1. 1
   A health clinic runs a public awareness campaign about sexually transmitted infections (STIs), including HIV, explaining how they are spread and how their spread can be reduced within the community.

   (a)

   A health clinic runs a campaign to raise awareness of infections that can be passed from one person to another through sexual contact. What term describes these infections?

   [1 mark]

   • ASexually transmitted infections (STIs)
   • BAutoimmune diseases
   • CGenetic disorders
   • DDeficiency diseases

   (b)

   HIV is a pathogen that causes an STI. Which type of organism is HIV?

   [1 mark]

   • AA bacterium
   • BA fungus
   • CA virus
   • DA protoctist

   (c)

   State what HIV infection may lead to if untreated, and describe one method by which HIV can be transmitted between people.

   [2 marks]

   Total for question 1: 4 marks

2. 2
   The health clinic advises that using barrier contraception during sexual contact, along with regular testing and treatment, are effective ways of reducing the spread of HIV and other sexually transmitted infections within a community.

   (a)

   The clinic advises that using barrier contraception, such as condoms, during sexual contact reduces the risk of transmitting HIV and other STIs. Why does this method reduce transmission?

   [1 mark]

   • AIt cures an existing infection
   • BIt kills the pathogen immediately on contact
   • CIt boosts the immune system's production of antibodies
   • DIt prevents direct contact between body fluids that could carry the pathogen

   (b)

   The clinic also emphasises the importance of regular testing so that people who are infected can be identified and treated. Why is early testing and treatment important in controlling the spread of an STI such as HIV within a population?

   [1 mark]

   • ATesting removes the need for barrier contraception
   • BAn infected person who does not know they are infected is more likely to unknowingly transmit the infection to others
   • CTesting prevents the pathogen from ever mutating
   • DTreatment always completely removes HIV from the body within a day

   (c)

   Explain how the spread of STIs such as HIV can be controlled within a population.

   [2 marks]

   Total for question 2: 4 marks

3. 3
   A local health authority runs a public health campaign providing free barrier contraception and free confidential testing for STIs, and later analyses why rates of a particular STI fell more sharply in this region than in a neighbouring region that only provided free testing.

   (a)

   A local health authority notices that rates of a particular STI have fallen significantly in a region after a public health campaign that provided free barrier contraception and free confidential testing. Suggest why providing these two things together, rather than just one, might have had a greater effect on reducing STI transmission in the region.

   [3 marks]

   (b)

   The neighbouring region only provided free confidential testing, without free barrier contraception, and saw a smaller fall in STI rates. Explain why relying on testing alone, without also promoting barrier contraception, might be less effective at reducing the spread of an STI within a population.

   [4 marks]

   Total for question 3: 7 marks

4. 4
   A national government is designing a long-term strategy to reduce the spread of HIV across the whole country, considering public education, free barrier contraception, widespread testing and access to treatment as possible components of the strategy, and is also concerned about the stigma associated with STIs discouraging people from seeking help.

   (a)

   Evaluate the roles that public education, free barrier contraception, widespread testing and access to treatment could each play in this strategy, explaining how they might work together to reduce transmission at a national level.

   [6 marks]

   (b)

   The government is also concerned that the stigma (social disapproval and shame) associated with STIs discourages many people from seeking testing or treatment, even where these services are freely available. Explain why stigma could undermine an otherwise well-designed strategy to reduce the spread of HIV, and suggest how addressing stigma might improve the effectiveness of the other measures described.

   [6 marks]

   Total for question 4: 12 marks

End of questions