I Sexually Transmitted Infections
a) The CDC collects and analyzes data on many STIs, though only cases of syphilis, gonorrhea, chlamydia, and HIV have mandatory reporting rules. b) STIs can be caused by several agents, some of which are bacterial, others viral, which affect the treatment options available. A) Attitudes About Sexually Transmitted Infections
a) The contagion of a disease has always elicited fear and STIs have historically been viewed as symbols of corrupt sexuality, where many people believed those afflicted “got what they deserved,” also referred to as the punishment concept of disease. b) The self-stigmatization of STIs can interfere with the act of getting tested. B) High-Risk Groups and Sexually Transmitted Infections c) Higher rates of STIs have been found young people, certain racial/ethnic groups, and minority populations, and men who have sex with men (MSM). d) In the U.S., more than 19 million cases of sexually transmitted infections (STIs) are reported each year, and almost half of these are in young people aged 15 to 24. e) Women are at greater risk for long-term complications from STIs because the tissue of the vagina is much more fragile than penile skin; heterosexual women are also more susceptible because semen often remains in the female reproductive tract and are also more likely to be asymptomatic, while some infections have properties of latency making it difficult to detect. f) African American communities have higher rates of STIs than any other group in the U.S., though there are a host of factors responsible for some of the rate disparities. g) Over the past few decades, rates of STIs in MSM have been increasing due to factors such as lack of knowledge, increased Internet access to partners, and higher risk taking behaviors. h) The overall risk for women who have sex with women (WSW) is lower than bisexual and heterosexual women, though WSW are less likely to obtain yearly pelvic exams, putting them at greater risk for adverse complication if they do have a STI. C) Birth Control, Pregnancy, and Sexually Transmitted Infections i) In 1993, the U.S. FDA approved labeling contraceptives for STI protection. j) Nonoxynol-9 (N-9) is an effective spermicide, though may increase the rate of genital ulceration causing a higher risk for STI infection. k) Condoms are the most effective method, though that depends on correct and consistent use. l) Oral contraceptives may help decrease the risk of STIs because of the increased hormone levels changing cervical mucus and the lining of the uterus, though they may also cause the cervix to be more susceptible due to changes in vaginal discharge. m) When a woman becomes pregnant, untreated STIs can adversely affect her pregnancy and the fetus, with some STIs, such as syphilis crossing the placenta and infecting the fetus, or gonorrhea, chlamydia, and herpes affecting the newborn as he/she passes through the vagina during delivery. n) Antibiotics or antiviral medications may be given to a pregnant woman who has a STI; a cesarean section may also be recommended.
I Ectoparasitic Infections: Pubic Lice and Scabies
D) Pubic Lice
o) Pubic lice are a parasitic STI—small, wingless insects that can attach to pubic hair and feed off the tiny blood vessels just beneath the skin. 1) Incidence
a) Pubic lice are common and regularly seen by health clinics, though there are no mandated reporting laws. b) If not attached to the human body, lice cannot survive more than 24 hours, though they will reproduce rapidly if...