Indigenous understandings or respect for gender-diverse individuals.
120
What important roles do Two-Spirit people historically hold within their community?
* Healers
* Mediators
* Matchmakers
* Name givers
* Ceremonial leaders
They often held sacred roles and were respected as visionaries or spiritual leaders in their communities.
121
Today, Canada is steeped in colonial notions of __________ and __________.
Today, Canada is steeped in colonial notions of gender and sexuality, which often erase or marginalize Indigenous understandings of identity.
122
Why is the term ‘Two-Spirit’ problematic?
* It is a pan-Indigenous term and may not reflect every Nation’s specific traditions or language.
* Some Indigenous people may not identify with the term, preferring to use their own community-specific language or roles.
123
Indigenous gender and sexual minorities are a high-risk demographic for _______.
They are a high-risk demographic for violence and suicide.
Risk factors include:
* Colonialism
* Homophobia and transphobia
* Displacement from culture and community
* Discrimination in healthcare and education
Protective factors include:
* Cultural and spiritual connection
* Support from community and Elders
* Affirmation of identity
* Access to culturally relevant services
124
What kinds of discrimination happen within LGBTQ+ spaces?
Racism, exclusion, fetishization—especially for BIPOC.
125
What issue do international LGBTQ+ students face?
Lack of mental health support and fear of being outed.
126
How much have hate crimes over sexual orientation increased?
By 64% (StatsCan, 2023).
127
What do new laws in some provinces require?
Parental consent for name/pronoun changes; limits on gender-affirming care.
What risks do these laws create?
Self-harm, depression, substance use, suicide.
128
Where do LGBTQ2+ people face discrimination?
Workplaces, healthcare, schools.
129
Who faces the highest discrimination?
Trans, Two-Spirit, BIPOC, and gender-diverse people.
130
How is Québec improving LGBTQ2+ rights?
* Ended blood donation ban
* Doubled anti-hate budget
* Approved “X” gender markers
131
What is Rézo and its mission?
Rézo is a non-profit in Montreal supporting gay, bisexual, and other men who have sex with men (MSM), cis or trans. Its mission is to prevent STIs and promote sexual, mental, physical, and social health.
132
Who does Rézo serve?
* GB-MSM (gay/bisexual men who have sex with men)
* Trans people
* Psychoactive drug users
* Sex workers (especially men, trans, or non-binary)
* People from countries where HIV, Hep C/B are endemic
133
What are some of Rézos services/programs?
* Short-term counselling
* Interventions in saunas, bars, clinics, cruising spots
* Group workshops, social events
* Online support
134
What services does Rézo’s “Team TDS” offer?
* Drop-in centre (6–10 PM): food, shelter, STI gear, vaccinations
* Street and bar outreach
* Individual counseling
* Help with legal, medical, or housing support
135
What is harm reduction?
Harm reduction is a respectful, non-judgmental, person-centered approach that supports people in making safer choices. It connects them with services, builds relationships, and helps improve health and well-being through dignity, food, shelter, and support.
136
What are some harm reduction practices in Canada?
* Free access to sterile drug-use supplies
* Naloxone kits
* Opioid substitution treatment (e.g., methadone)
* Education and referrals
* Outreach work
* Supervised injection sites
137
What is Bill C-36, and why/how has it been harmful for sex workers?
Bill C-36 (Protection of Communities and Exploited Persons Act) criminalizes the buying of sex but decriminalizes its sale. Passed in 2014, it aimed to protect sex workers—but:
* Sex workers weren’t consulted in its drafting.
* It assumes all sex workers are exploited, ignoring those with agency.
* It does not distinguish between consensual sex work, exploitation, and trafficking.
* It restricts negotiation and advertising, making work less safe.
138
How do our daily interactions impact human trafficking?
Our actions matter—how we treat others can either increase or reduce vulnerability. When we show compassion, inclusion, and respect, especially toward marginalized groups like LGBTQ+ youth, we help create safer communities. Judgment, rejection, and indifference can push people toward unsafe situations, making them more susceptible to exploitation and trafficking.
139
What is the hallmark symptom of measles?
A red, blotchy rash that first appears on the forehead and spreads to the rest of the body.
140
What are serious health complications? Who is primarily affected?
Complications: Diarrhea, ear infections, pneumonia, brain swelling, brain damage, and even death.
Primarily affected: Infants and children under 5, adults over 20, pregnant women, and immunocompromised individuals.
141
What is herd immunity rate for measles?
At least 95% of the population must be vaccinated to achieve herd immunity and stop the spread.
142
Why has there been a recent outbreak in Canada?
Due to low vaccination rates in some communities and school districts (as low as 30–60%), many people—especially children under 5—remain unprotected. As of March 15, 2025, there were 496 cases, with many requiring hospitalization.
143
Why has there been a “backslide” in child vaccination rates in the past several years?
The COVID-19 pandemic led to misinformation, vaccine delays, and a rise in vaccine hesitancy, which caused many parents to refuse or delay MMR vaccinations.
144
What is the hallmark symptom of whooping cough?
Rapid coughing fits followed by a high-pitched “whoop” sound when breathing in; may also include vomiting after coughing.
145
What is a “breakthrough case”? How long does recovery take?
A case that occurs in someone who is vaccinated. These individuals usually experience milder symptoms due to partial protection from the vaccine.
Recovery can take weeks to months. The illness progresses in three stages over up to 12 weeks, with the final stage involving slow recovery and lingering susceptibility to other infections.
146
What causes malaria and how is it transmitted?
Malaria is caused by a life-threatening parasite and is transmitted through the bite of an infected mosquito.
147
Where is malaria most commonly found (endemic)?
Malaria is endemic in many areas of the world, especially Africa and Southeast Asia.
148
How severe can malaria cases be?
Cases can range from mild to severe, often requiring hospitalization. Complications include neurological damage and high death rates, particularly in children.
149
Are there malaria vaccines available?
Yes, vaccination campaigns are underway, especially in Africa, although their progress may be affected by funding cuts to international malaria programs.
150
What political factor has impacted malaria vaccination campaigns?
Funding and services to international malaria vaccination campaigns have been hampered by Trump’s administration cutting support.
151
What is the hallmark symptom of mpox and how long can recovery take?
The hallmark symptoms are fever and rash, which develop into painful blisters. Recovery usually takes 2–4 weeks, and isolation is required during this time.
152
How is mpox transmitted?
Mpox is spread through:
* Surfaces, bedding, clothing
* Physical contact
* Exchange of body fluids
* Respiratory droplets (e.g., breathing, talking)
153
Is there a vaccine for mpox?
Yes. The Imvamune vaccine is available:
* 2 doses given 28 days apart
* Recent data shows 78–86% effectiveness
154
What population is at higher risk of serious health complications or death from mpox?
People with advanced HIV and those who are immunocompromised are at highest risk.
155
Can children get mpox?
Yes. While the primary age group affected has been 18–49 years, outbreaks (such as in Montreal) have impacted both adults and children.
156
Where did the name 'mpox' come from and why was it changed?
Originally called "monkeypox," the name was changed to mpox by WHO in 2022 to avoid racist and stigmatizing language. The change was pushed by Montreal’s organization RÉZO.
157
What strain of mpox was recently detected in Canada?
In April 2024, clade Ib (a more serious and highly transmissible strain) was detected in Manitoba—the first confirmed case in Canada.
158
Why are we seeing a risk in STI rates in Canada and worldwide?
* Lack of testing and awareness
* Multiple sexual partners (e.g., 61% had more than one in the past 3 months)
* Rise of drug-resistant STIs (e.g., gonorrhea)
* Delayed care post-COVID
* Stigma and misinformation
159
Can STI’s be passed on from mother to child? If so, what are health risks to infant?
Yes. STIs like syphilis can be passed during pregnancy or childbirth, causing congenital infections.
Risks:
* Stillbirth
* Developmental delays
* Physical deformities
* Organ damage
160
Why are a third of young adults not received medical care for treatment/management of a diagnosed STI?
* Cost of medication and care
* Stigma around STIs and HIV
* Lack of education on the long-term health consequences
* Access barriers, including not knowing where to go or fear of judgment
161
What people might experience barriers to getting a pap smear?
* Lack of access to clinics or healthcare providers
* Nurse shortages (as seen in Montreal)
* Embarrassment or discomfort with pelvic exams
* Stigma around sexual health
* Time constraints or lack of childcare
162
Which test is more accurate in detecting HPV – pap smear by physician or self-administered at-home HPV test. Why?
At-home HPV tests are equally or more accurate and increase access, especially for people who don’t attend regular screenings.
* Canada is moving toward at-home testing to improve reach and reduce missed cases.
* Experts say the tests are effective, reliable, and empower individuals to take charge of their health.
163
Are HPV vaccinations effective in preventing genital warts, cervical cancer (see slide notes for answer)?
Yes – HPV vaccinations are highly effective.
* In a 10-year study (2024, n=450,000), girls vaccinated at ages 12–13 had zero cases of cervical cancer.
* Another study (2023, n=1000) showed no cases of genital warts or cervical cancer in vaccinated teens.
* Compared to unvaccinated individuals, vaccinated groups had significantly fewer cases (3.2 vs. 8.4 per 100,000).
164
In recent years, why have HIV diagnosis rates increased in Canada?
* Delayed testing and reduced screening during the COVID-19 pandemic
* Lack of awareness of rising STI and HIV rates
* Stigma that prevents people from getting tested
* Barriers to access like cost, time, and fear of judgment
* Increase in travel and mobility after restrictions lifted (e.g., spikes seen in Montreal after summer travel)
165
Why are the population rates for HIV significant higher in Saskatchewan and Manitoba?
* These provinces report the highest rates of new HIV cases in Canada.
* The main driver is injection drug use (PWID):
o In Manitoba (2023), PWID accounted for 64% of male cases and 81.2% of female cases.
* Contributing factors include:
o Limited access to clean harm reduction supplies
o Lack of healthcare access (e.g., no health card)
o Barriers to screening
o Stigma and mistrust of healthcare, especially among Indigenous communities and people experiencing homelessness
166
Which populations are disproportionally affected?
* People who inject drugs (PWID)
* Indigenous communities
* People experiencing homelessness
* Women (in some provinces like Manitoba)
* Younger adults (particularly 25–39 age range)
* Men who have sex with men (MSM) – especially in urban centers
167
Canadian stats: 1 in ___ people living with HIV are unaware of their status. Amongst which populations are there higher rates of infection?
* In 2018: 1 in 8 people with HIV didn’t know their status.
* In 2020: 1 in 10 people were unaware of their status (approx. 6,590 individuals).
168
What are the 90-90-90 HIV targets?
1. 90% of people living with HIV (PLHIV) will know their status
2. 90% of those diagnosed will be on treatment
3. 90% of those on treatment will have a suppressed viral load
169
In Canada, when is non-disclosure of HIV status not a crime before sexual activity?
Non-disclosure is not criminal when there is no realistic possibility of transmission.
This applies when:
* The person has a low viral load (<200 copies/mL) due to ART (antiretroviral therapy)
* AND a condom is used
170
What is U=U and what does it mean?
U=U stands for Undetectable = Untransmittable
* If a person living with HIV is taking ART and has an undetectable viral load, they cannot transmit HIV sexually
171
What is the public health message of U=U?
* Reduces stigma against people living with HIV
* Encourages early testing and treatment adherence
* Empowers people living with HIV with evidence-based knowledge
* Promotes safe and inclusive sexual health conversations
172
Who is most affected by the criminalization of HIV non-disclosure in Canada?
Disproportionately impacted groups include:
* Black people
* Indigenous women
* Gay and bisexual men who have sex with men (gbMSM)
* Women in vulnerable relationships, who may fear abuse or loss of immigration status
173
What are the drug regimes that someone can follow to *prevent* HIV infection / HIV seroconversion?
* PrEP (Pre-Exposure Prophylaxis): Taken before exposure to HIV (e.g., sex, injection drug use). Daily pill or long-acting injectable (Apretude).
* PEP (Post-Exposure Prophylaxis): Taken after potential HIV exposure (within 72 hours), for 28 days.
* Apretude (cabotegravir): Injectable PrEP approved in Canada (2024), taken every 2 months.
* Lenacapavir: Injectable every 6 months, shown to reduce HIV risk by 96–99.9% in trials (PURPOSE 1 & 2).
174
Who might benefit from these therapies?
* People at higher risk of HIV exposure:
o Those with sexual partners who are HIV positive
o MSM (men who have sex with men)
o Transgender and nonbinary individuals
o People who use injection drugs
o Individuals with multiple partners or who don't consistently use condoms
o Survivors of sexual assault
175
Overall, is the effectiveness of these drugs high or low?
Very high effectiveness when taken correctly:
* PrEP: ~99% effective in preventing HIV from sex; ~74% from injection drug use
* Apretude: Every-2-month injection; extremely effective in real-world use
* Lenacapavir: In trials, reduced HIV incidence by 96–99.9%
176
What signs and symptoms do long COVID and Lyme disease share?
* Fatigue
* Fever
* Muscle and joint pain
* Headaches
* Brain fog and trouble concentrating
* Chest pain and shortness of breath
* Nerve-related symptoms (numbness, tingling, dizziness)
* Mood disorders and sleep issues
Both conditions can lead to chronic symptoms, organ damage, and decreased quality of life. Symptoms may fluctuate over time.
177
Can Lyme disease be transmitted from person to person or from pets to humans?
No, Lyme disease is not contagious. It cannot be transmitted person-to-person or from animals (like a dog) to humans.
178
What are some early signs of Lyme disease?
* Bullseye rash (only in ~60–80% of cases)
* Fatigue, fever, headache, joint pain
* Rash may expand rapidly (>5 cm), sometimes with pale edges
179
What are the long-term symptoms of untreated or late-stage Lyme disease?
* Expanding rashes
* Facial paralysis, numbness in limbs
* Severe headaches, neck pain
* Joint swelling (often painless)
* Chest pain, palpitations, dizziness
* Stage 3 Lyme may cause permanent damage to brain, joints, and nervous system
180
Why are we seeing an increase in vector-borne illnesses in North America?
* Climate change is expanding the habitats of ticks and mosquitoes, allowing them to survive and spread in new areas.
* Warmer temperatures and longer summers increase the breeding season and range of these vectors.
* Urban development and deforestation bring humans closer to wildlife habitats where vectors live.
* Higher infection rates in ticks (20–70% carry Lyme in some areas) and mosquitoes carrying West Nile virus.
* Delayed detection and lack of awareness about prevention also contribute.
181
What is the hallmark sign (but not always present) that a tick bite contains the Borrelia bacteria that causes Lyme disease?
* A bullseye-shaped rash (circular with pale edges), appearing 24–48 hours after a bite.
* Present in ~60–80% of Lyme cases, but not always visible.
* Rash expands rapidly to >5cm.
* Fatigue, fever, muscle aches may also appear early.
182
Can I get a tick bite at any time of year?
Ticks are most active from spring to fall, but in warmer climates or during mild winters, they may be active year-round.
183
Are bug repellents effective? DEET vs. icaridin vs. permethrin-treated clothing?
* DEET and icaridin are both effective; icaridin is less irritating and preferred for children.
* Permethrin-treated clothing repels and kills ticks but must be used with caution—do not apply directly to skin.
184
Will you feel a tick bite?
No, tick bites are usually painless, which is why regular checks are important.
185
Where do ticks love to hide?
* Hair
* Inside or around ears
* Armpits
* Navel
* Lower back
* Groin
* Crease of buttocks
* Knee folds
186
What are good clothing tips for tick prevention?
* Wear long sleeves and tuck pants into socks.
* Light-colored clothing helps spot ticks.
* Wash clothes in hot water and dry on high heat after outdoor activities.
187
What are some outdoor tips for avoiding ticks?
* Stick to clear trails; avoid tall grasses and leaf litter.
* Use bug repellent with DEET or icaridin.
* Check your body, clothes, and pets after being outdoors.
188
What should you do if you discover a tick bite?
* Remove the tick immediately (preferably within 24 hours).
* Why? It takes 36–48 hours for Lyme disease bacteria (Borrelia) to enter the bloodstream, so removing the tick early minimizes infection risk (<2%).
* Save the tick for testing (Borrelia may not show in blood for 2–6 weeks).
* See a doctor or pharmacist—especially in regions like the Eastern Townships.
* Start antibiotics early if Lyme disease is suspected (treatment lasts 2–6 weeks).
* Watch for a rash—a “bull’s eye” ring is a key sign of Lyme disease.
* Recovery: Most treated people recover quickly, but some may have symptoms for months.
189
How to properly remove a tick.
* Remove the tick as soon as possible—within 24 hours, the risk of Lyme disease is very low.
* Use fine-tipped tweezers to grasp the tick close to the skin (avoid squeezing the abdomen).
* Pull steadily and gently—don’t twist or crush it.
o If the head stays in the skin, try to remove it with tweezers. If not, let the skin heal.
* Save the tick in a sealed container, label the bite location and removal date, and refrigerate it.
* Wash the bite area and your hands with soap and water.
🧠 Why it matters: It takes 36–48 hours for the Borrelia bacteria to enter the bloodstream—acting fast reduces the chance of infection.
