PSY 325 1st Edition Lecture 5 Outline of Current Lecture I. Epidemiology of Sexually Transmitted InfectionsII. Why IS STI Prevention Important?III.What is Epidemiology?IV. Risky Sexual Behaviorsa. The Major STIsV. Effective Strategies for Decreasing STI Riska. Safer Sex: Negotiating Sexual ActivityVI. What is Pain?VII. Physiological ComponentsVIII.Psychological Componentsa. Factors Influencing the Experience of PainIX. Theories of Paina. Specificity Theoryb. Gate Control Theoryc. The Measurement of PainCurrent LectureEpidemiology of Sexually Transmitted InfectionsPrevalence=proportion of cases in a population at a given time rather than the rate of occurrence of newcases.Incidence= a measure of the risk of developing some new condition within a specified period of timeTrichomoniasis =7.4 millionHIV—56,000 new cases a yearHealthy People 2020:Goal—Promote healthy sexual behaviors, STI overview>25 infectious organisms transmitted primarily via sexual activityThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.Largely preventableHarmful, often irreversible costly clinical complications:Reproductive health problemsFetal and Perinatal health problemsCancerFacilitation of the sexual transmission of HIV infectionSTD vs. STI: VD came before STD (Venereal disease); the term STI has replaced STD.Sexually Transmitted Infection—STI is a more encompassing term that includes infections that are asymptomatic. There is a lot less social stigma with an infection than a “disease” too. Asymptomatic means there are no symptoms. This contributes to an under diagnosis of these symptoms. STI is an umbrella term. Why is STI Prevention Important?19 million new STD infections annually50 percent among young people (ages 15-24) Possible reasons: More sex, more sex with more people, not using protection, invincibility among this age group$15.9 billion annually used to treat and diagnose STIs. Reportable vs. not: HIV, Chlamydia, Gonorrhea and Syphilis are reported to the CDC. This means your demographic information gets reported to the CDC.The other STIs are not reportable to the CDCEstimated that 24,000 women every year become infertile because they have undiagnosed and untreated STI.Understanding STIs- Biological Factorso Acquired through unprotected sex with partner. Asymptomatic nature—either don’t produce clear signs or symptoms or they are so mild and benign symptoms that they don’t know they have it.o Gender Disparities—women suffer more frequent and more serious consequences as a result of STI than men. Ectopic pregnancy is outside the uterus. Chronic pelvic pain is another thing that happens to women. o Age Disparities—15-24 age group are more likely to get STIs. o Lag time between infection and complicationso —Generally you have sex with people in youro Social, economic and behavioral factors  Access to care, fewer attempts to get medical treatment… Poverty and marginalization—low SE status  High risk sexual behavior is common more so in poorer communities.  Access to health care is important for diagnosis and treatment obviously Substance abuse Sexual networks—linking of people in a group of who they’re having sex with. Increases probability What is Epidemiology?Distribution and determinants of disease within a populationWho, What, and WherePart of the Core function of public healthAssessment, Assurance, Policy Development Why is this Important?Where disease is occurring, and who is getting it. Plan for control and prevention activities. Key in trying to decrease epidemics among certain populationsRisky Sexual BehaviorsUnprotected sex (whether it is oral/vaginal/anal sexual contact without a condom)Using barrier methods inconsistently or using unreliable barrier methodsMultiple Partners/overlapping partnersChanging sexual partners frequentlyAnal SexAnonymous SexThe Major STIs- HIV/AIDS- Genital warts (HPV infection)- Genital herpes- Hepatitis B- Chlamydia - Gonorrhea- Syphilis- TrichimoniasisCan have high incidence-common it is with new cases in US (lots of new cases) and low prevalence.ChlamydiaIncidence: Very common (1.4 million new cases)Cause: BacteriumTransmission: via sexual contact with infected person, whether or not that person has symptoms. Symptoms: burning with urination, dischargeOften asymptomatic: 75% of women and 50% of mend Treatment: antibioticsUS govt suggests women under 26 get screened for chlamydia.Women have higher rates of diagnosis than men. But, regardless of gender, the current trend shows that it is going up. Women get screened and tested. No equivalent test for men. Women are more likely to get tested and treated. Most people in US are heterosexual. With urine based testing, many more men are getting tested now. Deep South—more heavily infectedChlamydia Rates by Age and SexGonorrheaIncidence: CommonCause: BacteriumTransmission: via sexual contact with infected person, whether or not that person has symptoms Man who has unprotected sex with infected women has 20-30 percent chance of becoming infectedSymptoms: burning with urination, discharge, pelvic pain, spotting between periodsUsually within a few days to a few weeks after infectionAsymptomatic: 30 percent of women and 10 percent of menTreatment: antibioticsGonorrhea rates by Sex: 1990-2010, there is a decrease. Men had higher rates of infection in early 1990s.Gonoccoccal Resistance or to Ciprofloxacin; there is a spike in resistance to the medication. There are nota lot of drug companies in the market to make STI curing drugs. Resistance to medicine is a big problemChlamydia and Gonorrhea15-19 years30 percent of Chlamydia infections24% of Gonorrhea infections20-24 years39% of Chlamydia infections34% of Gonorrhea infectionsHepatitis BIncidence: less commonCause: Virus (THE FOUR H’s are caused by viruses)Transmission: via infected body fluidsBlood, semen, vaginal secretions, salivaPartner infected? Get immunizedSymptoms: nausea, yellowing of skin, diarrheaOften asymptomaticTreatment: none for acute infection, interferon (pharmaceutical drug) is prescribed if the infection is chronic.95%: infection resolves, virus cleared5% remain chronically infected even after symptoms subside (carriers)Since 1981: HerpesIncidence: VERY commonCause: virus (herpes simplex virus)Transmission: via skin contact with area of partner that’s infected or with