NE
Forum Guru
Topics: 53
Posts: 504
|
A 26-year-old homosexual man comes to clinic to receive the results of an HIV test. While he has had no specific symptoms, he was concerned, as he has had two episodes of unprotected sex in the past, though he routinely wears condoms now. The patient denies any signs or symptoms of sexually transmitted diseases (STDs), and reports being in good health. He is currently involved in a long-term monogamous relationship, but just “wants to be safe”. He is relieved to hear that his HIV screening test (an Elisa based assay with a confirmatory Western Blot) is negative. Which of the following is an appropriate strategy to advise to reduce the risk of STDs?
A. Annual screening for chlamydial infection
B. Annual screening for HIV infection
C. Polymerase chain reaction (PCR) for HIV
D. Use of nonoxynol-9 coated condoms
E. Vaccination with hepatitis A and B vaccine
|
| 92306
Forum Senior
Topics: 14
Posts: 126
|
D. Use of nonoxynol-9 coated condoms
|
| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,515
|
studies show that Nonoxynol-9 (N-9) does NOT protect against HIV/AIDS and other STDs, but is unsure if it actually increases the risk of contracting HIV/AIDS.
http://www.physiciansforlife.org/content/view/620/36/
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,123
|
Condoms is always the best method for STD prevention.
Answer D
___________________
The Key to Succeed is Patience.
|
| huyniid
Forum Elite
Topics: 9
Posts: 195
|
Use spermicide with condoms was shown increase rate of HIV in some studies, because the spermicide itself can cause chemical injury to the mucous membrane, favoring to the infection of HIV
I cannot choose any !
Edited by huyniid on 03/04/07 - 10:56 PM
|
| DrPak
Forum Elite
Topics: 49
Posts: 348
|
The question asks which of the following will decrease the risk (of contracting) STDs. Of all the answer choices, only D (use condoms) is a possible answer. All the other options are screening tests to detect an STD, they would not decrease the risk of contracting an STD. The bit about the condoms being coated is just a distractor. It could be coated with peanut butter, it would still be the right answer.
None of the Hepatitis viruses are contracted sexually at significant rates, so E is not the answer.
|
| chemamr
Forum Hero
Topics: 703
Posts: 4,488
|
D, condoms?
|
| mjl1717
Forum Hero
Topics: 959
Posts: 5,467
|
DrPak wrote:
The question asks which of the following will decrease the risk (of contracting) STDs. Of all the answer choices, only D (use condoms) is a possible answer. All the other options are screening tests to detect an STD, they would not decrease the risk of contracting an STD. The bit about the condoms being coated is just a distractor. It could be coated with peanut butter, it would still be the right answer.
None of the Hepatitis viruses are contracted sexually at significant rates, so E is not the answer.
Yes baby! Yes Dr Pak! Speak with conviction! Yes!(i hear ya) 
___________________
Smell the coffee! "Is That an Osler move??"
|
| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,515
|
Yes, ofcourse condoms are the best way to prevent HIV transmission. My point was just that if you had to pick a choice of condoms with or without non-9, pick the choice that says without because non-9 actually increases the risk of transmission of HIV due to breaking down the mucus membrane, making it easier for for the HIV particles to penetrate.
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
| NE
Forum Guru
Topics: 53
Posts: 504
|
For dr.Pak- "None of the Hepatitis viruses are contracted sexually at significant rates" . Can you give me a references for this?
I have to admit I chose D because of the magic word "condom"!
But the answer is E, even if I think the only way to prevent STD is condom!
|
| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,515
|
can you please explain WHY the answer is D?
How do Hep A and B effect HIV? thanks.
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
| may_u_b_blessed
Forum Newbie
Topics: 6
Posts: 14
|
i think the keyword here is homosexual man. Although we generally know that Hepatitis A is spread through contaminated food, it is also transmitted by sexual practises such as 'rimming' i.e. oral intercourse of the anus which are usually adopted by homesexuals.
Hepatitis B speaks for itself.
___________________
http://www.mayyoubeblessedmovie.com/
|
| Geroo
Forum Guru
Topics: 114
Posts: 799
|
I believe that D should be the answer.hebatitis vaccination will only protect against hep A and B.but condoms will protect against all STDS.
NE where is the question from?
|
| mytime
Go Marching in!
Topics: 40
Posts: 3,165
|
I think it's coz of the sexual orientation of the guy.......here....he can get only HIV and Hepatitis not Chlamydias( only vaginal infection) . Since Condoms won't help with these the ones mentioned safe to choose E. Even though for all purposes D is good.
|
| DrPak
Forum Elite
Topics: 49
Posts: 348
|
Hep A is not sexually transmitted, so it can't be part of the right answer...
|
| may_u_b_blessed
Forum Newbie
Topics: 6
Posts: 14
|
yes i was like u in thinking that sexual transmission is impossible in hepatitis A but this is what i read from an article ( emedicine.)
Sex:
• HAV infection has no sex predilection.
• Homosexual males may have a higher risk of infection than heterosexual males.
Causes:
• HAV is a positive-sense, single-stranded, nonenveloped RNA virus that belongs to the picornavirus family and Hepadnavirus genus.
• Transmission is via the fecal-oral route, and viral replication occurs in the liver. HAV is then excreted into the bile. Its concentration is highest in the stool, especially during the 2 weeks prior to the onset of jaundice. This correlates with the period of peak infectivity. Children and adults can be assumed to be noninfectious one week after the appearance of jaundice.
• Common-source outbreaks from contaminated food or water may occur.
o HAV is concentrated in filter-feeding shellfish, which may thrive close to sewage outlets, and widespread outbreaks can occur from a single contaminated source, such as uncooked vegetables, which are then disseminated to restaurants or grocery stores.
o Statistically, eating out is actually less risky than home cooking.
• Childcare centers may be sources of outbreaks from contaminated changing tables. These outbreaks may not be identified until an adult contact has a recognizable HAV infection because young children are often asymptomatic or have anicteric illnesses.
• Nosocomial outbreaks have occurred because of HAV shedding.
• Outbreaks of HAV infection have been increasingly reported among illicit drug users.
• International travel is another risk factor for HAV infection.
• HAV spread from nonhuman primates to humans has been reported.
• HAV vertical transmission (mother to neonate) and transmission by means of blood transfusion are extremely rare.
• Sexual transmission is possible, especially between homosexual men.
source: http://www.emedicine.com/PED/topic977.htm#section...
___________________
http://www.mayyoubeblessedmovie.com/
|
| NE
Forum Guru
Topics: 53
Posts: 504
|
The q is from qbank and the explication was give by may_u_b_blessed ; hep A could be sexual transmited between homosexual males. And hep A and B are the only STD which have a vaccine.
|
| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,515
|
Ah ok... The question asked which is an appropriate way to reduce the risk of STD, in a homosexual NOT HIV specificallly... so it makes sense now. Thanks. Good question.
___________________
Our greatest glory is not in never falling, but in rising every time we fall.
|
| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,303
|
Yeah , That 's BIG TIME on board guys !
As a matter of fact , Dr Fisher also mention that in Step 3 lectures and he also said that the only diahrrea that can be considerate as STD is GIARDIASIS
The morale of the story is Giardia Lambia and Hepatitis A is transmitted by fecal oral route , so homosexual by " licking the anogenital area" can surely got those nasty organism that 's why they sometimes put them under the list of STD
Great question Dr Virgo !
___________________
The elevator to succes is broke ,you must take the stairs
|
| vradojc1
Forum Elite
Topics: 21
Posts: 309
|
E is the one. Since the patient is already using condoms regularly, addition of spermicidal substances will not help reducing rate of STDs since the pathogens are located in seminal fluid/blood and not in the spermatozoa which are the main target of the compound. Although it has some antimicrobial effect, it is offset by the chemical injury to the mucus membranes.
|
|
| |
| | | | | | | | | | | | | | | | | | | | |
Similar forum topics