ABC of Sexually Transmitted Infections E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: ABC Series
• Sprache: Englisch

Seitenzahl: 367

Veröffentlichungsjahr: 2011

Beschreibung

With sexually transmitted infections (STIs) a major cause of morbidity and mortality throughout the world, the new edition of ABC of Sexually Transmitted Infections is a much-needed introduction and reference guide providing concise and practical information on a range of conditions.

This sixth edition includes the latest guidance on the prevalence, prevention and treatment of STIs, screening programmes and new testing methods. It features new chapters on service modernisation and new care providers, high risk and special needs groups, the use of the internet for information and education, systemic manifestations and sexually transmitted infections in resource-poor settings. Contraception is also covered, reflecting the increasing integration of STI and contraceptive services.

With an international authorship, the ABC of Sexually Transmitted Infections is an authoritative guide and reference for all practitioners, especially those providing community based STI diagnosis and management such as GPs, primary care physicians and contraceptive service providers. Junior doctors, medical students, and nurses working in community or specialist services will also find it a valuable resource as will those working in the fields of obstetrics and gynaecology and public health. This new edition also provides information useful for new STI care providers such as pharmacists, those in the voluntary sector and providers of STI services in resource-poor settings.

Leseprobe

Contents

Contributors

Preface

CHAPTER 1: Sexually Transmitted Infections: Why are they Important?

What are sexually transmitted infections?

Why are STIs important?

Size of the problem

Who gets STIs and why?

Prevention

Conclusions

Further reading

CHAPTER 2: STI Control and Prevention

Pattern of spread

Principles of control

Primary prevention

Secondary prevention

Further reading

CHAPTER 3: Provision and Modernisation of Sexual Health Services

Provision of sexual health services

Modernisation of sexual health services

Further reading

CHAPTER 4: The Sexual Health Consultation in Primary and Secondary Care

Who to test

The sexual health consultation

Investigations

Limitations of STI testing

Treatment

The future of sexual health services

Further reading

CHAPTER 5: Examination Techniques and Clinical Sampling

Examining the female patient

Examining the male patient

Blood tests

Further reading

CHAPTER 6: Main Presentations of Sexually Transmitted Infections in Male Patients

Urethral discharge and dysuria

Scrotal swelling and pain

Pelvic pain in the male

Anal symptoms

Further reading

CHAPTER 7: Other Conditions Affecting the Male Genitalia

Conditions affecting the glans and prepuce

Normal variants

Inflammatory dermatoses

Infection

Premalignant conditions

Conditions affecting the scrotum and groins

Other conditions affecting sexual function

Peyronie’s disease

Erectile dysfunction

Ejaculatory disorders

Further reading

CHAPTER 8: Vaginal Discharge: Causes, Diagnosis, and Treatment

Physiology

Diagnostic tests

Vaginal candidiasis

Bacterial vaginosis

Gonorrhoea and chlamydia

Risk factors for presence of STIs

Vaginal discharge in children

Other conditions affecting the vagina

Self-help and over-the-counter treatments

Further reading

CHAPTER 9: Pelvic Inflammatory Disease and Pelvic Pain

Clinical diagnosis of PID

Investigations

Treatment of acute PID

Further management

Partner notification

Prevention of pelvic infection

Pelvic pain

Further reading

CHAPTER 10: Vulval Diseases

Vulval symptoms

Vulval signs

Investigations

General principles of management

Vulval dermatoses

Pre-malignant and malignant conditions of the vulva

Pigment changes

Vulvodynia

Hormonal changes

Bartholin’s cyst and abscess

Female sexual dysfunction

Acknowledgement

Further reading

CHAPTER 11: Sexually Transmitted Infections and HIV in Pregnancy

Chlamydia

Gonorrhoea

Trichomoniasis

Bacterial vaginosis

Syphilis

Genital warts

Genital herpes

HIV infection

Further reading

CHAPTER 12: Genital Ulcer Disease

Genital herpes

Lymphogranuloma venereum

Chancroid

Donovanosis (granuloma inguinale)

Further reading

CHAPTER 13: Syphilis: Clinical Features, Diagnosis, and Management

Stages and natural history of syphilis

Diagnosis and management

Treatment and prognosis

Syphilis and pregnancy

HIV infection and syphilis

Further reading

CHAPTER 14: Genital Growths and Infestations

Genital warts

Scabies

Pediculosis pubis

Further reading

CHAPTER 15: Viral Hepatitis

Hepatitis A virus

Hepatitis B virus

Hepatitis D (delta virus)

Hepatitis C virus (HCV)

Further reading

CHAPTER 16: Systemic Manifestations of STIs

Sexually acquired reactive arthritis

Disseminated gonococcal infection

Other conditions with systemic manifestations

Further reading

CHAPTER 17: HIV

Epidemiology

Prevention and control

Immunology

Natural course

Treatment

Further reading

CHAPTER 18: Diagnosis of Sexually Transmitted Infections

Gonorrhoea

Chlamydia

Lymphogranuloma venereum

Mycoplasma genitalium

Chancroid

Syphilis

Herpes simplex

Trichomonas vaginalis

Bacterial vaginosis

Point of care testing for STIs

Quality control

Further reading

CHAPTER 19: Contraception

Why is contraception important for those requesting STI services?

Discussion of contraceptive needs

Effectiveness of contraceptive methods

Long-acting reversible contraception

Short-acting reversible contraception

Emergency contraception

Male and female sterilisation

Further reading

CHAPTER 20: Care of Specific Risk Groups

Men who have sex with men

Children and young people

Sex workers

Sexual assault, rape, and historical abuse

Travellers

Further reading

CHAPTER 21: Sexual Health Care in Resource Poor Settings

Further reading

CHAPTER 22: Vaccinations, Treatments, and Postexposure Prophylaxis

Vaccinations

Postexposure prophylaxis for HIV

Treatments

Further reading

CHAPTER 23: The Internet as a Resource for STI Education and Information

Diagnosis and management

Information about diagnosed conditions and support groups

Education

Further reading

APPENDICES: Proformas for Taking Sexual Histories

Appendix 1: Male sexual history proforma

Appendix 2: Female sexual history proforma

Appendix 3: Assessment proforma for young people attending sexual health services

Index

This edition first published 2011, © Blackwell Publishing Ltd

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Library of Congress Cataloging-in-Publication DataABC of sexually transmitted infections. – Sixth Edition / edited by Karen Rogstad, Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, South Yorkshire, UK.p. ; cm.Includes bibliographical references and index.ISBN 978-1-4051-9816-5 (pbk. : alk. paper) 1. Sexually transmitted diseases. 2. Communicable diseases. I. Rogstad, Karen, editor.[DNLM: 1. Sexually Transmitted Diseases. WC 140]RA644.V4A24 2011614.5′47 – dc22

2010047401

To Luke and Annabelle

Preface

It is over a quarter of a century since the first edition of ABC of Sexually Transmitted Infections was published. In that time there have been major changes in sexually transmitted infections. AIDS in 1984 was only just being recognised, but then subsequently became a major global epidemic. Initially there was no effective treatment and death was inevitable for most sufferers; now it is treatable, although the infection cannot be eliminated. While there is still no universal access to treatment, significant inroads have been made in treatment provision in resource-poor nations. Syphilis in the western world has shown a decline over the 25 years but there has been a recent resurgence. Lymphogranuloma venereum was a tropical STI but is now endemic in some communities of men who have sex with men. Gonorrhoea continues its relentless progress in developing resistance to antibiotics. STI diagnosis has changed from being labour intensive, requiring laboratory diagnosis by highly trained staff, to more sensitive tests that can be performed by a broader range of providers in the community, including the patient themselves.

The way sexual health care is provided has also shown a dramatic change, with much more community testing and treatment, and the integration of STI and contraceptive care. In addition, there has been an increased awareness of the need to address child protection issues for some sexually active adolescents. Finally, the internet has revolutionised how patients access information and services, and how professionals learn.

This new edition has also evolved over the years to reflect these changes, moving from the excellent 1984 edition written by Professor Michael Adler to a book with international authorship which brings together all the developments listed above to provide a resource for all those providing sexual health services, and those who wish to learn more about the subject. It is hoped that traditional and new sexual health care providers, as well as medical, nursing and pharmacy students, throughout the world will be able to utilise the information in this edition to enhance their own knowledge and thus improve patient care and STI prevention. I would like to acknowledge the expertise and work of the editors of the previous edition, which has formed the basis for this one – Michael Adler, Frances Cowan, Patrick French, Helen Mitchell, and John Richens.

Karen E Rogstad

Contributors

Sarah AlexanderClinical Scientist, Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, London, UK

Monique AnderssonSpecialist Registrar in Virology and Genitourinary Medicine, Health Protection Agency Regional Laboratory South West; Bristol Sexual Health Clinic, Bristol, UK

Gill BellNurse Consultant and Sexual Health Adviser, Genitourinary Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

Alison BigriggDirector, The Sandyford Initiative, Glasgow, UK

Aparna BriggsSpecialist Registrar in Genitourinary Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

M Gary BrookClinical Lead GUM/HIV, North West London Hospitals NHS Foundation Trust, London, UK

Chris BunkerConsultant Dermatologist, University College and Chelsea & Westminster Hospital; Professor of Dermatology, University College, London, UK

Elizabeth CarlinConsultant Physician in Genitourinary Medicine, Sherwood Forest Hospitals NHS Foundation Trust and Nottingham University Hospitals NHS Trust, Nottinghamshire, UK

Frances CowanSenior Lecturer and Honorary Consultant, University College London, London, UK

David DanielsConsultant in Sexual Health and HIV, West Middlesex University Hospital NHS Foundation Trust, Isleworth, UK

Sarah EdwardsConsultant GU Physician, Suffolk Community Health, West Suffolk Hospital, Bury St Edmunds, UK

Claudia EstcourtReader in Sexual Health and HIV, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, UK

Christopher K FairleyChair of Sexual Health Unit, University of Melbourne; Director, Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, Australia

Kevin A FentonDirector, National Centers for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA

Paul A FoxConsultant in Sexual Health and HIV, Ealing Hospital; Honorary Senior Lecturer, Imperial College School of Medicine, London, UK

Patrick FrenchConsultant Physician, Camden Primary Care Trust, London, UK; Honorary Senior Lecturer, University College London, London, UK

Keerti GedelaSpecialist Registrar GUM/HIV, West Middlesex University Hospital NHS Foundation Trust, Isleworth, UK

Nadi GuptaSpecialist Registrar in Genitourinary Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

Phillip HayReader in HIV/GU Medicine, Centre for Infection, St George’s, University of London, London, UK

Ashini JayasuriyaConsultant in Genitourinary Medicine, Nottingham University Hospitals, Nottingham, UK

Vincent LeeConsultant, Manchester Centre for Sexual Health, Manchester, UK

David A LewisHead of the Sexually Transmitted Infections Reference Centre, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa

Pat MundayConsultant Genitourinary Physician, Watford Sexual Health Centre; West Herts Hospitals NHS Trust, Watford, UK

Rak NandwaniActing Director, The Sandyford Initiative, Glasgow, UK

Raj PatelConsultant in Genitourinary Medicine, Department of GU Medicine, Royal South Hants Hospital, Southampton, UK

Katrina PerezSpecialist Registrar, Manchester Centre for Sexual Health, Manchester, UK

Anna PryceSpecialist Registrar in Genitourinary Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

Cecilia PriestleyConsultant in Genitourinary Medicine, Dorset County Hospital NHS Foundation Trust, Dorchester, UK

John RichensClinical Lecturer, Centre for Sexual Health and HIV Research, University College London, London, UK

Angela J RobinsonConsultant in Genitourinary Medicine, Mortimer Market Centre, London, UK

Karen E RogstadConsultant Physician, Department of Sexual Health and HIV, Sheffield Teaching Hospitals NHS Foundation Trust; Honorary Senior Lecturer, University of Sheffield, Sheffield, UK

Jonathan D C RossProfessor of Sexual Health and HIV, Whittall Street Clinic; Queen Elizabeth Hospital (Birmingham), Birmingham, UK

John SaundersSpecialist Registrar, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, UK

Ian WilliamsSenior Lecturer, Centre for Sexual Health & HIV Research, The Royal Free and University College London Medical School; Honorary Consultant Physician, UCL Research Department of Infection and Population Health, London, UK

Janet WilsonConsultant in Genitourinary Medicine, Department of Genitourinary Medicine, The General Infirmary at Leeds, Leeds, UK

Clare L N WoodwardSpecialist Registrar GUM, Department of Genitourinary Medicine, Mortimer Market Centre, London, UK

CHAPTER 1

Sexually Transmitted Infections: Why are they Important?

Kevin A Fenton1and Karen E Rogstad2

1Centers for Disease Control and Prevention, Atlanta, USA

2Department of Sexual Health and HIV, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

OVERVIEW

There are more than 30 different sexually transmissible bacteria, viruses and parasitesA million people acquire HIV or another STI every dayThere are 33.4 million people with HIV worldwide, with 2.7 million new HIV infections and 2 million HIV-related deaths annually (1998 data)STIs (excluding HIV) are the second most common cause of healthy life lost in 15- to 44-year-old womenSTIs cost $16 billion annually to the health care systemPreventing a single HIV transmission would save £0.5–1 million in health benefits and costs

What are sexually transmitted infections?

Sexually transmitted infections (STIs) are infections that are spread primarily through person-to-person sexual contact. There are more than 30 different sexually transmissible bacteria, viruses, and parasites (Table 1.1). Several, in particular HIV and syphilis, can also be transmitted from mother to child during pregnancy and childbirth, and through blood products and tissue transfer.

In general, the viral STIs (including sexually transmitted HIV and hepatitis A, B, and C) are more prevalent, often causing lifelong infections, frequently asymptomatic in their early phases, and may result in serious long-term sequelae including chronic morbidity or even mortality. In contrast, the bacterial and protozoal STIs are generally curable, and often asymptomatic. The causative organisms may cause a spectrum of genitourinary symptoms, including urethral discharge, genital ulceration, and vaginal discharge with or without vulval irritation.