Global Patterns of STIs Midterm
AIDS as a modern plague - ✅✅ --almost 2 million new infections yearly, 37.9
million infected total
-second only to Black Plague as largest epidemic in history
-35 million people have died since beginning of epidemic (76 million have
contracted it since beginning)
-death toll includes many children infected during birth or breastfeeding
-0.5% of world is infected
-the toll is worst in Africa, where parents, teachers, nurses, doctors, farmers
die frequently
Bacterial STI Control Program Strategies - ✅✅--interrupt transmission:
shorten length of infection
-prevent the development of diseases or complications (screenings, case
findings, improved access to healthcare, improved case management)
-reduce the transmission of HIV infection (
Bacterial STIs - ✅✅ --can be treated with antibiotics
-complications: Pelvic inflammatory disease (PID), urethritis, infertility, ectopic
pregnancy
Cancers caused by HPV - ✅✅
--.cervical (common)
-oropharyngeal (most common)
-anal (increasingly common)
-penile (rare)
-vaginal (rare)
-vulvar (rare)
CD4 counts and AIDS - ✅✅ --healthy count: 500-1500/mm^3 blood
-AIDS diagnosed when CD4 count<200
-can also be diagnosed if patient has HIV and certain associated diseases like
tuberculosis or Pneumocystis carinii pneumonia (PCP)
Chancroid - ✅✅ --Haemophilus ducreyi
-mostly transmitted through sexual contact, but sometimes by contact with
pus-like fluid from ulcer
-higher risk: uncircumsised men, HIV+ people
-most cases in US are imported cases
-common in developing countries, but rare in US (~100 per year)
, -common symptoms, so hard to diagnose
Chlamydia* - ✅✅ --Chlamydia trachomatis
-vaginal, oral, or anal contact with infected partner
-#1 most common (3 million US cases per year)
-vertical transmission, antibiotic ointment applied to babies' eyes to treat
undetected chlamydia
-co-occurs with gonorrhea, so people are treated for both
contact tracing - ✅✅ --partner notification and management (partner of STI+
individual is notified, informed of exposure, and offered treatment and support
services)
-goals: reduce asymptomatic infections, shorten average period of
infectiousness, reduction of disease transmission
Control - ✅✅ --eliminating (or controlling) infection/disease after exposure or
infection
-antibiotics
-condoms can be used to prevent the spread to uninfected individuals
(sometimes)
cultural competence - ✅✅ -integration and transformation of knowledge
about individuals and groups of people into specific standards, policies,
practices, and attitudes used in appropriate cultural settings to increase the
quality of services, thus resulting in better outcomes
Cultural risk factors associated with HIV - ✅✅ --gender relations/norms
(linked to low participation in sex ed; as gender equality increases, HIV
incidence decreases; can have large impact on global populations)
Cultural risk factors NOT associated with HIV - ✅✅ --practices involving
bodily fluids (traditional surgical practices like scarification, male genital
circumcision, genital tattooing, female genital mutilation; all using unsterile
techniques or tools)
-sexual norms (number of sexual partners increases risk of transmission,
partner concurrency, sexual promiscuity are not big factors in large
populations)
-early marriage and/or sexual debut (higher lifetime sexual partners, early
marriage between young female and older male, who is more likely to be
HIV+, smaller risk factor in global populations)
AIDS as a modern plague - ✅✅ --almost 2 million new infections yearly, 37.9
million infected total
-second only to Black Plague as largest epidemic in history
-35 million people have died since beginning of epidemic (76 million have
contracted it since beginning)
-death toll includes many children infected during birth or breastfeeding
-0.5% of world is infected
-the toll is worst in Africa, where parents, teachers, nurses, doctors, farmers
die frequently
Bacterial STI Control Program Strategies - ✅✅--interrupt transmission:
shorten length of infection
-prevent the development of diseases or complications (screenings, case
findings, improved access to healthcare, improved case management)
-reduce the transmission of HIV infection (
Bacterial STIs - ✅✅ --can be treated with antibiotics
-complications: Pelvic inflammatory disease (PID), urethritis, infertility, ectopic
pregnancy
Cancers caused by HPV - ✅✅
--.cervical (common)
-oropharyngeal (most common)
-anal (increasingly common)
-penile (rare)
-vaginal (rare)
-vulvar (rare)
CD4 counts and AIDS - ✅✅ --healthy count: 500-1500/mm^3 blood
-AIDS diagnosed when CD4 count<200
-can also be diagnosed if patient has HIV and certain associated diseases like
tuberculosis or Pneumocystis carinii pneumonia (PCP)
Chancroid - ✅✅ --Haemophilus ducreyi
-mostly transmitted through sexual contact, but sometimes by contact with
pus-like fluid from ulcer
-higher risk: uncircumsised men, HIV+ people
-most cases in US are imported cases
-common in developing countries, but rare in US (~100 per year)
, -common symptoms, so hard to diagnose
Chlamydia* - ✅✅ --Chlamydia trachomatis
-vaginal, oral, or anal contact with infected partner
-#1 most common (3 million US cases per year)
-vertical transmission, antibiotic ointment applied to babies' eyes to treat
undetected chlamydia
-co-occurs with gonorrhea, so people are treated for both
contact tracing - ✅✅ --partner notification and management (partner of STI+
individual is notified, informed of exposure, and offered treatment and support
services)
-goals: reduce asymptomatic infections, shorten average period of
infectiousness, reduction of disease transmission
Control - ✅✅ --eliminating (or controlling) infection/disease after exposure or
infection
-antibiotics
-condoms can be used to prevent the spread to uninfected individuals
(sometimes)
cultural competence - ✅✅ -integration and transformation of knowledge
about individuals and groups of people into specific standards, policies,
practices, and attitudes used in appropriate cultural settings to increase the
quality of services, thus resulting in better outcomes
Cultural risk factors associated with HIV - ✅✅ --gender relations/norms
(linked to low participation in sex ed; as gender equality increases, HIV
incidence decreases; can have large impact on global populations)
Cultural risk factors NOT associated with HIV - ✅✅ --practices involving
bodily fluids (traditional surgical practices like scarification, male genital
circumcision, genital tattooing, female genital mutilation; all using unsterile
techniques or tools)
-sexual norms (number of sexual partners increases risk of transmission,
partner concurrency, sexual promiscuity are not big factors in large
populations)
-early marriage and/or sexual debut (higher lifetime sexual partners, early
marriage between young female and older male, who is more likely to be
HIV+, smaller risk factor in global populations)
